Dr. Carolyn Gotay of the UBC School of Population and Public Health delivered an impressive takedown of the “most cancers are simply bad luck” article published by Tomasetti and Vogelstein in Science early this year (which is among the most irritating examples of basic scientists overstepping their authority that I’ve encountered in recent memory. I’ve accepted that I will forever have a bone to pick with people who think we can completely understand the world by sequencing it.)
The essence is: just because you can prove that an increased probability of acquiring “random” mutations contributes to a higher rate of cancer in tissues that have higher rates of cell division doesn’t mean that these are the ONLY relevant factors, as the authors implied in the article. The phenomenon described in this study doesn’t in any way rule out the contribution of external factors (like pollution, obesity, inflammation, infection, and likely many others that have not yet been described), which would then be amplified in tissues that have more frequently dividing cells. But there is so little funding for research into the environmental causes of cancer, which are not readily elucidated by high-tech ‘omics approaches currently captivating the field, that it’s easy to get the impression they aren’t relevant at all.
One thing I’ve found lacking from nearly all critiques of the original Science article is that they let corporate polluters off the hook (the implication in the original article was that if most mutations are simply “bad luck”, why worry about pollution as a risk factor?) Instead they mostly draw attention to the “lifestyle choices” leading to cancer only Personal Responsibility™ can fix.
The publication and uncritical acceptance of studies like this one brings into focus the need to seriously rethink the overwhelming tendency towards studying cancer as a molecular disease, using molecular approaches, lest we risk missing the forest for the trees (or dots on a sequencing chip). The documentary, Pink Ribbons, Inc., presents some good suggestions on where to start.