CANCER: NINETEENTH CENTURY SCIENCE — TWENTIETH CENTURY TECHNOLOGY

Cancer is a major cause of death in western societies. Overall, there has been no decline in the incidence and little improvement in survival for twenty years. Hundreds of millions of dollars are regularly spent on cancer research. It is argued that much research effort is misdirected as a consequence of a limited view of the nature of the cancer process and the influences on it. Preoccupation with a nineteenth century view of the genesis of cancer and a twentieth‐century high‐technology approach to treatment has prevented the proper exploration of the determinants of cancer, and the development of different therapeutic modes. Several models of the cancer process are examined. A model which considers human populations, human behaviour (including social and economic factors) and the interactive nature of the biologic response of living organisms to the environment is developed. Some of the implications of this model for research and therapy are discussed.