A Critique of Pure (Genetic) Information

158 Chapter 4
divide. Smithers’s analysis well describes all the implications of the
autonomous-cell-as-cancer-cell equation and in so doing highlights how
many taken-for-granted “facts” about cancer may have to be made problematic
if the basic notions expressed in, for example, numbers 1 and 6
were to be reconsidered.
Smithers’s list of incompatibilities is as follows:
1. The multicentric origin of neoplasia. (Many cancers appear to be
derived from more than one cell.)
2. The long prediagnostic natural history and the many predisposing
factors in the development of tumours. (Histologists never see a radical
transition in cancer, only gradual changes along a continuum over time.)
3. Age incidence and geographical variation.
4. Progression and regression in tumor behaviour. (The experience of
spontaneious regression is of particular interest in this regard.)
5. The conditional persistence of some tumors. (Some tumors appear to
continue to be dependent on certain environmental conditions.)
6. The hormonal dependence of other tumors. (The status of a cell as a
cancer cell may be hormone-dependent.)
Smithers’s list consists of those frequently observed aspects of carcinogenesis
that point away from a strictly internal (to-the-cell) basis of
cancer and toward the relevance of higher levels of organization. None
of these six points has become irrrelevant during the ensuing 35 years;
rather, attempts have been made to accommodate such observations with
somatic mutation hypotheses such that they do not appear to be wholly
anomalous. But this would be the pattern seen for any number of
research programs that begin to run out of explanatory steam. Even if
alleged contradictions can be eased or softened, there is still the danger
of each new emendation to the model increasingly taking on an ad hoc
character. As an alternative to piecemeal attempts to fix the somatic
mutation theory Smithers offered what amounts to the reassertion of a
developmental-organizational perspective as follows:
1. Cancer is a disease of organization.
2. The word “cancer,” however, merely covers the most disorganized
end of a progression in disorganization extending from maldevelopment,