Nick Lane at Literary Hub:
The idea that mutations cause cancer remains the dominant paradigm. A special issue of Nature from 2020 wrote: “Cancer is a disease of the genome, caused by a cell’s acquisition of somatic mutations in key cancer genes.” Yet over the last decade it has looked as if the juggernaut has rolled too far. It has certainly failed to deliver on its promise in terms of therapies. So why hasn’t the death rate from malignant cancer changed since 1971?
The oncogene paradigm is not actually wrong, but neither is it the whole truth. Oncogenes and tumor-suppressor genes certainly do mutate, and they certainly can drive cancer, but the context is far more important than the paradigm might imply. We are not immune to dogmas even today, and the idea that cancer is a disease of the genome is too close to dogma. Biology is not only about information. Just as human delinquency cannot be blamed on individuals only, but partly reflects the society in which we live, so the effects of oncogenes said to cause cancer are not set in stone, but take their meaning from the environment.