The Road Not Taken in Cancer: Host-Driven Oncology

Cancer has made many advances in diagnosis and treatment in the last century, but it is still one of the leading causes of death and remains a conundrum for humankind.
I define the nature of cancer with three essential properties: clonal evolution, metastasis, and drug resistance. Cancer shows intertumor and intratumor heterogeneity by the continuous clonal evolution, free movement within an individual through invasion and metastasis, and uncontrollable resistance acquired from previously experienced drugs. Cancer can be cured by overcoming these fundamental properties of cancer.
Considering the essential properties, the nature of cancer can be fully understood by recognizing changes in the tumor and the host, based on the stream of time and the expansion of space within the human body. Thus, it is necessary to initiate an approach to cancer treatment from a host-centered viewpoint.
So far, cancer research has been zooming in on tissues, genes, and even a single cancer cell. However, cancer does not exist as a single cell in the human body but as a mass of multiple tumor cells. It does not exist in isolation but interacts with surrounding tissues and various organs in the human body. The tumor grows and proliferates interacting with various life phenomena in the human body. Therefore, studies with fixed subjects in a controlled experimental environment have limitations in identifying the intravital reality of cancer in the human body. For instance, antiangiogenetic agents based on the angiogenesis mechanism rather increase tumor invasion and metastasis as a hypoxic tumor response. Targeted therapeutics prolonged progression-free survival but showed limitations in overall survival.
Here, I propose a host-centered top-down approach to cancer with a macro perspective. The methodology of research and treatment of cancer with a host-centered perspective is not easy and is even vague. However, it will be necessary to go on the road not taken because humanity has yet defeated cancer. If we bring the existing tumor-centered bottom-up research together with the host-centered top-down research, we will find the key solution to cancer treatment.

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