<i>The Biology of Cancer</i>: A Book Worth Reading

The Biology of Cancer is a textbook of molecular oncology by Robert A. Weinberg, professor of biology at MIT and member of the US National Academy of Sciences. It is regarded as a classic in the life sciences and is admired by students, teachers, researchers, and clinicians worldwide. It suits not only Western-medicine scholars but also those studying TCM anticancer therapy.

Today the cancer literature is vast, with new findings reported every month and information dazzling. But this information lacks systematic organization, making it hard to gain a comprehensive understanding of cancer biology.

Robert A. Weinberg's The Biology of Cancer fills this gap. Its content is clearly organized and well structured, explaining the entire conceptual system of cancer biology in accessible language. The author writes well, so the book is readable—though, of course, however accessible a specialized book like this is, it remains demanding for lay readers.

I was first recommended this book by a biology postdoc at Zhejiang University, who also offered to tutor me through biology basics as I read. At the time I doubted I could understand such a professional book and hesitated to buy it. After reading many popular biology books, I grew genuinely interested in the discipline, so I acquired this one, kept it on my desk, and dip into it now and then, benefiting greatly.

Objectively, textbooks by American scholars are of high level; they explain difficult professional knowledge accessibly. When I was in high school, biology in Chinese senior high was just a formality—a required graduation-exam subject but not tested on the college entrance exam. I was a science student but not a biology major, so my biology foundation was weak. Yet I can still understand The Biology of Cancer, which shows how well Weinberg writes. Of course, I have studied medicine for years and self-studied biology for a long time, so I am not starting from zero.

A big book like The Biology of Cancer should not be rushed. My experience is to read a few pages a day; it stays light and one does not grow tired from feeling overwhelmed. Weinberg explains basic concepts in detail—for example, "homozygous" and "heterozygous," "wild-type" and "mutant" genes—and includes many figures and tables. But cancer biology involves so many basic concepts that digestion is not easy. If you gulp the whole book at once, you essentially skim without understanding or learning anything. Reading a few pages a day, grasping a few concepts daily and following Weinberg step by step, you can master the theoretical foundation of cancer biology.

Although scientists only began studying cancer at the molecular-biology level in 1975 (that year, Harold Varmus and J. Michael Bishop's lab in San Francisco discovered that normal-cell genomes carry proto-oncogenes that become tumor-promoting after mutation—a milestone in cancer research), the scientific literature on tumorigenesis has since exploded, with over a million research reports to date, and great progress has been made in treatment.

In developed countries such as Canada, Japan, and the United States, five-year survival is already high—over two-thirds of cancer patients live beyond five years. In China too, 40% of cancer patients survive five years, largely thanks to molecular biology's growing role in treatment.

The Biology of Cancer is a monograph in molecular oncology from which we can learn the origins of cancer and the principles behind contemporary treatments. Researching cancer at the genetic level is the trend; molecular medicine is what will most likely solve this world medical puzzle. But as we now see, whether differentiation-induction therapy or immunotherapy, side effects cannot be ignored, efficacy is hardly ideal, and five-year survival is not cure.

Multidisciplinary treatment of cancer is inevitable, and traditional medicines like TCM can play a role. Even Chinese medicine may move toward molecular medicine—for example, the use of the Chinese herb Pishuang (arsenic trioxide) in differentiation-induction therapy for leukemia no longer follows traditional TCM pattern differentiation but the principles of molecular medicine.

Those who research TCM anticancer therapy without understanding molecular oncology are not doing patients a favor. How can TCM compensate for the shortcomings of molecular medicine? Are there more drugs like arsenic trioxide among Chinese medicinal resources, with reliable anticancer efficacy, waiting to be excavated? These are new questions facing modern scholars of TCM oncology. So today's TCM anticancer researchers would do well to master molecular oncology and understand its theoretical system comprehensively.

Combining Chinese medicine with molecular medicine to treat tumors has attracted widespread academic attention. Not only Chinese oncology circles, but developed countries such as the United States have set up specialized institutes to study Chinese medicine's anticancer effects. Yet abroad they do not study TCM as the TCM field in China does; they study the active ingredients purely from a molecular-medicine angle.

Any TCM clinician with a little experience knows that studying Chinese anticancer medicine purely from molecular biology is to catch one and miss ten. Many TCM formulas, used by pattern differentiation, have good efficacy for cancer patients' complications and even for controlling the tumor itself.

For example, I have seen Professor Pei Yongqing use Sanren Tang as the base, modified according to each patient, to treat several cancer-fever cases with good results, even shrinking tumors in several patients—true TCM pattern differentiation. For years I have combined TCM pattern differentiation with Western disease differentiation to solve patients' problems, with good results in some. Abandoning either approach yields poorer outcomes.

The Biology of Cancer has given me much inspiration; many of its theories have changed my earlier understanding of tumors and pushed me to think more deeply about solutions. The cure rate for mid-to-late-stage cancer remains unsatisfactory, and doctor-patient conflict in oncology is sharp: patients spend heavily yet are not cured or saved. This forces oncology researchers to keep learning and trying new methods. I believe that in the near future, molecular oncology and TCM can collaborate more closely and produce more findings that benefit the broad population of cancer patients.