The Long Evolutionary Journey of Cancer from Ancestor to Modern Humans

In this article, we review various key issues in cancer development and progression that have important implications for both cancer prevention and treatment: (1) evolutionary aspects of cancer appearance; (2) evidence of organ-specific adult stem cells as cancer-initiating cells; (3) the immortality of cancer-initiating cells; (4) cancer cell loss of growth control, contact inhibition, terminal differentiation, and apoptosis; (5) stem-cell versus de-differentiation theory of carcinogenesis; (6) mutations in cancer; (7) oncogenes and tumor suppressor genes; (8) epigenetics as the rate-limiting step in carcinogenesis; (9) the potential role of cultural, lifestyle, and nutritional behaviors in oncology; and (10) changes of commensal microbial community and its metagenome in carcinogenesis and tumor progression. Relevant, combined evidence is discussed from a standpoint whereby cancer is considered a multifaceted disease requiring integrated biomolecular and clinico-pathological information to design and implement strategies for either primary prevention or therapy.