From reductionism to holism in our understanding and treatment of cancer.

Twentieth century biology can describe brilliantly the structures of cells of which organisms are made. We can go further and describe in great detail the various types of cell present in different parts of the body, and the wondrous arrangement of these cells within the various tissues and organs we recognize as bodily substructures. We cannot, however, yet offer an acceptable account of how these differences come about. The difficulty is fundamental and very simple. As we understand it now, the most fundamental information about an organism is held, not in one central place, such as the brain, but contained in each separate cell of the organism.

We assume that this information is held in the cell nucleus as genes on DNA, unique to a particular organism but copied identically in all the separate cells of that organism. We suppose that the form of each organism is encoded somehow in its gene pool. This, however, requires cells in different parts of the organism to read the differences between them from identical pools of information, which is logically impossible. The fundamental sub-structure of living things, as we now know it, offers no plausible mechanism that could determine the variety of cells or the characteristic forms adopted by the hierarchy of tissues, organs and whole bodies into which masses of cells arrange themselves. We cannot explain why, when cells multiply, a bodily form develops rather than a random, amorphous mass.[1]

From our knowledge to date, we can only justify cautious speculation. DNA clearly defines the content, if not the structural arrangement, of cells individually. It probably enables each cell to receive and interpret information about the forms and functions in which it is involved. It cannot, however, originate the form or functions of the whole organism: for that we must look outside the cell. A radical re-think of this kind is essential if we are to understand cancer.

Malignant cells function abnormally and ignore form altogether. Malfunction may result from disturbances we already understand, but defiance of form need not. We require some better idea of how form is imposed in order to understand how it can be defied, and whether we can ever then reassert it.

This additional perspective - loosely dubbed "the whole is greater than the sum of its parts" - is the defining characteristic of holism. Modern medicine, while laying claim to it in principle, functions without any reference to it. But we should remember, however, that modern medicine is the exception. Every other known medical system is holistic in principle and in practice. Some of them deal only with wholes, ignoring separate parts entirely.

Were scientists in the West to take holism seriously as a fundamental research question, however, we should find it extremely fertile …