© 2000 by Oxford University Press
Journal of the National Cancer Institute, Vol. 92, No. 22, 1852-1853,
November 15, 2000
© 2000 Oxford University Press
BOOK REVIEWS |
Infectious Causes of Cancer: Targets for Intervention
J. Goedert, ed. Totowa (NJ): Humana Press, 2000. 498 pp., illus., $110. ISBN 0-896-03772-X
Correspondence to: W. Thomas London, M.D., Division of Population Science, Fox Chase Cancer Center, 7701 Burholme Ave., Rm. R206, Philadelphia, PA 19111 (e-mail: WT_London{at}fccc.edu).
It has taken a long time, but the scientific community now accepts that infectious agents are causally associated with a variety of human cancers. For many years, there was resistance to this fact. Currently, it is estimated that at least 15% of all incident cancers worldwide are etiologically related to an infectious agent. James Goedert, head of the Viral Epidemiology branch of the National Cancer Institute (Bethesda, MD), has assembled as contributors to Infectious Causes of Cancer: Targets for Intervention a group of experts who provide not only detailed information on the current understanding of the relationship of specific viruses, bacteria, and parasites to particular cancers but also the history of how these insights were acquired. These histories are important because they reveal the reasons why scientists were reluctant to believe the causality of the infection–cancer relationship. Furthermore, these histories are rarely known by either investigators of noninfectious causes of cancer or even those working directly in the field.
In the preface, Dr. Goedert presents six lessons derived from studies of the relationship of infectious agents to cancer, which he believes may apply to other chronic diseases of unknown etiology. The lessons are also a good part of the reason that the virus–cancer relationship was so slow in being appreciated by most cancer investigators. These lessons can be summarized as follows: 1) The infection must be chronic or persistent. 2) The relationship between an infectious agent and a cancer is not one of simple cause and effect. 3) The cancer of interest may occur in the absence of the infectious agent. 4) Part of the disease process results from host responses to the agent or the tumor, such as inflammation, sclerosis, neovascularization, etc., that, until recently, have been poorly understood. 5) The cancer may be prevented by preventing infection with the agent or by treating the infection. 6) Cancer can be difficult to define. As examples of lesson 6, Dr. Goedert cites Epstein-Barr virus-associated fulminant X-linked lymphoproliferative disease and post-transplant lymphoproliferative disease, which are difficult to distinguish from agressive non-Hodgkin’s lymphomas. I would add two corollaries to Dr. Goedert’s second lesson. The interval from acquiring the infection to the onset of cancer is usually long, often decades, and the great majority of individuals infected with a cancer-causing infectious agent will not develop the cancer in their lifetimes. Nevertheless, these lessons provide a useful framework for the organization of the book as well as the individual chapters.
The book is divided into seven parts: a superbly written introductory chapter by John Graner on the history of infectious disease oncology, from Galen to Rous; a nine-chapter, detailed examination of the relationship of herpes viruses to several malignancies; three chapters devoted to retroviruses and cancer; three chapters on papillomaviruses and anogenital, skin, and head and neck cancers; three chapters on hepatitis viruses and liver and other cancers; six chapters on the relationship of bacteria and helminths to several cancers; and three chapters devoted to other possible virus–cancer relations. Each part begins with an excellent overview of the viruses or other agents under consideration. The subsequent chapters then address specific virus (or other agent) and cancer relationships in detail. Much of the information presented in this book is difficult to find anywhere else. The chapters are, in general, well written and understandable by a general audience.
The subtitle, Targets for Intervention, refers to the second aim of this book, namely, the attempt to discuss the molecular mechanisms involved in each of the infectious agent-associated cancers. This objective is very difficult to achieve and was handled differently, and sometimes not at all, by the various contributors. Notwithstanding the unevenness, the attempts to identify potential molecular targets are stimulating and one of the attractive features of this book.
Despite its comprehensiveness, there are still omissions. Liver flukes, Clonorchis sinensis and Opistorchis viverrini, have been implicated in the etiology of cholangiocarcinoma, particularly in Asian countries. This relationship, which is not included, is at least as strong as the association of Salmonella typhi and S. paratyphi with gallbladder cancer, which receives its own chapter. The editor could have separated the schistomes and liver flukes from Helicobacter pylori and the salmonellae into a chapter of their own. The relationship between simian virus 40 (SV40) and mesothelioma and other human tumors is given short shrift in the chapter on polyomaviruses. There is, in fact, much more extensive literature implicating SV40 as a cofactor with asbestos exposure in the etiology of mesothelioma than is cited by the author of this chapter.
Although Dr. Goedert says that his book "is intended to serve as an introduction to infectious disease oncology for practitioners," it is far more than that. Students, teachers, experts, and nonexperts will benefit from reading this book and having it close at hand for frequent reference.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||