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Commentary: The nature of cancer research

Cancer research reflects an implicit conflict. On the one hand, there is an overwhelming desire to control the disease. We all wish that. On the other hand, we would like to understand why cancer follows so many clearly defined yet puzzling patterns. Why is there such regularity in the rates of progression? Why do different tissues vary so much? There should, of course, be no conflict between control and understanding. But the history of cancer research seems to say that those different goals remain oddly estranged. Peto's 1977 article locates the seeds of this conflict most clearly. He describes what is still the most powerful theoretical perspective for analyzing the causes of cancer. He presents many key unsolved puzzles within that context. He also says why most cancer researchers are not interested in these fundamental issues. The subsequent decades of research grew around this rift, blindly, in the way that research disciplines often grow. Let us revisit Peto, almost 40 years ago. We can learn much about the current nature of cancer research.