Love to add my two cents. I have always liked to describe cancer as an evolutionary process on a rapid scale. You can think of the cells like an individual organism and whole cancer like an ecosystem. Because one of the main distinctions in cancer is genetic instability due to rapid proliferation you begin to see a “survival of the fittest” emerge. In later stages, it’s not hard to believe that you start getting different cancers that develop traits that make them more adapted to their niche. This process is shaped by all the unique environmental stress which can change from person to person and organ to organ.
Furthermore, even in each individual tumor, there are subpopulations. Previously we would take a whole-tumor mass and say it’s one phenotype. I believe this would be like taking all the biomass in the woods and say the only thing living there would be trees. It fails to incorporate the complexities and interactions of the other organisms. Pretty recently we have had the technology now to isolate the populations and characterize them leading to a better understanding of the complexities of cancer.
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