In The Emperor of All Maladies: A Biographic of Cancer, the oncologist Siddhartha Mukherjee, MD, intuits, “Down to their innate molecular core, cancer cells are hyperactive, survival-endowed, scrappy, fecund, inventive copies of ourselves.”1 Replace “cancer cells” with “viruses” and the quote holds equally true.
Darwinian perpetrators of genomic dysregulation, many viruses have integrated foundationally into the human genome. Indeed, nearly 8% of our genome is believed to consist of inactive viral sequences, an ancient graveyard of disabled invaders that attacked our ancestors eons ago now lying as “remnants of past infections.”2
Over billions of years of evolution, the complex genomic battle between virus and cellular host has varied from symbiosis, to detente, to revolution. In its most rapid, extreme, and antagonistic form, infection results in exuberant viral replication, uncontrolled inflammatory responses, communicable dissemination, and swift death of individuals or species by pandemic. In a slower but invariably malignant process, viral mediated cellular transformation leads to uncontrolled host cell proliferation and cancer death. For his discovery of hepatitis B virus and connecting the concepts of viral genomic integration and certain cancer risks along with the development of a vaccine and prevention of liver cancer by this mechanism, Barry Blumberg, MD, of Fox Chase Cancer Center in Philadelphia, won the Nobel Prize in Medicine some 40 years ago.
Viral infections and cancers share more than just their desire for nucleic control. While the spectrum of these disease states are equally broad, ranging from indolent to virulent, perhaps the greatest and most universal human emotion stoked by both invasive ailments is fear. This is partly because of their universality, our personal histories, and their cryptic inevitability. It has been said that what the mind does not understand, it fears.
As the world negotiates its first global pandemic in over a century, the lessons learned from our human responses to COVID-19 can teach us a great deal about our visceral response to cancer. As Neil Shubin put it in a Wall Street Journal article, both literally and figuratively, “Each of us is part virus (and part cancer), in ways that affect who we are and what we do.”2
Robert G. Uzzo, MD, MBA, FACS
G. Willing “Wing” Pepper Chair in Cancer Research
Professor and Chairman, Department of Surgery
Fox Chase Cancer Center, Temple University
- Mukherjee S. The Emperor of All Maladies: A Biography of Cancer. Detroit: Gale, Cengage Learning. 2012.
- Shubin N. The viruses that shaped our DNA. Wall Street Journal. Published online March 14, 2020.