An example

One of those questions is how to make cancer treatment more successful. Despite the huge progress that has been made in cancer therapy during the last decades, cancer is still one of the biggest killers worldwide. Drug resistance is a huge problem in cancer treatment.

Looking at cancer from an evolutionary perspective leads to several approaches. One idea sounds particularly counterintuitive at first: Do not try to kill all cancer cells with high-dosage treatment but keep tumour growth at bay with moderate doses accepting that cancer cells will be there. But taking into account the evolutionary principle of natural selection, the idea starts to sound as if it could work as a long-term treatment strategy: Cancer cells with mutations that deliver a survival advantage in order to reproduce in a certain environment are the ones that will be dominant in numbers after a short time. Those mutated cells cause drug resistance and rapid tumour growth after initial treatment successes in many cancers. The aim of treating cancer with lower and very finely tuned chemo dosages is to not create those mutated cells that survive harsh chemotherapy and lead to drug-resistant tumours. If the mutation rate can be slowed by not initiating a survival-of-the-fittest race among cancer cells, treatment dosage can be decreased and drugs may be effective for longer.

This may mean that such a cancer treatment approach leads to treatment regimens similar to those for chronic diseases, closely monitored and personalised for the patient’s specific profile. The benefits could be a better quality of life for patients and higher life expectancy with fewer complications.