Jump to ratings and reviews
Rate this book

The Cheating Cell: How Evolution Helps Us Understand and Treat Cancer

Rate this book
A fundamental and groundbreaking reassessment of how we view and manage cancer

When we think of the forces driving cancer, we don’t necessarily think of evolution. But evolution and cancer are closely linked because the historical processes that created life also created cancer. The Cheating Cell delves into this extraordinary relationship, and shows that by understanding cancer’s evolutionary origins, researchers can come up with more effective, revolutionary treatments.

Athena Aktipis goes back billions of years to explore when unicellular forms became multicellular organisms. Within these bodies of cooperating cells, cheating ones arose, overusing resources and replicating out of control, giving rise to cancer. Aktipis illustrates how evolution has paved the way for cancer’s ubiquity, and why it will exist as long as multicellular life does. Even so, she argues, this doesn’t mean we should give up on treating cancer―in fact, evolutionary approaches offer new and promising options for the disease’s prevention and treatments that aim at long-term management rather than simple eradication. Looking across species―from sponges and cacti to dogs and elephants―we are discovering new mechanisms of tumor suppression and the many ways that multicellular life-forms have evolved to keep cancer under control. By accepting that cancer is a part of our biological past, present, and future―and that we cannot win a war against evolution―treatments can become smarter, more strategic, and more humane.

Unifying the latest research from biology, ecology, medicine, and social science, The Cheating Cell challenges us to rethink cancer’s fundamental nature and our relationship to it.

224 pages, Hardcover

Published March 24, 2020

Loading interface...
Loading interface...

About the author

Athena Aktipis

6 books11 followers

Ratings & Reviews

What do you think?
Rate this book

Friends & Following

Create a free account to discover what your friends think of this book!

Community Reviews

5 stars
55 (37%)
4 stars
60 (40%)
3 stars
20 (13%)
2 stars
11 (7%)
1 star
1 (<1%)
Displaying 1 - 25 of 25 reviews
Profile Image for Rossdavidh.
535 reviews183 followers
January 8, 2021
I forget how it was that I first came to notice Dr. Athena Aktipis on the internet, but somehow or other I found her website. It talked about the intriguing idea that cooperation among cells in a multicellular organism, and among organisms in a group of conspecifics, even humans in a society, could be described by similar models. She is obviously a believer in the (controversial, but now I believe mainstream) idea of "multi-level selection", as a driver for cooperation. Natural selection can (and does) operate at the level of the gene, the cell, the organism, and perhaps even at higher levels. That is, even if cheaters do better within a group, if the groups with fewer cheaters do better in group vs. group selection, you could still see cooperation predominate.

But not to the complete exclusion of cheaters (aka "exploiters" or "parasites"), unfortunately. The word for such cheaters at the cellular level, she believes, is "cancer". Finally, she has put into book form the intriguing work that she has been mentioning on her website. I ordered it as soon as I found out it existed, and moved it to the front of the TBR queue.

Once reading it, though, I proceeded more cautiously. This is not a book to gallop through, however tempted one may be to do that. Each chapter bears thinking on, and it is a good idea to give yourself a day after each one before you proceed on, so that your subconscious has time to process what you've read:
Chapter 1: Introduction: Evolution in the Flesh
Chapter 2: Why Does Cancer Evolve?
Chapter 3: Cheating in Multicellular Cooperation
Chapter 4: Cancer from Womb to Tomb
Chapter 5: Cancer across the Tree of Life
Chapter 6: The Hidden World of Cancer Cells
Chapter 7: How to Control Cancer

The basic idea is that cancer is, in its essence, a group of cells which continue to take resources from the organism, without playing by the rules of cooperation which allow that organism to survive. Now, in a lot of cases, the tumor may stay small enough that it never kills the host. In many others, though, because the cancer cells are able to put more of their resources into reproducing and for many other reasons besides, cancer will eventually kill the host it lives in.

It has been said that "nothing in biology makes sense except in light of evolution". Aktipis has taken this statement to heart, it seems, and shows the many levels at which evolutionary pressures can explain what cancer is, and how it works, and how the body (ours, or an elephant's, or that of a cactus) has evolved to detect and destroy cancer. Also, some of the ways in which normal healthy processes like healing from a wound or gestating the next generation, can make it harder to keep cancer under control.

There are a lot of ideas here, and Aktipis does a good job with examples, metaphors, and drawings to help the reader keep up. I couldn't tell for sure who did the drawings, but they helped make an already readable text even better. In fact, it is so readable that I sometimes had to remind myself to pause and reflect, instead of racing ahead to the next page or chapter, and then at other times it fired the imagination so much that I found myself staring off into space as I turned over the many consequences of (and questions raised by) every few paragraphs. It was a pretty intense read.

Perhaps aware of the politically-tinged fireworks that have accompanied any discussion of multilevel selection in the past, Aktipis entirely steers clear of any discussion of how the concept of "cheating=cancer" might apply to human society. It's probably a wise decision on her part to leave that as an exercise for the reader. But it's not hard to imagine potential parallels.

The last chapter is, necessarily, a list of exciting new techniques and a few new possibilities, rather than, say, a cure for cancer. But crucially, by the time you get to that chapter, the significance of the use of the word "control" rather than "cure" is apparent. We all of us have cancer, all of the time, even though it is only when it is propagating out of control that we are aware of it.

Aktipis' book is a smashing good read, and I very much hope that we don't end up having to wait another decade for her next.
Profile Image for Stefan Mitev.
164 reviews685 followers
August 16, 2020
В последно време рядко попадам на книги, които наистина ме карат да се замисля дълбоко по даден въпрос. "Мамещата клетка: Как еволюцията ни помага да разберем и лекуваме рака" със сигурност успя да провокира и задържи вниманието ми върху разглежданите теми.

Авторката Атина Актипис е се представя едновременно като онкологичен биолог, социален психолог и кооперационен теоретик. Книгата ѝ разглежда рака от изцяло еволюционна гледна точка. Между другото, еволюцията е биологичен факт. Фанатично религиозните хора може да спрат да четат ревюто.

Онкологичните заболявания са неизбежно последствие на възникването и развитието на многоклетъчните организми. Срещат се при не само при животните, но дори и при растенията (където се наричат фасциации, образувайки понякога красиви форми). Според Атина Актипис раковата клетка успява да измами организма, чиято основна цел е многоклетъчна кооперация. Основна теза в книгата е, че еволюционната борба за оцеляване и репродукция (делене в случая на клетките) протича постоянно в тялото ни. Раковите клетки се делят неконтролируемо и дават много по-голямо "потомство" спрямо нормалните клетки, които рутинно извършват функциите си.

Раковите клетки трябва да се справят с агресивни фактори на средата (имунната система), за да оцелеят и да се възпроизведат. Според Актипис раковите клетки използват еволюционни стратегии за справяне с проблемите, а именно - мутиране, което осигурява генетично разнообразие с цел по-добро приспособяване, както и различни механизми за "скриване" от имунната система.

Книгата е пълна с препратки към научни публикации, но за съжаление предимно in vitro и с животни. Единственото проучване с хора, за което прочетох включва само 11 пациенти с рак на простатата - крайно малък брой за изваждане на каквито и да е изводи.

Финалната глава предлага идеи за промени при лечение на онкологичните заболявания. За първи път прочетох за адаптивна терапия. Тя изглежда е насочена към тумори, които не можем да унищожим напълно с наличните към този момент лекарства. В такъв случай Актипис предлага прилагане на ПО-НИСКИ дози и динамично проследяване на различни маркери на заболяването с цел контрол, а не излекуване. Спекулативната идея е, че химиотерапията създава враждебна среда около раковите клетки, в която ще оцелеят най-агресивните, даващи метастази. Авторката говори за превръщане на рака в хронично заболяване, с което можем да живеем, а не за цялостното му излекуване.

В "Мамещата клетка" има немалко смели идеи, които граничат с провокация и спекулация, но със сигурност заслужават да бъдат проверени в по-големи клинични изпитвания. В крайна сметка, далеч повече пари се харчат за проучване на вече категорично отхвърлени шарлатански методики като хомеопатия и акупунктура.

Еволюционните стратегии и проблеми са навсякъде около нас. Вероятно дори и при онкологичните заболявания.
Profile Image for Ramon van Dam.
392 reviews6 followers
October 22, 2023
A fascinating and insightful work on the broad subject of cancer. The author clearly shows she is not only an authority on the matter, but she also has a knack for being able to explain it to people like me who are mostly new to it.

As Aktipis points out on several occasions, this disease is one that everybody will encounter in some form from up close at least once in their lifetime. It was pretty eye-opening to me how she makes the case for us having to live with it instead of expecting to eradicate it, and why that doesn't have to be a bad thing.

The book covers quite a lot of ground in a couple hundred pages. The author explains what cancer is on a biological level, where it came from looking at evolution and how treatments we use right now and hopefully in the near future work.

At times it's a bit dry, but I can't complain about that. This is very serious and important subject matter and I think everybody should read this.
Profile Image for Ashar Malik.
52 reviews2 followers
March 30, 2020
This book is fantastic. It gives a new perspective on Cancer and sheds lights on how new approaches from an evolutionary perspective can and should be taken up to cure it. The author takes her time to introduce two key aspects, the ecology and evolution of cancer and concludes how both comprise pathways which can be used to target it. While I did find some content to be redundant, the book manages to deliver the message quite clearly. I will definitely recommend this book to everyone, from a lay person to a seasoned cancer researcher. The book has something for everyone.
April 6, 2022
Преди милиони години многоклетъчните организми сключили сделка - поели риска от рак в името на еволюцията към по-висши организми. При рак клетките се делят с голяма скорост, използват максимално ресурсите на средата, разпространяват се и колонизират нови територии (метастазират), като стават почти безсмъртни. Това са все неща, които еволюцията утвърждава. Раковата клетка има еволюцията на своя страна - тя умее да оцелява. А тези, които оцеляват, се репродуктират и предават своите белези на бъдещите поколения. Авторката описва рака като неконтролируема еволюция, случваща се в тялото. Когато използваме дадено лекарство при пациент, то убива най-неприспособимите ракови клетки, като така остават да оцеляват и да се размножават най-устойчивите. Това може би означава, че трябва да се опитваме не да лекуваме радикално рака, а да го контролираме и да го превърнем в хронично заболяване, с което да може да се живее. Безспорно книга с революционни идеи.
Profile Image for Silvia.
61 reviews35 followers
Shelved as 'effequ'
November 8, 2023
non dico mai niente sui libri effequ ma gente questo saggio è *importante*
17 reviews
September 9, 2022
Some interesting ideas, but most of the ideas could have been summed up in maybe 10 pages. The author repeats every idea multiple times, often worded only slightly differently, then uses some analogy instead of talking about cells, which really doesn’t add much. Then repeats the same idea a few more times. The last chapter summarized the book, and in the summary those same few ideas were repeated multiple times again.
123 reviews
November 10, 2021
Obviously, alongside Kat Arney's 'Rebel Cell', I am loving this newfound appreciation for evolutionary theory in cancer research, which still isn't being completely recognised even in the field. This is undoubtedly why both books focus so heavily on adaptive theory, as it is a demonstration of how an approach to a disease which we feel so familiar with can be completely transformed by taking a wholly new perspective. I have my fingers crossed, but it is worth mentioning that the results from adaptive therapy, especially successful ones, are very preliminary (whilst Arney presents adaptive therapy via an example, as she does for a lot of the book, Aktipis takes a far more holistic, almost academic approach), and it might end up being one of those techniques which is incredibly neat and effective in theory, but in practice is too difficult to control. Indeed, Arney especially doubles down on the balance which must be reached.

I did enjoy 'The Cheating Cell', even if it was slightly heavier than 'Rebel Cell'. The illustrations were often incredibly useful, and it was interesting to see how Aktipis has played a role in this revolution as well. That said, sometimes the writing came across a little stilted, and Aktipis had a tendency to randomly repeat themselves. That said, it is still a book about a really fascinating topic that should pique the interests of anyone interested in how scientific disciplines intermingle.
Profile Image for Laura.
561 reviews35 followers
July 14, 2022
For a specialist working in cancer research the book doesn't add much, and I fear for a non-specialist the writing may be too technical. I'm also a bit hesitant about the emerging therapies suggested at the end of the book--some of them haven't even been tested in humans yet, and the "giving mice bicarbonate to lower their tumor pH" sounds a bit like wishful thinking to me. I'd like to see some repeats of that experiment, in humans not mice, and then I'll buy into that.
4 reviews2 followers
September 21, 2020
Just read it !!
One of the best written books! It concisely and elegantly demonstrates the paradigm shift in viewing cancer in its evolutionary context, why it happens and what we can do about it!
601 reviews5 followers
February 10, 2023
5 sterren omdat het boek doet nadenken over kanker , en hoe meer mensen helpen nadenken hoe meer verschillende standpunten (... oplossingen? ) gevonden kunnen worden om ,om te kunnen gaan met deze ingrijpende ziekte ,
..... Ken het organisme om het te begrijpen , proberen te denken als een (kanker) cel .... dan zijn medicatie en therapieën obstakels die men moet proberen te verschalken door te verstoppen , samenwerking aan te gaan met eventuele micro-organismen,.. proberen deze obstakels te omzeilen ,
Ergens kent iedereen waarschijnlijk iemand van veraf of jammer genoeg van op de eerste rij met deze ziekte , ... het leven op cel niveau vind ik heel moeilijk te begrijpen als organisme , cellen doen wat hun programma hun opdraagt ( hun programma kan gekaapt worden of in de war gestuurd worden door allerhande invloeden , micro-organismen, straling,hormonen, stress , insecticiden enz )
Er valt nog veel te leren op cel niveau,
Een goed boek ( met metaforen die ruimdenkend zijn maar waar ik ook bedenkingen bij heb ) over cellen en deze (voorlopig?) nog ongrijpbare ziekte ,
Profile Image for Bryan.
10 reviews
April 8, 2023
Athena Aktipis and her book The Cheating Cell changed how I thought about cancer. I enjoyed her interview on the 80,000 Hours Podcast, and decided I'd check out her book for a more detailed account. Showing how evolutionary and ecological forces define cancer makes it far less mysterious, even as they reveal how incredibly complex cancer is. While the book discusses many ways cancer evolves to get around our defenses, which in turn helps to explain why it's so hard to eradicate, it also offers hope for more promising approaches to research and treatment.

The book does get repetitive at times, but in audiobook form it sometimes felt like a lecturer trying to reinforce important points in the student's memory, and I'll probably remember those lessons better as a result.
Profile Image for Heather.
677 reviews23 followers
May 24, 2023
This was recommended by Hank Green on the Dear Hank & John podcast. I cannot believe I liked and even mostly followed such a detailed scientific work! It was fascinating, frustrating (cancer is SO COMPLEX!), but also somewhat hopeful. The author discussed a possible goal of people living with cancers that that are currently untreatable (rather than trying to eradicate it in those cases and sometimes inadvertently making it worse - for reasons I won't get into here). Unfortunately, the day after I finished the book, Hank Green posted a video announcing that he has cancer. I'm not sure if was aware of the book because of his own diagnosis or if he had read and/or recommended it before then.
Profile Image for Marghe.
38 reviews7 followers
February 21, 2024
Libro molto interessante, offre una nuova prospettiva sul cancro e su quanto possa essere utile adottare un approccio evolutivo ed ecologico nella terapia. Il libro entra molto nel dettaglio su concetti chiave dell'ecologia e dell'evoluzione del cancro, in modo abbastanza rindondante e usando molte analogie. Su ben altri concetti, tuttavia, ho avuto non poche difficoltà a capire, però alla fine si è rivelata una lettura molto stimolante e questo mi ha portata più che mai ad una maggiore curiosità sull'argomento.
September 19, 2022
A book I will definitely be coming back to. I personally have a hard time retaining information especially if it’s a little too complex, but I found this book wasn’t too difficult to take in (I listened to the audiobook, so that helped). I very much recommend this book to anyone interested in the topic especially where it concerns what cancer really is and why we haven’t found a “cure” yet.
Profile Image for Allison.
148 reviews
September 14, 2023
Really enjoyed the book. There were a lot of good analogies for the interactions mentioned, i.e. cells, tissues, and organisms. I especially like the focus on control, not complete eradication of the cancer cells.
Profile Image for Nichola Raihani.
Author 2 books65 followers
January 2, 2021
Loved this book and learned a lot on the way. A much-needed overview of why we must think of cancer in evolutionary terms - to better understand it and to devise more effective treatments.
Profile Image for Matt.
26 reviews1 follower
February 10, 2022
A bit dense at times, but full of some pretty mind-blowing ideas and facts.
Profile Image for Eimad.
171 reviews25 followers
February 18, 2022
Quite interesting especially the idea of adaptive therapy in metastatic cases.
Profile Image for Jente Ottenburghs.
Author 1 book9 followers
September 24, 2022
A wonderful book that provides an evolutionary perspective on cancer and how to treat it. Some sections were a bit repetitive and could have been structured better. But all in all, a great read.
Profile Image for Sanda.
139 reviews34 followers
August 1, 2023
Minunată carte! Câte sunt de învățat!
Azi o iau de la capăt să mă asigur că am înțeles și reținut informațiile.
Profile Image for Stefano.
14 reviews
November 22, 2023
Esemplare, scritto benissimo e mi ha aperto il mondo su una chiave di lettura del cancro totalmente nuova e inaspettata
Profile Image for Jessica Ayers.
3 reviews1 follower
October 11, 2019
Couldn’t put it down! I learned so much about cancer, how scientists identify it, how they treat it, and why that might be problematic. I started this book as a total novice to most of this information and feel like I learned so much!
Displaying 1 - 25 of 25 reviews

Can't find what you're looking for?

Get help and learn more about the design.