title: Dynamics of preventive vs post-diagnostic cancer control using low-impact measures.
abstract: Cancer poses danger because of its unregulated growth, development of resistance, and metastatic spread to vital organs. We currently lack quantitative theory for how preventive measures and post-diagnostic interventions are predicted to affect risks of a life threatening cancer. Here we evaluate how continuous measures, such as life style changes and traditional treatments, affect both neoplastic growth and the frequency of resistant clones. We then compare and contrast preventive and post-diagnostic interventions assuming that only a single lesion progresses to invasive carcinoma during the life of an individual, and resection either leaves residual cells or metastases are undetected. Whereas prevention generally results in more positive therapeutic outcomes than post-diagnostic interventions, this advantage is substantially lowered should prevention initially fail to arrest tumour growth. We discuss these results and other important mitigating factors that should be taken into consideration in a comparative understanding of preventive and post-diagnostic interventions.
authors.affiliation: Institut des Sciences de l'Evolution de Montpellier, University of Montpellier, Montpellier, France.
authors.forename: Andrei R
authors.initials: AR
authors.lastname: Akhmetzhanov
authors.affiliation: Institut des Sciences de l'Evolution de Montpellier, University of Montpellier, Montpellier, France.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Hochberg
mesh_terms: D006801:Humans; D008962:Models, Theoretical; D009369:Neoplasms / Q000401:mortality / Q000517:prevention & control* / Q000628:therapy*; D011379:Prognosis; D016019:Survival Analysis
keywords: cancer prevention; computational biology; evolution; human; human biology; mathematical models; medicine; systems biology