ABSTRACT
In the 1970s, opinion was divided as to whether cancer was fundamentally a genetic disease or arose through mechanisms independent of genetic alteration. The difference between genetic and epigenetic can be explained by analogy with a poor musical performance. To demonstrate linkage one needs to ‘follow’ genetic material through successive family generations. Such gene tracking is achieved with genetic markers that allow maternal and paternal DNA to be distinguished. Cancer is the end result of not one or two but many genetic alterations occurring in a distinct stepwise process. Each mutation gives rise to a new subclone of daughter cells. The generation of a cancer would appear to be the culmination of a sequence of irreversible genomic changes a permanent reprogramming of the instructional machinery of the cell.
