ABSTRACT
The natural history of a disease refers to its uninterrupted course in the absence of intervention, from initiation through its end stage, resolution, chronic illness or death. Any model for natural history of clinical cancer, either conceptual or formal, must address at least two central dynamics: the growth kinetics of the primary tumor, and the dynamics of metastatic spread to both regional and distant sites. The authors’ motivation to study cancer natural history is not purely intellectual interest. After all, cancer is very rarely left to follow its unperturbed natural history, so at first glance this might be considered an irrelevant problem. However, rational a priori design of treatment protocols and optimized screening programs requires models that accurately reproduce disease dynamics in the absence of intervention. This chapter focuses on the evolution of both conceptual and formal models of cancer's long-term natural history and inferences about proper treatment strategies that may be deduced from these models about proper treatment strategies.
