July 23, 2024

The Legacy of Darwinian Evolution in Medicine

One way that the legacy of Darwinian Evolution has influenced science in society is via the development of Darwinian medicine. Darwinian medicine or evolutionary medicine is a field that came about as a way to “[apply] principles of evolutionary adaptation and natural selection to the study of disease” (Ewald, 2018). What makes this field of medicine stand out in comparison to, perhaps, other fields is its specific emphasis on the idea that “a full understanding of medical problems requires an understanding of why states of disease exist” (Ewald, 2018). It guides us to ask questions like, “Why the body is not better designed [to avoid disease in general]?” (Nesse, 2001). Darwinian evolution has reimagined medicine in a way that is unique and begs us to approach health in different way. One could argue that Darwinian medicine is more inclusive. While traditional medicine usually approaches health in a more individualistic way, Darwinian medicine moves beyond that. Instead of asking “why one person becomes obese and another does not”, it encourages us to ask “why are our bodies designed so that most of us eat too much and exercise too little?” (Nesse, 2001). This removes the blame that some people may face for being obese or ill in any other way. It frames disease as an evolutionary byproduct and it seeks to find ways to cure or avoid illness, as such.

One disease in which Darwinian medicine has prevailed is cancer. In the eyes of Darwinian medicine, “vulnerability to cancer is … a consequence of the ‘design’ limitations, compromises and trade-offs that characterize evolutionary processes” (Greaves, 2007). As we all know, one of the main issues with cancer is that it cannot be cured my antibiotics. One of the main treatments for cancer is chemotherapy. Even then, chemotherapy is not a cure. It is one of the only treatments we have but it usually does not get rid of the cancer in an individual. The aggressiveness of cancer makes it so that cancer cells are resistant even to the vicious treatment of chemotherapy. Darwinian medicine applies the theory of natural selection as an explanation for this resistance. It views “the hugely problematic development of resistance to … cancer chemotherapeutics … [as] an inevitable consequence of genetic diversity and selective pressure” (Greaves, 2007). Furthermore, under this view of medicine, we are implored to see the “adaptive evolution of [tumor] clones … [as] driven by the formation of new environmental niches” and as having “huge implications for screening, prognosis, and therapy” (Fredrich et. al, 2019; Greaves, 2007). Considering this view, has enormous implications to what drugs, therapies, and treatments we develop for cancer in the future. As a matter of fact, it might lead us to “focus efforts on prophylactic hormonal or immunological intervention” (Greaves, 2007). Approaching cancer from an evolutionary standpoint can provide science and society with “new insights into gene culture co-evolution” and, potentially, “bridge many of the dichotomous approaches” that are currently used when we try to understand major public health problems associated with cancer (Purushotham & Sullivan, 2010). If “trans-disciplinary collaborations” occurred between cancer researchers and evolutionary biologists, we would probably see many more advancements in our overall understanding of cancer as a society (Purushotham & Sullivan, 2010).

References

Ewald, P. W. (2018, September 05). Darwinian Medicine: Evolutionary Approaches to Disease. Retrieved October 25, 2020, from https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118924396.wbiea1862

Fredrich, T., Rieger, H., Chignola, R., & Milotti, E. (2019). Fine-grained simulations of the microenvironment of vascularized tumours. Science Reports, 9, 11698. doi:10.1101/661603

Greaves, M. (2007). Darwinian medicine: A case for cancer. Nature Reviews Cancer, 7(3), 213-221. doi:10.1038/nrc2071

Nesse, R. M. (2001). How is Darwinian medicine useful? Western Journal of Medicine, 174(5), 358-360. doi:10.1136/ewjm.174.5.358

Purushotham, A. D., & Sullivan, R. (2010). Darwin, medicine and cancer. Annals of Oncology, 21(2), 199-203. doi:10.1093/annonc/mdp537

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