i have enjoyed this piece not because i am in any position to refute or authenticate what it seeks to sell (an idea) but because as a surgeon constantly working within body depths and recesses, and constantly re-sculpting gross anatomy to redeem errant conditions inflicted by a morbid anatomy (be these neoplastic or non-neoplastic), i am increasingly beginning to see how re-sculpting at the molecular level may prove the ultimate and more durable strategy to cancer control.

The science understandably is still imperfect but its seed is virile and only needs fertile minds to grow it.

Human biology must be the ultimate teacher in these areas; revealing to us the constant tendency of a body to harm itself through the activities of a few but threateningly placed mischievous signalling agents hijacking regulatory pathways and pushing the entire being down a steep slope into expiry.

To be able to understudy the body's own means of keeping these molecular mischief makers in check, locate the strategic game-changing triggers and harness them onto the winning side of a beleagured physiology is the ultimate means in my view of how we can work with the body to protect the body.

it boils down to expanding nature to keep nature's frontiers intact.

As i read about cytokine modulators and monoclonal antibodies being deployed into these frontiers, seeking to beat intracellular 'anti-molecularists' at their own game, i can only feel upbeat that a fighting phalanx complementary to the surgeon's knife, and with a more logical battle-winning tactic is on the horizon.

what is left is a more operational knowledge of these molecular pathways, greater familiarity with how to construct to be able to distinguish 'friend from foe' and so deliver a coup fatal only to the right spot.

By its logical conclusion ( whenever that finally comes), molecular manipulation will spell the eventual death of surgeons like us who still believe in weilding little else but a knife in a battle better won within the cells than anywhere else.

That said, i will still be slow in applying these biological agents to my patients knowing the art is still rather messy

but

full of hopes that future generations of similar patients will have a neater and more biased therapeutic regime in their armouries.

It is an inescapable fact, that to end it all well and profitably in the world of cancers, we need the continuing attention of basic science to all of the choreographies daily playing out within our cells; all of the cybernetics, the cross- molecular talks, straight or riddles

Competing interests: None declared