Intended for healthcare professionals

  1. Student
  2. Mistaken identity
  3. Mistaken identity
Student Education

Mistaken identity

BMJ 2007; 334 doi: https://doi.org/10.1136/sbmj.07018 (Published 01 January 2007) Cite this as: BMJ 2007;334:07018
  1. George Murphy, final year medical student1,
  2. Malcolm R Alison, professor of stem cell biology2
  1. 1Bart's and the London, Queen Mary's School of Medicine and Dentistry, London
  2. 2Centre for Diabetes and Metabolic Medicine, Queen Mary's School of Medicine and Dentistry

Cancer is really a stem cell disease, argue George Murphy and Malcolm R Alison

“Mrs Smith, I'm afraid you have cancer.” The words die on your lips as you wait to see how she reacts-a bolt from the blue or just official confirmation of a long nursed suspicion? She's petrified-no diagnosis scares her more, with some justification: one in four Europeans will die of some form of cancer, despite mean five year survival rates of more than 45%.w1 But what if you could treat cancer, any cancer, as simply and effectively as a bacterial infection? Such a world may be closer than you think, and is coming from a surprising direction-stem cells.

Dynamic tissues

Tissues such as the gut epithelium and skin are constantly regenerated from tissue specific stem cells. Moreover, even those tissues which are not routinely renewed, such as neurones, appear to have previously unrecognised populations of stem cells that may be involved in maintenance and repair.w2

So, human tissues are not static collections of similar cells but are arranged instead as a hierarchy,w3 based on the cells' replicative potential and functional abilities. At the top of this hierarchy are stem cells (see box 1). This small population of self renewing cells generates the next group-transit amplifying cells.

Box 1: What are stem cells?w3

Stem cells have five key characteristics

  • They can self renew. This allows stem cells to maintain their own population and produce transit amplifying cells

  • They are relatively undifferentiated. This allows stem cells to produce several different types of terminally (fully) differentiated cell

  • They divide continuously. They need to survive for the lifespan of the individual

  • They replicate rarely but can do so many times. This reduces the risk of mutation while allowing many daughter cells to be produced

  • They live within a “niche.” The niche nurtures and controls the …

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