Multi-parameter systematic strategies for predictive, preventive and personalised medicine in cancer

Cancer is a complex disease that is caused by the interplay of multiple internal factors and extrinsic factors [1,2]. DNA binding and induction of mutations in cancer-susceptibility genes are considerable mechanisms of tumour initiation. It is also reported that over 80% of cancer deaths in Western industrial countries can be attributed to extrinsic factors such as tobacco, alcohol, diet, infections and occupational exposures [1].Alterations in multiple genes expression in cancer lead to dysregulation of the normal cellular programme for cell division, differentiation, apoptosis and proliferation. This results in an imbalance of cell replication and cell death, which favours growth of a tumour cell population [3,4]. Clinically, cancer appears to be many different diseases with different phenotypic characteristics. As cancer progresses, the genetic drift in the cell population produces cell heterogeneity with characteristics including cell antigenicity, invasiveness, metastatic potential, rate of cell proliferation, differentiation state and response to chemotherapeutic agents [5,6].In the past 10 years, a number of radiotherapy and chemotherapy strategies available to treat cancer have increased [7]. Much of medical practice is based on standards of care. These interventions are based on knowledge and experience from the different levels of evidence generated by epidemiological and clinical studies or evidence-based medicine [8,9]. However, large randomised studies are designed to determine approach for the average populations, but not for specific individuals, which results in the therapeutic model ‘the same therapeutic strategy for the same type of disease’. In addition, basic scientists and clinicians have raised a lot of fundamental questions regarding identification of the causes of cancer, preventive measurement taken, the common characters in tumour susceptible group, predictive measurement used, the basic mechanisms of malignant transformation of cells, poss