Chapter 7
Natural History of Clinical Cancer
7.1 Introduction
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: (1) the growth kinetics of the primary tumor, and (2) the dynamics of metastatic spread to both regional (e.g., lymph nodes) and distant sites. Ultimately, our 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, ...
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