Cancer and genetics: What we need to know now

Abstract Profound changes brought about by discoveries in molecular biology may enable us in the future to treat cancer without causing late effects or to prevent cancer altogether. Even before that happens, the age of molecular medicine has arrived. Molecular biology is the study of biological processes at the level of the molecule. A major aspect of molecular biology is molecular genetics—the science that deals with DNA and RNA. Most of the progress in molecular biology has been made in the second half of the 20 th century. Each discovery or technological innovation has built on previous discoveries and paved the way for the next, culminating in the current effort to map, sequence, and understand the functions of the entire human genome. In the past 20 years, many pieces of the cancer puzzle have been found, showing us how the normal cellular control mechanisms go awry to cause cancer and setting the stage for genetic testing and disease treatment. These new discoveries bring both promise and peril. To provide comprehensive care for survivors of childhood cancer and care in other settings as well, health care providers must now be familiar with the concepts and language of molecular biology, understand its applications to cancer care, and be fully informed about its implications for clinical practice, research, and education.