Contrary to the findings in patients with breast and colorectal cancers, the presence of the p53 gene mutation in oesophageal cancer does not have any influence on the success of treatment with chemoradiotherapy.

Scientists in Tokyo assessed the survival rates among 40 patients with localised advanced oesophageal squamous cell cancer who were treated with infusions of 5 fluorouracil and cisplatin in combination with chest radiotherapy.

Their average survival time was 14 months and the two year survival rate was 20 per cent.

Previous studies have suggested that p53 may play a critical role in cell death in response to cytotoxic agents, ultraviolet light and radiation. However, 60 per cent of the tumour specimens in this study demonstrated a p53 mutation, but the presence of this mutation had no bearing on the patient's survival (J Gastroenterol, 2001; 36: 303- 11).

The findings of the Japanese study appear to echo recent calls from Canadian scientists to reassess the definition of disease in the post genome era.

Dr James G. Wright, of The Hospital for Sick Children in Toronto, and his colleagues say that, given our expanding knowledge of genetics, the term 'disease' needs to be redefined so that it is not applied to every genetic abnormality.

They point out that "labelling someone as 'diseased' . . . has enormous individual, social, financial and physical implications".

The scientists fear that these far reaching implications will have adverse consequences if the thousands of genetic variations that will be found by human genome sequencing come to be associated with disease.

In other words, conventional science has discovered what alternative practitioners have known for years variation from the norm does not always mean abnormal (Science, 2001; 293: 807-8).