  Cancer is a disease of cellular regulation, often initiated by genetic
mutation within cells, and leading to a heterogeneous cell population within
tissues. In the competition for nutrients and growth space within the tumors
the phenotype of each cell determines its success. Selection in this process is
imposed by both the microenvironment (neighboring cells, extracellular matrix,
and diffusing substances), and the whole of the organism through for example
the blood supply. In this view, the development of tumor cells is in close
interaction with their increasingly changing environment: the more cells can
change, the more their environment will change. Furthermore, instabilities are
also introduced on the organism level: blood supply can be blocked by increased
tissue pressure or the tortuosity of the tumor-neovascular vessels. This
coupling between cell, microenvironment, and organism results in behavior that
is hard to predict. Here we introduce a cell-based computational model to study
the effect of blood flow obstruction on the micro-evolution of cells within a
cancerous tissue. We demonstrate that stages of tumor development emerge
naturally, without the need for sequential mutation of specific genes.
Secondly, we show that instabilities in blood supply can impact the overall
development of tumors and lead to the extinction of the dominant aggressive
phenotype, showing a clear distinction between the fitness at the cell level
and survival of the population. This provides new insights into potential side
effects of recent tumor vasculature renormalization approaches.
