Bystander effects: a concept in need of clarification

An increasing body of evidence indicates that the response to genotoxic agents such as radiation or drugs is a group phenomenon, rather than the summed response of individual independent cells to injury. Thus, a complex contagion-like response may spread beyond the initial impact of an agent to enlarge its effect. This indirect effect, termed "Bystander Effect," is multifaceted and may play a significant role in the therapy of tumors and in carcinogenesis. A better understanding of this phenomenon is needed in order to modulate treatment protocols to therapeutic advantage and to provide more rational guidelines for the evaluation of environmental hazards.