“There is good reason to feel deceived by the promises of cancer research.” Early in Prof. Jarle Breivik’s Making Sense of Cancer, we get a taste of the relentless, bitter-sour, yet brutally honest expedition we’re about to embark on to understand the evilest of all diseases: cancer. We’ll explore the answers to the most complex cancer-related questions: what it is, why we get it, and if we can defeat it.
So, what is cancer really about?
Like the ancient Indian parable where a group of blind men each describe an elephant based on the part they touch, the definition of cancer varies depending on who you ask.
It’s about biology, evolution, philosophy, social priorities, and our relationship to life, aging, and death. It’s definitely about money—a lot of it—and inequalities. Ultimately, beyond all these, cancer is about communication. The essence of cancer and death lies in the interplay between information and its adaptation.
A few months ago, I received a friendly e-mail from Jarle Breivik, MD-PhD, a professor of medicine at the University of Oslo, inviting me to collaborate on science communication and critically read his book, Making Sense of Cancer: From Its Evolutionary Origin to Its Societal Impact and the Ultimate Solution. This invitation struck a chord with me and my deep investment in advancing science and science communication.
However, he noted the book’s mild attention despite excellent reviews, as few pick up books on cancer without promises of miracle cures.
This highlights a significant issue: awareness about cancer and cancer-related questions often fails at the initial stages of communication.
So, does Breivik lose the reader with unclear and inaccurate communication? Absolutely not. On the contrary, Making Sense of Cancer provides an exceptional description and portrayal of all things cancer from different perspectives.
When do we eliminate cancer?
Patients, medical doctors, researchers, businesses, politicians, journalists, and policymakers all have vested interests in the fight against cancer.
Breivik underscores the economic reality: ‘As usual, the underlying story is about money—lots of money.’ Cancer drives the economy, involving significant money, multinational companies, and healthcare systems. As a result, the connection between economy and hope shapes our narratives.
Sure, cancer researchers want to untangle the intricacies of cancer to understand the big picture, but they also seek fame and funding. Journalists look for impactful headlines that will please their editors. Meanwhile, cancer patients and their families cling to the hope that promising news is just around the corner.
Breivik reminds us of the expectations set by Nixon’s “War on Cancer,” Obama’s and Biden’s “Cancer Moonshot,” the American Cancer Society’s ongoing fight “for a world without cancer,” and Norwegian billionaire Trond Mohn’s belief in defeating cancer by 2030.
The hopeful narrative tells us we’re on a crusade to eliminate cancer. So, as Breivik provocatively asks us, “Why on earth should anyone be critical of the quest to cure cancer?”
Despite hopeful messages, most researchers recognize that cancer will likely increase over time, as longer life spans naturally increase cancer risk. Even if we manage to beat cancer effectively, prolonged life will, most probably, increase the likelihood of developing cancer. The reason is simple, albeit seemingly sad: we’re not meant to live forever.
Making Sense of Cancer critiques the portrayal of cancer as the enemy and patient outcomes as win-or-lose, similar to the vague War on Terror. While this rhetoric helps research funding and political campaigns, it also causes guilt, stigma, and unnecessary fear, potentially leading to decisions that impair quality of life.
“If we want to understand cancer, we need to see beyond the fearful monster.”
Fighting cancer, aging, and death
In The Denial of Death, anthropologist and author Ernest Becker describes that the fear of death drives much of human activity as we strive to deny its inevitability. Consequently, in our pursuit to control death, we’re ready to convince ourselves that dying of cancer trumps all other nightmares and, ultimately, accept the seemingly empty promises of a world without cancer.
But what if, contrary to popular belief, cancer is the best way of dying?
Breivik, citing former editor at The BMJ, Richard Smith, argues that dying of cancer can be a natural and even preferable end, offering time to prepare with “love, morphine, and whiskey.”
The idea might trigger strong reactions, and Smith acknowledges the need for caution when ranking such experiences. Still, such a view may offer a new and perhaps sounder perspective on how we approach cancer and death.
Cancer therapies may improve enough to extend our lives – sometimes by months or years. We can also postpone cancer with rejuvenation approaches through stem-cell therapies and organ transplantation.
Breivik discusses the ethical dilemmas of anti-aging and biotechnological advances, questioning how much we are willing to sacrifice for extended life and at what point we are ready to face death. “Anyhow, let us assume that we are able to provide everybody with 120 years of good quality life. Will everybody then agree to die at this age?”
Also, from a social perspective, how much effort and money should we devote to developing technologies that merely benefit a minority, people who can afford the treatments?
The solution may lie beyond merely eliminating cancer. Maybe we need to change the narrative to destigmatize and accept cancer as a part of life and focus on constructive approaches that improve our lives—while we live.
Genes, epigenes, and memes
Clearly, the information we receive about cancer shapes our perceptions and actions. However, the transmission of information extends beyond interpersonalؙ—it passes through generations.
Breivik provides an eye-opening framing of cancer (and life) as a constant flow of information. Survival of the fittest is more than the survival of the “strongest” or most adaptable organism or species; it’s about survival of information. “The genes were first. They developed us, and we are their creatures.”
Our bodies are merely vehicles for genetic information, which seeks to replicate and pass on to the next generation.
Information also includes the epigenome, the DNA organization that controls our genes without altering the underlying genetic code, which can be passed on through generations. Additionally, Breivik highlights that evolutionary adaptation and propagation of information also apply to memes, a unit of cultural transmission spread by imitation.
In short, life’s about transmitting information, and development and adaptation occur through the constant struggle between contradicting genetic, epigenetic, and memetic information.
As an example, Breivik highlights tobacco, which, as a cultural meme, affects our genes and epigenes. “When the smoking meme leads to cancer by manipulating our genes, it promotes the development of new memes. Anti-smoking laws, for example, are memes that have emerged and spread in the population.”
Who’s this book for?
Making Sense of Cancer captivates curiosity while challenging preconceived ideas about cancer and death. Although many concepts may seem provocative and pessimistic at first glance, it ultimately conveys an optimistic message. Minding the narrative can create more realistic and constructive conditions for cancer patients and future treatments.
While the book is for everyone, people often ignore books about cancer without instant results or miracle cures, creating a contrast in its target audience.
On one hand, the book targets the general public, who often lack reliable knowledge about cancer and its treatments. It pedagogically guides readers through cancer, from the molecular pathways to cellular processes and evolution—constantly building toward the final conclusion about “the meaning of cancer.” Breivik sets the information straight and makes the knowledge accessible to anyone.
On the other hand, the book is for curious minds seeking a nuanced understanding of cancer. It provides a long-term philosophical and scientific reframing that challenges prevailing cancer narratives and can improve how we approach cancer in the future.
It requires a more systemic approach and proposes a different fight—a dialectical one, with information as the key character.
Consequently, although Making Sense of Cancer doesn’t immediately solve our concerns about cancer at a patient level, we need more of this reframing to understand and confront cancer, death, and information.
