Origin of cancer

Eva Kamerer, associate professor at the Department of Philosophy of the Faculty of Philosophy in Belgrade, deals with the philosophy of science, philosophy biology and evolutionary ethics. Her book Fierce rival (Fedon, Belgrade 2024), which should also be called philosophy cancer, summarizes and deepens contemporary scientific, medical, biological, but also philosophical perspectives on a vicious disease that he will alternately call a rival and an opponent in the book. The results of her research show that the causes of cancer today, among other things, are more to be found in the cellular structures themselves than in external circumstances. The basic question is: how to understand the "behavior" of cells affected by cancer?

"WEATHER" Why did you call cancer a rival in the title of your book?, and no, let's say, opponent (so that we could, maybe, expected)?

EVA KAMERER: The title of the book is inspired by the National Act by which Richard Nixon in 1971 declared the beginning of the "war on cancer". In this document, cancer is characterized as terrifying and insidious. And we must agree that such a characterization is completely justified. "Cruel" in my title is associated with exactly that: cancer is not cruel, it is not brutal, it is much more ferocious, that is, perfidious and merciless. When I decided to put the word rival and not adversary in the title, a word I also use in the book when talking about a malignant tumor, I think I was guided by the sound effect at first. That alliteration, the repetition of the s sound, combined with the meaning of the title, should cause anxiety in the listener. However, it seems to me that we can also talk about the meaning aspect. Although "rival" and "adversary" have the same meaning, there are very specific contexts in which we will prefer to use the former rather than the latter. Let's say, a love triangle comes to mind: the man with whom we compete for the girl will be labeled as our rival. In other words, the "rival" hides a much greater emotional charge than the "adversary" and seems to be reserved for situations in which the difference between love and hate, between the self and the other, is not entirely clear. This is exactly the case with cancer. It is created by the transformation of our own cells and brings ominous disorder into the space of the organism that survives thanks to the coordinated cooperation of its parts.

Science and medicine have a monopoly on the interpretation of cancer and, of course, to fight him. Where is the philosophy in this??

Cancer research has a long history that in many ways resembles the history of other research in science. But it also hides one specificity that, in my opinion, makes it quite special. Since the subject of research is an extremely complicated disease that has a very painful course and often leads to death, the public always expects great discoveries and final solutions from cancer scientists. I suspect that this fact has a retroactive effect on the self-perception of cancer researchers. Thus, an interesting thing happened: the situation in this research area was defined as a permanent crisis that cannot be resolved. Although I do not agree with all theses of Thomas Kuhn, the modern philosopher of science, one is very close to me. Kuhn says that in times when science falls into crisis, philosophy enters the scene. Something similar can indeed be observed in the study of cancer: although scientists have collected a huge amount of empirical data on the origin and spread of cancer, although medicine is technically more powerful than ever before, it seems that an adequate perspective is missing that would allow them to look at cancer in a new and potentially more productive way. This of course does not mean that philosophy can lead to the design of new cancer drugs, but perhaps it can change the way scientists see cancer, or at least draw their attention to the limitations of their research methods. I believe that this is precisely why there are more and more philosophical books about cancer.

You say that philosophy offers a different perspective. How would you describe (explained) that perspective?

In the book, I found support in a style of thinking that had already been developed in evolutionary biology, and I tried to show that such an approach often leads to productive explanations that can move science forward. I will present it in a simple way: when scientists are faced with such a complicated problem as the origin and spread of cancer, they sometimes reach more significant results if they present the cancer as something else, say as a population of bacteria or as an actor that behaves strategically, etc., than if they limit themselves only to the analysis of empirical data. In such a situation, the philosopher is the one who points out the meaning and acceptability of the mentioned procedure, he makes the new perspective clearly visible. And another point here is significant: when science is no longer understood as a collection of facts guided by the hope that an explanation will emerge from them, it becomes much closer to philosophy, because it is obvious that science also needs a significant amount of speculation in order to successfully solve problems.

"Causes of cancer", you write, "they cannot be reduced to modern risk factors". What does that mean and what causes do you focus on??

Your question hits the central theme of my book. As we know, the occurrence of cancer is usually explained by the influence of harmful factors that lead to genetic mutations or changes in gene expression. In other words, the disease is linked to current circumstances. And there is really no doubt that they are of great importance. However, in modern science there is another direction in cancer research that relies on the theoretical resources of evolutionary biology. It is a set of hypotheses that shed a whole new light on the origin of cancer and that could be very valuable in the search for optimal therapy. For example, according to one of the evolutionary hypotheses, the appearance of cancer is actually a return to evolutionary early forms of life, in which a part of our organism becomes independent and establishes a new organization, similar to that of a colony of single-celled organisms. It is clear that such hypotheses require a completely different theoretical context than the one we find in the dominantly genetic interpretation of cancer: the organism is no longer viewed in the usual way, but as a society of cells that have established a stable cooperation during long organic evolution. Thus, viewed from an evolutionary perspective, cancer appears as a rival that we may not be able to eliminate, since it is a remnant of the natural history in which we arose. So it's probably better to accept him as a legitimate doppelgänger to live with. Efforts in modern medicine to keep this disease under control, as well as some other chronic diseases, are going in that direction.

Therefore, evolution is at the center? And cancer goes through a process of evolution?

photo: marija janković

Yes, the subject of my analysis is precisely the evolutionary mechanisms and their potential importance in the processes that lead to the development and spread of cancer. The first major breakthrough of evolutionary biology into cancer research went hand in hand with a significant change in perspective. The emergence of cancer was no longer seen as the appearance of an isolated rebellious cell that broke away from the control of regulatory mechanisms in the body, but as a consequence of the processes taking place in the cell population. Cancer began to be understood as a product of some kind of social evolution. This means that scientists are no longer only looking for differences between normal and cancer cells, but also for the effects of cell interactions. The hypothesis that introduced this new line of research was quite simple: the division of a cell in which genetic mutations have occurred creates a cell population in which, thanks to further mutations, some cells are better able to survive and spread. It is a population in which evolutionary mechanisms, primarily natural selection, operate. Although this hypothesis has some weaknesses, it has certainly remained a powerful explanatory tool in the history of cancer research, moreover, in my opinion, it has enabled cancer to begin to be analyzed in terms of the great evolutionary changes I mentioned earlier.

How cancer cells work together? You write, let's say, on the sociology of cancer cells (What is it, at least at first glance, astonishing)?

We are used to talking about cooperation between people, possibly between animals. However, when it comes to entities that do not possess any consciousness, "collaboration" or "cooperation" seem like completely inappropriate terms. Evolutionary biology has completely changed things in that area as well, because it has made it possible to observe cooperation independently of conscious motives. Thus, if we have actors whose behavior helps other actors to survive and multiply, it is legitimate to talk about cooperation, regardless of the fact that the actors do not possess consciousness. Starting from this assumption, it is quite justified to claim that plants, bacteria or viruses behave cooperatively. Furthermore, biological structures that we do not usually perceive as individuals in the usual sense can also cooperate. In our case, these are cancer cells. A little while ago, I said that in a research program based on evolutionary theses, cancer is presented as an entity in which social evolution takes place: its formation is determined by the mutual interactions of tumor cells, their conflict over the resources that the patient's body provides them, and the cooperation that enables their further progression. "Sociology of cancer cells" is therefore a very appropriate label for research dealing with this aspect of cancer. The concept of the organism as a society of cells is not entirely new, it has been developing since the 19th century and it finds its mature expression in the point of view that in the first half of the 20th century was called the sociology of the cell. The phrase I use when I talk about the social evolution of cancer is just an extension of that point of view.

You write that the gene "the most famous strategist" in biological literature. What it means?

So far we have seen that cancer, like any other biological phenomenon, can be described in different ways. Sometimes these descriptions turn out to be an adequate basis for scientific explanations, and sometimes scientists reject them and search for an alternative approach. Thanks to the fact that scientists began to represent biological entities as actors that behave strategically, that is, as actors whose actions depend on the actions of other actors or other players, they were able to create scientific models whose explanatory power is exceptional. For example, a cancer cell is interpreted as a rational player that reacts to the destructive power of chemotherapy or to the behavior of entities in its microenvironment by adopting a strategy that allows it to adapt. However, it should be emphasized that behavior is understood here in the broadest sense and that attributing strategy to biological objects that are not conscious is associated with difficulties that require great caution. But as long as scientists are aware of these limitations, this circumstance need not worry us much.

What does the world look like to you? (European) philosophical scene, and how is it homemade??

Philosophy has certainly lost its importance in our time. I would say that it is related to the complete dominance of popular culture, which imposes simplicity as the only criterion of acceptability. We know that philosophical concepts are not simple and that it is difficult to present them in a popular and understandable way. Whenever I think about it, I think of Hesse's novel Glass bead game. Hesse describes the modern era as a "feltonistic epoch" in which superficiality and vanity reign. Today's philosophy seems to be trying to survive in such an environment, and in this respect the European and domestic philosophical scenes are not very different. The way in which philosophical problems are written about is too standardized, the aesthetic qualities of philosophical texts are considered unimportant, the questions that philosophers deal with are very specialist. On the other hand, when a concept appears that seeks its foothold in the great ideas of the past, it is usually perceived as anachronistic. Philosophy, obviously, is still "out of date", as Nietzsche liked to say. But I am not a pessimist, I think that this is a period of crisis that philosophy has often gone through during its history. I believe that it will once again be a constitutive element of true culture.

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