The War on Cancer and its discontents
Apr. 17th, 2025 08:13 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
bloodygranuaileLast night I went to see Nafis Hasan at Brookline Booksmith for an event for his book, Metastasis: The Rise of the Cancer-Industrial Complex and the Horizons of Care. I first met Nafis through DSA and had not seen him since he left Boston, so I was looking forward to the event very much. It is cool to know smart and talented people whomst write books! It also was a great talk. In personal triumphs, last weekend I took advantage of the bad weather and my girlfriend’s unfortunate work schedule to make sure that for once in my life I read the book before the event, so I could be prepared.
Metastasis is short but very information-dense, covering a wide range of cancer-related topics, with a focus on the political dimensions of science. We learn about the history of cancer research and specifically of funding for cancer research, and both the scientific and ideological histories of how cancer is understood and what lines of inquiry people expect to find results in. Nafis criticized the overfocus on finding a “cure” and specifically the overfocus on finding a cure via genetics, to the detriment of focus on environmental and occupational cancer risks, even though the biggest factor in reducing cancer mortality in the last few decades appears to have been the generational drop in smoking rates. He highlights the ideological reasons that individualist causes and solutions to cancer dominate the world of cancer research, and the history of the framing of cancer as a matter of militaristic conflict–i.e., the “War on Cancer,” which we’ve been fighting for 50 years now. There’s an infuriating walk through the finances of cancer drug development and pricing, and some interesting comparisons to the way other countries do it, particularly Cuba and Brazil. The most narrowly focused parts of the book explain the issues with Somatic Mutation Theory, which is the current dominant understanding of the causes of cancer; the subjects then expand steadily in scope to a discussion of Marxist biology and the changes in the class position of the working scientist over the past couple of decades.
I am not particularly close to the world of cancer research and found myself a little surprised at the degree to which the, for lack of a better term, official world of Knowing Stuff About Cancer is so closely focused on genetics. I certainly knew that it was accepted that genetics were considered a risk factor, but I don’t think I’d quite realized the degree to which, after telling us all to wear sunscreen and never start smoking, the environmental factors seem to be considered officially cleaned up and all that anyone is researching is genes. I feel like outside the halls of power, especially in the realms of ordinary people, the understanding is alive and well that stuff can give you cancer. This all still seems to stick with a very individualist lifestyle bent, from the ordinary admonitions to wear sunscreen to the more anti-Big-Pharma-to-the-point-of-crankery admonitions to simply go through modern life without interacting with any chemicals whatsoever, which is… sort of a tall order. But the problems with various shady chemicals in our society are very real, and I have to wonder at the relationship between the neglect of Big Pharma/Big Business-Funded Research/Big Lobbyists for Small FDA and anti-science, pseudo-naturalistic “wellness” lifestyle peddling. How am I supposed to know who’s being a crank and who’s not when they tell me “Stay away from that, it’ll give you cancer” when “that” can be basically anything? Idk, maybe I’m surrounded by too many crunchy weirdos of both the left and right flavors that I had stone cold forgotten that I too used to see all the newspaper articles that were like “We are mapping the human genome, and with that we are going to Cure All Cancer Forever,” and it’s been itching my brain all week.
Anyway, that’s my own digression. This book has different digressions! One is on the scientific community’s response to the Republican party’s outright anti-science turn, and the way this both has and has not changed many scientists’ views of science as apolitical (or at least as *supposed* to be apolitical), and the political divide between the centrist inclinations of many scientists who consider themselves non-ideological, and the sort of left insurgency of a high-education, low-wage, mostly younger cohort of a scientific workforce that has been steadily proletarianizing. Another is about America’s fucked-up stupid health insurance system and what aspects of it would and would not be fixed by implementing Medicare for All. There was also a really wild history lesson about Nazi Germany’s research into the links between smoking and lung cancer, and what happened (or, more properly, did not happen) to that research after the war. If this is making it sound like the book is disjointed I can assure you it is not; its topics flow very logically from one another; they start very narrowly and broaden in scope as the book builds its arguments. Also, while I wouldn’t exactly call it easy reading, Nafis is very good about defining his terms so that readers who are not already familiar with the literature of either cancer research or Marxist theory (or both) don’t get lost among terms like “cancer-industrial complex” and “dialectical biology.”
Final verdict is that this is a highly informative, deeply researched, and thought-provoking book that provides a much-needed critique of the state of medical research from a pro-science, pro-patient, pro-organizing point of view. Read it and let it radicalize you.
Metastasis is short but very information-dense, covering a wide range of cancer-related topics, with a focus on the political dimensions of science. We learn about the history of cancer research and specifically of funding for cancer research, and both the scientific and ideological histories of how cancer is understood and what lines of inquiry people expect to find results in. Nafis criticized the overfocus on finding a “cure” and specifically the overfocus on finding a cure via genetics, to the detriment of focus on environmental and occupational cancer risks, even though the biggest factor in reducing cancer mortality in the last few decades appears to have been the generational drop in smoking rates. He highlights the ideological reasons that individualist causes and solutions to cancer dominate the world of cancer research, and the history of the framing of cancer as a matter of militaristic conflict–i.e., the “War on Cancer,” which we’ve been fighting for 50 years now. There’s an infuriating walk through the finances of cancer drug development and pricing, and some interesting comparisons to the way other countries do it, particularly Cuba and Brazil. The most narrowly focused parts of the book explain the issues with Somatic Mutation Theory, which is the current dominant understanding of the causes of cancer; the subjects then expand steadily in scope to a discussion of Marxist biology and the changes in the class position of the working scientist over the past couple of decades.
I am not particularly close to the world of cancer research and found myself a little surprised at the degree to which the, for lack of a better term, official world of Knowing Stuff About Cancer is so closely focused on genetics. I certainly knew that it was accepted that genetics were considered a risk factor, but I don’t think I’d quite realized the degree to which, after telling us all to wear sunscreen and never start smoking, the environmental factors seem to be considered officially cleaned up and all that anyone is researching is genes. I feel like outside the halls of power, especially in the realms of ordinary people, the understanding is alive and well that stuff can give you cancer. This all still seems to stick with a very individualist lifestyle bent, from the ordinary admonitions to wear sunscreen to the more anti-Big-Pharma-to-the-point-of-crankery admonitions to simply go through modern life without interacting with any chemicals whatsoever, which is… sort of a tall order. But the problems with various shady chemicals in our society are very real, and I have to wonder at the relationship between the neglect of Big Pharma/Big Business-Funded Research/Big Lobbyists for Small FDA and anti-science, pseudo-naturalistic “wellness” lifestyle peddling. How am I supposed to know who’s being a crank and who’s not when they tell me “Stay away from that, it’ll give you cancer” when “that” can be basically anything? Idk, maybe I’m surrounded by too many crunchy weirdos of both the left and right flavors that I had stone cold forgotten that I too used to see all the newspaper articles that were like “We are mapping the human genome, and with that we are going to Cure All Cancer Forever,” and it’s been itching my brain all week.
Anyway, that’s my own digression. This book has different digressions! One is on the scientific community’s response to the Republican party’s outright anti-science turn, and the way this both has and has not changed many scientists’ views of science as apolitical (or at least as *supposed* to be apolitical), and the political divide between the centrist inclinations of many scientists who consider themselves non-ideological, and the sort of left insurgency of a high-education, low-wage, mostly younger cohort of a scientific workforce that has been steadily proletarianizing. Another is about America’s fucked-up stupid health insurance system and what aspects of it would and would not be fixed by implementing Medicare for All. There was also a really wild history lesson about Nazi Germany’s research into the links between smoking and lung cancer, and what happened (or, more properly, did not happen) to that research after the war. If this is making it sound like the book is disjointed I can assure you it is not; its topics flow very logically from one another; they start very narrowly and broaden in scope as the book builds its arguments. Also, while I wouldn’t exactly call it easy reading, Nafis is very good about defining his terms so that readers who are not already familiar with the literature of either cancer research or Marxist theory (or both) don’t get lost among terms like “cancer-industrial complex” and “dialectical biology.”
Final verdict is that this is a highly informative, deeply researched, and thought-provoking book that provides a much-needed critique of the state of medical research from a pro-science, pro-patient, pro-organizing point of view. Read it and let it radicalize you.