Abstract
This is a fine work that successfully combines a well-written and very accessible scientific description of the processes that lead to cancer with a thoughtful and wide-ranging discussion of the theological questions that arise from the existence of such a paradoxical disease. The essential thesis is that the processes that lead to cancer are part and parcel of the processes that permitted, and continue to permit, the evolution of life on earth. Cancer, at its basest level, is the survival of mutated cells that go on to prevent the proper functioning of the human body.
Evolution also requires random mutations that, over time, allow organisms with particular genetic advantages to survive in preference to others, and hence adapt to new environments. Therefore, in some ways cancer is just an inevitable side effect of the possibility of life on earth. Here, chance and necessity come into play – chance, because each mutation is (to some extent at least) a chance event, but also necessity, because by careful scientific investigation of the mechanisms involved in tumour development, the existence of such events is, ultimately, essential in our human world. While the science detailed in the first half of their book is generally excellent and very clearly laid out, I am not sure that I entirely accept the hypothesis that exogenous somatic mutations are required for evolution. However, the general point remains, and seems a sensible one: cancer is effectively unavoidable if we are to live in the world we do. The authors do not challenge that world, and it is from that starting point of ‘practical theology’ that they seek to develop their theology – or rather theologies – of cancer.
They essentially set out two different, but complementary, ways of looking at this paradox of cancer – that it is somehow necessary and inherent to our world, and we must find ways of accepting it but also that God has something more in store for us, yet acknowledging the foolishness in trying to nail down the details given cancer’s inevitability in an evolutionary world.
In many ways, this book frames many familiar arguments, including the problem of pain and passability, in the context of cancer, with a good dose of Luther, as would be expected from these authors. Their own theological sense is certainly that of a kenotic God and not a God of the gaps, and they both highlight and to some extent resolve the tension inherent in their two theological paths by suggesting that God is seen in scientific developments and medical treatments, in excluding carcinogens, in human empathic responses, and in other signs of God’s love in meeting the disease and the hope of overcoming it. This, to them, is wisdom – the ability to cope with the world as it is, while trusting in God to reveal something beyond. Cancer is no longer a ‘problem’ to be solved theologically, but part of the mystery of the created order and a loving creator. Ultimately, theirs is a theology of hope and trust, where we ‘search… for the meaning of the world with these features [cancer] within the love of the crucified God for creation’ (p. 143).