Towards a Relational Ontology for Cancer

To account for carcinogenesis and cancer dynamics, in this chapter I present a Dynamic and Relational View and a Relational Ontology of biological levels and processes. From an ontological point of view, I claim that the multilevel phenomenology of cancer reveals the peculiar dynamic organization of metazoans, that I characterise through the concepts of ‘multi-unity’ and of Operational Integrating Systems, in which we have a new mode of causality: causation ‘by holding’ as opposed to causation ‘by doing’. From an epistemological point of view, I argue that our attention should be directed primarily to the regulation and organization principles, only secondarily to the single levels that are maintained or disrupted in the hierarchical dynamic organization of living entities. Overcoming the priority of mereology (i.e., a default assumption of parts-whole organization), I get to a strong notion of emergence: constitutive, synchronic and reflexive emergence. I apply this framework to interpret why different levels of biological organization are always involved in cancer onset, and how they can be causally relevant (genes, for example, are relevant as far as they participate in the organizational structure of biological levels). Finally, I set up a view of cancer as imbalance between processes of differentiation and proliferation, and between heterogeneity and homeostasis.