Metastasis: The Rise of The Cancer-Industrial Complex and The Horizons of Care by Nafis Hasan (Common Notions Press, 2025)
In his recent book, Metastasis: The Rise of The Cancer-Industrial Complex and The Horizons of Care, Nafis Hasan describes the origins of the “cancer-industrial complex.” Hasan illuminates how a sinister alliance between government, industry leaders, and non-profit organizations maintains a cancer drug industry that relies on the exploitation of scientific workers and patients, from their finances to their genes. He argues that the cancer-industrial complex affects everyone, and like capitalism, metastasizes and subsumes to the point that the predominant modes of treatment are those that can be commercialized.
Hasan first shows us how there has been a known link between workplace exposure to toxins and cancer since at least 1775, when British surgeon Percivall Pott discovered that England’s chimney sweeps (children as young as four years old) developed scrotal cancer later in life. These links were made consistently throughout the Industrial Revolution, as incidents of cancer rose alongside the expansion of factories pumping smoke into the air. Cancer rates spiked among workers in petrochemical industries after the introduction of fossil-fuel powered technology. This evidence, Hasan explains, is at the heart of “the environmentalist thesis,” whereby incidents of cancer are driven by exposure to harmful chemicals in the environment and workplaces.
The evidence that most human cancers are caused by environmental exposures, and are therefore preventable, has been widely endorsed, including by the World Health Organization, international cancer research agencies, and major labor unions in the United Kingdom and United States like the former Oil, Chemical and Atomic Workers Union (now part of United Steelworkers). Despite this, scientific research under capitalism and decades of neoliberalism (resulting in cuts to industry regulations) has instead focused its attention on causes located in genetic mutations, otherwise known as the Somatic Mutation Theory (SMT).
Hasan critiques the evidence and capitalist interests underpinning SMT, which serves as the basis for commercialization of drug treatments. Guided by SMT, widespread efforts to “find a cure” are rationalized by neoliberal governments and cancer drug corporations gazing at the bodies of working class people as sites of experimentation, testing, and profit through new and expensive treatments. For capitalists, Hasan notes, “Finding a cure is a more profitable endeavor than prevention”.
The logic of cancer drug development is focused on identifying what researchers term cancer-causing “oncogenes,” part of the over twenty thousand proteins in our bodies, which have each been commodified as a target for drug treatment. This focus, in addition to a widespread discourse on finding a cure and cancer survivorship, facilitates a war-like drive on the part of corporations, and the allied corporate university conducting their research. This industrial complex drives the cancer research industry toward increasing taxpayer funding to individual research labs who in turn seek to maximize profits for corporations, rather than finding opportunities for cancer prevention, public health protections, and the regulation of industry that produce harmful chemicals into the atmosphere.
In 1995, five of the best-selling cancer drugs were developed by publicly funded research, with each bringing more than $1 billion USD a year to their respective companies. This arrangement eliminates or reduces risk to companies because taxpayers cover the research and development costs, before companies then profit from drugs sold to cancer patients whose taxes funded the drug development in the first place. In a particularly insidious system, profit maximization is enabled by drug prices determined ‘by the market’ and a captive consumer base (cancer patients who need treatment). The cancer-industrial complex serves profits over people by keeping patients alive longer at exorbitant costs to continue to develop new drugs and maintain the cycle.
Drawing on his family’s experience with the financial hardship of treating cancer, and many years of study and work in cancer research, it is clear that Hasan’s indictment of the neoliberalized cancer industry comes from a place of deep knowing, and belief in an alternative. Hasan’s outrage at the corporations profiting from patients’ sickness is palpable, and would be shared by anyone reading his analysis. Indeed, Hasan cites organizers such as the Union for Affordable Cancer Treatment who “fight for cancer treatment and care to be affordable and available, everywhere, for everyone who needs it.”
In the current context of Trump’s America, deregulation and austerity measures are flourishing, including cancelling the development of vaccines for HIV and avian influenza H5N1, a life-threatening disease with pandemic potential. One can only imagine the uphill battle required to struggle away from the “capitalist totality” acutely felt by cancer patients who face no choice but to exhaust their savings—risking poverty, itself a known cause of cancer—for a chance at delaying the cancer’s progression and hopefully going into remission.
Hasan reminds us that health justice is not possible without justice for all. He calls for government regulators to adopt the Precautionary Principle (as many European countries have done since the 1980s) to prevent use of substances harmful to human health or the environment, even if a causal relationship has not yet been established scientifically. He also highlights examples of groups that organizers can draw inspiration from to fight for patients’ rights and for healthy environments free from carcinogens, such as the anti-capitalist Breast Cancer Action group, Sozialistisches Patientenkollektiv (Socialist Patients’ Collective), and ACT UP AIDS activists. Building a healthcare system outside the grip of capitalism, Hasan emphasizes, requires us to build popular movements alongside “housing justice advocates, labor unions, abolitionists and anti-carceral activists, disability rights activists, and everyone else”.
Nafis Hasan provides a brave and insightful critique of the scientific industry and the systems that maintain the status quo. He offers a blueprint for healthcare organizers, patients, and workers—scientists in particular—to untangle and resist the cancer-industrial complex which continues to commodify the bodies of patients down to the microbiological level, routinize the scientific method, and commercialize scientific outputs for the pursuit of profit over people. Hasan grapples with the human, scientific and political elements of the cancer industry with compassion for those it harms. His book moves us toward a horizon to struggle for new ways of doing science, in service of people, public health, and health equity, not commercialization and profits.
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