Cancer, collapse, and the politics of somatic evolution

Michel Salzet

Evolution, Medicine, and Public Health

https://doi.org/10.1093/emph/eoag004

Abstract

Multicellularity rests on a social contract: cells give up autonomy in exchange for shared resources, division of labour, and protection. Cancer is what happens when that contract collapses, and somatic evolution runs loose inside the body. Here, the multicellular social contract is used as a framework to recast tumour suppressors, tissue architecture, and immune surveillance as enforcement devices, and cancer as a ‘rogue society’ where cheater lineages exploit public goods, remodel niches, and build hierarchies. This perspective links clonal evolution, phenotypic plasticity, and therapy resistance to the ‘politics’ of rules and enforcement, and points towards therapies that do not just kill malignant cells but actively reshape the conditions under which somatic evolution proceeds.