Reframing Cancer through a Processual Ontology

Cancer research has long been dominated by a gene-centric, substantialist ontology that reduces the disease to static mutations, overlooking its dynamic, relational nature. This letter proposes a processual ontology, inspired by Alfred North Whitehead’s philosophy, to reframe cancer as a system of interactions across genetic, epigenetic, and environmental scales. Evidence highlights non-genetic plasticity in resistance, tissue context in tumor behavior, and ancient survival programs in cancer’s origins. Shifting to this perspective fosters holistic research and adaptive therapies, offering a more comprehensive understanding of cancer’s complexity and promising improved outcomes beyond traditional models.