Tony Ingesson finds it fairly easy to show a bit of attitude in front of the camera. David Gisselsson Nord has a little more difficulty, blaming years of practicing to perfect the right “look of empathy” to meet his patients with. They are a strange couple – both in terms of appearance and profession. Yet they come together over a shared interest in pushing – and working across – boundaries.
“Since Tony conducts research in international cooperation and security, I wondered whether there might be parallels between his area of expertise and the way in which tumours avoid being obliterated by various treatments,” says David Gisselsson Nord.
Tony Ingesson was a slightly doubtful at first, but when David Gisselsson Nord explained how cancer does everything in order to survive, by adapting in response to whichever therapy is deployed, Tony was quickly convinced.
“Today, cancer treatment is on the cusp of a revolution in which increasing numbers of targeted medicines based on the tumour’s molecular composition are used. The problem is that the cancer appears to outsmart these medicines, becoming resistant after a time,” says David Gisselsson Nord.
So, difficult-to-cure cancer can be seen as a struggle with an opponent, one that with the help of evolution adapts itself in a way that resembles human antagonists in international power struggles. If you have this as your starting point, concepts from military strategy and intelligence studies could be transferable to cancer treatment.
“There is something called reflexive control, a term that is used within military and political analysis to describe a method that involves manipulating an opponent in order to achieve your own aims,” Tony Ingesson explains.
Tricking the cancer cells
Since cancer cells cannot plan ahead, but merely react to what they are exposed to, doctors are able to exploit this through switching between targeted medicines to trick cancer cells into being increasingly responsive to treatment, before introducing a medicine that eliminates them.
It is also possible to apply military counter-insurgency methods – abbreviated to F3EAD (find, fix, finish, exploit, analyse, disseminate) – in cancer treatment. This would entail first diagnosing the cancer and then determining the extent of its spread. Afterwards, attempts are made to eliminate the disease, before assessing and analysing the therapeutic benefit of the treatment.
“Unfortunately, today’s methods within cancer diagnosis are not advanced enough when it comes to collecting molecular information about how cancer has reacted to treatment. This is somewhere we could make use of counter-insurgency’s exploit and analyse steps, through examining residual tumours and assessing how various medicines affect their growth,” says David Gisselsson Nord.
New ways of thinking
The theories should be seen as a framework for brainstorming in order to contribute to new ways of thinking as a cancer researcher. Tony Ingesson feels satisfaction at being able to share his knowledge in an area as crucial as cancer research, and finds it liberating to use intelligence analysis in such a refined scenario. In addition, he has also gained several new insights into tumour biology and cancer development:
“Within medicine, there is always a correct answer. In my area, with intelligence theories, it is more difficult to be that concrete. I have many years’ experience of exploiting ambiguity and leaning on the fact that it is ‘my interpretation,’” Tony Ingesson jokes.
The research team already have new things underway. They have, for example, proposed a freestanding course, Medicine in global conflict, for which the faculties of Medicine, Law, and Social Science along with the Swedish Defence University will teach about the overlaps between medicine, law and security policy. The target group includes those working within international research collaborations, international aid, or in standby groups.
“Although, of course, we have to earn our salaries first and foremost, being able to work like this across boundaries at a large university like LU is an extra bonus. In fact, I think I am the only medical scientist in the world collaborating with an intelligence expert,” David Gisselsson Nord concludes.