Of drug administration, war and oïkos: mediating cancer with nanomedicines

Abstract

This paper focuses on nano-enabled drug delivery systems (NDDS) in the context of cancer medicine. It regards NDDS as relational objects whose modes of existence are defined by their relationships with a complex biocultural environment that includes both the biological processes of our bodies and the values representations and metaphors our societies associate with cancer and cancer therapy. Within this framework the abundant use of war metaphors in NDDS – from ‘smart bombs’ to ‘magic nano-bullets’ – is discussed from various angles: in terms of therapeutic efficacy, it limits the potential of the technique by preventing the inclusion of the (patho)biological environment in the nanomedicine's mode of action. In terms of development opportunities, the military strategy of active specific targeting faces cost and complexity bottlenecks. In terms of ethical values, it favors the questionable image of cancer patients as ‘fighters’. On the basis of these criticisms different metaphorical frameworks are suggested, in particular that of oïkos, whereby nanomedicine is reframed as a kind of domestic economy addressing the system–environment relationships of embodied processes with further imagination and care.