Draft:Jarle Breivik

Breivik studied medicine at the University of Oslo, where he obtained his medical degree (MD).^[1] He completed a PhD in cancer biology at the University of Oslo and the Norwegian Radium Hospital in 2000.^[6] In 2014 he earned a Doctor of Education (EdD) from the University of Pennsylvania.^[7]

Breivik has held academic positions at the University of Oslo, where he is head of the Department of Behavioural Medicine, a research unit studying the interaction of medicine, psychology and social science.^[1][8] His research has addressed topics including cancer biology, genomic instability, evolutionary explanations of cancer, and medical education.^[2]

He has published in peer-reviewed journals including the Proceedings of the National Academy of Sciences of the United States of America and EMBO Reports.^[9][10][11]

Breivik has argued that cancer can be understood in part as an evolutionary phenomenon. In Scientific American, the science writer Carl Zimmer discussed evolutionary approaches to cancer and quoted Breivik’s view that cancer is “a fundamental consequence of the way we are made” and that “there is no real solution to the problem” short of changing how humans reproduce.^[3] In this article, cancer risk was described as linked to the biology of multicellular organisms and to natural selection, which favours reproductive success over the prevention of late-life disease.^[3]

A 2003 feature in Scientific American by W. Wayt Gibbs described Breivik’s hypothesis that genetically unstable cells may gain a selective advantage in environments with chronic damage.^[2] According to this account, cells with impaired DNA repair mechanisms may continue to proliferate despite damage, whereas normal cells halt division to repair DNA errors.^[2] Gibbs reported that Breivik used the metaphor of a cellular “war zone” to describe such environments, in which genetically unstable cells may eventually outcompete more stable cells.^[2]

Breivik has also written about large-scale cancer initiatives and public expectations of medical progress. In an opinion article published in The New York Times in 2016, he criticised political rhetoric about “curing cancer once and for all”, arguing that such initiatives may overestimate what current biomedical research can achieve and may underemphasise the links between aging, medical treatment and overall disease burden.^[12]

Breivik has participated in public debate in Norway on cancer, aging and the aims of modern medicine. In a feature article in the Norwegian newspaper VG, he stated that cancer development is closely linked to aging and that increasing cancer incidence is associated with rising life expectancy.^[8] In the same article, he was quoted as saying that cancer is part of the aging process and that individuals who live to advanced age have a high likelihood of developing the disease.^[8]

In interviews and opinion pieces, Breivik has discussed how cancer is framed in public discourse, including the use of metaphors of “fighting” disease and expectations of cure.^[8][13] According to Morgenbladet, he has argued that such framings may obscure broader questions about aging, mortality and the limits of medical intervention.^[13]

Breivik has also commented on the implications of medical progress for population health. In VG, he argued that reductions in early mortality and improvements in treatment contribute to a growing number of older individuals living with age-related diseases, including cancer.^[8] He has supported greater emphasis on prevention and public health measures, including lifestyle and environmental factors, noting that a proportion of cancer cases may be preventable.^[8]

In discussions of end-of-life care, Breivik has referred to arguments by the former BMJ editor Richard Smith regarding different causes of death in old age.^[14] In this context, he has suggested that death from cancer in old age may be comparable to other causes such as dementia or organ failure, while emphasising variation in individual experiences.^[8][14]

Breivik has expressed opposition to active euthanasia. In interviews, he has argued that increased technological control over death may create social pressures on older or seriously ill individuals to end their lives.^[13]

Breivik has appeared in Norwegian broadcast media, including the NRK programme Dagsnytt 18, where he has discussed topics such as longevity, cancer and public perceptions of disease.^[15][16] His views have also been discussed in international science journalism, including a 2013 article in Wired and a 2024 review in Medical Independent.^[4][5]

Breivik is the author of the English-language book Making Sense of Cancer: From Its Evolutionary Origin to Its Societal Impact and the Ultimate Solution (River Grove Books, 2019).^[5] The book discusses evolutionary perspectives on cancer, the relationship between aging and disease, and the implications of medical advances for society. Reviews of the book have highlighted its combination of scientific and philosophical perspectives. In The BMJ, Richard Smith described it as addressing the “meaning” of cancer through a synthesis of evolutionary biology, genetics and reflections on the future of humanity.^[14] Kirkus Reviews described the book as an account that combines explanations of cancer’s evolutionary basis with broader reflections on aging and mortality.^[17]

In Norwegian, Breivik is the author of Løsningen på kreftgåten (Pitch forlag, 2022).^[18] The book presents arguments about cancer, aging and medical progress for a general audience. According to coverage in VG, it discusses cancer as a condition associated with aging and considers broader questions related to longevity and medical intervention.^[8] A review in the Norwegian medical journal Michael described the book as a discussion of cancer in a wider biological and societal context.^[19]

Breivik’s views on cancer and aging have prompted responses from other medical professionals in Norway. In a 2023 feature in the national newspaper VG, Sigbjørn Smeland, head of the Cancer Clinic at Oslo University Hospital, agreed with Breivik that cancer risk increases with age and that living long enough implies a high probability of developing cancer, saying that if you reach 100 years of age you are fortunate not to have cancer.^[8] Smeland highlighted improvements in survival, noting that a growing proportion of patients live at least five years after a cancer diagnosis and that mortality has declined despite rising incidence, and argued that cancer research and treatment aim to reduce suffering and premature death rather than to pursue “eternal life”.^[8]

Geir Sverre Braut, a professor of community medicine at Western Norway University of Applied Sciences and deputy leader of the Norwegian Public Health Association, described Breivik’s arguments in Løsningen på kreftgåten as based on solid and broad knowledge and as not controversial from a medical or natural science perspective.^[8] He characterised the book’s questions as thought‑provoking and challenging, particularly regarding aging, demographic change and the need to live with age‑related conditions such as cancer and dementia, and argued that societies will have to learn to live with cancer and dementia as common conditions in old age.^[8]

In Scientific American, Breivik’s ideas have been presented as part of broader discussions of evolutionary perspectives on cancer and the difficulty of eradicating the disease given its roots in basic biological processes.^[3][2]