From the title, one might think this is a work of theodicy with a special focus on cancer. But it is not. Rather, it is a work of practical theology: in the context of faith in the goodness of God, it aims at cultivating faithful understandings and wise responses to living in a world in which cancer exists.
The first part of the book is an excellent summary of what cancer is and how it develops, easily understood by nonspecialists. It shows persuasively that cancer is a disease of evolution, operating by the same mechanisms that enabled the evolutionary emergence of humans and all life. This sets the problem addressed in the second part of the book: given that God is Creator (and good), and accepting that evolution is an essential feature of this world and cancer a virtually inevitable result of the mechanisms of evolution, what might be faithful understandings and wise responses to cancer?
In the second part of the book, the authors develop their practical theology of cancer. They first survey evolutionary theologies that produce the faithful understanding and wise response of acceptance. Cancer is part of the natural process of evolution, and one can still maintain faith in God's goodness and love in the face of this fact. They then survey theologies emphasizing eschatological hope. Trusting in the promises of God in Scripture (e.g., Isa 11:6–7; Rev 21:3–4), one can hope that God in some way will bring about a world without the suffering and pain of cancer. The authors argue that both theologies of acceptance and hope are faithful understandings and wise responses to a world in which cancer exists.
The final chapter seeks to formulate a theology of “the love of God in, with, and under the chance and necessity of cancer” (120). They survey the nonreligious view of Jacques Monod stressing that chance and necessity govern the evolutionary world, as well as the religious interpretations of Arthur Peacocke and Charles Sanders Peirce that God's love is somehow active in this evolutionary world. Asking how God's love might be at work, the authors offer two possible ways of affirming God's loving activity. Number one: relying on Luther's doctrine of the hidden God, they argue that one can understand scientific advances in the understanding and treatment of cancers as God's covert action to alleviate the suffering of cancer and bring about its healing. And two: theological symbols and stories of hope in the face of cancer witness to God's loving presence in, with, and under the experience of cancer's suffering. This, too, one can understand as God's action, grace that both reveals and makes real God's love for the world, even with the reality of cancer in it.
On the last page of the book (170), the authors offer a very thought-provoking and beautiful idea: that those who suffer from cancer are suffering for all humanity, paying the (redemptive?) price for our evolution. However, they do not develop this idea.
I have two critical comments. First, the understanding of how God acts in an evolutionary world is minimally developed in this book. Even though the authors refer to John Polkinghorne's theology, they do not engage his suggestions concerning how God acts. Nor do they engage Arthur Peacocke's suggestions about divine action, even though they rely on his testimony regarding his own cancer. Although they suggest that God is at work in scientific advances in cancer research and treatments, one wants to ask specifically how God does this. Perhaps the authors regard such questions as going beyond the bounds of practical theology, but they are questions that naturally arise from their suggestions.
Second, the authors accept the binary understanding of evolution as governed by chance and necessity. Although this has been the standard view in biology, complexity theory—which has been receiving increasing attention in the science-religion dialogue—offers a more subtle understanding of evolution. It alters the rigid outlook of the “chance and necessity” rubric and might make it easier to develop understandings of God's action “in, with, and under” the evolutionary world.
