An interdisciplinary team has examined public perceptions about nanomedicine and nanotechnology relating to cancer treatment and are now urging for more community engagement around future developments and research in this area.
Nanomedicine has the potential to introduce brand new methods of delivering drugs through the skin, eyes and mucus membranes using creams, eye drops, nasal sprays and more. These developments have the potential to be used in a variety of medical fields including in curing cancer or treating it over a long period.
However, these new techniques also create new social and ethical concerns as they may also have cosmetic or aesthetic effects, such as aiding with scar tissue, rashes or dryness, as well as fighting the cancer directly.
The study1, which was conducted by scientists at the University of New South Wales and published in Nanomedicine: Nanotechnology, Biology and Medicine, examined these social and ethical considerations through semi-structured interviews with 12 participants engaged in cancer research and healthcare.
The findings of these interviews revealed three distinct narratives which shaped how the public viewed the development of new cancer treatments that had these types of cosmetic effects.
The ethics of cancer treatment
The paper’s lead author, Geneviève Duché of UNSW’s School of Chemistry, told Lab Down Under that she had always been interested in developing a skin-based drug delivery system using nanotechnology after seeing those in her family struggle with needles and pills.
For cancer, Duché said that drug delivery systems through the skin could be used to do more than treat this terrible disease.
“It could also be used to treat the effect of the treatment itself. Because it goes through the skin, you could have something else in that drug delivery that could help with the scarring, skin dryness, etc., which is how the aesthetics and cosmetics of cancer treatment came into the project.”
While these types of treatments had possible benefits beyond actually curing cancer, their aesthetic and cosmetic outcomes were what caused these additional social and ethical considerations to emerge, Duché said.
A failure in public outreach on nanotech
The most important ethical consideration that emerged from the study was the need to engage the public in this type of research, Duché told Lab Down Under.
“We need to understand what the real problems are and what people are interested in rather than inventing or thinking up problems and trying to solve those through research. By having a larger involvement of the public, hopefully the science we do will be more widely understood and accepted.”
The disjoint between the goals of scientists and the community was created in part because of the way nanotechnology had been framed in public discourse, Duché said.
“When we talk about nanotechnology, we use a lot of words and metaphors that come from warfare — so we have the war on cancer, we have the magic bullet, or the therapeutic missile. I don’t know about you, but when I hear these words, I’m a bit afraid. So I may wonder whether these things are toxic or whether they have risks.”
Risk and toxicity of nanomedicine was also at the forefront of people’s minds because of the way the topic had been portrayed in science fiction, she said, pointing to Bill Joy’s grey goo2 where tiny uncontrolled replicators obliterate life on Earth, or the Michael Crichton novel Prey3 in which a cloud of intelligent nano-robots escapes from a US lab.
A tale of three narratives
The study aimed to bridge the gap between scientists and the community by examining public views on cancer treatment using nanomedicine and skin-based drug delivery systems.
Semi-structured interviews were conducted with 12 individuals including cancer researchers, representatives of cancer support groups, social scientists and cancer thrivers. After reviewing the transcripts from these interviews, two broad views were uncovered between those who felt the need to cure “at all costs” and those who wanted a more holistic approach.
Three narratives were also revealed by sitting down and talking to these individuals about nanomedicine, cancer treatments and any aesthetic implications:
- A continuum between cancer treatment and post-treatment describing the importance of thinking about post-treatment care while attempting to cure the cancer itself
- The existence of a trade-off in prioritising the treatment of cancer and quality of life and questions around when you stop trying to cure at all costs and instead focus on the comfort of the patient
- A view of post-treatment considerations as unnecessary or “frivolous” in which the aftermath of the treatment, such as aesthetics, was thought to be insignificant
When asked about the sample size of the interview group, Duché said that 12 was a large enough number considering that the responses were not meant to be statistically representative of the wider Australian population anyway. Instead, the research aimed to examine responses in a qualitative rather than quantitative way.
Embedded research and community outreach
For future studies on nanomedicine and cancer treatments, Duché said that research teams should consider the social implications of their work.
“I don’t advise every scientist to go outside and do social science, because that is really, really time consuming and difficult. But I think science would be better and would benefit from having a social scientist in every research group.”
Currently research was being conducted the wrong way around, she said, with ethics considerations only being examined at the end of a potential technological development.
“So we often ask questions that are irrelevant because the product is already there. And I really think the ethical questions should actually frame the technological development and help it evolve and grow.”
For example, cancer researchers could reach out to the community and ask whether aspects such as screening and prevention should be prioritised instead of cures.
“If we ask the public about an issue that the public wants done rather than simply trying to find a treatment, maybe that could also influence the kind of research that we do,” Duché said.
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1 Duché G, Thordarson P, Kearnes M. The importance of reflecting on treatment and post-treatment care when assessing the social aspects of cosmetic nanomedicine and transdermal delivery system. Nanomedicine: Nanotechnology, Biology and Medicine. Volume 28, August 2020, 102214.
2 Joy B. Why the future doesn’t need us. Wired, April 2000.
3 Crichton M. Prey. Published by HarperCollins, 2002.