Why the Fight Against Terrorism Is like the Fight Against Cancer

A new war metaphor for cancer.

Posted Oct 02, 2011

Over the past several years, the approach to fighting the insurgencies in Iraq and Afghanistan has undergone a big change. The new strategy was spearheaded by General David Petraeus when he took command in Iraq in 2007, soon turning the war around for the coalition forces after years of failure. The troop "surge" of that year, when 20,000 additional American soldiers were deployed to Iraq, was designed to implement this new strategy. Within a couple years, civilian and coalition casualties dropped and the situation on the ground had improved enough so that most coalition forces could withdraw.

One way to understand the new model of counterinsurgency is by comparing it to something that's more familiar to us—the collective fight against cancer. The campaigns against cancer and terrorism are no doubt different in many ways, but they share an important feature based on how they've changed over the years: Both have progressed from attacking the enemy head-on to a more indirect plan of attack.

Fighting Cancer

One of the earliest approaches to treating cancer was to tear into it and extract it from the body—with the innovation of anesthesia in the 1840s, surgery became the standard practice for dealing with tumors. Unfortunately, this often meant removing substantial chunks of surrounding muscle and nerves along with the tumor. Without microscopes or a basic understanding about what cancer was, surgery was the only real hope of success, though its success rate was very low.

The next milestones in cancer treatment were radiation therapy (first used around 1900) and chemotherapy (the 1940s). Like surgery, their goal is to eliminate cancer from the body, but risk collateral damage of destroying healthy body parts. Furthermore, none of these treatments can guarantee that all the cancer will be obliterated, or that it won't return someday.

We've learned a lot about cancer over the years, with the toughest lesson being that there's no magic bullet for most types of cancer, no universal cure. This reality has transformed the fight against cancer from one of aggressive treatments, to one of prevention and maintenance of overall health. In other words, the prevention of cancer has become the "cure" for cancer. This means primary prevention, like a healthy diet, exercise, and avoiding cigarettes and other carcinogens. It also means secondary prevention—identifying and treating cancer in its early stages, with screening procedures like colonoscopies, breast exams, and pap tests.

Surgery, chemo and radiation therapy are still used, of course, but only when necessary. The key difficulty with these direct approaches is that cancer inhabits the body's normal infrastructure and functions, making it tricky to separate the cancer cells from the healthy, non-cancerous cells. The two are similar in most ways, but cancer cells usually just have a few screws loose that cause them to go haywire and do damage.

Fighting Terrorism

In the early years of the Afghanistan and Iraq wars, the counterinsurgency strategy was enemy-centric—the primary objective was to kill as many insurgents as possible using overwhelming firepower and superior technology.

The hitch, as we've seen, is that many civilians are caught in the crossfire, along with the difficulty of eliminating an enemy who blends in with the population at will. This is precisely why insurgents fight this way and exploit the population as they do, so standard military tactics are not only ineffective against them, but counterproductive. In other words, the enemy-centric strategy wasn't working in Iraq because it played to the insurgents' strengths; this is the strategy they were anticipating and this is why they were winning. A different approach was needed.

The newer model of counterinsurgency, rather than being enemy-centric, is population-centric. Here, the first and foremost goal is to protect the civilian population. After that, the overall strategy is more political than militaristic—it seeks to "win hearts and minds" of the locals and get them on your side. This is done by developing durable alliances with the people and their leaders, building stable institutions and governance, stimulating economic development, and giving the people the means to govern and protect themselves. All this makes the people less vulnerable to intimidation and exploitation by the insurgents.

However, killing insurgents remains a critical part of this overall strategy, such as targeted killings (e.g., bin Laden) and small-scale offensives carried out away from civilians. This enemy-centric component, though important, is still secondary to the larger goal of securing and strengthening the population.

Thus, the campaigns against terrorism and cancer have both shifted to become less enemy-centric and more population-centric—they're less about attacking the enemy directly and more about nurturing what's valuable to us.


Kilcullen, D. (2009). The accidental guerrilla: Fighting small wars in the midst of a big one. New York: Oxford University Press.

Mukherjee, S. (2010). The emperor of all maladies: A biography of cancer. New York: Scribner.