Modern biology, echoing the philosophical debate between Parmenides and Heraclitus, is torn between the dualities of permanence and change. Our scientific understanding begins with “epistemic cuts” that divide the seamless fabric of life into analyzable units: gene versus cell; cell versus tissue; and organism versus environment. Yet, living systems are not aggregates of parts but emergent wholes: coherent networks of dynamic interactions across space and time. Cancer, long conceptualized as a cluster of autonomous mutant cells, is increasingly understood as a collective, multiscale, integrative phenomenon. As Krakauer and colleagues propose, individuality in biology is fluid; cancer shifts between clonal autonomy, environmental dependency, and multicellularity, traversing identity states that defy binary categorization. Metastasis, for instance, reveals cancer as a distributed living system composed of spatially distinct but functionally connected nodes. Insights from Rashevsky’s relational epimorphism and Miller’s living systems theory remind us that biological architecture, despite appearing very different at the cellular or organismal level, has fractal-like functional similarity. The nested hierarchies of life operate through horizontal and vertical feedback loops of energy, matter, and information, underscoring the need to study cancer as a system, not merely as a genetic aberration, or as a cellular or tissular disease. Moreover, the relationship between biological forms and processes needs a novel formalism that transcends analytic reductionism and models the complexity of dynamic, multiscale evolving systems. While physics often gleans equations from structure, in biology, form is contingent to process, not just a blueprint of physical or chemical laws. The true nature of cancer lies in flow, in context, in transitions.