1 00:00:05,720 --> 00:00:08,600 Speaker 1: Hey, welcome to Stuff to Blow Your Mind. My name 2 00:00:08,640 --> 00:00:11,320 Speaker 1: is Robert Lamb and I'm Joe McCormick. And today we're 3 00:00:11,320 --> 00:00:13,680 Speaker 1: going into the vault for an older episode of the show. 4 00:00:13,720 --> 00:00:18,040 Speaker 1: This one originally published on July and this is an 5 00:00:18,120 --> 00:00:21,079 Speaker 1: interview I did with Cat Arnie, the author of a 6 00:00:21,120 --> 00:00:24,520 Speaker 1: book about cancer and evolution, last summer. This was an 7 00:00:24,560 --> 00:00:30,400 Speaker 1: interesting interview, so we hope you enjoy it. Welcome to 8 00:00:30,400 --> 00:00:33,760 Speaker 1: Stuff to Blow Your Mind, production of My Heart Radio. 9 00:00:39,840 --> 00:00:42,000 Speaker 1: Hey are you welcome to Stuff to Blow Your Mind. 10 00:00:42,240 --> 00:00:45,360 Speaker 1: My name is Robert Lamb and I'm Joe McCormick, and 11 00:00:45,479 --> 00:00:48,840 Speaker 1: today we're bringing you another interview that I conducted last 12 00:00:48,840 --> 00:00:51,760 Speaker 1: week while Robert was taking a break from work. That's right. 13 00:00:51,880 --> 00:00:55,440 Speaker 1: Once a year, I like to bury myself in some 14 00:00:55,840 --> 00:00:59,680 Speaker 1: sacred imported soil and allow my my body to break 15 00:00:59,760 --> 00:01:02,480 Speaker 1: down and the reconstitute itself so that I can rise 16 00:01:02,600 --> 00:01:06,520 Speaker 1: once more and be up to the challenges of podcasting 17 00:01:06,560 --> 00:01:08,960 Speaker 1: in this day and age. Today we are going to 18 00:01:09,080 --> 00:01:12,360 Speaker 1: be sharing the conversation that I had with the British 19 00:01:12,400 --> 00:01:17,240 Speaker 1: geneticist and science communicator Cat Arnie talking about her upcoming book, 20 00:01:17,360 --> 00:01:21,480 Speaker 1: Rebel Cell Cancer Evolution in the New Science of life's 21 00:01:21,520 --> 00:01:25,320 Speaker 1: oldest betrayal, so a little bit of biographical information. Cat 22 00:01:25,440 --> 00:01:29,840 Speaker 1: Arnie hosts the Genetics Unzipped podcast and she holds a 23 00:01:29,920 --> 00:01:34,120 Speaker 1: PhD in developmental genetics from Cambridge University. She was a 24 00:01:34,200 --> 00:01:37,720 Speaker 1: key part of the science communications team at Cancer Research 25 00:01:37,880 --> 00:01:42,039 Speaker 1: UK from two thousand four to co founding the charity's 26 00:01:42,080 --> 00:01:46,080 Speaker 1: award winning science blog and acting as a principal media spokesperson. 27 00:01:46,400 --> 00:01:50,680 Speaker 1: She's also the author of Hurting Hemmingway's Cats, Understanding How 28 00:01:50,720 --> 00:01:54,520 Speaker 1: Our Genes Work and How to Code a Human and 29 00:01:54,600 --> 00:01:58,320 Speaker 1: she's written for Wired, The Daily Mail, Nature Mosaic, New 30 00:01:58,400 --> 00:02:02,920 Speaker 1: Scientist and more, and presented many BBC radio programs. You 31 00:02:02,960 --> 00:02:07,400 Speaker 1: can find Cat Arnie on Twitter at at cat Underscore 32 00:02:07,480 --> 00:02:11,079 Speaker 1: Arnie a r in e Y and I should note 33 00:02:11,080 --> 00:02:13,400 Speaker 1: that the book is coming out at different times in 34 00:02:13,480 --> 00:02:16,120 Speaker 1: the UK in the US, so Rebel Cell can be 35 00:02:16,160 --> 00:02:20,320 Speaker 1: found in the UK starting on August six, and then 36 00:02:20,440 --> 00:02:22,640 Speaker 1: in the US. I believe it's coming out on September 37 00:02:22,680 --> 00:02:25,440 Speaker 1: twenty nine, but you can go ahead and preorder it online. 38 00:02:25,840 --> 00:02:27,720 Speaker 1: All right, Well, I'm I am in a rare position 39 00:02:27,760 --> 00:02:30,480 Speaker 1: here because I am just like the listeners out there. 40 00:02:30,520 --> 00:02:33,480 Speaker 1: I have not heard this interview yet myself. So I 41 00:02:33,520 --> 00:02:36,520 Speaker 1: am excited, uh to to to listen in as she 42 00:02:36,520 --> 00:02:42,840 Speaker 1: sheds light on this, uh, this fascinating topic. Cat Arnie, 43 00:02:42,880 --> 00:02:45,200 Speaker 1: thanks so much for joining us today on the podcast. 44 00:02:45,680 --> 00:02:48,400 Speaker 1: Thank you for having me. It's an absolute pleasure. It's 45 00:02:48,400 --> 00:02:50,120 Speaker 1: a pleasure to have someone on the show who has 46 00:02:50,240 --> 00:02:52,160 Speaker 1: not only written a great book, but you are actually 47 00:02:52,200 --> 00:02:55,240 Speaker 1: a podcaster yourself. So you're so you're used to this 48 00:02:55,280 --> 00:02:58,160 Speaker 1: whole game talking into the mic with alone by yourself 49 00:02:58,200 --> 00:03:01,200 Speaker 1: in a room. Yeah. I've been making the Jannetix Unzipped podcast. 50 00:03:01,520 --> 00:03:03,520 Speaker 1: I do have to say that through this time, we've 51 00:03:03,600 --> 00:03:06,560 Speaker 1: we've deliberately made it a COVID free zone, so it 52 00:03:06,639 --> 00:03:10,480 Speaker 1: is currently a COVID free genetics podcast. So that's been 53 00:03:10,680 --> 00:03:13,240 Speaker 1: that's been a nice thing to do during during this time, 54 00:03:13,400 --> 00:03:15,000 Speaker 1: I got to say I was listening to one of 55 00:03:15,000 --> 00:03:17,480 Speaker 1: your episodes of the gene Lex un Zip podcast, the 56 00:03:17,480 --> 00:03:20,600 Speaker 1: one about Maud Sly and Pauline Grows, which I thought 57 00:03:20,639 --> 00:03:23,440 Speaker 1: was fantastic. Of course it connects to the book that 58 00:03:23,440 --> 00:03:26,800 Speaker 1: we're going to be talking about today. So personal endorsement 59 00:03:27,400 --> 00:03:30,480 Speaker 1: from me of your podcast. Don't really like it? Thank you. Yeah, 60 00:03:30,480 --> 00:03:32,600 Speaker 1: it's really fun. We we alternate. We do sort of 61 00:03:32,639 --> 00:03:35,160 Speaker 1: interviews with scientists who are working now in genetics. But 62 00:03:35,200 --> 00:03:37,520 Speaker 1: I also really like to go back through those stories 63 00:03:37,560 --> 00:03:40,840 Speaker 1: and dig out, particularly the untold women who were often 64 00:03:40,880 --> 00:03:43,560 Speaker 1: they're doing the work, doing lots and lots of stuff, 65 00:03:43,680 --> 00:03:48,480 Speaker 1: incredibly detailed observations and breeding experiments, and then basically didn't 66 00:03:48,480 --> 00:03:50,920 Speaker 1: really get the credit for it, because until the middle 67 00:03:50,920 --> 00:03:54,120 Speaker 1: of the twentieth century or later, women weren't really respected 68 00:03:54,120 --> 00:03:57,240 Speaker 1: as a scientist. So it's it's just a wonderful expliration 69 00:03:57,240 --> 00:03:59,800 Speaker 1: you come up with all these incredible people, although of 70 00:04:00,320 --> 00:04:02,360 Speaker 1: in the early century lots them do turn out to 71 00:04:02,360 --> 00:04:07,040 Speaker 1: be eugenicists, but different podcast I think, yeah, So I 72 00:04:07,080 --> 00:04:10,760 Speaker 1: think maybe a good place to start when talking about cancer. 73 00:04:10,800 --> 00:04:13,520 Speaker 1: Of course, your book is about cancer, and specifically a 74 00:04:13,560 --> 00:04:16,600 Speaker 1: lot about the genetics of cancer. I wanted to maybe 75 00:04:16,600 --> 00:04:20,000 Speaker 1: start off by talking about this strange kind of gut 76 00:04:20,120 --> 00:04:26,400 Speaker 1: feeling or almost superstition that somehow, unlike other diseases, cancer 77 00:04:26,640 --> 00:04:31,560 Speaker 1: is a modern synthetic, uh, some kind of perversion in 78 00:04:31,600 --> 00:04:35,560 Speaker 1: some way against nature, and that it sometimes comes with 79 00:04:35,640 --> 00:04:39,599 Speaker 1: this odd edge of moralism, that cancer is not just unfortunate, 80 00:04:39,960 --> 00:04:43,920 Speaker 1: but it's somehow decadent and an indicator of something wrong 81 00:04:43,960 --> 00:04:46,840 Speaker 1: with our age. Parts of your book indicate to me 82 00:04:46,920 --> 00:04:49,520 Speaker 1: that you've come up against this kind of thinking a 83 00:04:49,520 --> 00:04:52,480 Speaker 1: lot as well. What do you think this sort of 84 00:04:52,520 --> 00:04:57,200 Speaker 1: thinking signifies. I think it's absolutely fascinating. Cancer is not 85 00:04:57,360 --> 00:05:01,320 Speaker 1: a new disease, and that really became abundant clear to me. So, 86 00:05:01,480 --> 00:05:03,839 Speaker 1: just as a little bit of background, I spent twelve 87 00:05:03,920 --> 00:05:07,520 Speaker 1: years working at Cancer Research UK, the UK's biggest cancer charity, 88 00:05:07,920 --> 00:05:10,359 Speaker 1: answering lots of questions from the public, and all the 89 00:05:10,400 --> 00:05:13,280 Speaker 1: time this question comes up. It's like, why me, isn't 90 00:05:13,279 --> 00:05:15,760 Speaker 1: it just a modern disease, Oh, it's all this stuff 91 00:05:15,800 --> 00:05:18,320 Speaker 1: in the air, or it's stress. What what is it? 92 00:05:18,760 --> 00:05:21,680 Speaker 1: And you start to look into what cancer really is, 93 00:05:22,279 --> 00:05:26,960 Speaker 1: and it's it's ancient. It's hardwired into our biology because 94 00:05:27,000 --> 00:05:30,600 Speaker 1: it's just cells doing what they're going to do. Cells multiplying, 95 00:05:30,920 --> 00:05:35,160 Speaker 1: cells jostling for space, cells competing with the cells around them, 96 00:05:35,240 --> 00:05:39,160 Speaker 1: obeying the processes of evolution. And so when you really 97 00:05:39,200 --> 00:05:42,279 Speaker 1: start to look, it's not surprising that you find cancer 98 00:05:42,360 --> 00:05:45,039 Speaker 1: going all the way back through human history, all the 99 00:05:45,040 --> 00:05:48,320 Speaker 1: way back through the history of animal life on this planet. 100 00:05:49,080 --> 00:05:51,600 Speaker 1: But at the same time, when people start to become 101 00:05:51,760 --> 00:05:54,120 Speaker 1: aware of cancer as a disease. They start to ask 102 00:05:54,200 --> 00:05:57,120 Speaker 1: questions about, well, where did this come from? Why has 103 00:05:57,160 --> 00:06:00,320 Speaker 1: it affected me? You start to get the Greek as 104 00:06:00,360 --> 00:06:03,440 Speaker 1: people like Hippocrates who were writing about cancers in their 105 00:06:03,440 --> 00:06:06,440 Speaker 1: patients and saying, well, what has caused it? It must 106 00:06:06,440 --> 00:06:09,280 Speaker 1: be the gods, It must be the humors. Something is 107 00:06:09,320 --> 00:06:12,320 Speaker 1: out of whack in here. And then you start to 108 00:06:12,360 --> 00:06:14,400 Speaker 1: get the slightly more religious thing of well it is 109 00:06:14,520 --> 00:06:17,240 Speaker 1: it's fins visited on us. It is something to do 110 00:06:17,320 --> 00:06:21,480 Speaker 1: with immorality, modern living. And then you bring up to 111 00:06:21,480 --> 00:06:25,920 Speaker 1: today this we don't necessarily have such a strong religious 112 00:06:25,960 --> 00:06:28,240 Speaker 1: view of it, but certainly the idea of almost wellness 113 00:06:28,240 --> 00:06:31,760 Speaker 1: as a religion. You've done something toxic to yourself and 114 00:06:31,880 --> 00:06:34,599 Speaker 1: that's why you you now have cancer, and you look 115 00:06:34,640 --> 00:06:38,360 Speaker 1: back at the history of cancer as a biological phenomenon, 116 00:06:38,839 --> 00:06:42,080 Speaker 1: and that's simply not true. You know. It's it's basically 117 00:06:42,120 --> 00:06:45,560 Speaker 1: like the dark side of life, rather than anything that 118 00:06:45,680 --> 00:06:48,920 Speaker 1: we have particularly brought on ourselves in our modern life. Yeah, 119 00:06:48,960 --> 00:06:50,720 Speaker 1: that's one of the things I really loved about your 120 00:06:50,760 --> 00:06:53,359 Speaker 1: book was the way you how you show cancer to 121 00:06:53,400 --> 00:06:58,560 Speaker 1: be so fundamentally integrated with with with life itself or 122 00:06:58,600 --> 00:07:02,880 Speaker 1: I guess, multi cellular life life um. And so so 123 00:07:02,920 --> 00:07:05,479 Speaker 1: maybe we should focus on on a couple of these 124 00:07:05,520 --> 00:07:08,479 Speaker 1: ideas in particular. One of them, I guess, is the 125 00:07:08,520 --> 00:07:11,360 Speaker 1: idea of modernity, right, the idea that that cancer is 126 00:07:11,400 --> 00:07:15,880 Speaker 1: something that was very rare until recently. You make an 127 00:07:15,960 --> 00:07:18,440 Speaker 1: argument against and people have argued this, but you make 128 00:07:18,480 --> 00:07:20,880 Speaker 1: an argument against this in the book, and you cite 129 00:07:20,960 --> 00:07:25,520 Speaker 1: some both some reasoning about why a lot of cancers 130 00:07:25,520 --> 00:07:28,240 Speaker 1: wouldn't necessarily show up in the kinds of remains we 131 00:07:28,280 --> 00:07:31,640 Speaker 1: can examine, and then pointing out examples that we do 132 00:07:31,720 --> 00:07:34,760 Speaker 1: find in fact in the human record and physical remains 133 00:07:34,800 --> 00:07:38,760 Speaker 1: of human society and prehistory. Yeah, it's the classic thing 134 00:07:38,800 --> 00:07:41,720 Speaker 1: in biology that you find what you're looking for, and 135 00:07:41,800 --> 00:07:44,720 Speaker 1: people have not been looking for signs of cancer in 136 00:07:44,800 --> 00:07:47,720 Speaker 1: ancient remains. And the thing about cancer is that that 137 00:07:47,800 --> 00:07:51,000 Speaker 1: when you're thinking about ancient remains that we find mostly 138 00:07:51,040 --> 00:07:54,520 Speaker 1: you're talking about bones, and particularly when you get very ancient, 139 00:07:54,520 --> 00:07:58,960 Speaker 1: you're talking about fossilized bones. And not every cancer leaves 140 00:07:59,000 --> 00:08:02,600 Speaker 1: its trace in the bones. So when you're thinking about 141 00:08:02,640 --> 00:08:06,280 Speaker 1: cancers that affect the soft tissue, you may never see 142 00:08:06,320 --> 00:08:09,640 Speaker 1: the traces of a cancer that killed someone. Also, you know, 143 00:08:09,920 --> 00:08:14,600 Speaker 1: ancient remains don't turn up in beautifully aged, matched structured populations, 144 00:08:14,600 --> 00:08:16,760 Speaker 1: so you can say, oh, this is exactly the population 145 00:08:16,760 --> 00:08:18,960 Speaker 1: that was alive at the time. This is exactly the 146 00:08:19,040 --> 00:08:22,679 Speaker 1: number of cancers in this population. I think some people 147 00:08:22,720 --> 00:08:26,960 Speaker 1: have argued that the fact that cancers are rare in 148 00:08:27,200 --> 00:08:31,040 Speaker 1: ancient humans is an argument that cancer was very, very rare. 149 00:08:31,480 --> 00:08:34,400 Speaker 1: But I slightly feel the other way around. I feel 150 00:08:34,440 --> 00:08:37,080 Speaker 1: like the fact that the more people start looking for 151 00:08:37,200 --> 00:08:41,800 Speaker 1: cancers in human and animal remains from from way way back, 152 00:08:42,280 --> 00:08:45,600 Speaker 1: the more cancers they start to find suggest that it 153 00:08:45,720 --> 00:08:49,600 Speaker 1: was more common. We will never know how how common 154 00:08:49,640 --> 00:08:51,600 Speaker 1: it was, because you can't do, you know, a lovely 155 00:08:51,960 --> 00:08:54,840 Speaker 1: epidemiological study on the sort of stuff that you can 156 00:08:54,880 --> 00:08:56,360 Speaker 1: get out of the ground. You get what you get 157 00:08:56,400 --> 00:08:59,600 Speaker 1: and you get on with it, basically. But I do 158 00:08:59,720 --> 00:09:03,600 Speaker 1: think that cancer is not an exclusively modern disease. I 159 00:09:03,640 --> 00:09:07,160 Speaker 1: will say, certainly it is more common as we live longer. 160 00:09:07,800 --> 00:09:09,880 Speaker 1: So another of the things I go into you later 161 00:09:09,920 --> 00:09:12,080 Speaker 1: in the book is the idea that there's almost a 162 00:09:12,080 --> 00:09:15,720 Speaker 1: sort of a shooting up point. After you have got 163 00:09:15,760 --> 00:09:18,560 Speaker 1: to a certain age, your risk of cancer does significantly 164 00:09:18,600 --> 00:09:21,959 Speaker 1: go up. So if you think about ancient populations when 165 00:09:21,960 --> 00:09:24,199 Speaker 1: there were many, many, many more things that we're going 166 00:09:24,240 --> 00:09:27,439 Speaker 1: to kill you, your chances of getting to an age 167 00:09:27,480 --> 00:09:30,199 Speaker 1: where you could dive cancer before something else got you 168 00:09:30,840 --> 00:09:35,520 Speaker 1: were smaller. So it's not surprising we find fewer ancient 169 00:09:35,520 --> 00:09:39,320 Speaker 1: remains with cancer. But when you think about some children 170 00:09:39,440 --> 00:09:42,280 Speaker 1: have been found with types of cancer that are very 171 00:09:42,400 --> 00:09:44,920 Speaker 1: very rare in populations, and the fact that we have 172 00:09:44,960 --> 00:09:47,720 Speaker 1: found them at all suggests that this is a disease 173 00:09:48,040 --> 00:09:52,360 Speaker 1: that has always been with us, and it's not exclusively 174 00:09:53,040 --> 00:09:56,719 Speaker 1: a confection of modernity. It's it's basically, you know, it 175 00:09:57,160 --> 00:09:59,960 Speaker 1: is with us and always has been. And what about 176 00:10:00,080 --> 00:10:02,720 Speaker 1: the part of the misconception that views cancer is something 177 00:10:02,760 --> 00:10:06,720 Speaker 1: that is uniquely kind of human and maybe associated with uh, 178 00:10:07,080 --> 00:10:10,440 Speaker 1: with the synthetic products of human industry and all that. Like, 179 00:10:10,920 --> 00:10:13,640 Speaker 1: this ties into the idea that sharks don't get cancer, right, 180 00:10:13,720 --> 00:10:18,240 Speaker 1: that there's a widespread belief that for some reason, animals 181 00:10:18,240 --> 00:10:20,360 Speaker 1: that don't engage, you know, don't live in cities and 182 00:10:20,440 --> 00:10:23,840 Speaker 1: drive cars and eat processed food and stuff, won't get cancer. 183 00:10:23,960 --> 00:10:27,400 Speaker 1: But they do. Yeah, this really blew my mind. I 184 00:10:28,200 --> 00:10:30,280 Speaker 1: can see over on my bookshelf. I'm so tempted to 185 00:10:30,320 --> 00:10:33,080 Speaker 1: go and grab it. But there's a book where someone 186 00:10:33,120 --> 00:10:35,920 Speaker 1: has gone through all the different species that have been 187 00:10:35,960 --> 00:10:39,800 Speaker 1: known to have cancer in In some cases it's many examples, 188 00:10:39,840 --> 00:10:42,200 Speaker 1: in some it's just a few, but it's pages and 189 00:10:42,320 --> 00:10:45,840 Speaker 1: pages and pages. Is everything from like odd wolves to zebras, 190 00:10:46,400 --> 00:10:51,160 Speaker 1: and almost every branch of the animal kingdom develops cancer. 191 00:10:51,600 --> 00:10:54,720 Speaker 1: There are a couple of really weird exceptions. So one 192 00:10:54,840 --> 00:10:58,680 Speaker 1: is comb jellies. Comb jellyfish don't seem to get cancer, 193 00:10:58,960 --> 00:11:04,280 Speaker 1: never been detected. And also sponges really weirdly resistant to sponges. 194 00:11:04,280 --> 00:11:07,880 Speaker 1: There's this guy in in Arizona, guy called Carlo Malei, 195 00:11:08,200 --> 00:11:11,920 Speaker 1: who is zapping sponges with enormous amounts of radiation like 196 00:11:12,360 --> 00:11:15,000 Speaker 1: that would kill a human, and they're just fine. They 197 00:11:15,080 --> 00:11:17,640 Speaker 1: just shrug it off. So there are some species that 198 00:11:17,679 --> 00:11:21,400 Speaker 1: are cancer resistant, but pretty much everything else, to a 199 00:11:21,440 --> 00:11:24,920 Speaker 1: greater or lesser extent is and humans aren't even the 200 00:11:24,960 --> 00:11:28,439 Speaker 1: most susceptible species. There are some that are much more 201 00:11:28,480 --> 00:11:31,920 Speaker 1: susceptible to cancer than humans are. So this idea that 202 00:11:31,960 --> 00:11:34,720 Speaker 1: it's it's just a modern disease, it's just a human disease. 203 00:11:35,280 --> 00:11:38,439 Speaker 1: It just doesn't stack up. You know. Yes, there are 204 00:11:38,440 --> 00:11:41,160 Speaker 1: things that we do in our modern lives that increase 205 00:11:41,200 --> 00:11:44,440 Speaker 1: the risk of cancer, and our lovely living to a 206 00:11:44,520 --> 00:11:47,920 Speaker 1: nice old age is a major risk factor. You know. 207 00:11:48,000 --> 00:11:49,920 Speaker 1: Thank god we don't all die in childbirth and of 208 00:11:49,920 --> 00:11:53,880 Speaker 1: infectious diseases before our tenth birthday. But you know, we 209 00:11:53,960 --> 00:11:57,120 Speaker 1: are we are not, you know, unique and wonderful when 210 00:11:57,120 --> 00:12:00,360 Speaker 1: it comes to cancer again, it's it is just part 211 00:12:00,400 --> 00:12:03,679 Speaker 1: of life. There are some other interesting observations you mentioned 212 00:12:03,720 --> 00:12:08,360 Speaker 1: in your book about what might create a specific propensity 213 00:12:08,440 --> 00:12:11,320 Speaker 1: for cancer in certain species versus others. One that I 214 00:12:11,360 --> 00:12:14,520 Speaker 1: recall is that you mentioned that it's cancer seems to 215 00:12:14,600 --> 00:12:17,160 Speaker 1: be more prevalent in species that have been through a 216 00:12:17,200 --> 00:12:20,640 Speaker 1: genetic bottleneck at some point in the relatively recent past. 217 00:12:20,679 --> 00:12:24,280 Speaker 1: So like, if their breeding population was reduced to a 218 00:12:24,280 --> 00:12:27,480 Speaker 1: pretty small number at some point, they tend to be 219 00:12:27,559 --> 00:12:30,760 Speaker 1: more susceptible to cancer. Is that correct? Yes, so that 220 00:12:30,880 --> 00:12:33,240 Speaker 1: does seem to be the case, which suggests that there 221 00:12:33,280 --> 00:12:36,199 Speaker 1: are genetic factors at work, because if you shrink a 222 00:12:36,240 --> 00:12:39,440 Speaker 1: population down to a very small what's called an effective 223 00:12:39,440 --> 00:12:41,760 Speaker 1: breeding size, you've got quite a small population that's all 224 00:12:41,800 --> 00:12:44,080 Speaker 1: breeding with each other. You do start to get a 225 00:12:44,120 --> 00:12:48,640 Speaker 1: pile up of mutations being passed from generation to generation, 226 00:12:49,000 --> 00:12:52,800 Speaker 1: which might be increasing the risk of cancer. One of 227 00:12:52,800 --> 00:12:55,600 Speaker 1: my favorite species in this case is the Syrian hamster, 228 00:12:56,200 --> 00:12:59,480 Speaker 1: which all the Syrian hamsters pretty much that in pets 229 00:12:59,520 --> 00:13:01,839 Speaker 1: and and abs all over the world, are descended from 230 00:13:01,840 --> 00:13:04,800 Speaker 1: one litter of hamsters, and they are incredibly cancer prone 231 00:13:04,960 --> 00:13:09,240 Speaker 1: because they're just massively in bread um. But yeah, every 232 00:13:09,240 --> 00:13:13,520 Speaker 1: every species, some more than others and some much less 233 00:13:13,559 --> 00:13:18,080 Speaker 1: than others. So elephants very surprisingly, you'd think when you 234 00:13:18,080 --> 00:13:21,720 Speaker 1: think about it logically, animals that are very very big, 235 00:13:22,440 --> 00:13:25,200 Speaker 1: they have lots of cells, they live for a very 236 00:13:25,280 --> 00:13:28,520 Speaker 1: very long time, you would think that elephants should be 237 00:13:28,600 --> 00:13:31,079 Speaker 1: riddled with cancer by the time they die, but they 238 00:13:31,120 --> 00:13:34,720 Speaker 1: are not. They are amazingly resistant and really long lived 239 00:13:34,760 --> 00:13:38,160 Speaker 1: animals like bowhead whales, even some of the really long 240 00:13:38,160 --> 00:13:41,760 Speaker 1: lived bats, brand bats that live for forty years, very 241 00:13:41,800 --> 00:13:47,520 Speaker 1: resistant to cancer. So they have evolved mechanisms that enable 242 00:13:47,600 --> 00:13:51,520 Speaker 1: them to live these very long, luxury lifestyles and be 243 00:13:51,640 --> 00:13:54,960 Speaker 1: resistant to cancer. Whereas you have very small rodents, things 244 00:13:55,000 --> 00:13:58,400 Speaker 1: that live fast and die young, why bother you know 245 00:13:58,400 --> 00:13:59,800 Speaker 1: you're going to be around for a couple of breeding 246 00:13:59,800 --> 00:14:03,560 Speaker 1: sea reasons and then near out and humans are kind 247 00:14:03,559 --> 00:14:06,480 Speaker 1: of in the middle. You know, we live for many decades, 248 00:14:06,960 --> 00:14:10,000 Speaker 1: we reach our childbearing years in between our sort of 249 00:14:10,040 --> 00:14:13,160 Speaker 1: twenties to forties, hang around for a bit after, and 250 00:14:13,200 --> 00:14:15,360 Speaker 1: then the risk of cancer does start to go up. 251 00:14:16,000 --> 00:14:19,280 Speaker 1: So you know, this is when you put humans in 252 00:14:19,320 --> 00:14:22,479 Speaker 1: the context of all of life, you start to understand 253 00:14:22,880 --> 00:14:27,640 Speaker 1: how our evolution as a species is intrinsically tied to 254 00:14:27,760 --> 00:14:31,000 Speaker 1: our as a species risk of cancer. But you do 255 00:14:31,120 --> 00:14:34,040 Speaker 1: have to separate that from personal risk of cancer as well, 256 00:14:34,080 --> 00:14:35,600 Speaker 1: and that's a that's kind of a bit hard to 257 00:14:35,640 --> 00:14:40,400 Speaker 1: get your head around, so talking about evolutionary risks versus 258 00:14:40,680 --> 00:14:44,800 Speaker 1: personal risks. So one of the most interesting ideas in 259 00:14:44,840 --> 00:14:48,400 Speaker 1: your book that that you keep returning to is a 260 00:14:48,480 --> 00:14:52,360 Speaker 1: framework for thinking about multicellular life through the analogy of 261 00:14:52,400 --> 00:14:57,800 Speaker 1: a society, that a multicellular organism is a society of cells. 262 00:14:57,920 --> 00:15:00,280 Speaker 1: Could you explain this way of thinking in and some 263 00:15:00,360 --> 00:15:04,640 Speaker 1: of the implications that extend from it. Yeah, this really 264 00:15:05,240 --> 00:15:09,440 Speaker 1: really blew my mind when I started to understand this. So, 265 00:15:10,160 --> 00:15:13,680 Speaker 1: this idea of cells as a society, it goes about 266 00:15:13,800 --> 00:15:16,120 Speaker 1: quite a few decades. A lot of things I discovered 267 00:15:16,120 --> 00:15:19,119 Speaker 1: while I was researching the book are quite old ideas 268 00:15:19,160 --> 00:15:21,640 Speaker 1: that have got you know, subsumed or left behind in 269 00:15:21,680 --> 00:15:24,760 Speaker 1: this this rush to just understand cancer as a purely 270 00:15:24,840 --> 00:15:30,400 Speaker 1: genetic disease. But the idea is that cells and organisms 271 00:15:30,680 --> 00:15:34,600 Speaker 1: and individuals in a species, they live in societies, and 272 00:15:34,640 --> 00:15:38,080 Speaker 1: there are rules of societies at every single level. You know, 273 00:15:38,160 --> 00:15:40,600 Speaker 1: things like do the job you're meant to do, don't 274 00:15:40,680 --> 00:15:44,480 Speaker 1: take more than you need, clean up after yourself, all 275 00:15:44,520 --> 00:15:46,840 Speaker 1: these kind of things. There are rules to societies that 276 00:15:46,880 --> 00:15:51,160 Speaker 1: make societies work productively. And you start to look around 277 00:15:51,560 --> 00:15:54,600 Speaker 1: at groups of cells that are in tissues and in 278 00:15:54,760 --> 00:15:58,720 Speaker 1: organs in your body. You look at societies like ants 279 00:15:58,720 --> 00:16:03,640 Speaker 1: and bees. You look at colonies, you look at troops 280 00:16:03,840 --> 00:16:07,000 Speaker 1: of chimps and herds of deer, and you look at 281 00:16:07,080 --> 00:16:10,280 Speaker 1: human societies and they all work in the same way. 282 00:16:11,320 --> 00:16:14,360 Speaker 1: And this particularly an idea that I was influenced by. 283 00:16:14,520 --> 00:16:18,040 Speaker 1: There's a researcher in Arizona called Athena Actipis, and she 284 00:16:18,160 --> 00:16:22,680 Speaker 1: works a lot on social cooperation and cheating, and the 285 00:16:22,800 --> 00:16:28,440 Speaker 1: idea that cancer cells basically cheat in society. They are cheaters, 286 00:16:29,000 --> 00:16:32,240 Speaker 1: They take more than they need, they produce waste, They 287 00:16:32,280 --> 00:16:35,640 Speaker 1: proliferate out of control, they don't die when they're meant to. 288 00:16:35,720 --> 00:16:39,640 Speaker 1: They are not good cells. Now, if every cell in 289 00:16:39,680 --> 00:16:42,000 Speaker 1: your society was doing that, it would just be you know, 290 00:16:42,320 --> 00:16:45,160 Speaker 1: mad Max style dystopia. Nothing would work, Your body would 291 00:16:45,160 --> 00:16:50,000 Speaker 1: not function. But you can get away with being a 292 00:16:50,080 --> 00:16:54,800 Speaker 1: cancer cell and cheating and keeping going and keeping going 293 00:16:55,520 --> 00:16:59,400 Speaker 1: because to a certain extent, cheaters do prosper. And it's 294 00:16:59,400 --> 00:17:01,920 Speaker 1: the same in many animal societies. So one of the 295 00:17:02,000 --> 00:17:06,480 Speaker 1: lovely examples that I found was these cape honey bees. 296 00:17:07,280 --> 00:17:11,000 Speaker 1: So this just wonderful examples. So cape honey bees, they 297 00:17:11,080 --> 00:17:13,760 Speaker 1: have a classic honeybee population structure. You have the queen, 298 00:17:14,040 --> 00:17:16,240 Speaker 1: and you have all the workers, the female workers, but 299 00:17:16,240 --> 00:17:18,200 Speaker 1: the queen is the only one who gets to reproduce, 300 00:17:18,720 --> 00:17:20,359 Speaker 1: and so all the workers are busy doing all the 301 00:17:20,400 --> 00:17:23,919 Speaker 1: work in the hive, and the queen's just cleaning around 302 00:17:23,960 --> 00:17:27,800 Speaker 1: basically like ah ha um, and you know, popping off 303 00:17:27,800 --> 00:17:30,159 Speaker 1: to reproduce when she feels like it. But there is 304 00:17:30,200 --> 00:17:35,240 Speaker 1: a genetic change, single genetic change that means that these 305 00:17:35,280 --> 00:17:39,600 Speaker 1: worker bees can become queens and they start to just 306 00:17:39,640 --> 00:17:43,639 Speaker 1: sit around, you know, cleaning it up, and eventually the 307 00:17:43,720 --> 00:17:48,119 Speaker 1: hive starts to collapse under the weight of all these cheaters, 308 00:17:48,880 --> 00:17:51,440 Speaker 1: and it's just a single genetic change that enables them 309 00:17:51,440 --> 00:17:54,520 Speaker 1: to do this. And actually some of these queens will 310 00:17:54,560 --> 00:17:56,800 Speaker 1: go off to other hives and start to infect them 311 00:17:56,840 --> 00:17:59,840 Speaker 1: and turn them into cheaters as well, and it's almost 312 00:17:59,840 --> 00:18:04,000 Speaker 1: like a bee cancer, I suppose, because ultimately it leads 313 00:18:04,040 --> 00:18:06,919 Speaker 1: to the destruction of the hive. And you say, well, 314 00:18:07,359 --> 00:18:09,840 Speaker 1: why would the bees have this, Why would it be 315 00:18:09,960 --> 00:18:14,040 Speaker 1: so fragile that one genetic change can disrupt it like this? 316 00:18:14,440 --> 00:18:16,720 Speaker 1: And it turns out that where the bees live it's very, 317 00:18:16,800 --> 00:18:19,600 Speaker 1: very windy, So there's a risk that if you just 318 00:18:19,640 --> 00:18:22,200 Speaker 1: have one queen and that's all you get, your queen 319 00:18:22,240 --> 00:18:24,680 Speaker 1: could get blown off course and you might lose he 320 00:18:24,800 --> 00:18:29,119 Speaker 1: totally and then your hive would collapse anyway. So the 321 00:18:29,200 --> 00:18:33,560 Speaker 1: ability to flip into queen mode it's really useful for 322 00:18:33,600 --> 00:18:37,199 Speaker 1: the bees for their evolutionary survival, but it comes with 323 00:18:37,240 --> 00:18:41,520 Speaker 1: a risk. And it's the same with cells. So we 324 00:18:41,600 --> 00:18:44,720 Speaker 1: need to be able to make new cells. You need 325 00:18:44,800 --> 00:18:48,200 Speaker 1: to regenerate millions of cells in your body every day, 326 00:18:48,520 --> 00:18:51,760 Speaker 1: millions of cells in your skin, your blood, your bowel. 327 00:18:52,040 --> 00:18:54,520 Speaker 1: You need to be able to heal yourself. If you're wounded, 328 00:18:54,720 --> 00:18:57,200 Speaker 1: you need to be able to grow from one cell 329 00:18:57,640 --> 00:19:01,920 Speaker 1: into an adult human. Cells need to reproduce, they need 330 00:19:01,960 --> 00:19:05,640 Speaker 1: to do stuff. Flip side of that is that they 331 00:19:05,640 --> 00:19:08,080 Speaker 1: can sometimes go out of control because it's the same 332 00:19:08,119 --> 00:19:11,360 Speaker 1: mechanisms that make cells grow and multiply in the right 333 00:19:11,400 --> 00:19:15,320 Speaker 1: way that they kind of harness and hijack when they 334 00:19:15,320 --> 00:19:18,159 Speaker 1: decide to cheat and grow out of control in the 335 00:19:18,160 --> 00:19:21,320 Speaker 1: wrong way. So that's interesting. You're sort of showing how 336 00:19:21,760 --> 00:19:25,000 Speaker 1: cancer is one side of an evolutionary balance where on 337 00:19:25,000 --> 00:19:28,080 Speaker 1: one hand, you've got you know, as your ability to 338 00:19:28,160 --> 00:19:31,520 Speaker 1: do something good goes up, the risks associated with those 339 00:19:31,560 --> 00:19:34,280 Speaker 1: same genes that code for that also go up. So 340 00:19:34,440 --> 00:19:36,719 Speaker 1: we know on one side what the downside is. We 341 00:19:36,720 --> 00:19:40,360 Speaker 1: can see tumors and cancer. And you're saying that the 342 00:19:40,359 --> 00:19:45,480 Speaker 1: the the goods that make those risks worthwhile are basically 343 00:19:45,480 --> 00:19:48,399 Speaker 1: being able to proliferate quickly in in cell growth. And 344 00:19:48,480 --> 00:19:50,440 Speaker 1: this would have to do not just with growth in youth, 345 00:19:50,480 --> 00:19:53,399 Speaker 1: but in healing and things like that. Yeah, exactly, And 346 00:19:53,440 --> 00:19:56,639 Speaker 1: you see this. This starts to explain the differences across 347 00:19:56,680 --> 00:20:00,520 Speaker 1: species because if you if you cut a mouse, mice 348 00:20:00,600 --> 00:20:05,600 Speaker 1: heal amazingly fast. Their cells just basically knit themselves back together. 349 00:20:05,680 --> 00:20:09,919 Speaker 1: It's it's absolutely incredible. Um. One of the stories that 350 00:20:09,960 --> 00:20:12,119 Speaker 1: I discovered when I was talking to a researcher in 351 00:20:12,160 --> 00:20:14,320 Speaker 1: Santa Barbara who's trying to work with the animals in 352 00:20:14,320 --> 00:20:17,720 Speaker 1: the zoo to understand their cancer risks. She's she went 353 00:20:17,760 --> 00:20:19,120 Speaker 1: to the zoo and said, can I get a little 354 00:20:19,119 --> 00:20:21,639 Speaker 1: bit of skin from your giant tortoise? And they were like, 355 00:20:21,720 --> 00:20:25,440 Speaker 1: hell no, we cut a tortoise. It takes a year 356 00:20:25,480 --> 00:20:29,680 Speaker 1: to heal, and tortoises live for a very long time. 357 00:20:29,760 --> 00:20:33,639 Speaker 1: They're incredibly cancer resistant, but they the flip side of 358 00:20:33,640 --> 00:20:37,200 Speaker 1: that is that they don't heal very easily. So humans 359 00:20:37,240 --> 00:20:39,640 Speaker 1: again somewhere in the middle. We don't heal as fast 360 00:20:39,680 --> 00:20:43,600 Speaker 1: as mice. We live much longer than mice. So there's 361 00:20:43,760 --> 00:20:46,159 Speaker 1: there's all of this stuff is a trade off about 362 00:20:46,160 --> 00:20:49,640 Speaker 1: the evolutionary journey that your species has taken. And one 363 00:20:49,640 --> 00:20:51,320 Speaker 1: of the things that I sort of took this to 364 00:20:51,359 --> 00:20:56,040 Speaker 1: its logical conclusion, and I was like, if there's aliens, 365 00:20:56,720 --> 00:21:01,240 Speaker 1: aliens would get cancer. There's very unlikely that they would 366 00:21:01,280 --> 00:21:05,800 Speaker 1: not if they obey the general rules of evolution, And 367 00:21:06,000 --> 00:21:09,600 Speaker 1: this idea that, like cells, organisms living in a society 368 00:21:09,720 --> 00:21:13,000 Speaker 1: behave according to the rules of that we know make 369 00:21:13,040 --> 00:21:16,000 Speaker 1: a good society. I don't think there's any reason why 370 00:21:16,040 --> 00:21:19,600 Speaker 1: aliens wouldn't get cancer. She's like, that's a bit of 371 00:21:19,640 --> 00:21:21,680 Speaker 1: a that was a bit of a sort of late 372 00:21:21,760 --> 00:21:27,480 Speaker 1: night thought. I think, because all that's necessary is that 373 00:21:27,720 --> 00:21:31,320 Speaker 1: they exist by cell division, right, I mean that's pretty 374 00:21:31,359 --> 00:21:33,639 Speaker 1: much it. Yeah, yeah, exactly if you have cells and 375 00:21:33,640 --> 00:21:36,399 Speaker 1: your cells are doing cell division, and also if you 376 00:21:36,520 --> 00:21:40,400 Speaker 1: have evolution by natural selection, which is basically the engine 377 00:21:40,880 --> 00:21:44,719 Speaker 1: that drives cells to to proliferate and be selected for 378 00:21:44,800 --> 00:21:47,760 Speaker 1: and to keep going, and species to keep proliferating and 379 00:21:47,840 --> 00:21:52,439 Speaker 1: keeping going, then yeah, you probably could get cancer. And 380 00:21:52,480 --> 00:21:56,080 Speaker 1: that's what we generally see across the entire animal kingdom. Well, 381 00:21:56,320 --> 00:21:58,800 Speaker 1: thinking about aliens getting cancer makes me think of another 382 00:21:58,880 --> 00:22:01,439 Speaker 1: interesting part of your book, would was about difficulties in 383 00:22:01,520 --> 00:22:06,440 Speaker 1: classifying what appears to be some form of uncontrolled cell 384 00:22:06,520 --> 00:22:10,879 Speaker 1: growth in animals, or even not animals, other organisms that 385 00:22:10,920 --> 00:22:13,200 Speaker 1: are very different from us. So can you look at 386 00:22:13,280 --> 00:22:15,760 Speaker 1: what's going on in a clam and say that it 387 00:22:15,840 --> 00:22:19,520 Speaker 1: has cancer? Yeah? Probably, But what about a mushroom or 388 00:22:19,560 --> 00:22:24,480 Speaker 1: in an algae or something yeah, this was This was interesting. So, 389 00:22:24,880 --> 00:22:28,399 Speaker 1: you know, what is cancer and when is cancer is 390 00:22:28,440 --> 00:22:32,400 Speaker 1: an interesting question. And when you get to more organized animals, 391 00:22:32,400 --> 00:22:36,879 Speaker 1: and particularly mammals, we define invasive cancers as cancers that 392 00:22:36,960 --> 00:22:39,600 Speaker 1: kind of break through the sort of molecular I guess 393 00:22:39,600 --> 00:22:42,199 Speaker 1: you'd call it like saran wrap that's around your organs 394 00:22:42,240 --> 00:22:45,160 Speaker 1: and your tissues. They break through this membrane, and that's 395 00:22:45,160 --> 00:22:49,120 Speaker 1: what we call invasive cancer. But really, you know, the 396 00:22:49,119 --> 00:22:52,400 Speaker 1: phenomenon of cells growing out of control is all over 397 00:22:52,440 --> 00:22:54,120 Speaker 1: the place. You can see it in plants when they 398 00:22:54,119 --> 00:22:57,040 Speaker 1: get gals. You can see it in in fungi. You 399 00:22:57,080 --> 00:22:58,919 Speaker 1: can see it in all sorts of things. And what 400 00:22:59,000 --> 00:23:03,719 Speaker 1: are the interesting quest ens is you know something like endometriosis, 401 00:23:03,760 --> 00:23:06,640 Speaker 1: which is a condition where you get rogue tissue within 402 00:23:06,680 --> 00:23:09,400 Speaker 1: the body and it's sort of it grows and its 403 00:23:09,400 --> 00:23:12,359 Speaker 1: spreads and it bleeds and it's very very painful. It's like, 404 00:23:12,600 --> 00:23:17,120 Speaker 1: but that's not cancer, it's not invasive. But actually, when 405 00:23:17,119 --> 00:23:18,880 Speaker 1: you look at that kind of tissue, it has lots 406 00:23:18,920 --> 00:23:21,200 Speaker 1: and lots of the kind of mutations and changes we'd 407 00:23:21,200 --> 00:23:25,239 Speaker 1: expect to find in cancer. But that's not cancer, and 408 00:23:25,280 --> 00:23:30,280 Speaker 1: that's in humans. So this this idea that mutations, it's 409 00:23:30,359 --> 00:23:34,200 Speaker 1: not just what makes cancer. Uncontrolled cell growth is not 410 00:23:34,280 --> 00:23:39,920 Speaker 1: just what makes cancer. It's it's sort of this this invasive, aggressive, 411 00:23:40,000 --> 00:23:45,880 Speaker 1: evolving characteristic that really is what we can classify as 412 00:23:46,400 --> 00:23:49,320 Speaker 1: as cancer. All Right, we're going to take a quick break, 413 00:23:49,320 --> 00:23:55,640 Speaker 1: but we'll be right back. And we're back. So maybe 414 00:23:55,640 --> 00:23:58,600 Speaker 1: we should shift to talking about the history of our 415 00:23:58,680 --> 00:24:02,440 Speaker 1: understanding of the approximate causes or maybe better to say, 416 00:24:02,440 --> 00:24:05,440 Speaker 1: the risk factors for cancer where it comes from, whether 417 00:24:05,520 --> 00:24:09,560 Speaker 1: that's there's an hereditary component and an environmental component. Uh, 418 00:24:09,640 --> 00:24:11,840 Speaker 1: there's a part in the book where you mentioned this 419 00:24:11,920 --> 00:24:15,479 Speaker 1: thing that was called the Daily Mail Oncology Ontology blog, 420 00:24:15,800 --> 00:24:19,080 Speaker 1: which I really appreciated because so the idea was this 421 00:24:19,160 --> 00:24:21,760 Speaker 1: was an attempted list of all the things that either 422 00:24:21,880 --> 00:24:25,399 Speaker 1: cause or cure cancer, according to the Daily Mail. And 423 00:24:25,480 --> 00:24:27,399 Speaker 1: that made me say, I've got to admit something. I 424 00:24:27,800 --> 00:24:30,320 Speaker 1: read a lot of science and medical news from my work, 425 00:24:30,440 --> 00:24:33,560 Speaker 1: and I have all but completely turned off my recognition 426 00:24:33,600 --> 00:24:37,320 Speaker 1: system for articles about, you know, new supposed causes or 427 00:24:37,400 --> 00:24:41,119 Speaker 1: cures for cancer, because this was already like a cliche 428 00:24:41,240 --> 00:24:43,600 Speaker 1: to the point of being a hack joke for comedians 429 00:24:43,600 --> 00:24:47,320 Speaker 1: in the nineteen nineties. Is there something we should learn 430 00:24:47,400 --> 00:24:50,240 Speaker 1: from this, like the way that we get this conditioned 431 00:24:50,359 --> 00:24:54,479 Speaker 1: kind of numb reaction to these types of news stories. Yeah, 432 00:24:54,720 --> 00:24:56,640 Speaker 1: that's we used to get a lot of that when 433 00:24:56,640 --> 00:24:58,760 Speaker 1: I was at cancer a set k. You know, I 434 00:24:58,760 --> 00:25:02,840 Speaker 1: think the stupid this one was that water gives you cancer, 435 00:25:03,640 --> 00:25:06,399 Speaker 1: and also that turning on turning on the light at 436 00:25:06,560 --> 00:25:09,879 Speaker 1: night to go to the bathroom gives you cancer. So 437 00:25:10,600 --> 00:25:13,880 Speaker 1: you know this, this is really really frustrating. So there's 438 00:25:13,960 --> 00:25:16,200 Speaker 1: kind of a couple of there's a couple of things 439 00:25:16,200 --> 00:25:19,480 Speaker 1: to dissect because it's also comes down to like what 440 00:25:19,480 --> 00:25:24,080 Speaker 1: what is actually the nature of cancer? And the way 441 00:25:24,119 --> 00:25:25,960 Speaker 1: that cancer has been thought about for a very long 442 00:25:26,000 --> 00:25:28,639 Speaker 1: time is according to what scientists like to call the 443 00:25:28,640 --> 00:25:32,200 Speaker 1: somatic mutation theory of cancer. So this is this idea 444 00:25:32,240 --> 00:25:35,720 Speaker 1: that cells pick up changes in their DNA and their 445 00:25:35,720 --> 00:25:38,280 Speaker 1: genome that the instructions that they used to do what 446 00:25:38,320 --> 00:25:41,760 Speaker 1: they do. They pick up these changes, these mutations, and 447 00:25:41,880 --> 00:25:44,280 Speaker 1: that enables them to do more bad things. And then 448 00:25:44,280 --> 00:25:45,960 Speaker 1: they pick up more and they do more bad things. 449 00:25:46,440 --> 00:25:50,760 Speaker 1: So it's this gradual accumulation of nasty mutations turns nice, 450 00:25:50,800 --> 00:25:55,360 Speaker 1: well behaved cells into aggressive cancer cells. And we can 451 00:25:55,520 --> 00:26:00,959 Speaker 1: start to see some of the characteristic fingerprints that different 452 00:26:01,040 --> 00:26:04,280 Speaker 1: agents leave in the genome. So we can see, for example, 453 00:26:04,640 --> 00:26:07,560 Speaker 1: cigarette smoke or ultra violet light from the sun, we 454 00:26:07,640 --> 00:26:11,960 Speaker 1: can see those characteristic fingerprints of damage in the genome. 455 00:26:13,080 --> 00:26:17,040 Speaker 1: What that doesn't necessarily tell us because when you start 456 00:26:17,080 --> 00:26:19,760 Speaker 1: looking closely at a cancer or even in fact at 457 00:26:19,920 --> 00:26:24,240 Speaker 1: normal tissue, you start to see these changes and mutations everywhere. 458 00:26:25,160 --> 00:26:28,360 Speaker 1: So this kind of simplistic model that it's a hit 459 00:26:28,440 --> 00:26:29,720 Speaker 1: in this green and a hit in this green, and 460 00:26:29,720 --> 00:26:30,800 Speaker 1: a hit in the stree and a hit in the 461 00:26:30,840 --> 00:26:32,480 Speaker 1: street in a bang, that you've got a cancer cell 462 00:26:33,840 --> 00:26:38,000 Speaker 1: is nonsense because loads of healthy cells such as peppered 463 00:26:38,000 --> 00:26:42,119 Speaker 1: with mutations and loads of things do damage our DNA, 464 00:26:42,720 --> 00:26:47,480 Speaker 1: and that's kind of like it's mostly fine. So it's 465 00:26:47,480 --> 00:26:50,360 Speaker 1: a bit more of a sophisticated understanding of yes, there 466 00:26:50,400 --> 00:26:54,639 Speaker 1: are things that damage DNA. A lot of them we 467 00:26:54,720 --> 00:26:57,000 Speaker 1: know about, some of them we don't know about yet. 468 00:26:57,400 --> 00:26:59,639 Speaker 1: Researchers are trying to figure out, you know, how do 469 00:26:59,680 --> 00:27:02,359 Speaker 1: we match chuck these signatures of damage to things that 470 00:27:02,400 --> 00:27:06,840 Speaker 1: are in the environment alas mostly the most single, most 471 00:27:06,920 --> 00:27:10,120 Speaker 1: damaging thing you can do for your DNA is breathe oxygen, 472 00:27:11,520 --> 00:27:14,920 Speaker 1: literally just being alive. The processes of life in your 473 00:27:14,920 --> 00:27:20,240 Speaker 1: cells damage your DNA unfortunately. But then if all your 474 00:27:20,280 --> 00:27:23,560 Speaker 1: cells are to some extent, you know, more or less 475 00:27:24,040 --> 00:27:27,160 Speaker 1: messed up. Everyone's got a few mutations here and there, 476 00:27:27,320 --> 00:27:31,040 Speaker 1: some more than others. What is it then that tips 477 00:27:31,040 --> 00:27:34,480 Speaker 1: a cell into becoming a cancer cell? If everyone's a 478 00:27:34,560 --> 00:27:39,080 Speaker 1: bit weird, what makes that cheating cell kind of slip 479 00:27:39,200 --> 00:27:43,760 Speaker 1: the bonds of good society and really start going for it? 480 00:27:44,520 --> 00:27:48,639 Speaker 1: And that really is is an evolutionary question that cell 481 00:27:48,680 --> 00:27:52,960 Speaker 1: has involved the capacity to do that, And so I 482 00:27:52,960 --> 00:27:55,800 Speaker 1: think it's it's far too simplistic to say, oh, well, 483 00:27:55,880 --> 00:27:58,960 Speaker 1: you know your cancer was absolutely caused by smoking, that 484 00:27:59,119 --> 00:28:01,679 Speaker 1: was it. It's like, well, that was a risk factor 485 00:28:02,080 --> 00:28:05,920 Speaker 1: and it certainly didn't help, but there were many other things. 486 00:28:06,040 --> 00:28:09,000 Speaker 1: And also many people who do smoke don't get cancer. 487 00:28:09,520 --> 00:28:12,199 Speaker 1: So it's like we've got to be more sophisticated in 488 00:28:12,359 --> 00:28:16,600 Speaker 1: understanding what makes normal cells become damaged and what makes 489 00:28:16,680 --> 00:28:20,399 Speaker 1: kind of sad cells become really bad cells. Yeah, this 490 00:28:20,480 --> 00:28:24,479 Speaker 1: is an important point about thinking about risk factors instead 491 00:28:24,520 --> 00:28:27,359 Speaker 1: of causes. And I know that that's it's infuriating to 492 00:28:27,400 --> 00:28:29,680 Speaker 1: people especially. I think if you don't have a lot 493 00:28:29,720 --> 00:28:34,399 Speaker 1: of like training in a statistics oriented field, that it 494 00:28:34,520 --> 00:28:37,760 Speaker 1: just doesn't feel very comfortable to think about, especially something 495 00:28:37,800 --> 00:28:40,200 Speaker 1: that's a really important life and death issue like cancer 496 00:28:40,600 --> 00:28:43,400 Speaker 1: in terms of probabilities. You want to know like what 497 00:28:43,480 --> 00:28:46,640 Speaker 1: it was or what what did it? Yeah, exactly. I 498 00:28:46,680 --> 00:28:49,200 Speaker 1: think the best analogy that I really came up with is, 499 00:28:49,600 --> 00:28:52,840 Speaker 1: and this is spoilers. Now, if anyone's seen Agatha Christie's 500 00:28:52,880 --> 00:28:56,600 Speaker 1: murder on the Orient Express where and I am this 501 00:28:56,680 --> 00:28:58,520 Speaker 1: is a massive spoiler, but come on the books, like 502 00:28:58,840 --> 00:29:01,440 Speaker 1: really older should have read. Now see the movie with 503 00:29:01,480 --> 00:29:06,680 Speaker 1: Albert Finn's great But it's a murder, but all the 504 00:29:06,760 --> 00:29:10,720 Speaker 1: people involved they all have a stab, so you never 505 00:29:10,840 --> 00:29:16,080 Speaker 1: know who actually was the murderer. So it's it's kind 506 00:29:16,080 --> 00:29:18,560 Speaker 1: of like this. So you know, we have lots and 507 00:29:18,640 --> 00:29:20,920 Speaker 1: lots of genes that we know are implicated in cancer. 508 00:29:21,200 --> 00:29:23,200 Speaker 1: There are lots of things that can damage our DNA. 509 00:29:23,800 --> 00:29:27,560 Speaker 1: There are lots of things that can like improve the 510 00:29:27,720 --> 00:29:30,240 Speaker 1: environment of our tissues or not. We know that things 511 00:29:30,280 --> 00:29:33,360 Speaker 1: like you know, keeping keeping well and healthy and doing 512 00:29:33,360 --> 00:29:36,000 Speaker 1: all the boring healthy living stuff that helps to keep 513 00:29:36,080 --> 00:29:39,840 Speaker 1: your your body healthy, makes your cells more likely to 514 00:29:39,880 --> 00:29:43,960 Speaker 1: fall into line. But saying exactly like it was that thing, 515 00:29:44,240 --> 00:29:47,280 Speaker 1: you know it was, it was that sunny holiday in 516 00:29:47,320 --> 00:29:52,240 Speaker 1: marbea in that damage that skin cell that gave you cancer, 517 00:29:52,320 --> 00:29:55,120 Speaker 1: as I you know, that's that's simply not possible. So 518 00:29:55,240 --> 00:29:57,800 Speaker 1: trying to say oh, it's this, Oh it's that, do this, 519 00:29:57,920 --> 00:30:01,080 Speaker 1: don't do that, I think is it is not terribly 520 00:30:01,120 --> 00:30:03,920 Speaker 1: helpful because at some point we've just got to get 521 00:30:03,960 --> 00:30:06,160 Speaker 1: on and live and try and negotiate the risks that 522 00:30:06,200 --> 00:30:09,400 Speaker 1: we're happy with taking. Right at the same time, you 523 00:30:09,400 --> 00:30:12,920 Speaker 1: do point out how there are certain factors that increase 524 00:30:13,000 --> 00:30:16,360 Speaker 1: your likelihood so far above the baseline that maybe at 525 00:30:16,400 --> 00:30:18,760 Speaker 1: that point it even though you still can't quite say 526 00:30:18,800 --> 00:30:21,120 Speaker 1: it's a cause, it's something closer to a cause. And 527 00:30:21,240 --> 00:30:23,720 Speaker 1: one I think one common example given would be tobacco. 528 00:30:24,160 --> 00:30:27,240 Speaker 1: Remember you mentioned another example in the book about uh, 529 00:30:27,440 --> 00:30:31,920 Speaker 1: just chronic exposure dermal exposure to soot in chimney sweeps. 530 00:30:31,920 --> 00:30:36,680 Speaker 1: I believe it was. Yeah, this was the first example 531 00:30:37,040 --> 00:30:41,040 Speaker 1: of someone actually showing that something a substance in the 532 00:30:41,200 --> 00:30:44,640 Speaker 1: environment could increase the risk of cancer. And this is 533 00:30:44,720 --> 00:30:49,719 Speaker 1: an English surgeon called Percival Pot who had a purely professional, 534 00:30:49,800 --> 00:30:54,200 Speaker 1: interest in the scrutums of young boys, purely professional, because 535 00:30:54,200 --> 00:30:58,280 Speaker 1: he was interested in chimney sweeps in London. Now this 536 00:30:58,440 --> 00:31:02,160 Speaker 1: was in there, and chimney sweeps were basically sent naked 537 00:31:02,720 --> 00:31:05,600 Speaker 1: up the chimneys by gang masters to clean the chimneys. 538 00:31:05,600 --> 00:31:08,400 Speaker 1: So they were exposed to a lot of soot, and 539 00:31:08,720 --> 00:31:11,240 Speaker 1: they noticed that they started to get these cancers in 540 00:31:11,280 --> 00:31:13,960 Speaker 1: their genitals, and they were called soot warps, and these 541 00:31:13,960 --> 00:31:18,200 Speaker 1: were very very very nasty cancers, really horrible kind of stuff. 542 00:31:18,920 --> 00:31:22,880 Speaker 1: And Pot realized that it was the soot that these 543 00:31:22,880 --> 00:31:25,560 Speaker 1: boys were being exposed to that was causing these cancers. 544 00:31:25,640 --> 00:31:27,800 Speaker 1: And he said, right, you know, we've got to get 545 00:31:27,920 --> 00:31:30,440 Speaker 1: nice in Germany that all the chimney sweeps have these 546 00:31:30,520 --> 00:31:33,760 Speaker 1: nice kind of tight fitting uniforms so they weren't being 547 00:31:33,800 --> 00:31:35,719 Speaker 1: directly exposed on their skin. And he was like, right, 548 00:31:35,760 --> 00:31:38,160 Speaker 1: we've got to get those in. Got to protect these boys, 549 00:31:38,160 --> 00:31:42,440 Speaker 1: stop sending them naked up the chimneys. M Alas it 550 00:31:42,520 --> 00:31:45,960 Speaker 1: took over a hundred years for people to actually change 551 00:31:46,000 --> 00:31:48,960 Speaker 1: in Britain because the gang masters were like, no, those 552 00:31:49,240 --> 00:31:52,160 Speaker 1: those uniforms are too expensive. It'll make our sweeps too expensive, 553 00:31:52,280 --> 00:31:55,000 Speaker 1: you know, they're they're cheap, we don't really care. So 554 00:31:55,280 --> 00:31:58,920 Speaker 1: that was really tragic that they managed to link this 555 00:31:59,040 --> 00:32:02,720 Speaker 1: cause to these very horrible cancers, and there was something 556 00:32:02,720 --> 00:32:04,680 Speaker 1: that everyone knew could be done that was helping in 557 00:32:04,680 --> 00:32:08,560 Speaker 1: other countries and nope, nope, it didn't happen for a 558 00:32:08,680 --> 00:32:12,200 Speaker 1: very long time. Um. But yes, that Percival part is 559 00:32:12,280 --> 00:32:16,680 Speaker 1: kind of the father of this idea of external sources 560 00:32:16,720 --> 00:32:20,800 Speaker 1: of carcinogenic chemicals, I think, but I think it has 561 00:32:20,840 --> 00:32:24,440 Speaker 1: stuck in the imagination that like it's all external, it's 562 00:32:24,440 --> 00:32:27,280 Speaker 1: all from from something you've done, or something you've got, 563 00:32:27,400 --> 00:32:30,280 Speaker 1: or something you've touched or eaten or been exposed to. 564 00:32:30,720 --> 00:32:33,360 Speaker 1: Well to go to the other side. So there's a 565 00:32:33,400 --> 00:32:35,240 Speaker 1: part of your book where you explored I think we 566 00:32:35,280 --> 00:32:38,400 Speaker 1: actually mentioned this earlier about your podcast episode about Maud 567 00:32:38,480 --> 00:32:42,480 Speaker 1: Sly and Pauline gross and in the role, for example 568 00:32:42,480 --> 00:32:46,400 Speaker 1: of the research of maud Sly in establishing that there 569 00:32:46,520 --> 00:32:49,760 Speaker 1: is a hereditary component to cancer that I think at 570 00:32:49,800 --> 00:32:52,520 Speaker 1: the time you say that, you know, the primary argument 571 00:32:52,560 --> 00:32:56,200 Speaker 1: was about two different major theories of external causes, whether 572 00:32:56,320 --> 00:33:01,200 Speaker 1: cancer was caused primarily by inflammation or by infectious agents 573 00:33:01,200 --> 00:33:04,720 Speaker 1: and parasites. Is that correct. Yeah, So at the beginning 574 00:33:04,800 --> 00:33:07,560 Speaker 1: of the twentieth century, the early twentieth century, there was 575 00:33:07,600 --> 00:33:11,760 Speaker 1: this idea that cancer was either all caused by external 576 00:33:11,800 --> 00:33:16,440 Speaker 1: things like certain things in the environment, or it was viruses. 577 00:33:16,600 --> 00:33:19,760 Speaker 1: Mostly there were a couple of good examples in animals 578 00:33:20,160 --> 00:33:23,200 Speaker 1: where you could take viruses exposed the animals to them 579 00:33:23,200 --> 00:33:25,920 Speaker 1: and they would develop certain types of cancer. So the 580 00:33:26,280 --> 00:33:29,120 Speaker 1: first one was a guy called Peyton Rouse who discovered 581 00:33:29,360 --> 00:33:32,160 Speaker 1: a virus that caused cancer and chickens. So by the 582 00:33:32,240 --> 00:33:35,240 Speaker 1: sixties everyone was just obsessed with the idea that it 583 00:33:35,280 --> 00:33:39,360 Speaker 1: was viruses. And now you know, we really understand that 584 00:33:40,000 --> 00:33:43,480 Speaker 1: there are families that are affected by multiple cases of cancer, 585 00:33:43,520 --> 00:33:47,360 Speaker 1: that cancer can be to some extent influenced by the 586 00:33:47,440 --> 00:33:50,280 Speaker 1: genes we inherit. But really this was a wast a 587 00:33:50,320 --> 00:33:54,360 Speaker 1: completely separate, parallel strand running up through the first half 588 00:33:54,920 --> 00:33:57,920 Speaker 1: of the twentieth century, and it was work in mice 589 00:33:58,120 --> 00:34:01,400 Speaker 1: in families. In the podcast, we talk about the story 590 00:34:01,400 --> 00:34:03,600 Speaker 1: of mord Sly who bred all these mice together to 591 00:34:03,640 --> 00:34:06,360 Speaker 1: show cancer could be inherited, and then the story of 592 00:34:06,360 --> 00:34:08,520 Speaker 1: Pauline and Gross, who was a seam stress who meant 593 00:34:08,760 --> 00:34:11,880 Speaker 1: a scientist, and she said, you know I'm going to 594 00:34:11,960 --> 00:34:15,160 Speaker 1: die young, and he mapped out all her family because 595 00:34:15,360 --> 00:34:18,200 Speaker 1: so many members of her family were affected by the 596 00:34:18,239 --> 00:34:22,200 Speaker 1: same types of cancer. And it took, you know, decades 597 00:34:22,719 --> 00:34:26,080 Speaker 1: until they pinned down the particular gene fault that was responsible. 598 00:34:26,800 --> 00:34:29,800 Speaker 1: But yeah, they're all these lines were like running a 599 00:34:29,920 --> 00:34:33,840 Speaker 1: completely separate to each other until it all started to 600 00:34:33,920 --> 00:34:38,120 Speaker 1: coalesce together in this understanding that you know, there are 601 00:34:38,160 --> 00:34:41,160 Speaker 1: things that damage our genes. There are genes in ourselves 602 00:34:41,239 --> 00:34:44,839 Speaker 1: that make ourselves replicate that that stop ourselves from dying. 603 00:34:44,920 --> 00:34:47,839 Speaker 1: This is good normally, but they can go wrong. They 604 00:34:47,840 --> 00:34:50,920 Speaker 1: can be mutated, they can be changed, we can inherit 605 00:34:51,040 --> 00:34:54,560 Speaker 1: versions that affect their function. And it all sort of 606 00:34:54,600 --> 00:34:58,640 Speaker 1: started to coalesce into this very sensible idea of of 607 00:34:58,680 --> 00:35:01,959 Speaker 1: how cancer starts. But I think it just became very 608 00:35:02,120 --> 00:35:05,680 Speaker 1: very focused on the genes and the cells just yes, 609 00:35:05,800 --> 00:35:09,960 Speaker 1: single genes, shopping lists of genes and changes, and forgot 610 00:35:10,000 --> 00:35:13,400 Speaker 1: to look at this broader picture of the environment in 611 00:35:13,400 --> 00:35:16,560 Speaker 1: which cells are, the society in which they're living, how 612 00:35:16,600 --> 00:35:21,160 Speaker 1: they can interact with each other, cheat, overcome expand push 613 00:35:21,200 --> 00:35:24,640 Speaker 1: against each other. This more. I hate to use the 614 00:35:24,680 --> 00:35:27,680 Speaker 1: word holistic because it sounds really kind of hippy dippy, 615 00:35:27,719 --> 00:35:30,480 Speaker 1: but you know, it's it's part of our bodies. It's 616 00:35:30,480 --> 00:35:34,520 Speaker 1: not an external alien thing. These cells obey the rules 617 00:35:34,520 --> 00:35:36,919 Speaker 1: of our bodies to to a certain extent, they cheat 618 00:35:36,960 --> 00:35:40,160 Speaker 1: the rules to another extent, but it's all kind of 619 00:35:40,239 --> 00:35:44,000 Speaker 1: part of one piece. And we've just focused on on 620 00:35:44,200 --> 00:35:48,319 Speaker 1: genes and molecules for the past couple of decades. I think, far, 621 00:35:48,480 --> 00:35:50,759 Speaker 1: far too much. All right, we're going to take a 622 00:35:50,840 --> 00:35:54,319 Speaker 1: quick break, but will be right back with more than 623 00:35:56,400 --> 00:35:59,000 Speaker 1: all right, we're back. So you mentioned in the book 624 00:35:59,080 --> 00:36:02,960 Speaker 1: that you believe that the future of our resistance against 625 00:36:02,960 --> 00:36:05,840 Speaker 1: cancer and medical treatments of cancer are going to rely 626 00:36:06,040 --> 00:36:10,080 Speaker 1: on quote shifting towards a new way of evolutionary and 627 00:36:10,200 --> 00:36:14,880 Speaker 1: ecological thinking about cancer. So I assume there you're connecting 628 00:36:14,880 --> 00:36:16,840 Speaker 1: to the ideas you were just articulating. But could you 629 00:36:16,880 --> 00:36:20,040 Speaker 1: expand on what you mean by that. Yeah, So, as 630 00:36:20,080 --> 00:36:24,000 Speaker 1: all the sort of strands of cancer research over the 631 00:36:24,000 --> 00:36:26,680 Speaker 1: past that of one years started to coalesce on this 632 00:36:26,800 --> 00:36:30,080 Speaker 1: idea that that cancer starts when cells pick up certain 633 00:36:30,080 --> 00:36:34,040 Speaker 1: genetic mutations and they go out of control. And then 634 00:36:34,080 --> 00:36:36,279 Speaker 1: we started to get to this idea that then well, 635 00:36:36,320 --> 00:36:39,560 Speaker 1: the way you treat them if you find the molecules 636 00:36:39,600 --> 00:36:41,560 Speaker 1: the genes that are making them go out of control, 637 00:36:41,880 --> 00:36:43,880 Speaker 1: and you target them with drugs, and that's going to 638 00:36:43,960 --> 00:36:46,560 Speaker 1: be the way we're going to cure cancer. And there's 639 00:36:46,600 --> 00:36:52,840 Speaker 1: been so much, so much effort, money, research, time, patients, lives, 640 00:36:52,840 --> 00:36:56,919 Speaker 1: in clinical trials have gone into testing these very molecularly 641 00:36:57,000 --> 00:37:01,640 Speaker 1: targeted drugs, and you know, some in some cases there 642 00:37:01,640 --> 00:37:05,080 Speaker 1: have been incredible success stories. So for example, a drug 643 00:37:05,120 --> 00:37:08,960 Speaker 1: called gliveck for treating a certain type of leukemia is 644 00:37:09,000 --> 00:37:13,480 Speaker 1: incredibly successful. It targets a very specific genetic fault in 645 00:37:13,520 --> 00:37:17,360 Speaker 1: the cancer cells, and it is it was game changing 646 00:37:17,440 --> 00:37:21,239 Speaker 1: and it continues to be game changing. But lots and 647 00:37:21,320 --> 00:37:24,160 Speaker 1: lots of the other drugs that have been developed along 648 00:37:24,200 --> 00:37:29,640 Speaker 1: these lines, they have not transformed survival in the way 649 00:37:29,680 --> 00:37:32,239 Speaker 1: that we would hope they've They've eked out, you know, 650 00:37:32,280 --> 00:37:35,560 Speaker 1: in some cases months, in some cases, you know, a 651 00:37:35,560 --> 00:37:39,160 Speaker 1: few years. In one case, I saw a paper that 652 00:37:39,200 --> 00:37:43,759 Speaker 1: said nine days increase in survival with this particular incredibly 653 00:37:43,760 --> 00:37:48,760 Speaker 1: expensive targeted drug. And you're like, these are not cures. 654 00:37:49,400 --> 00:37:51,759 Speaker 1: These these are these are the magic bullets that we 655 00:37:51,760 --> 00:37:55,080 Speaker 1: were promised, and they are not cures. And in virtually 656 00:37:55,120 --> 00:37:58,680 Speaker 1: all these cases, the campcer comes back. And why does 657 00:37:58,719 --> 00:38:02,279 Speaker 1: it come back because of Charles flipping Darwin? You know, 658 00:38:02,400 --> 00:38:05,759 Speaker 1: it's it's evolution. You hit something, you get rid of 659 00:38:05,880 --> 00:38:08,879 Speaker 1: most of the cells that are sensitive, and you've still 660 00:38:08,920 --> 00:38:11,600 Speaker 1: got a core of resistance because you've got so much 661 00:38:11,719 --> 00:38:16,400 Speaker 1: genetic diversity in that population of cancer cells. And so 662 00:38:16,520 --> 00:38:19,920 Speaker 1: they start growing again, and this time they're resistant to 663 00:38:19,960 --> 00:38:23,400 Speaker 1: the drug. So maybe you try another drug, same thing happens. 664 00:38:23,680 --> 00:38:26,640 Speaker 1: You get rid of the sensitive cells, you've still got 665 00:38:26,640 --> 00:38:30,400 Speaker 1: a core of resistance, and they grow back, and eventually 666 00:38:30,520 --> 00:38:35,080 Speaker 1: you run out of options. And there's time now to 667 00:38:35,200 --> 00:38:40,440 Speaker 1: think about cancer in a much more evolutionary and ecological way, 668 00:38:40,480 --> 00:38:43,640 Speaker 1: as you say, thinking about well, if we know that 669 00:38:43,680 --> 00:38:46,520 Speaker 1: this process of evolution is at work, that if you 670 00:38:46,520 --> 00:38:49,359 Speaker 1: get rid of the sensitive cells, the resistant ones come back, Like, well, 671 00:38:49,360 --> 00:38:52,600 Speaker 1: why don't we try and approach this in a different way. 672 00:38:53,000 --> 00:38:55,480 Speaker 1: Why don't we try not to knock them all out? 673 00:38:55,520 --> 00:38:59,320 Speaker 1: Why don't we try and balance these populations, keep them suppressed, 674 00:38:59,440 --> 00:39:02,000 Speaker 1: keep them under control, much in the way that say 675 00:39:02,000 --> 00:39:05,280 Speaker 1: a farmer would try and control the pests in his crop, 676 00:39:05,520 --> 00:39:08,360 Speaker 1: rather than completely trying to nuke them all from orbit 677 00:39:08,440 --> 00:39:12,719 Speaker 1: or eradicate every single last grasshopper, you know, and understanding 678 00:39:13,040 --> 00:39:17,000 Speaker 1: the ecology the tissue biology, So you know, are you 679 00:39:17,040 --> 00:39:20,960 Speaker 1: actually causing more damage to tissues by treating with drugs 680 00:39:21,040 --> 00:39:24,239 Speaker 1: or radiotherapy or surgery. How can we minimize that so 681 00:39:24,280 --> 00:39:27,359 Speaker 1: that it doesn't encourage cells to to cheat even more 682 00:39:27,640 --> 00:39:32,160 Speaker 1: in a damaged environment. So it's this this idea is 683 00:39:32,160 --> 00:39:35,759 Speaker 1: starting to come through, But I think I think it 684 00:39:35,840 --> 00:39:39,480 Speaker 1: does take a bit of a subtle and sophisticated understanding 685 00:39:40,600 --> 00:39:46,239 Speaker 1: of cancer as an evolutionary process within the tissue environment 686 00:39:46,320 --> 00:39:49,520 Speaker 1: of the body, rather than just like these are some 687 00:39:50,160 --> 00:39:51,799 Speaker 1: rogue cells that have gone wrong and they're growing out 688 00:39:51,800 --> 00:39:53,040 Speaker 1: of control, and we just need to hit them with 689 00:39:53,160 --> 00:39:55,400 Speaker 1: enough magic bullets and they'll go away. You know, the 690 00:39:55,440 --> 00:40:00,200 Speaker 1: classic cure for cancer that we've almost been sold it's 691 00:40:00,239 --> 00:40:04,040 Speaker 1: I don't think it's it should look like that, um 692 00:40:04,080 --> 00:40:07,880 Speaker 1: because we tried that and it's not really working. So 693 00:40:07,920 --> 00:40:10,320 Speaker 1: I think we need to try a different approach. This 694 00:40:10,480 --> 00:40:14,239 Speaker 1: way of talking about tumors is reminding me of something 695 00:40:14,239 --> 00:40:16,200 Speaker 1: you mentioned earlier in the book actually, which I thought 696 00:40:16,280 --> 00:40:19,719 Speaker 1: was really interesting image that stuck with me. The idea 697 00:40:19,760 --> 00:40:23,400 Speaker 1: of a hypothetical hyper tumor. I'd never considered this before, 698 00:40:23,440 --> 00:40:27,080 Speaker 1: but the idea that a tumor can get a tumor. Yeah. 699 00:40:27,239 --> 00:40:31,520 Speaker 1: So again, it's the thing that really jumped out at 700 00:40:31,520 --> 00:40:36,440 Speaker 1: me researching this book is that cancer is a microcosm 701 00:40:36,480 --> 00:40:40,480 Speaker 1: of evolution. It's it's a crucible of evolution. A dumpster 702 00:40:40,560 --> 00:40:43,040 Speaker 1: fire of evolution is probably the best way of putting it. 703 00:40:43,239 --> 00:40:47,400 Speaker 1: Cancer is a dumpster fire of evolution, Thank you, um. 704 00:40:47,440 --> 00:40:52,040 Speaker 1: But yeah, everything, every innovation of life that you see 705 00:40:52,160 --> 00:40:58,640 Speaker 1: on Earth, cancer can evolve because you have a very large, 706 00:40:58,680 --> 00:41:02,600 Speaker 1: genetically diverse, popular lation of cells that have got lots 707 00:41:02,600 --> 00:41:06,279 Speaker 1: of opportunity to try stuff out. So you know, it's 708 00:41:06,320 --> 00:41:09,960 Speaker 1: not surprising that even within a horrible cheating atmosphere of 709 00:41:10,000 --> 00:41:13,920 Speaker 1: a cancer you might get some really really badass cells 710 00:41:13,960 --> 00:41:19,000 Speaker 1: that will start proliferating even more and actually suppress the 711 00:41:19,080 --> 00:41:23,680 Speaker 1: original tumor by just out competing them in a Darwinian sense. 712 00:41:24,280 --> 00:41:28,640 Speaker 1: And then there's some really wild things that I discovered. 713 00:41:28,680 --> 00:41:34,960 Speaker 1: So the most crazy innovation is that a guy is 714 00:41:35,000 --> 00:41:38,319 Speaker 1: a guy called Kenneth Pienta in Baltimore has discovered that 715 00:41:38,360 --> 00:41:42,120 Speaker 1: cancer cells have invented how to have sex. This this 716 00:41:42,360 --> 00:41:46,479 Speaker 1: really blew my mind. Because the implications are massive. Here. 717 00:41:47,360 --> 00:41:50,040 Speaker 1: We have this idea that cancer cells they just they 718 00:41:50,080 --> 00:41:53,480 Speaker 1: reproduced basically by splitting into that's fine, you know you 719 00:41:53,480 --> 00:41:55,400 Speaker 1: have one cancer cell, it becomes two, it becomes for 720 00:41:55,920 --> 00:41:58,480 Speaker 1: all of that kind of thing. There's no transfer of 721 00:41:58,560 --> 00:42:03,279 Speaker 1: information between cells and after that. But he's discovered with 722 00:42:03,320 --> 00:42:09,400 Speaker 1: these prostate cancer cells that they fuse together and become 723 00:42:09,440 --> 00:42:13,280 Speaker 1: resistant to treatments. And then they start kind of budding 724 00:42:13,280 --> 00:42:16,960 Speaker 1: off little cells that are resistant to treatment. And you're like, 725 00:42:17,800 --> 00:42:21,680 Speaker 1: what you know that looks like sex, I mean for 726 00:42:21,719 --> 00:42:23,799 Speaker 1: a very poor value of sex, but that you know, 727 00:42:23,840 --> 00:42:27,120 Speaker 1: that's the biological process of Sex's two cells fusing together 728 00:42:27,840 --> 00:42:33,680 Speaker 1: and and creating more. And you're like, whoa, because that's 729 00:42:33,680 --> 00:42:37,880 Speaker 1: a way of genetically combining forces. And again it's an 730 00:42:37,880 --> 00:42:42,320 Speaker 1: evolutionary innovation. Sex has evolved on this planet multiple times. 731 00:42:42,719 --> 00:42:46,160 Speaker 1: You know, it's not unheard of. And if you have 732 00:42:46,280 --> 00:42:49,239 Speaker 1: enough rolls of that dice, as might happen in in 733 00:42:49,280 --> 00:42:53,080 Speaker 1: a cancer you know, weird, weird, weird, our stuff is 734 00:42:53,080 --> 00:42:57,720 Speaker 1: going to happen in there. Um. It's just it really 735 00:42:57,800 --> 00:43:02,400 Speaker 1: is mind blowing. Every innovation of life. Cancer cells, you know, 736 00:43:02,680 --> 00:43:06,600 Speaker 1: at some point somewhere might have a go at. And 737 00:43:06,680 --> 00:43:09,719 Speaker 1: so when I realized this, when I realized that, you know, 738 00:43:10,239 --> 00:43:12,319 Speaker 1: cells can have sex, cells can do all these kind 739 00:43:12,320 --> 00:43:15,520 Speaker 1: of crazy evolutionary things. They can smash their chromosomes out, 740 00:43:15,520 --> 00:43:17,800 Speaker 1: they can glue themselves back together. It's all kind of crazy. 741 00:43:18,760 --> 00:43:24,719 Speaker 1: And then I started learning about the thing that was 742 00:43:24,800 --> 00:43:30,120 Speaker 1: just really incredible. So, right, imagine there's a disaster movie happening. Right, 743 00:43:30,200 --> 00:43:33,520 Speaker 1: you know what happens in a disaster movie. Everything's going wrong. 744 00:43:33,760 --> 00:43:35,680 Speaker 1: You've got the guy and you've got the girl, and 745 00:43:36,239 --> 00:43:39,360 Speaker 1: what do you do when your world's ending, right, You 746 00:43:39,400 --> 00:43:42,680 Speaker 1: have sex basically, So that's like a last ditch attempt 747 00:43:43,000 --> 00:43:45,279 Speaker 1: for cancer cells to try and come up with some 748 00:43:45,400 --> 00:43:48,319 Speaker 1: kind of evolutionary innovations that are going to get them 749 00:43:48,320 --> 00:43:51,759 Speaker 1: out of trouble. But then there's one more thing that 750 00:43:51,920 --> 00:43:55,360 Speaker 1: happens at the end of a disaster movie, right, you 751 00:43:55,480 --> 00:43:59,960 Speaker 1: leave the planet. Sure, yeah, and like and cancer cell 752 00:44:00,280 --> 00:44:05,560 Speaker 1: do this, and this is absolutely incredible. So so this 753 00:44:05,640 --> 00:44:08,200 Speaker 1: is where we get to infectious cancer, the idea that 754 00:44:08,239 --> 00:44:12,680 Speaker 1: it could actually be contagious. Yeah, so this is this 755 00:44:12,719 --> 00:44:16,080 Speaker 1: is kind of spooky and scary because it's a very 756 00:44:16,120 --> 00:44:19,799 Speaker 1: medieval idea that cancer is contagious. That you catch it 757 00:44:19,840 --> 00:44:23,280 Speaker 1: from someone. And I will say that in certainly in humans, 758 00:44:23,280 --> 00:44:26,480 Speaker 1: there's no contagious cancers that we know of. But the 759 00:44:26,520 --> 00:44:30,799 Speaker 1: first example was the Tasmanian Devils. So this was back 760 00:44:30,840 --> 00:44:34,799 Speaker 1: in the nineties nineties. The Tasmanian Devils, they're all in Tasmania, 761 00:44:34,960 --> 00:44:38,240 Speaker 1: Southern Australia. They're very cute animals, but like they're evil. 762 00:44:39,120 --> 00:44:42,239 Speaker 1: They're very you know, they're they're placid more or less 763 00:44:42,239 --> 00:44:46,239 Speaker 1: around humans, but they absolutely hate each other. So when 764 00:44:46,320 --> 00:44:49,880 Speaker 1: you get to Tasmanian devils together, they're just like, really, 765 00:44:49,920 --> 00:44:54,880 Speaker 1: go for it now, biting each other's faces. And researchers 766 00:44:54,920 --> 00:44:58,719 Speaker 1: started to notice that these animals were getting big tumors 767 00:44:58,719 --> 00:45:02,160 Speaker 1: in their faces and in some cases it was killing them, 768 00:45:02,200 --> 00:45:05,600 Speaker 1: and that they're already endangered as it is, and this 769 00:45:05,719 --> 00:45:09,799 Speaker 1: cancer started sweeping through the populations and I was like, 770 00:45:09,840 --> 00:45:13,239 Speaker 1: oh no, what we're going to do. And a woman 771 00:45:13,280 --> 00:45:15,840 Speaker 1: in Australia, she was working for the for the government 772 00:45:15,880 --> 00:45:18,760 Speaker 1: in a hospital. She's she was looking at cancer samples 773 00:45:18,760 --> 00:45:21,360 Speaker 1: from humans and looking at the chromosomes. It was a 774 00:45:21,360 --> 00:45:23,880 Speaker 1: way back then of identifying the kind of cancer you 775 00:45:23,960 --> 00:45:28,200 Speaker 1: might have. And so she started looking at these Tasmania 776 00:45:28,239 --> 00:45:31,920 Speaker 1: devil cancer samples. Now, the thing about human cancers is 777 00:45:32,000 --> 00:45:35,080 Speaker 1: every human cancer is a one off. It's a unique 778 00:45:35,280 --> 00:45:38,319 Speaker 1: evolutionary event. It starts in you, it grows a new 779 00:45:38,360 --> 00:45:40,680 Speaker 1: it evolves in you, and it it dies in you 780 00:45:40,920 --> 00:45:43,759 Speaker 1: one way or the other. When she was looking at 781 00:45:43,800 --> 00:45:51,320 Speaker 1: these devil cancers, like they're all the same from every animal. 782 00:45:52,040 --> 00:45:55,919 Speaker 1: The chromosomes were absolutely the same, and it's like, that 783 00:45:56,920 --> 00:46:00,480 Speaker 1: does not happen. That is that? And she was like, 784 00:46:01,360 --> 00:46:05,080 Speaker 1: this is a contagious cancer and uh. And eventually they 785 00:46:05,160 --> 00:46:06,960 Speaker 1: kind of pinned it down and it said, yes, it 786 00:46:07,080 --> 00:46:11,200 Speaker 1: was cancer cells transmitting from one devil to another through 787 00:46:11,239 --> 00:46:14,759 Speaker 1: that mechanism of biting and fighting and scratching. So it's 788 00:46:14,800 --> 00:46:17,080 Speaker 1: a you need with a contagious cancer. You need to 789 00:46:17,080 --> 00:46:19,839 Speaker 1: have a mechanism of transfer to get the cells from 790 00:46:19,880 --> 00:46:23,759 Speaker 1: one organism to the other. So with the devils, it 791 00:46:23,800 --> 00:46:27,279 Speaker 1: was it was biting and fighting. Um. And then there 792 00:46:27,320 --> 00:46:31,160 Speaker 1: was another cancer, contagious cancer, which were allowed to talk 793 00:46:31,160 --> 00:46:36,640 Speaker 1: about dog genitals. Oh yeah, just I just did so. Yeah, 794 00:46:36,640 --> 00:46:42,080 Speaker 1: so there's a dog genital cancer called canine venereal tumor 795 00:46:42,600 --> 00:46:47,240 Speaker 1: as CTBT and so yeah, it's again when when dogs 796 00:46:47,239 --> 00:46:50,080 Speaker 1: have sex. It's not pretty, but they get kind of 797 00:46:50,080 --> 00:46:55,080 Speaker 1: tied together in the the gentleman and lady department, and 798 00:46:55,440 --> 00:46:58,360 Speaker 1: that can cause some injury. So again you have a 799 00:46:58,400 --> 00:47:01,359 Speaker 1: mechanism for cancer cells to try its fer from one 800 00:47:01,400 --> 00:47:06,160 Speaker 1: dog to the other. And this cancer it transmits through populations. 801 00:47:06,239 --> 00:47:10,000 Speaker 1: And there's a woman called Elizabeth Murchison who's in Cambridge University. 802 00:47:10,040 --> 00:47:13,160 Speaker 1: She started studying the devils and then she started studying 803 00:47:13,160 --> 00:47:16,680 Speaker 1: these dogs and they discovered that these cancer cells in 804 00:47:16,719 --> 00:47:20,160 Speaker 1: the dogs have been around for thousands of years. The 805 00:47:20,239 --> 00:47:25,120 Speaker 1: first dog with that cancer lived and died thousands of 806 00:47:25,200 --> 00:47:28,640 Speaker 1: years ago, and it's gone all over the world. And 807 00:47:28,719 --> 00:47:32,279 Speaker 1: that's like, it's like the oldest I don't know, it's 808 00:47:32,320 --> 00:47:36,840 Speaker 1: like the oldest mammal. I suppose. It's just incredible. Um 809 00:47:36,880 --> 00:47:39,319 Speaker 1: this they've worked out what kind of dog it was. 810 00:47:39,520 --> 00:47:40,920 Speaker 1: It was, you know, a little kind of dog with 811 00:47:41,000 --> 00:47:45,320 Speaker 1: like pointy ears and a sandy coat, and it's amazing. 812 00:47:46,040 --> 00:47:48,560 Speaker 1: So when you're saying it's the oldest mammal, in a way, 813 00:47:48,600 --> 00:47:50,800 Speaker 1: you're saying that the tumor is in a sense of 814 00:47:50,920 --> 00:47:54,080 Speaker 1: part of that original dog. It is that dog. It 815 00:47:54,200 --> 00:47:57,959 Speaker 1: is that dog's body exactly the tumor arose in the dog. 816 00:47:58,280 --> 00:48:00,760 Speaker 1: It's got the genome of the oridge, an old dog, 817 00:48:00,840 --> 00:48:04,200 Speaker 1: like seriously messed up, I mean, and these cancers are 818 00:48:04,200 --> 00:48:08,440 Speaker 1: now evolving independently in different dog populations all over the world. 819 00:48:08,520 --> 00:48:13,600 Speaker 1: But yeah, it's it's an incredibly long lived organism. I suppose, 820 00:48:13,680 --> 00:48:17,000 Speaker 1: so that that was one devil cancer which was relatively 821 00:48:17,040 --> 00:48:19,400 Speaker 1: recent a dog cancer, and then they found a new 822 00:48:19,600 --> 00:48:24,080 Speaker 1: second devil tumor that had arisen even more recently. So 823 00:48:24,120 --> 00:48:26,200 Speaker 1: that's very unlucky for the devils. And they think it's 824 00:48:26,200 --> 00:48:30,040 Speaker 1: because again they're quite an inbred population, so with this 825 00:48:30,040 --> 00:48:33,759 Speaker 1: this fighty bity mechanism of transfer, so you've got quite 826 00:48:33,840 --> 00:48:38,000 Speaker 1: high probability that this might happen. And then there's all 827 00:48:38,040 --> 00:48:42,520 Speaker 1: these weird shellfish that have cancer and seem to transfer 828 00:48:42,680 --> 00:48:46,480 Speaker 1: it between each other by shedding cancer cells into the sea, 829 00:48:47,400 --> 00:48:52,880 Speaker 1: which is just disgusting. Um. It has made me rethink 830 00:48:53,000 --> 00:48:56,680 Speaker 1: my idea of swimming. But there's some really incredible examples 831 00:48:56,800 --> 00:49:00,160 Speaker 1: of transmissible cancers in nature. And again I think the 832 00:49:00,200 --> 00:49:02,719 Speaker 1: more we look, the more we're going to find. You know, 833 00:49:02,760 --> 00:49:05,000 Speaker 1: each one of these papers just gets published and less 834 00:49:05,040 --> 00:49:08,080 Speaker 1: and less impressive journal is more and more, more and 835 00:49:08,120 --> 00:49:12,200 Speaker 1: more turn up. But there are some examples in humans, 836 00:49:12,200 --> 00:49:14,920 Speaker 1: and I talk about a couple in the book. So 837 00:49:15,000 --> 00:49:19,680 Speaker 1: there's one which is they're absolutely horrendous. Is a guy 838 00:49:19,760 --> 00:49:23,000 Speaker 1: called Chester Southam who was in New York, I think 839 00:49:23,000 --> 00:49:27,360 Speaker 1: in the fifties, and he was doing experiments on prisoners, 840 00:49:28,080 --> 00:49:32,080 Speaker 1: mostly black prisoners in the US, people in care homes 841 00:49:32,719 --> 00:49:35,680 Speaker 1: can existing cancer patients. People are very desperate and not 842 00:49:35,719 --> 00:49:39,480 Speaker 1: consenting to these experiments properly, and he was putting cancer 843 00:49:39,480 --> 00:49:43,760 Speaker 1: cells into them and in some cases they did developed humors. 844 00:49:43,800 --> 00:49:46,600 Speaker 1: Mostly they didn't, which shows the human immune system will 845 00:49:46,719 --> 00:49:50,600 Speaker 1: fight these cells off, but some of them did. And 846 00:49:50,640 --> 00:49:54,360 Speaker 1: also there's a very sad story of a woman who 847 00:49:55,280 --> 00:49:58,399 Speaker 1: developed melanoma. And at the time, this is around about 848 00:49:58,400 --> 00:50:00,759 Speaker 1: the sixties, I think it was an idea that you 849 00:50:00,840 --> 00:50:05,600 Speaker 1: could transplant some cancer cells into someone to get an 850 00:50:05,600 --> 00:50:10,440 Speaker 1: immune reaction going uh, and then give that kind of 851 00:50:10,440 --> 00:50:12,520 Speaker 1: blood back to the patient and it would help to 852 00:50:12,520 --> 00:50:15,680 Speaker 1: treat their cancer. It's sort of an early idea immunotherapy, 853 00:50:16,160 --> 00:50:19,560 Speaker 1: so basically getting someone's donor immune system to generate some 854 00:50:19,600 --> 00:50:23,400 Speaker 1: antibodies to neutralize the cancer when you donated them. And 855 00:50:23,520 --> 00:50:25,879 Speaker 1: so this woman's mother said all right, I'll do this. 856 00:50:26,239 --> 00:50:29,280 Speaker 1: You transplant me with a bit of my daughter's cancer, 857 00:50:30,040 --> 00:50:32,840 Speaker 1: I'll generate the antibodies, and then you can take my 858 00:50:32,840 --> 00:50:36,520 Speaker 1: blood and give it to her. And unfortunately, the daughter 859 00:50:36,800 --> 00:50:41,200 Speaker 1: actually passed away very quickly, and a few weeks later 860 00:50:41,960 --> 00:50:44,600 Speaker 1: it was discovered that the mother actually did have the 861 00:50:44,640 --> 00:50:47,759 Speaker 1: cancer growing in her and and then shortly after that, 862 00:50:47,800 --> 00:50:50,960 Speaker 1: the mother passed away from the cancer that had killed 863 00:50:50,960 --> 00:50:55,040 Speaker 1: her daughter. And you're like, it's rare. Um and probably 864 00:50:55,080 --> 00:50:59,960 Speaker 1: because they were related, you overcome the problems of immune rejection, 865 00:51:00,120 --> 00:51:05,719 Speaker 1: but you're like, oh, well, it could happen. Ah. And 866 00:51:05,760 --> 00:51:12,000 Speaker 1: then there's the most absolutely disgusting one, which is this 867 00:51:12,080 --> 00:51:19,080 Speaker 1: is really sad and awful but also gross. Um. So, 868 00:51:19,080 --> 00:51:21,800 Speaker 1: there was a man who walks into an HIV clinic 869 00:51:22,200 --> 00:51:26,759 Speaker 1: in Colombia complaining of feeling very unwell. And so he 870 00:51:26,840 --> 00:51:29,520 Speaker 1: had HIV for a long time, so his immune system 871 00:51:29,600 --> 00:51:33,319 Speaker 1: was very suppressed. He hadn't been taking his medication, and 872 00:51:33,360 --> 00:51:35,680 Speaker 1: he was feeling very unwell. And they looked in his 873 00:51:35,719 --> 00:51:39,680 Speaker 1: body and they found all these little nodules in his 874 00:51:39,800 --> 00:51:44,080 Speaker 1: body and and they were like, well, these don't look 875 00:51:44,120 --> 00:51:48,040 Speaker 1: like human cells. This is very weird, and well, maybe 876 00:51:48,040 --> 00:51:50,840 Speaker 1: it's a parasite or something. And they gave him some 877 00:51:50,840 --> 00:51:53,239 Speaker 1: some treatment, and he went away and and he came 878 00:51:53,280 --> 00:51:55,000 Speaker 1: back and he's like, it's still no better, and there's 879 00:51:55,040 --> 00:51:58,120 Speaker 1: more and more of these weird things. And they looked 880 00:51:58,120 --> 00:52:02,640 Speaker 1: more closely, they got them analyzed, and it was he'd 881 00:52:02,640 --> 00:52:06,920 Speaker 1: been infected by tapeworm, but the tape worm had a 882 00:52:07,000 --> 00:52:13,240 Speaker 1: cancer and the cancer had infected the man. And you're like, whoa, 883 00:52:14,120 --> 00:52:19,160 Speaker 1: that is a just the stuff of nightmares. Um. Be 884 00:52:19,600 --> 00:52:22,160 Speaker 1: highlights how powerful the human immune system is at the 885 00:52:22,200 --> 00:52:25,080 Speaker 1: best of times. And see it's like, oh my god. 886 00:52:26,360 --> 00:52:29,960 Speaker 1: You know, also tape worms can get cancer, so it 887 00:52:30,040 --> 00:52:32,839 Speaker 1: sort of highlights a lot of the principles at work here. 888 00:52:33,080 --> 00:52:36,160 Speaker 1: And very sad for that man, but unfortunately he couldn't 889 00:52:36,160 --> 00:52:40,319 Speaker 1: be treated in the time. Um and it's like, this 890 00:52:40,400 --> 00:52:46,520 Speaker 1: is an incredible biological phenomenon really that we were only 891 00:52:46,600 --> 00:52:49,719 Speaker 1: just starting to understand. Yeah, I mean, these are all 892 00:52:50,400 --> 00:52:53,680 Speaker 1: just unbelievable examples. And and go in the column of 893 00:52:54,440 --> 00:52:56,640 Speaker 1: you know, the case you make that we should shift 894 00:52:56,680 --> 00:52:59,919 Speaker 1: towards that thinking of cancer in an evolutionary and ecological 895 00:53:00,000 --> 00:53:03,839 Speaker 1: way instead of a purely molecular way. So if that's 896 00:53:03,880 --> 00:53:07,680 Speaker 1: the dark side. What about thinking about cancer and an 897 00:53:07,680 --> 00:53:11,239 Speaker 1: evolutionary and ecological way gives you hope? Do you see 898 00:53:11,440 --> 00:53:15,319 Speaker 1: lines of research extending from that framework that give you 899 00:53:15,320 --> 00:53:18,719 Speaker 1: hope for the future and of cancer treatment and and 900 00:53:18,840 --> 00:53:22,319 Speaker 1: the fight against cancer. Yeah, so you know, you can 901 00:53:22,360 --> 00:53:24,960 Speaker 1: get very sort of nihilistic about this, and I, oh, yeah, 902 00:53:25,080 --> 00:53:29,040 Speaker 1: resistance always emerges. Evolution is is so powerful. But then 903 00:53:29,080 --> 00:53:32,040 Speaker 1: I look at the kind of researchers that are really 904 00:53:32,560 --> 00:53:36,200 Speaker 1: getting to grips with evolutionary therapy, and it's a growing bunch. 905 00:53:36,680 --> 00:53:39,200 Speaker 1: It's all started, particularly I think from the Mopic Cancer 906 00:53:39,280 --> 00:53:43,120 Speaker 1: Center in Tampa and Florida and a man called Bob 907 00:53:43,120 --> 00:53:46,000 Speaker 1: Gattenby and his team there, and they are just really 908 00:53:46,040 --> 00:53:51,480 Speaker 1: incredible people. So I mean, I'm a biologist, I am biased, 909 00:53:51,560 --> 00:53:55,720 Speaker 1: I will say against mathematicians and physicists. But it turns 910 00:53:55,719 --> 00:53:58,840 Speaker 1: out the secret the secret weapon in the war on 911 00:53:58,920 --> 00:54:02,840 Speaker 1: cancer is as So there you go. So he's brought 912 00:54:02,840 --> 00:54:07,480 Speaker 1: together all these mathematicians and biologists and they're actually doing 913 00:54:08,080 --> 00:54:13,200 Speaker 1: evolutionary modeling on cancer populations, trying to understand the rise 914 00:54:13,280 --> 00:54:17,240 Speaker 1: and the fall of resistant and sensitive cells, trying to go, okay, 915 00:54:17,400 --> 00:54:20,640 Speaker 1: if if resistance is going to emerge when you treat. 916 00:54:21,320 --> 00:54:24,400 Speaker 1: Can we predict how that's going to happen? How do 917 00:54:24,520 --> 00:54:29,480 Speaker 1: we kind of let cell populations balance them cells out 918 00:54:29,520 --> 00:54:33,319 Speaker 1: and stay in control rather than just you know, nuke 919 00:54:33,360 --> 00:54:36,120 Speaker 1: it from orbit, which is kind of the conventional idea 920 00:54:36,160 --> 00:54:40,640 Speaker 1: about cancer therapy. And so they've they've done a most 921 00:54:40,640 --> 00:54:44,600 Speaker 1: successful clinical trial so far as in prostate cancer and 922 00:54:44,680 --> 00:54:47,719 Speaker 1: it's it's an absolutely fascinating trial of an approach that 923 00:54:47,760 --> 00:54:51,239 Speaker 1: they call adaptive therapy. And the way it works is 924 00:54:51,560 --> 00:54:55,239 Speaker 1: you assume that within any cancer at any size, there 925 00:54:55,280 --> 00:54:58,200 Speaker 1: are going to be sensitive cells to the drug and 926 00:54:58,239 --> 00:55:00,400 Speaker 1: there's going to be resistant cells to the d and 927 00:55:00,400 --> 00:55:04,080 Speaker 1: it's a drug called abiratarone that they use. And so 928 00:55:04,120 --> 00:55:08,560 Speaker 1: what you do is you you also have to have 929 00:55:08,600 --> 00:55:11,960 Speaker 1: a marker that will tell you how much tumor is 930 00:55:11,960 --> 00:55:15,640 Speaker 1: in anyone's body at any given time. And for protect cancer, 931 00:55:15,640 --> 00:55:17,520 Speaker 1: we have quite a good marker. It's called p s A. 932 00:55:17,680 --> 00:55:19,759 Speaker 1: So you can look at someone's p s A level 933 00:55:19,840 --> 00:55:23,360 Speaker 1: in their bloodstream and say, okay, that's a proxy for 934 00:55:23,400 --> 00:55:26,440 Speaker 1: how much cancer is in their body. And so they 935 00:55:26,480 --> 00:55:31,120 Speaker 1: start treating this these men with prostate cancer advanced prostate cancer, 936 00:55:31,160 --> 00:55:34,640 Speaker 1: so they're there probably their their life expectancy is, you know, 937 00:55:34,680 --> 00:55:37,040 Speaker 1: about eighteen months on this drug before it starts to 938 00:55:37,080 --> 00:55:40,920 Speaker 1: get really gnarly for them. And and they treat them 939 00:55:40,960 --> 00:55:43,759 Speaker 1: with this drug and it starts to work and their 940 00:55:43,760 --> 00:55:47,600 Speaker 1: tumors start to shrink. And then the difficult bit is 941 00:55:47,719 --> 00:55:50,960 Speaker 1: you wait till it's shrunk to half the size it was, 942 00:55:52,520 --> 00:55:58,040 Speaker 1: and then you stop treating and you wait. So the 943 00:55:58,120 --> 00:56:00,920 Speaker 1: idea is you've knocked down all the insitive cells, or 944 00:56:00,960 --> 00:56:02,960 Speaker 1: as many of them as you. You feel the urge too, 945 00:56:03,200 --> 00:56:05,880 Speaker 1: and there's still some sensitive cells there which are keeping 946 00:56:05,920 --> 00:56:09,920 Speaker 1: the resistant cells in check. And then you wait and 947 00:56:09,960 --> 00:56:13,040 Speaker 1: you wait for them to grow back. But because being 948 00:56:13,080 --> 00:56:15,879 Speaker 1: resistant to the drug is kind of it's it's it's 949 00:56:15,880 --> 00:56:17,640 Speaker 1: not very good for you, these cells are less fit. 950 00:56:17,719 --> 00:56:19,840 Speaker 1: They struggled to grow as much. So it's the sensitive 951 00:56:19,840 --> 00:56:23,040 Speaker 1: cells that grow back, and so you treat them again. 952 00:56:23,480 --> 00:56:25,799 Speaker 1: And so you ride this kind of roller coaster of 953 00:56:26,440 --> 00:56:29,560 Speaker 1: start the drug, let the tumor shrink, stop the drug, 954 00:56:30,080 --> 00:56:33,480 Speaker 1: let the tumor grow. Start the drug, let the tumor shrink. 955 00:56:33,760 --> 00:56:35,760 Speaker 1: And they have men who have been on this regime 956 00:56:36,000 --> 00:56:39,680 Speaker 1: for four years, I mean gradually, in the end the 957 00:56:39,719 --> 00:56:43,080 Speaker 1: tumor does the cancer does start to evolve because that 958 00:56:43,120 --> 00:56:46,439 Speaker 1: population of resistant cells does start to get bigger, very 959 00:56:46,440 --> 00:56:49,319 Speaker 1: slightly every time. But this is you know, if this 960 00:56:49,400 --> 00:56:52,000 Speaker 1: was a drug and you were saying, I've gone from 961 00:56:52,120 --> 00:56:55,560 Speaker 1: average eighteen months through to four years, you know, if 962 00:56:55,600 --> 00:56:58,840 Speaker 1: this was a drug, the industry would just be throwing 963 00:56:58,840 --> 00:57:02,239 Speaker 1: itself trying to to get this, you know, get this 964 00:57:02,360 --> 00:57:04,440 Speaker 1: to the clinic, get this to work, get this to everyone. 965 00:57:05,239 --> 00:57:09,560 Speaker 1: So that was that was a really powerful demonstration of 966 00:57:09,680 --> 00:57:13,279 Speaker 1: an evolutionary therapy of understanding and accepting you've got these 967 00:57:13,280 --> 00:57:16,240 Speaker 1: cell populations in there and they're kind of how to 968 00:57:16,320 --> 00:57:21,520 Speaker 1: balance them. There are other sort of adaptive strategies, evolutionary strategies. 969 00:57:21,520 --> 00:57:23,840 Speaker 1: This one called the Suckers gambit, which is where you 970 00:57:23,880 --> 00:57:26,800 Speaker 1: treat cancer cells with a drug that you want them 971 00:57:26,800 --> 00:57:31,480 Speaker 1: to develop evolved resistance too. But you know that for 972 00:57:31,520 --> 00:57:34,800 Speaker 1: them to have evolved resistance, they have to have activated 973 00:57:34,880 --> 00:57:37,320 Speaker 1: certain molecular pathways, they have to have gone down an 974 00:57:37,360 --> 00:57:40,960 Speaker 1: evolutionary route in one direction, and then you hit them 975 00:57:40,960 --> 00:57:44,200 Speaker 1: with another drug that they can't get out of, so 976 00:57:44,240 --> 00:57:46,240 Speaker 1: you're sort of you you get them into a blind 977 00:57:46,280 --> 00:57:51,040 Speaker 1: evolutionary end. It's like a double punch. Yeah, exactly. You know, 978 00:57:51,080 --> 00:57:54,760 Speaker 1: there's there's lots of ideas out there about using the 979 00:57:54,840 --> 00:57:58,280 Speaker 1: drugs we have, maybe even using drugs that are less 980 00:57:59,160 --> 00:58:03,960 Speaker 1: less good I suppose less potent, less, less toxic, because 981 00:58:03,960 --> 00:58:07,000 Speaker 1: you don't want to just nuke everything. You want to 982 00:58:07,040 --> 00:58:09,960 Speaker 1: start thinking about how to balance cells, how to control 983 00:58:10,040 --> 00:58:14,680 Speaker 1: cell populations. But this comes to the really difficult thing, 984 00:58:14,800 --> 00:58:18,920 Speaker 1: which is the psychological element of this, because this is 985 00:58:18,960 --> 00:58:23,120 Speaker 1: not the cure for cancer that we were promised. This 986 00:58:23,200 --> 00:58:26,320 Speaker 1: is not the magic bullet, This is not eradicated from 987 00:58:26,360 --> 00:58:29,320 Speaker 1: your body. There may be some approaches where we actually 988 00:58:29,360 --> 00:58:32,160 Speaker 1: can and you know, the earlier you can diagnose cancer 989 00:58:32,440 --> 00:58:35,440 Speaker 1: if you can treat it with surgery. Um, some cancers 990 00:58:35,480 --> 00:58:39,720 Speaker 1: can be treated really effectively and cured at an early stage. 991 00:58:40,320 --> 00:58:43,919 Speaker 1: But for cancers, once that evolutionary process has really kicked off, 992 00:58:44,840 --> 00:58:48,760 Speaker 1: you have to approach them with an evolutionary mindset, and 993 00:58:48,840 --> 00:58:52,120 Speaker 1: that may mean driving them to extinction with the right 994 00:58:52,160 --> 00:58:55,960 Speaker 1: combination of sort of extinction events at the right time. 995 00:58:57,200 --> 00:59:00,760 Speaker 1: But it's a it's not going to be this kind 996 00:59:00,800 --> 00:59:04,720 Speaker 1: of perfect cure that I think people want, that we've 997 00:59:04,760 --> 00:59:07,760 Speaker 1: been led to expect, and it certainly won't be one 998 00:59:08,280 --> 00:59:11,919 Speaker 1: magic bullet drug that like, Yep, that's it. That's that's 999 00:59:11,920 --> 00:59:14,120 Speaker 1: the cure. That's it. We can now sell this and 1000 00:59:14,120 --> 00:59:17,360 Speaker 1: give it to everyone because, as I said, you know, 1001 00:59:17,760 --> 00:59:21,080 Speaker 1: every every individual cancer is a is a one off, 1002 00:59:21,120 --> 00:59:25,760 Speaker 1: it's a special snowflake. It's an individual evolutionary event. So 1003 00:59:25,920 --> 00:59:29,000 Speaker 1: we need to understand that where is it going, what's 1004 00:59:29,040 --> 00:59:32,200 Speaker 1: it doing, what are what are the contingencies in there? 1005 00:59:32,840 --> 00:59:35,800 Speaker 1: And how can we either drive this cancer to extinction 1006 00:59:36,840 --> 00:59:39,400 Speaker 1: or drive it to a place where we can control 1007 00:59:39,480 --> 00:59:43,160 Speaker 1: it for the rest of someone's natural lifespan. And you know, 1008 00:59:43,240 --> 00:59:46,439 Speaker 1: that's not a cure for cancer, but to me, that's 1009 00:59:46,560 --> 00:59:49,919 Speaker 1: you know, I think that's getting there. Yeah, I really 1010 00:59:49,960 --> 00:59:52,720 Speaker 1: like that. Thinking of the body not like as a 1011 00:59:52,800 --> 00:59:55,920 Speaker 1: malfunctioning car with a part that needs to be replaced 1012 00:59:56,000 --> 00:59:59,919 Speaker 1: or fixed, but as an environment with natural populations within 1013 01:00:00,040 --> 01:00:04,320 Speaker 1: it that in the relationships between them need to be managed. Yeah, 1014 01:00:04,400 --> 01:00:07,800 Speaker 1: sort of tending the garden is the idea, but you 1015 01:00:07,800 --> 01:00:11,080 Speaker 1: can take the ecological thing further. There are different sorts 1016 01:00:11,120 --> 01:00:14,440 Speaker 1: of cancers, you know. Some are lush, exotic rainforests that 1017 01:00:14,480 --> 01:00:16,720 Speaker 1: are really going for it. Some are arid deserts, some 1018 01:00:16,800 --> 01:00:20,720 Speaker 1: are more like you know, kind of neatly tendered gardens. 1019 01:00:20,800 --> 01:00:24,520 Speaker 1: But we've got to understand what each person's cancer is 1020 01:00:24,960 --> 01:00:28,320 Speaker 1: really like and how it's behaving. Not just a shopping 1021 01:00:28,320 --> 01:00:30,560 Speaker 1: list of mutations that you can try and fire magic 1022 01:00:30,560 --> 01:00:36,600 Speaker 1: bullets at, but a much more holistic understanding and accepting 1023 01:00:36,960 --> 01:00:40,360 Speaker 1: that evolution is going to happen, always has done. That's 1024 01:00:40,400 --> 01:00:42,840 Speaker 1: why we're here, that's why the diversity of life is here. 1025 01:00:43,440 --> 01:00:46,520 Speaker 1: But if we can harness it and work with it, 1026 01:00:46,960 --> 01:00:49,280 Speaker 1: then I really think we can start to make some 1027 01:00:49,320 --> 01:00:53,760 Speaker 1: progress in in some of these most difficult advanced cancers. Alright, 1028 01:00:53,800 --> 01:00:55,640 Speaker 1: I guess we will wrap it up there. But again, 1029 01:00:55,680 --> 01:00:59,360 Speaker 1: the book is Rebel Cell. It's a fantastic reed. We 1030 01:00:59,360 --> 01:01:01,800 Speaker 1: we really think you'll like it. And also you can 1031 01:01:01,880 --> 01:01:05,440 Speaker 1: check out cats podcast, the Genetics Unzipped podcast. Is there 1032 01:01:05,440 --> 01:01:07,160 Speaker 1: anywhere else they should look for your work right now, 1033 01:01:07,200 --> 01:01:14,000 Speaker 1: Cat um, my first book, Herding Hemmingway's Cats, is available. 1034 01:01:14,440 --> 01:01:16,360 Speaker 1: I've got another book called How to Code a Human 1035 01:01:17,000 --> 01:01:20,959 Speaker 1: and you can find me at on Twitter. I'm Cat 1036 01:01:21,080 --> 01:01:25,600 Speaker 1: Underscore Arnie. Pretty much. Yeah, every everything's pretty much the 1037 01:01:26,480 --> 01:01:28,720 Speaker 1: al Right, Well, that does it. Thanks again to Cat 1038 01:01:28,800 --> 01:01:31,760 Speaker 1: Arnie for joining us for this discussion. Again, if you're 1039 01:01:31,760 --> 01:01:33,480 Speaker 1: trying to look her up. You can find her on 1040 01:01:33,520 --> 01:01:37,160 Speaker 1: Twitter at at k A T underscore A r n 1041 01:01:37,160 --> 01:01:40,120 Speaker 1: e Y. And if you're looking for her book, Rebel 1042 01:01:40,160 --> 01:01:44,600 Speaker 1: Cell Cancer, Evolution and the New Science of Life's Oldest Betrayal. UH. 1043 01:01:44,680 --> 01:01:47,800 Speaker 1: The UK version is coming out on August six. The 1044 01:01:47,920 --> 01:01:50,920 Speaker 1: US version is coming out on September twenty nine. You 1045 01:01:50,920 --> 01:01:53,560 Speaker 1: can pre order now, I believe, if not, keep an 1046 01:01:53,600 --> 01:01:56,160 Speaker 1: eye out for it, and you can also look it 1047 01:01:56,240 --> 01:02:00,160 Speaker 1: up on her website at Rebel Cell book dot com 1048 01:02:00,280 --> 01:02:02,640 Speaker 1: or check out her work on the Genetics on Zipped 1049 01:02:02,680 --> 01:02:05,840 Speaker 1: podcast at Genetics on zip dot com. It's just such 1050 01:02:05,880 --> 01:02:08,360 Speaker 1: a great book title. I just keep coming back to 1051 01:02:08,400 --> 01:02:10,680 Speaker 1: how much I love that book title. It really is 1052 01:02:10,720 --> 01:02:13,080 Speaker 1: great and uh, and it has some resonance throughout the 1053 01:02:13,080 --> 01:02:16,160 Speaker 1: book with some other themes and metaphors she discusses in there, 1054 01:02:16,240 --> 01:02:18,560 Speaker 1: such as the Society of Cells. So, Robert, I really 1055 01:02:18,600 --> 01:02:20,360 Speaker 1: do recommend you read it if you get a chance. 1056 01:02:20,400 --> 01:02:22,840 Speaker 1: I I really enjoyed this one, all right. I'll have 1057 01:02:22,880 --> 01:02:26,800 Speaker 1: to look forward in September. In the meantime, everyone out 1058 01:02:26,800 --> 01:02:29,280 Speaker 1: there would like to listen to additional episodes of Stuff 1059 01:02:29,280 --> 01:02:32,160 Speaker 1: to Blow your mind, Well, you can find us absolutely 1060 01:02:32,240 --> 01:02:35,760 Speaker 1: wherever you get your podcasts and wherever that happens to be. 1061 01:02:35,880 --> 01:02:39,080 Speaker 1: We just asked that you rate, review, and subscribe. Those 1062 01:02:39,080 --> 01:02:41,280 Speaker 1: are three things that you can do. It just really 1063 01:02:41,280 --> 01:02:43,160 Speaker 1: helps out the show. Another thing you can do is just, 1064 01:02:43,160 --> 01:02:46,000 Speaker 1: of course, just tell people about the show. Huge thanks 1065 01:02:46,000 --> 01:02:49,280 Speaker 1: as always to our excellent audio producer Seth Nicholas Johnson. 1066 01:02:49,600 --> 01:02:51,160 Speaker 1: If you would like to get in touch with us 1067 01:02:51,160 --> 01:02:53,560 Speaker 1: with feedback on this episode or any other, to suggest 1068 01:02:53,560 --> 01:02:55,560 Speaker 1: a topic for the future, or just to say hello, 1069 01:02:55,800 --> 01:02:58,520 Speaker 1: you can email us at contact at stuff to Blow 1070 01:02:58,520 --> 01:03:08,440 Speaker 1: your Mind dot com. Stuff to Blow Your Mind is 1071 01:03:08,480 --> 01:03:11,160 Speaker 1: production of I Heart Radio. For more podcasts to my 1072 01:03:11,200 --> 01:03:14,160 Speaker 1: heart Radio. This is the I heart Radio app, Apple Podcasts, 1073 01:03:14,240 --> 01:03:27,760 Speaker 1: or wherever you're listening to your favorite shows.