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Speaker 1: Welcome to Stuff to Blow Your Mind production of My

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Speaker 1: Heart Radio. Hey are you welcome to Stuff to Blow

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Speaker 1: Your Mind? My name is Robert Lamb and I'm Joe McCormick.

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Speaker 1: And today we're bringing you another interview that I conducted

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Speaker 1: last week while Robert was taking a break from work.

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Speaker 1: That's right. Once a year, I like to bury myself

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Speaker 1: in some sacred imported soil and allow my my body

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Speaker 1: to break down and then reconstitute itself so that I

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Speaker 1: can rise once more and be up to the challenges

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Speaker 1: of podcasting in this day and age. Today we are

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Speaker 1: going to be sharing the conversation that I had with

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Speaker 1: the British geneticist and science communicator cat Arnie talking about

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Speaker 1: her upcoming book, Rebel Cell Cancer Evolution in the New

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Speaker 1: Science of Life's Oldest Betrayal. So a little bit of

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Speaker 1: biographical information. Cat Arnie hosts the Genetta Unzipped podcast and

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Speaker 1: she holds a PhD in developmental genetics from Cambridge University.

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Speaker 1: She was a key part of the science communications team

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Speaker 1: at Cancer Research UK from two thousand four to co

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Speaker 1: founding the charity's award winning science blog and acting as

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Speaker 1: a principal media spokesperson She's also the author of Hurting

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Speaker 1: Hemmingway's Cats, Understanding How Our Genes Work and How to

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Speaker 1: Code a Human and she's written for Wired, The Daily Mail, Nature, Mosaic,

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Speaker 1: News Scientist and more, and has presented many BBC radio programs.

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Speaker 1: You can find Cat Arnie on Twitter at at cat

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Speaker 1: Underscore Arnie A r in E Y and UH. I

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Speaker 1: should note that the book is coming out at different

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Speaker 1: times in the UK in the US, so Rebel Cell

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Speaker 1: can be found in the UK starting on August six,

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Speaker 1: and then in the US I believe it's coming out

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Speaker 1: on September twenty nine, but you can go ahead and

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Speaker 1: preorder it online. All right, Well, I'm I'm in a

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Speaker 1: rare position here because I am just like the listeners

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Speaker 1: out there. I have not heard this interview yet myself,

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Speaker 1: so I am excited, uh to to to listen in

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Speaker 1: as she sheds light on this, uh, this fascinating topic.

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Speaker 1: Cat Arnie, thanks so much for joining us today on

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Speaker 1: the podcast. Thank you for having me. It's an absolute pleasure.

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Speaker 1: It's a pleasure to have someone on the show who

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Speaker 1: has not only written a great book, but you're actually

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Speaker 1: a podcaster yourself, so you're so you're used to this

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Speaker 1: whole game talking into the mic with alone by yourself

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Speaker 1: in a room. Yeah, I've been making the Genetic sun

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Speaker 1: Zipped podcast. I did have to say that through this

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Speaker 1: time we've we've deliberately made it a COVID free zone,

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Speaker 1: so it is currently a COVID free genetics podcast. So

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Speaker 1: that's been that's been a nice thing to do during

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Speaker 1: during this time. I gotta say I was listening to

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Speaker 1: one of your episodes of the Genetics sun Zip podcast,

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Speaker 1: the one about mount Sly and Pauline Gross, which I

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Speaker 1: thought was fantastic. Of course it connects to the book

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Speaker 1: that we're gonna be talking about today. So, uh, personal

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Speaker 1: endorsement from me of your podcast. Don't really like it,

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Speaker 1: thank you. Yeah, it's really fun. We we alternate. We

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Speaker 1: do sort of interviews with scientists who are working now

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Speaker 1: in genetics. But I also really like to go back

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Speaker 1: through those stories and and dig out, particularly the untold

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Speaker 1: women who were often they're doing the work, doing lots

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Speaker 1: and lots of stuff, incredibly detailed observations and breeding experiments,

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Speaker 1: and then basically didn't really get the credit for it

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Speaker 1: because until the middle of the twentieth century or later,

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Speaker 1: women weren't really respected as a scientist, so it's it's

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Speaker 1: just a wonderful exploration you come up with all these

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Speaker 1: incredible people, although, of course, in the early twentieth century

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Speaker 1: lots of them do turn out to be eugenicists, but

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Speaker 1: that's different. Podcast. Yeah, so I think maybe a good

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Speaker 1: place to start when talking about cancer. Of course, your

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Speaker 1: book is about cancer, and specifically a lot about the

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Speaker 1: genetics of cancer. I wanted to maybe start off by

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Speaker 1: talking about this strange kind of gut feeling or almost

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Speaker 1: superstition that somehow, unlike other diseases, cancer is a modern synthetic,

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Speaker 1: some kind of perversion in some way against nature, and

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Speaker 1: that it sometimes comes with this odd edge of moralism,

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Speaker 1: that cancer is not just unfortunate, but it's somehow decadent

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Speaker 1: in an indicator of something wrong with our age. Parts

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Speaker 1: of your book indicate to me that you've come up

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Speaker 1: against this kind of thinking a lot as well. What

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Speaker 1: do you think this sort of thinking signifies. I think

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Speaker 1: it's absolutely fascinating. Cancer is not a new disease, and

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Speaker 1: that really became abundantly clear to me. So, just as

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Speaker 1: a little bit of background, I spent twelve years working

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Speaker 1: at Cancer Research UK, the UK's biggest cancer charity, answering

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Speaker 1: lots of questions from the public, and all the time

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Speaker 1: this question comes up. It's like, why me, isn't it

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Speaker 1: just a modern disease? Oh, it's all this stuff in

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Speaker 1: the air, Oh it's stress. What what is it? And

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Speaker 1: you start to look into what cancer really is, and

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Speaker 1: it's it's ancient. It's hardwired into our biology because it's

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Speaker 1: just cells doing what they're going to do. Cells multiplying,

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Speaker 1: cells jostling for space, cells competing with the cells around them,

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Speaker 1: obeying the processes of evolution. And so when you really

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Speaker 1: start to look, it's not surprising that you find cancer

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Speaker 1: going all the way back through human history, all the

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Speaker 1: way back through the history of of animal life on

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Speaker 1: this planet. But at the same time, when people start

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Speaker 1: to become aware of cancer as a disease, they start

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Speaker 1: to ask questions about, well, where did this come from?

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Speaker 1: Why has it affected me? You start to get the

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Speaker 1: Greek doctors, people like Hippocrates, who were writing about cancers

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Speaker 1: in their patients and saying, well, what what has caused it?

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Speaker 1: It must be the gods, it must be the humors.

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Speaker 1: Something is out of whack in here, and then you

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Speaker 1: start to get the slightly more religious thing of well

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Speaker 1: it is it's sins visited on us, it is something

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Speaker 1: to do with immorality, modern living. And then you bring

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Speaker 1: up to today this we don't necessarily have such a

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Speaker 1: strong religious view of it, but certainly the idea of

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Speaker 1: almost wellness as a religion. You've done something toxic to

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Speaker 1: yourself and that's why you you now have cancer, and

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Speaker 1: you look back at the history of cancer as a

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Speaker 1: biological phenomenon, and that's simply not true. You know. It's

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Speaker 1: it's basically like the dark side of life rather than

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Speaker 1: anything that we have particularly brought on ourselves in our

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Speaker 1: modern life. Yeah, that's one of the things I really

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Speaker 1: loved about your book was the way you how you

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Speaker 1: show cancer to be so fundamentally integrated with with with

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Speaker 1: life itself or I guess, multi cellular life. Um. And

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Speaker 1: so so maybe we should focus on on a couple

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Speaker 1: of these ideas in particular, one of them, I guess,

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Speaker 1: is the idea of modernity, right, the idea that that

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Speaker 1: cancer is something that was very rare until recently. You

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Speaker 1: make an argument against and people have argued this, but

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Speaker 1: you make an argument against this in the book, and

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Speaker 1: you cite some both some reasoning about why a lot

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Speaker 1: of cancers wouldn't necessarily show up in the kinds of

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Speaker 1: remains we can examine, and then pointing out examples that

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Speaker 1: we do find in fact, in the human record and

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Speaker 1: physical remains of human society and prehistory. Yeah, it's the

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Speaker 1: classic thing in biology that you find what you're looking for,

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Speaker 1: and people have not been looking for signs of cancer

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Speaker 1: in ancient remains. And the thing about cancer is that

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Speaker 1: that when you're thinking about ancient remains that we find,

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Speaker 1: mostly you're talking about bones, and particularly when you get

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Speaker 1: very ancient, you're talking about fossilized bones. And not every

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Speaker 1: cancer leaves its trace in the bones. So when you're

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Speaker 1: thinking about cancers that affect the soft tissue, you may

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Speaker 1: never see the traces of a cancer that killed someone. Also,

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Speaker 1: you know, ancient remains don't turn up in beautifully age

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Speaker 1: matched structured populations, so you can say, oh, this is

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Speaker 1: exactly the population that was alive at the time, this

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Speaker 1: is exactly the number of cancers in this population. I

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Speaker 1: think some people have argued that the fact that cancers

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Speaker 1: are rare in ancient humans is an argument that cancer

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Speaker 1: was very very rare. But I slightly feel the other

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Speaker 1: way around. I feel like the fact that the more

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Speaker 1: people start looking for cancers in human and animal remains

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Speaker 1: from from way way back, the more cancers they start

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Speaker 1: to find suggest that it was more common. We will

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Speaker 1: never know how how common it was, because you can't

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Speaker 1: do you know, a lovely epidemiological study on the sort

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Speaker 1: of stuff that you can get out of the ground.

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Speaker 1: You get what you get and you get on with it, basically.

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Speaker 1: But I do think that cancer is not an exclusively

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Speaker 1: modern disease. I will say, certainly it is more common

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Speaker 1: as we live longer. So another of the things I

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Speaker 1: go into later in the book is the idea that

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Speaker 1: there's almost a sort of a shooting up point. After

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Speaker 1: you have got to a certain age, your risk of

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Speaker 1: cancer does significantly go up. So if you think about

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Speaker 1: ancient populations when there were many, many, many more things

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Speaker 1: that we're going to kill you, your chances of getting

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Speaker 1: to an age where you could dive cancer before something

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Speaker 1: else got you worse smaller. So it's not surprising we

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Speaker 1: find fewer ancient remains with cancer. But when you think

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Speaker 1: about some children have been found with types of cancer

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Speaker 1: that are very very rare in populations, and the fact

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Speaker 1: that we have found them at all suggests that this

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Speaker 1: is a disease that has always been with us, and

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Speaker 1: it's not exclusively a confection of modernity. It's it's basically,

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Speaker 1: you know, it is with us and always has been.

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Speaker 1: And what about the part of the misconception that views

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Speaker 1: cancer is something that is uniquely kind of human and

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Speaker 1: maybe associated with uh, with the synthetic products of human

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Speaker 1: industry and all that. Like, this ties into the idea

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Speaker 1: that sharks don't get cancer, right, that there's a widespread

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Speaker 1: belief that that, for some reason, animals that don't engage,

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Speaker 1: you know, don't live in cities and drive cars and

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Speaker 1: eat processed food and stuff won't get cancer. But they do. Yeah,

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Speaker 1: And this really my mind. I can see over on

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Speaker 1: my bookshelf. I'm so tempted to go and grab it.

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Speaker 1: But there's a book where someone has gone through all

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Speaker 1: the different species that have been known to have cancer

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Speaker 1: in In some cases it's many examples, in some it's

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Speaker 1: just a few. But it's pages and pages and pages.

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Speaker 1: It's everything from like odd wolves to zebras, and almost

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Speaker 1: every branch of the animal kingdom develops cancer. There are

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Speaker 1: a couple of really weird exceptions. So one is comb jellies.

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Speaker 1: Comb jellyfish don't seem to get cancer, never been detected.

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Speaker 1: And also sponges really weirdly resistant to sponges. There's this

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Speaker 1: guy in in Arizona, guy called Carlo Malei, who is

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Speaker 1: zapping sponges with enormous amounts of radiation like that would

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Speaker 1: kill a human, and they're just fine. They just shrug

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Speaker 1: it off. So there are some species that are cancer resistant,

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Speaker 1: but pretty much everything else to a greater or lesser

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Speaker 1: extent is and humans aren't even the most susceptible species.

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Speaker 1: There are some that are much more susceptible to cancer

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Speaker 1: than humans are. So this idea that it's it's just

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Speaker 1: a modern disease, it's just a human disease, it just

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Speaker 1: doesn't stack up. You know. Yes, there are things that

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Speaker 1: we do in our modern lives that increase the risk

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Speaker 1: of cancer, and our lovely living to a nice old

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Speaker 1: age is a major risk factor. You know, Thank god

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Speaker 1: we don't all die in childbirth and of infectious diseases

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Speaker 1: before our tenth birthday. But you know, we are we

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Speaker 1: are not, you know, unique and wonderful when it comes

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Speaker 1: to cancer again, it's it is just part of life.

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Speaker 1: There are some other interesting observations you mentioned in your

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Speaker 1: book about what might create a specific propensity for cancer

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Speaker 1: in certain species versus others. Are One that I recall

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Speaker 1: is that you mentioned that it's cancer seems to be

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Speaker 1: more prevalent in species that have been through a genetic

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Speaker 1: bottleneck at some point in the relatively recent past. So like,

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Speaker 1: if their breeding population was reduced to a pretty small

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Speaker 1: number at some point, they tend to be more susceptible

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Speaker 1: to cancer. Is that correct? Yes, So that does seem

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Speaker 1: to be the case, which suggests that there are genetic

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Speaker 1: factors at work. Because if you shrink a population down

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Speaker 1: to a very small what's called an effective breeding size,

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Speaker 1: you've got quite a small population that's all breeding with

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Speaker 1: each other. You do start to get a pile up

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Speaker 1: of mutations being passed from generation to generation, which might

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Speaker 1: be increasing the risk of cancer. One of my favorite

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Speaker 1: species in this case is the Syrian hamster, which all

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Speaker 1: the Syrian hamsters pretty much that are in pets and

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Speaker 1: labs all over the world are descended from one litter

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Speaker 1: of hamsters, and they are incredibly cancer prone because they're

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Speaker 1: just massively in bread um. But yeah, every every species,

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Speaker 1: some more than others and some much less than others.

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Speaker 1: So elephants very surprisingly, you'd think when you think about

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Speaker 1: it logically, animals that are very very big, they have

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Speaker 1: lots of cells that they live for a very very

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Speaker 1: long time. You think that elephants should be riddled with

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Speaker 1: cancer by the time they die, but they are not.

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Speaker 1: They are amazingly resistant and really long lived animals like

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Speaker 1: bowhead whales, even some of the really long lived bats,

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Speaker 1: brand bats that live for forty years, very resistant to cancer.

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Speaker 1: So they have evolved mechanisms that enable them to live

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Speaker 1: these very long, luxury lifestyles and be resistant to cancer.

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Speaker 1: Whereas you have very small rodents, things that live fast

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Speaker 1: and die young. Why bother. You know, you're going to

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Speaker 1: be around for a couple of breeding seasons and then

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Speaker 1: you're out. And humans are kind of in the middle.

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Speaker 1: You know, we live for many decades, we reach our

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Speaker 1: child bearing years in between our sort of twenties to forties,

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Speaker 1: hang around for a bit after, and then the risk

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Speaker 1: of cancer does start to go up. So you know,

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Speaker 1: this is when you put humans in the context of

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Speaker 1: all of life, you start to understand how our evolution

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Speaker 1: as a species is in trance tied to our as

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Speaker 1: a species risk of cancer. But you do have to

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Speaker 1: separate that from personal risk of cancer as well, and

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Speaker 1: that's a that's kind of a bit hard to get

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Speaker 1: your head around. So we're talking about evolutionary risks versus

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Speaker 1: personal risks. So one of the most interesting ideas in

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Speaker 1: your book that that you keep returning to is a

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Speaker 1: framework for thinking about multicellular life through the analogy of

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Speaker 1: a society, that a multicellular organism is a society of cells.

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Speaker 1: Could you explain this way of thinking in some of

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Speaker 1: the implications that extend from it. Yeah, this really really

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Speaker 1: blew my mind when I started to understand this. So,

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Speaker 1: this idea of cells as a society, it goes about

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Speaker 1: quite a few decades. A lot of the things I

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Speaker 1: discovered while I was researching the book are quite old

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Speaker 1: ideas that have got, you know it, subsumed or left

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Speaker 1: behind in this this rush to just understand cancer as

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Speaker 1: a purely genetic disease. But the idea is that that

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Speaker 1: cells and organisms and individuals in a species, they live

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Speaker 1: in societies, and there are rules of societies at every

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Speaker 1: single level. You know things like do the job you're

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Speaker 1: meant to do, don't take more than you need, clean

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Speaker 1: up after yourself, all these kinds of things. There are

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Speaker 1: rules to societies that make societies work productively. And you

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Speaker 1: start to look around at groups of cells that are

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Speaker 1: in tissues and in organs in your body. You look

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Speaker 1: at societies like ants and bees. You look at colonies,

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Speaker 1: you look at troops of chimps and herds of deer,

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Speaker 1: and you look at human societies and they all work

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Speaker 1: in the same way. And this particularly an idea that

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Speaker 1: I was influenced by. There's a researcher in Arizona called

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Speaker 1: Athena Actipis, and she works a lot on social cooperation

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Speaker 1: and cheating and the idea that cancer cells basically cheat

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Speaker 1: in society. They are cheaters. They take more than they need,

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Speaker 1: they produce waste, they proliferate out of control, they don't

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Speaker 1: die when they're meant to. They are not good cells. Now,

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Speaker 1: if every cell in your society was doing that, it

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Speaker 1: would just be, you know, mad max style dystopia. Nothing

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Speaker 1: would work, your body would not function. But you can

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Speaker 1: get away with being a cancer cell and cheating and

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Speaker 1: keeping going and keeping going because to a certain extent,

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Speaker 1: cheaters do prosper, and it's the same in many animal societies.

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Speaker 1: So one of the lovely examples that I found was

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Speaker 1: these cape honey bees. So this just wonderful example. So

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Speaker 1: cape honeybees, they have a classic honeybee population structure. You

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Speaker 1: have the queen, and you have all the workers, the

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Speaker 1: female workers, but the queen is the only one who

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Speaker 1: gets to reproduce, and so all the workers are busy

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Speaker 1: doing all the work in the hive, and the queen's

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Speaker 1: just cleaning around basically like a um and you know,

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Speaker 1: popping off to reproduce when she feels like it. But

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Speaker 1: there is a genetic change, single genetic change that means

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Speaker 1: that these worker bees can become queens and they start

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Speaker 1: to just sit around, you know, queening it up, and

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Speaker 1: eventually the hive starts to collapse under the weight of

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Speaker 1: all these cheaters. And it's just a single genetic change

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Speaker 1: that enables them to do this. And actually some of

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Speaker 1: these queens will go off to other hives and start

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Speaker 1: to infect them and turn them into cheaters as well.

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Speaker 1: And it's almost like a bee cancer, I suppose, because

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Speaker 1: ultimately it leads to the destruction of the hive, and

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Speaker 1: you say, well, why would the bees have this, Why

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Speaker 1: would it be so fragile that one genetic change can

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Speaker 1: disrupt it like this? And it turns out that where

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Speaker 1: the bees live it's very, very windy. So there's a

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Speaker 1: risk that if you just have one queen and that's

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Speaker 1: all you get, your queen could get blown off course

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Speaker 1: and you might lose her totally, and then your hive

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Speaker 1: would collapse anyway. So the ability to flip into queen

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Speaker 1: mode it's really useful for the bees for their evolutionary survival,

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Speaker 1: but it comes with a risk. And it's the same

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Speaker 1: with cells. So we need to be able to make

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Speaker 1: new cells. You need to regenerate millions of cells in

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Speaker 1: your body every day, millions of cells in your skin,

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Speaker 1: your blood, your bowel. You need to be able to

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Speaker 1: heal yourself if you're wounded. You need to be able

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Speaker 1: to grow from one cell into an adult human. Cells

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Speaker 1: need to reproduce, they need to do stuff. Flip side

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Speaker 1: of that is that they can sometimes go out of

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Speaker 1: control because it's the same mechanisms that make cells grow

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Speaker 1: and multiply in the right way that they kind of

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Speaker 1: harness and hijack when they decide to cheat and grow

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Speaker 1: out of control in the wrong way. So that's interesting.

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Speaker 1: You're sort of showing how cancer is one side of

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Speaker 1: an evolutionary balance where on one hand, you've got you know,

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Speaker 1: as your ability to do something good goes up, the

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Speaker 1: risks associated with those same genes that code for that

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Speaker 1: also go up. So we know on one side what

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Speaker 1: the downside is. We can see tumors in cancer, and

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Speaker 1: you're saying that the the the goods that make those

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Speaker 1: risks worthwhile are basically being able to proliferate quickly in

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Speaker 1: cell growth. And this would have to do not just

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Speaker 1: with growth in youth, but in healing and things like that. Yeah, exactly,

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Speaker 1: And you see this. This starts to explain the differences

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Speaker 1: across species because if you if you cut a mouse,

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Speaker 1: mice heal amazingly fast. Their cells just basically knit themselves

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Speaker 1: back together. It's it's absolutely incredible. Um. One of the

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Speaker 1: stories that I discovered when I was talking to a

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Speaker 1: researcher in Santa Barbara who's trying to work with the

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Speaker 1: animals in the zoo to understand their cancer risks. She's

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Speaker 1: she went to the zoo and said, can I get

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Speaker 1: a little bit of skin from your giant tortoise, and

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Speaker 1: they were like, hell, no, cut a tortoise. It takes

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Speaker 1: a year to heal, and tortoises live for a very

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Speaker 1: long time. They are incredibly cancer resistance, but they the

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Speaker 1: flip side of that is that they don't heal very easily.

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Speaker 1: So humans again somewhere in the middle. We don't heal

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Speaker 1: as fast as mice. We live much longer than mice.

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Speaker 1: So there's there's all of this stuff is a trade

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Speaker 1: off about the evolutionary journey that your species has taken.

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Speaker 1: And one of the things that I sort of took

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Speaker 1: this to its logical conclusion, and I was like, if

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Speaker 1: there's aliens, aliens would get cancer, that there's very unlikely

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Speaker 1: that they would not if they obey the general rules

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Speaker 1: of evolution, and this idea that like cells, organisms living

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Speaker 1: in a society behave according to the rules of that

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Speaker 1: we know make a good society. I don't think there's

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Speaker 1: any reason why aliens wouldn't get cancer. She's like, that's

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Speaker 1: a bit of a that was a bit of a

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Speaker 1: sort of late night thought. I think, because all that's

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Speaker 1: necessary is that they exist by cell division, right, I mean,

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Speaker 1: that's pretty much it. Yeah, yeah, exactly, if you have

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Speaker 1: cells and your cells are doing cell division, and also

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Speaker 1: if you have evolution by natural selection, which is basically

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Speaker 1: the engine that drives cells to to proliferate and be

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Speaker 1: selected for and to keep going, and species to keep

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Speaker 1: proliferating and keeping going, then yeah, you probably could get cancer.

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Speaker 1: And that's what we generally see across the entire animal kingdom. Well,

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Speaker 1: thinking about aliens getting cancer makes me think of another

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Speaker 1: interesting part of your book, which was about difficulties in

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Speaker 1: classifying what appears to be some form of uncontrolled cell

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Speaker 1: growth in animals or even not animals, other organisms that

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Speaker 1: are very different from us. So can you look at

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Speaker 1: what's going on in a clam and say that it

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Speaker 1: has cancer? Yeah? Probably, But what about a mushroom or

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Speaker 1: in an algae or something? Yeah, this was this was interesting.

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Speaker 1: So you know, what is cancer and n is cancer?

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Speaker 1: Is an interesting question. And when you get to more

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Speaker 1: organized animals and particularly mammals, we define invasive cancers as

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Speaker 1: cancers that kind of break through the sort of molecular

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Speaker 1: I guess you'd call it like saran wrap that's around

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Speaker 1: your organs and your tissues. They break through this membrane,

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Speaker 1: and that's what we call invasive cancer. But really, you know,

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Speaker 1: the phenomenon of cells growing out of control is all

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Speaker 1: over the place. You can see it in plants when

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Speaker 1: they get ghouls, you can see it in in fungi.

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Speaker 1: You can see it in all sorts of things. And

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Speaker 1: what are the interesting questions is you know something like endometriosis,

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Speaker 1: which is a condition where you get rogue tissue within

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Speaker 1: the body and it's sort of it grows and its

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Speaker 1: spreads and it bleeds and it's very very painful. It's like,

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Speaker 1: but that's not cancer, it's not invasive. But actually, when

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Speaker 1: you look at that kind of tissue, it has lots

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Speaker 1: and lots of the kind of mutations and changes we'd

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Speaker 1: expect to find in cancer. But that's not cancer, and

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Speaker 1: that's in humans. So this this idea that mutations it's

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Speaker 1: not just what makes cancer. Uncontrolled cell growth is not

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Speaker 1: just what makes cancer. It's it's sort of this this invasive, aggressive,

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Speaker 1: evolving characteristic that really is what we can classify as

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Speaker 1: as cancer. All Right, we're gonna take a quick break,

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Speaker 1: but we'll be right back, and we're back. So maybe

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Speaker 1: we should shift to talking about the history of our

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Speaker 1: understanding of the proximate causes or maybe better to say,

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Speaker 1: the risk factors for cancer where it comes from, whether

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Speaker 1: that's there's a hereditary component and an environmental component. There's

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Speaker 1: a part in the book where you mentioned this thing

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Speaker 1: that was called the Daily Mail Oncology Ontology blog, which

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Speaker 1: I've really appreciated because so the idea was this was

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Speaker 1: an attempted list of all the things that either cause

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Speaker 1: or cure cancer, according to the Daily Mail, And that

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Speaker 1: made me say, I've got to it's something I read

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Speaker 1: a lot of science and medical news from my work,

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Speaker 1: and I have all but completely turned off my recognition

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Speaker 1: system for articles about, you know, new supposed causes or

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Speaker 1: cures for cancer, because this was already like a cliche

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Speaker 1: to the point of being a hack joke for comedians

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Speaker 1: in the nineteen nineties. Is there something we should learn

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Speaker 1: from this, like the way that we get this conditioned

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Speaker 1: kind of num reaction to these types of news stories. Yeah,

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Speaker 1: that's we used to get a lot of that when

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Speaker 1: I was at Cancer Research k. You know, I think

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Speaker 1: that the stupidest one was that water gives you cancer,

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Speaker 1: and also that turning on turning on the light at

431
00:24:39,600 --> 00:24:42,960
Speaker 1: night to go to the bathroom, gives you cancer. So

432
00:24:43,640 --> 00:24:46,679
Speaker 1: you know, this is this is really really frustrating. So

433
00:24:46,760 --> 00:24:49,040
Speaker 1: there's kind of a couple of there's a couple of

434
00:24:49,040 --> 00:24:51,760
Speaker 1: things to dissect because it's also comes down to like

435
00:24:51,920 --> 00:24:56,919
Speaker 1: what what is actually the nature of cancer? And the

436
00:24:56,960 --> 00:24:58,840
Speaker 1: way that cancer has been thought about for a very

437
00:24:58,840 --> 00:25:01,560
Speaker 1: long time is according to what scientists like to call

438
00:25:01,600 --> 00:25:04,840
Speaker 1: the somatic mutation theory of cancer. So this is this

439
00:25:04,920 --> 00:25:08,560
Speaker 1: idea that cells pick up changes in their DNA in

440
00:25:08,600 --> 00:25:11,199
Speaker 1: their genome that the instructions that they use to do

441
00:25:11,240 --> 00:25:14,679
Speaker 1: what they do, they pick up these changes, these mutations,

442
00:25:14,720 --> 00:25:17,199
Speaker 1: and that enables them to do more bad things. And

443
00:25:17,200 --> 00:25:19,040
Speaker 1: then they pick up more and they do more bad things.

444
00:25:19,520 --> 00:25:23,840
Speaker 1: So it's this gradual accumulation of nasty mutations terms nice

445
00:25:23,880 --> 00:25:28,440
Speaker 1: well behaved cells into aggressive cancer cells. And we can

446
00:25:28,600 --> 00:25:34,040
Speaker 1: start to see some of the characteristic fingerprints that different

447
00:25:34,080 --> 00:25:37,360
Speaker 1: agents leave in the genome. So we can see, for example,

448
00:25:37,680 --> 00:25:40,639
Speaker 1: cigarette smoke or ultra violet light from the sun, we

449
00:25:40,680 --> 00:25:45,040
Speaker 1: can see those characteristic fingerprints of damage in the genome.

450
00:25:46,160 --> 00:25:50,119
Speaker 1: What that doesn't necessarily tell us because when you start

451
00:25:50,119 --> 00:25:52,840
Speaker 1: looking closely at a cancer or even in fact at

452
00:25:53,000 --> 00:25:57,320
Speaker 1: normal tissue, you start to see these changes and mutations everywhere.

453
00:25:58,240 --> 00:26:01,399
Speaker 1: So this kind of simplistic model that it's a hit

454
00:26:01,480 --> 00:26:03,440
Speaker 1: in this gena hit in this gena hit in this street,

455
00:26:03,440 --> 00:26:04,600
Speaker 1: and a hit in the street in a bang there,

456
00:26:04,600 --> 00:26:09,359
Speaker 1: you've got a cancer cell is nonsense. Because loads of

457
00:26:09,400 --> 00:26:13,320
Speaker 1: healthy cells such a peppered with mutations and loads of

458
00:26:13,359 --> 00:26:16,800
Speaker 1: things do damage our DNA. And that's kind of like

459
00:26:17,440 --> 00:26:21,199
Speaker 1: it's mostly fine. So it's a bit more of a

460
00:26:21,240 --> 00:26:25,840
Speaker 1: sophisticated understanding of yes, there are things that damage DNA.

461
00:26:26,800 --> 00:26:29,040
Speaker 1: A lot of them we know about, some of them

462
00:26:29,080 --> 00:26:32,040
Speaker 1: we don't know about yet. Researchers are trying to figure out,

463
00:26:32,080 --> 00:26:34,040
Speaker 1: you know, how do we match up these signatures of

464
00:26:34,080 --> 00:26:38,480
Speaker 1: damage to things that are in the environment alas Mostly

465
00:26:38,600 --> 00:26:41,199
Speaker 1: the most single, most damaging thing you can do for

466
00:26:41,240 --> 00:26:45,920
Speaker 1: your DNA is a breathe oxygen. Literally, just being alive.

467
00:26:46,240 --> 00:26:50,160
Speaker 1: The processes of life in your cells damage your DNA unfortunately.

468
00:26:51,119 --> 00:26:55,479
Speaker 1: But then if all your cells are to some extent,

469
00:26:55,560 --> 00:26:58,879
Speaker 1: you know, more or less messed up. Everyone's got a

470
00:26:58,880 --> 00:27:02,199
Speaker 1: few mutations here and there, some more than others. What

471
00:27:02,480 --> 00:27:05,840
Speaker 1: is it then that tips the cell into becoming a

472
00:27:05,880 --> 00:27:09,680
Speaker 1: cancer cell? If everyone's a bit weird, what makes that

473
00:27:09,960 --> 00:27:14,800
Speaker 1: cheating cell kind of slip the bonds of good society

474
00:27:14,960 --> 00:27:18,760
Speaker 1: and really start going for it. And that really is

475
00:27:18,760 --> 00:27:23,720
Speaker 1: is an evolutionary question that cell has involved the capacity

476
00:27:23,760 --> 00:27:26,840
Speaker 1: to do that, and so I think it's it's far

477
00:27:26,920 --> 00:27:30,399
Speaker 1: too simplistic to say, oh, well, you know your cancer

478
00:27:30,560 --> 00:27:33,199
Speaker 1: was absolutely caused by smoking, that was it. It's like, well,

479
00:27:33,400 --> 00:27:36,480
Speaker 1: that was a risk factor and it certainly didn't help,

480
00:27:37,040 --> 00:27:40,360
Speaker 1: but there were many other things. And also many people

481
00:27:40,400 --> 00:27:43,160
Speaker 1: who do smoke don't get cancer. So it's like we've

482
00:27:43,200 --> 00:27:47,560
Speaker 1: got to be more sophisticated in understanding what makes normal

483
00:27:47,600 --> 00:27:50,840
Speaker 1: cells become damaged and what makes kind of sad cells

484
00:27:50,960 --> 00:27:54,360
Speaker 1: become really bad cells. Yeah, this is an important point

485
00:27:54,400 --> 00:27:58,320
Speaker 1: about thinking about risk factors instead of causes. And I

486
00:27:58,359 --> 00:28:01,280
Speaker 1: know that that's it's in fure creating to people especially.

487
00:28:01,320 --> 00:28:03,080
Speaker 1: I think if you don't have a lot of like

488
00:28:04,119 --> 00:28:08,040
Speaker 1: training in a statistics oriented field, that it just doesn't

489
00:28:08,080 --> 00:28:11,080
Speaker 1: feel very comfortable to think about, especially something that's a

490
00:28:11,119 --> 00:28:14,240
Speaker 1: really important life and death issue like cancer in terms

491
00:28:14,280 --> 00:28:17,040
Speaker 1: of probabilities. You want to know like what it was

492
00:28:17,200 --> 00:28:20,040
Speaker 1: or what what did it? Yeah, exactly. I think the

493
00:28:20,080 --> 00:28:22,760
Speaker 1: best analogy that I really came up with is and

494
00:28:22,800 --> 00:28:26,240
Speaker 1: this is spoilers now if anyone's seen Agatha Christie's murder

495
00:28:26,240 --> 00:28:29,800
Speaker 1: on the Orient Express where and I am this is

496
00:28:29,840 --> 00:28:32,120
Speaker 1: a massive spoiler, but come on, the books like really

497
00:28:32,160 --> 00:28:34,440
Speaker 1: old you should have read about now see the movie

498
00:28:34,440 --> 00:28:38,400
Speaker 1: with Albert Finning too. It's great, but it's a murder,

499
00:28:38,440 --> 00:28:42,680
Speaker 1: but all the people involved they all have a stab,

500
00:28:43,160 --> 00:28:48,200
Speaker 1: so you never know who actually was the murderer. So

501
00:28:48,480 --> 00:28:51,080
Speaker 1: it's it's kind of like this. So you know, we

502
00:28:51,160 --> 00:28:52,880
Speaker 1: have lots and lots of genes that we know are

503
00:28:52,920 --> 00:28:55,360
Speaker 1: implicated in cancer. There are lots of things that can

504
00:28:55,400 --> 00:28:58,800
Speaker 1: damage our DNA. There are lots of things that can

505
00:28:58,880 --> 00:29:02,320
Speaker 1: like impre of the environment of our tissues or not.

506
00:29:02,560 --> 00:29:05,560
Speaker 1: We know that things like you know, keeping keeping well

507
00:29:05,600 --> 00:29:07,920
Speaker 1: and healthy and doing all the boring healthy living stuff

508
00:29:08,240 --> 00:29:12,240
Speaker 1: that helps to keep your your body healthy makes yourselves

509
00:29:12,280 --> 00:29:15,880
Speaker 1: more likely to fall into line. But saying exactly like

510
00:29:16,160 --> 00:29:18,640
Speaker 1: it was that thing, you know it was, it was

511
00:29:18,720 --> 00:29:24,120
Speaker 1: that sunny holiday in Marbea in that damage that skin

512
00:29:24,160 --> 00:29:27,040
Speaker 1: cell that gave you cancer. As I know that's that's

513
00:29:27,080 --> 00:29:29,760
Speaker 1: simply not possible. So trying to say oh it's this,

514
00:29:29,920 --> 00:29:32,480
Speaker 1: oh it's that, do this, don't do that, I think

515
00:29:32,600 --> 00:29:35,920
Speaker 1: is not terribly helpful, because at some point we've just

516
00:29:36,000 --> 00:29:38,680
Speaker 1: got to get on and live and try and negotiate

517
00:29:38,720 --> 00:29:41,719
Speaker 1: the risks that we're happy with taking. Right though, at

518
00:29:41,720 --> 00:29:43,880
Speaker 1: the same time, you do point out how there are

519
00:29:44,040 --> 00:29:47,920
Speaker 1: certain factors that increase your likelihood so far above the

520
00:29:47,960 --> 00:29:50,960
Speaker 1: baseline that maybe at that point it even though you

521
00:29:50,960 --> 00:29:53,479
Speaker 1: still can't quite say it's a cause, it's something closer

522
00:29:53,520 --> 00:29:55,960
Speaker 1: to a cause. What I think one common example given

523
00:29:56,000 --> 00:29:58,800
Speaker 1: would be tobacco. Remember you mentioned another example in the

524
00:29:58,800 --> 00:30:03,680
Speaker 1: book about just chronic exposure dermal exposure to soot in

525
00:30:04,160 --> 00:30:08,600
Speaker 1: chimney sweeps. I believe it was. Yeah, this was the

526
00:30:08,680 --> 00:30:13,880
Speaker 1: first example of someone actually showing that something, a substance

527
00:30:13,920 --> 00:30:17,400
Speaker 1: in the environment could increase the risk of cancer. And

528
00:30:17,440 --> 00:30:21,040
Speaker 1: this is an English surgeon called Percival Pot who had

529
00:30:21,600 --> 00:30:25,400
Speaker 1: a purely professional interest in the scrotums of young boys,

530
00:30:25,880 --> 00:30:30,479
Speaker 1: purely professional because he was interested in chimney sweeps in London.

531
00:30:30,960 --> 00:30:33,840
Speaker 1: Now this was in the seventeen hundreds and chimney sweeps

532
00:30:33,880 --> 00:30:37,880
Speaker 1: were basically sent naked up the chimneys by gangmasters to

533
00:30:37,920 --> 00:30:39,880
Speaker 1: clean the chimneys. So they were exposed to a lot

534
00:30:40,000 --> 00:30:43,480
Speaker 1: of soot and they noticed that they started to get

535
00:30:43,520 --> 00:30:46,320
Speaker 1: these cancers in their genitals and they were called soot warps,

536
00:30:46,680 --> 00:30:50,560
Speaker 1: and these were very very very nasty cancers, really horrible

537
00:30:50,640 --> 00:30:54,680
Speaker 1: kind of stuff. And Pot realized that it was the

538
00:30:54,720 --> 00:30:57,560
Speaker 1: soot that these boys were being exposed to that was

539
00:30:57,600 --> 00:30:59,840
Speaker 1: causing these cancers. And he said, right, you know, we

540
00:31:00,040 --> 00:31:03,280
Speaker 1: gotta get nice in Germany that all the chimney sweeps

541
00:31:03,280 --> 00:31:06,240
Speaker 1: had these nice kind of tight fitting uniforms so they

542
00:31:06,240 --> 00:31:08,800
Speaker 1: weren't being directly exposed on their skin. And he was like, right,

543
00:31:08,840 --> 00:31:10,720
Speaker 1: we've got to get those in. I got to protect

544
00:31:10,760 --> 00:31:14,640
Speaker 1: these boys, stop sending them naked up your chimneys. Um Alas,

545
00:31:15,440 --> 00:31:18,640
Speaker 1: it took over a hundred years for people to actually

546
00:31:18,720 --> 00:31:21,640
Speaker 1: change in Britain because the gang masters were like, no,

547
00:31:21,760 --> 00:31:24,600
Speaker 1: those those uniforms are too expensive. They'll make our sweeps

548
00:31:24,600 --> 00:31:27,160
Speaker 1: too expensive. You know, they're they're cheap. We don't really care.

549
00:31:27,840 --> 00:31:31,720
Speaker 1: So that was really tragic that they managed to link

550
00:31:31,840 --> 00:31:35,480
Speaker 1: this cause to these very horrible cancers. And there was

551
00:31:35,520 --> 00:31:37,600
Speaker 1: something that everyone knew could be done that was helping

552
00:31:37,640 --> 00:31:41,520
Speaker 1: in other countries. And nope, nope, it didn't happen for

553
00:31:41,560 --> 00:31:45,080
Speaker 1: a very long time. Um but yes, that Percival part

554
00:31:45,240 --> 00:31:48,840
Speaker 1: is kind of the father of this idea of external

555
00:31:49,240 --> 00:31:53,520
Speaker 1: sources of of carcinogenic chemicals, I think, but I think

556
00:31:53,560 --> 00:31:57,320
Speaker 1: it has stuck in the imagination that like it's all external,

557
00:31:57,360 --> 00:32:00,360
Speaker 1: it's all from from something you've done, or something you've got,

558
00:32:00,440 --> 00:32:04,040
Speaker 1: or something you've touched or eaten or being exposed to. Well,

559
00:32:04,120 --> 00:32:06,640
Speaker 1: to go to the other side. So there's a part

560
00:32:06,640 --> 00:32:08,719
Speaker 1: of your book where you explored I think we actually

561
00:32:08,760 --> 00:32:11,760
Speaker 1: mentioned this earlier about your podcast episode about Maud Sly

562
00:32:11,960 --> 00:32:15,600
Speaker 1: and Pauline gross and in the role for example of

563
00:32:15,640 --> 00:32:19,680
Speaker 1: the research of maud Sly in establishing that there is

564
00:32:19,720 --> 00:32:22,960
Speaker 1: a hereditary component to cancer that I think at the

565
00:32:23,000 --> 00:32:25,640
Speaker 1: time you say that, you know, the primary argument was

566
00:32:25,720 --> 00:32:29,720
Speaker 1: about two different major theories of external causes, whether cancer

567
00:32:29,840 --> 00:32:34,959
Speaker 1: was caused primarily by inflammation or by infectious agents and parasites.

568
00:32:35,080 --> 00:32:38,120
Speaker 1: Is that correct? Yea. So at the beginning of the

569
00:32:38,160 --> 00:32:41,120
Speaker 1: twentieth century, the early twentieth century, there was this idea

570
00:32:41,160 --> 00:32:45,280
Speaker 1: that cancer was either all caused by external things like

571
00:32:45,440 --> 00:32:50,000
Speaker 1: certain things in the environment, or it was viruses. Mostly.

572
00:32:50,080 --> 00:32:53,440
Speaker 1: There were a couple of good examples in animals where

573
00:32:53,480 --> 00:32:56,320
Speaker 1: you could take viruses, exposed the animals to them and

574
00:32:56,360 --> 00:32:59,600
Speaker 1: they would develop certain types of cancer. So the first

575
00:32:59,600 --> 00:33:02,200
Speaker 1: one were as a guy called Peyton Rouse who discovered

576
00:33:02,400 --> 00:33:05,200
Speaker 1: a virus that caused cancer and chickens. So by the

577
00:33:05,280 --> 00:33:08,280
Speaker 1: sixties everyone was just obsessed with the idea that it

578
00:33:08,360 --> 00:33:12,440
Speaker 1: was viruses. And now, you know, we really understand that

579
00:33:13,040 --> 00:33:16,560
Speaker 1: there are families that are affected by multiple cases of cancer,

580
00:33:16,600 --> 00:33:20,440
Speaker 1: that cancer can be to some extent influenced by the

581
00:33:20,520 --> 00:33:24,400
Speaker 1: genes we inherit. But really this was almost a completely separate,

582
00:33:24,400 --> 00:33:28,200
Speaker 1: parallel strand running up through the first half of the

583
00:33:28,200 --> 00:33:32,000
Speaker 1: twentieth century, and it was work in mice in families.

584
00:33:32,760 --> 00:33:34,760
Speaker 1: In the podcast, we talk about the story of Maud

585
00:33:34,840 --> 00:33:37,280
Speaker 1: Sly who bred all these mice together to show cancer

586
00:33:37,280 --> 00:33:40,200
Speaker 1: could be inherited. And then the story of Pauline Gross,

587
00:33:40,240 --> 00:33:43,680
Speaker 1: who was a seamstress who meant a scientist and she said,

588
00:33:43,720 --> 00:33:46,840
Speaker 1: you know, I'm going to die young, and he mapped

589
00:33:46,880 --> 00:33:49,440
Speaker 1: out all her family because so many members of her

590
00:33:49,480 --> 00:33:53,360
Speaker 1: family were affected by the same types of cancer. And

591
00:33:53,520 --> 00:33:56,880
Speaker 1: it took, you know, decades until they pinned down the

592
00:33:56,920 --> 00:34:00,960
Speaker 1: particular gene fault that was responsible. But yeah, they're all

593
00:34:01,000 --> 00:34:04,480
Speaker 1: these lines were like running a completely separate to each

594
00:34:04,480 --> 00:34:08,719
Speaker 1: other until it all started to coalesce together in this

595
00:34:08,840 --> 00:34:12,560
Speaker 1: understanding that you know, there are things that damage our genes.

596
00:34:12,800 --> 00:34:15,920
Speaker 1: There are genes in our cells that make ourselves replicate

597
00:34:16,360 --> 00:34:19,000
Speaker 1: that that stop ourselves from dying. This is good normally,

598
00:34:19,360 --> 00:34:22,000
Speaker 1: but they can go wrong. They can be mutated, they

599
00:34:22,000 --> 00:34:26,040
Speaker 1: can be changed, We can inherit versions that affect their function.

600
00:34:26,719 --> 00:34:30,040
Speaker 1: And it all sort of started to coalesce into this

601
00:34:30,200 --> 00:34:33,640
Speaker 1: very sensible idea of of how cancer starts. But I

602
00:34:33,640 --> 00:34:37,000
Speaker 1: think it just became very very focused on the genes

603
00:34:37,040 --> 00:34:40,319
Speaker 1: and the cells, just yes, single genes, shopping lists of

604
00:34:40,360 --> 00:34:44,240
Speaker 1: genes and changes, and forgot to look at this broader

605
00:34:44,280 --> 00:34:48,120
Speaker 1: picture of the environment in which cells are, the society

606
00:34:48,160 --> 00:34:51,239
Speaker 1: in which they're living, how they can interact with each

607
00:34:51,239 --> 00:34:56,319
Speaker 1: other cheap, overcome expand push against each other. This more.

608
00:34:57,080 --> 00:34:58,880
Speaker 1: I hate to use the word holistic because it sounds

609
00:34:58,920 --> 00:35:02,040
Speaker 1: really kind of hippie dip it, but you know, it's

610
00:35:02,160 --> 00:35:05,560
Speaker 1: it's part of our bodies. It's not an external alien thing.

611
00:35:06,400 --> 00:35:08,560
Speaker 1: These cells obey the rules of our bodies to to

612
00:35:08,640 --> 00:35:11,240
Speaker 1: a certain extent, they cheat the rules to another extent,

613
00:35:11,880 --> 00:35:14,840
Speaker 1: but it's all kind of part of one piece. And

614
00:35:14,920 --> 00:35:19,400
Speaker 1: we've just focused on on genes and molecules for the

615
00:35:19,400 --> 00:35:22,239
Speaker 1: past couple of decades, I think far, far too much.

616
00:35:22,920 --> 00:35:24,520
Speaker 1: All Right, we're going to take a quick break. We'll

617
00:35:24,560 --> 00:35:30,279
Speaker 1: be right back with more than than all right, we're back.

618
00:35:30,960 --> 00:35:33,919
Speaker 1: So you mentioned in the book that you believe that

619
00:35:33,960 --> 00:35:37,280
Speaker 1: the future of our resistance against cancer and medical treatments

620
00:35:37,280 --> 00:35:41,320
Speaker 1: of cancer are going to rely on quote shifting towards

621
00:35:41,400 --> 00:35:45,200
Speaker 1: a new way of evolutionary and ecological thinking about cancer.

622
00:35:45,600 --> 00:35:48,560
Speaker 1: So I assume there you're connecting to the ideas you

623
00:35:48,600 --> 00:35:50,920
Speaker 1: were just articulating. But could you expand on what you

624
00:35:50,920 --> 00:35:53,719
Speaker 1: mean by that. Yeah, So, as all the sort of

625
00:35:53,840 --> 00:35:58,439
Speaker 1: strands of cancer research over the past that one years

626
00:35:58,480 --> 00:36:01,360
Speaker 1: started to coalesce on this eye dear that that cancer

627
00:36:01,400 --> 00:36:04,839
Speaker 1: starts when cells pick up certain genetic mutations and they

628
00:36:04,880 --> 00:36:07,920
Speaker 1: go out of control. And then we started to get

629
00:36:07,960 --> 00:36:10,080
Speaker 1: to this idea that then, well, the way you treat

630
00:36:10,120 --> 00:36:13,319
Speaker 1: them is you find the molecules the genes that are

631
00:36:13,360 --> 00:36:15,759
Speaker 1: making them go out of control, and you target them

632
00:36:15,800 --> 00:36:17,520
Speaker 1: with drugs. And that's going to be the way we're

633
00:36:17,560 --> 00:36:21,719
Speaker 1: going to cure cancer. And there's been so much, so

634
00:36:21,800 --> 00:36:27,040
Speaker 1: much effort, money, research, time, patients, lives in clinical trials

635
00:36:27,480 --> 00:36:32,040
Speaker 1: have gone into testing these very molecularly targeted drugs, and

636
00:36:33,080 --> 00:36:36,040
Speaker 1: you know, some in some cases there have been incredible

637
00:36:36,040 --> 00:36:39,400
Speaker 1: success stories. So, for example, a drug called gliveck for

638
00:36:39,480 --> 00:36:43,759
Speaker 1: treating a certain type of leukemia is incredibly successful. It

639
00:36:43,880 --> 00:36:47,920
Speaker 1: targets a very specific genetic fault in the cancer cells,

640
00:36:47,960 --> 00:36:51,400
Speaker 1: and it is it was game changing, and it continues

641
00:36:51,480 --> 00:36:54,840
Speaker 1: to be game changing. But lots and lots of the

642
00:36:54,880 --> 00:36:59,080
Speaker 1: other drugs that have been developed along these lines, they

643
00:36:59,080 --> 00:37:03,319
Speaker 1: have not transformed survival in the way that we would

644
00:37:03,360 --> 00:37:06,960
Speaker 1: hope they've They've eked out, you know, in some cases months,

645
00:37:07,000 --> 00:37:10,719
Speaker 1: in some cases, you know, a few years. In one case,

646
00:37:10,800 --> 00:37:14,480
Speaker 1: I saw a paper that said nine days increase in

647
00:37:14,560 --> 00:37:19,279
Speaker 1: survival with this particular incredibly expensive targeted drug. And you're like,

648
00:37:20,160 --> 00:37:23,799
Speaker 1: these are not cures. The these are these are the

649
00:37:23,840 --> 00:37:27,360
Speaker 1: magic bullets that we were promised, and they are not cures.

650
00:37:27,400 --> 00:37:30,600
Speaker 1: And in virtually all these cases, the cancer comes back.

651
00:37:31,239 --> 00:37:34,960
Speaker 1: And why does it come back? Because of Charles Flipping Darwin.

652
00:37:35,120 --> 00:37:38,480
Speaker 1: You know, it's it's evolution. You hit something, you get

653
00:37:38,600 --> 00:37:41,440
Speaker 1: rid of most of the cells that are sensitive, and

654
00:37:41,480 --> 00:37:44,120
Speaker 1: you've still got a core of resistance because you've got

655
00:37:44,160 --> 00:37:49,080
Speaker 1: so much genetic diversity in that population. Of cancer cells,

656
00:37:49,120 --> 00:37:52,399
Speaker 1: and so they start growing again, and this time they're

657
00:37:52,440 --> 00:37:55,240
Speaker 1: resistant to the drug. So maybe you try another drug,

658
00:37:55,600 --> 00:37:59,000
Speaker 1: same thing happens. You get rid of the sensitive cells,

659
00:37:59,000 --> 00:38:01,759
Speaker 1: you've still got a core war of resistance, and they

660
00:38:01,800 --> 00:38:06,080
Speaker 1: grow back, and eventually you run out of options, and

661
00:38:07,000 --> 00:38:10,799
Speaker 1: there's time now to think about cancer in a much

662
00:38:10,840 --> 00:38:15,800
Speaker 1: more evolutionary and ecological way, as you say, thinking about, well,

663
00:38:15,840 --> 00:38:18,600
Speaker 1: if we know that this process of evolution is at work,

664
00:38:19,120 --> 00:38:20,880
Speaker 1: that if you get rid of the sensitive cells, the

665
00:38:20,920 --> 00:38:23,719
Speaker 1: resistant ones come back, Like, well, why don't we try

666
00:38:23,800 --> 00:38:26,600
Speaker 1: and approach this in a different way. Why don't we

667
00:38:26,760 --> 00:38:29,000
Speaker 1: try not to knock them all out? Why don't we

668
00:38:29,040 --> 00:38:32,879
Speaker 1: try and balance these populations, keep them suppressed, keep them

669
00:38:32,920 --> 00:38:35,600
Speaker 1: under control, much in the way that say a farmer

670
00:38:35,640 --> 00:38:38,799
Speaker 1: would try and control the pests in his crop, rather

671
00:38:38,840 --> 00:38:41,560
Speaker 1: than completely trying to nuke them all from orbit or

672
00:38:41,600 --> 00:38:46,200
Speaker 1: eradicate every single last grasshopper. You know, and understanding the

673
00:38:46,239 --> 00:38:50,400
Speaker 1: ecology the tissue biology, so you know, are you actually

674
00:38:50,440 --> 00:38:54,120
Speaker 1: causing more damage two tissues by treating with drugs or

675
00:38:54,200 --> 00:38:57,440
Speaker 1: radiotherapy or surgery. How can we minimize that so that

676
00:38:57,520 --> 00:39:00,799
Speaker 1: it doesn't encourage cells to to cheat even more In

677
00:39:00,800 --> 00:39:05,680
Speaker 1: a damaged environment. So it's this this idea is starting

678
00:39:05,719 --> 00:39:09,040
Speaker 1: to come through, But I think I think it does

679
00:39:09,120 --> 00:39:13,879
Speaker 1: take a bit of a subtle and sophisticated understanding of

680
00:39:13,960 --> 00:39:19,440
Speaker 1: cancer as an evolutionary process within the tissue environment of

681
00:39:19,520 --> 00:39:23,479
Speaker 1: the body, rather than just like, these are some rogue

682
00:39:23,480 --> 00:39:25,240
Speaker 1: cells that have gone wrong and they're growing out of control,

683
00:39:25,239 --> 00:39:26,640
Speaker 1: and we just need to hit them with enough magic

684
00:39:26,640 --> 00:39:29,239
Speaker 1: bullets and they'll go away. You know, the classic cure

685
00:39:29,280 --> 00:39:33,359
Speaker 1: for cancer that that we've almost been sold. It's I

686
00:39:33,400 --> 00:39:37,560
Speaker 1: don't think it's it should look like that, um because

687
00:39:37,719 --> 00:39:41,080
Speaker 1: we've tried that and it's not really working. So I

688
00:39:41,080 --> 00:39:44,360
Speaker 1: think we need to try a different approach. This way

689
00:39:44,400 --> 00:39:47,400
Speaker 1: of talking about tumors is reminding me of something you

690
00:39:47,440 --> 00:39:49,400
Speaker 1: mentioned earlier in the book actually, which I thought was

691
00:39:49,480 --> 00:39:52,840
Speaker 1: really interesting image that stuck with me. The idea of

692
00:39:52,880 --> 00:39:56,600
Speaker 1: a hypothetical hyper tumor. I'd never considered this before, but

693
00:39:56,640 --> 00:40:00,279
Speaker 1: the idea that a tumor can get a tumor. Yeah.

694
00:40:00,320 --> 00:40:04,600
Speaker 1: So again, it's the thing that really jumped out at

695
00:40:04,600 --> 00:40:09,520
Speaker 1: me researching this book is that cancer is a microcosm

696
00:40:09,560 --> 00:40:13,560
Speaker 1: of evolution. It's it's a crucible of evolution, a dumpster

697
00:40:13,600 --> 00:40:16,120
Speaker 1: fire of evolution is probably the best way of putting it.

698
00:40:16,320 --> 00:40:20,480
Speaker 1: Cancer is a dumpster fire of evolution. Then you go, um,

699
00:40:20,520 --> 00:40:25,080
Speaker 1: but yeah, everything every innovation of life that you see

700
00:40:25,239 --> 00:40:31,720
Speaker 1: on Earth, cancer can evolve because you have a very large,

701
00:40:31,760 --> 00:40:35,719
Speaker 1: genetically diverse population of cells that have got lots of

702
00:40:35,760 --> 00:40:39,480
Speaker 1: opportunity to try stuff out. So you know, it's not

703
00:40:39,520 --> 00:40:43,120
Speaker 1: surprising that even within a horrible cheating atmosphere of a

704
00:40:43,200 --> 00:40:47,080
Speaker 1: cancer you might get some really really badass cells that

705
00:40:47,200 --> 00:40:52,680
Speaker 1: will start proliferating even more and actually suppress the original

706
00:40:52,719 --> 00:40:56,760
Speaker 1: tumor by just out competing them in a Darwinian sense.

707
00:40:57,360 --> 00:41:01,719
Speaker 1: And then there's some really wild things, um that I discovered.

708
00:41:01,760 --> 00:41:07,920
Speaker 1: So the most crazy innovation is that a guy is

709
00:41:08,040 --> 00:41:11,400
Speaker 1: a guy called Kenneth Pienta in Baltimore has discovered that

710
00:41:11,440 --> 00:41:15,200
Speaker 1: cancer cells have invented how to have sex. This this

711
00:41:15,440 --> 00:41:19,520
Speaker 1: really blew my mind because the implications are massive. Here.

712
00:41:20,440 --> 00:41:23,120
Speaker 1: We have this idea that cancer cells they just they

713
00:41:23,160 --> 00:41:26,560
Speaker 1: reproduce basically by splitting into that's fine. You know, you

714
00:41:26,560 --> 00:41:28,480
Speaker 1: have one cancer cell, it becomes two, it becomes for

715
00:41:29,000 --> 00:41:31,560
Speaker 1: all of that kind of thing. There's no transfer of

716
00:41:31,600 --> 00:41:36,360
Speaker 1: information between cells and after that. But he's discovered with

717
00:41:36,400 --> 00:41:42,440
Speaker 1: these prostate cancer cells that they fuse together and become

718
00:41:42,520 --> 00:41:46,320
Speaker 1: resistant to treatments, and then they start kind of budding

719
00:41:46,360 --> 00:41:50,040
Speaker 1: off little cells that are resistant to treatment. And you're like,

720
00:41:50,840 --> 00:41:54,759
Speaker 1: what you know that looks like sex, I mean, for

721
00:41:54,800 --> 00:41:56,880
Speaker 1: a very poor value of sex, but that you know,

722
00:41:56,920 --> 00:41:59,880
Speaker 1: that's the biological process of Sex's two cells fusing to

723
00:42:00,000 --> 00:42:06,280
Speaker 1: other and and creating more. And you're like, whoa, because

724
00:42:06,480 --> 00:42:10,799
Speaker 1: that's a way of genetically combining forces. And again, it's

725
00:42:10,840 --> 00:42:15,360
Speaker 1: an evolutionary innovation. Sex has evolved on this planet multiple times.

726
00:42:15,800 --> 00:42:19,200
Speaker 1: You know, it's not unheard of. And if you have

727
00:42:19,360 --> 00:42:22,319
Speaker 1: enough rolls of that dice, as might happen in in

728
00:42:22,360 --> 00:42:26,120
Speaker 1: a cancer you know, weird, weird, weird, our stuff is

729
00:42:26,160 --> 00:42:30,760
Speaker 1: going to happen in there. Um. It's just it really

730
00:42:30,880 --> 00:42:35,440
Speaker 1: is mind blowing every innovation of life. Cancer cells, you know,

731
00:42:35,719 --> 00:42:39,680
Speaker 1: at some point somewhere might have a go at. And

732
00:42:39,760 --> 00:42:42,799
Speaker 1: so when I realized this, when I realized that, you know,

733
00:42:43,320 --> 00:42:45,359
Speaker 1: cells can have sex, cells can do all these kind

734
00:42:45,400 --> 00:42:48,560
Speaker 1: of crazy evolutionary things. They can smash their chromosomes out,

735
00:42:48,600 --> 00:42:51,360
Speaker 1: they can glue themselves back together. It's all kind of crazy.

736
00:42:51,840 --> 00:42:57,799
Speaker 1: And then I started learning about the thing that was

737
00:42:57,880 --> 00:43:03,200
Speaker 1: just really incredible. So, right, imagine there's a disaster movie happening. Right,

738
00:43:03,239 --> 00:43:06,560
Speaker 1: you know what happens in a disaster movie. Everything's going wrong.

739
00:43:06,840 --> 00:43:08,719
Speaker 1: You've got the guy and you've got the girl, and

740
00:43:09,280 --> 00:43:12,440
Speaker 1: what do you do when your world's ending, right, you

741
00:43:12,480 --> 00:43:15,759
Speaker 1: have sex basically, So that's like a last ditch attempt

742
00:43:16,080 --> 00:43:18,359
Speaker 1: for cancer cells to try and come up with some

743
00:43:18,440 --> 00:43:21,399
Speaker 1: kind of evolutionary innovations that are going to get them

744
00:43:21,400 --> 00:43:24,840
Speaker 1: out of trouble. But then there's one more thing that

745
00:43:24,960 --> 00:43:28,440
Speaker 1: happens at the end of a disaster movie, right, you

746
00:43:28,560 --> 00:43:33,280
Speaker 1: leave the planet. Sure, yeah, and like and cancer cells

747
00:43:33,320 --> 00:43:38,520
Speaker 1: do this, and this is absolutely incredible. So so so

748
00:43:38,560 --> 00:43:41,120
Speaker 1: this is where we get to infectious cancer, the idea

749
00:43:41,200 --> 00:43:45,040
Speaker 1: that it could actually be contagious. Yeah, so this is

750
00:43:45,600 --> 00:43:48,719
Speaker 1: this is kind of spooky and scary because it's a

751
00:43:48,840 --> 00:43:52,760
Speaker 1: very medieval idea that cancer is contagious, that you catch

752
00:43:52,760 --> 00:43:55,400
Speaker 1: it from someone. And I will say that in certainly

753
00:43:55,400 --> 00:43:58,719
Speaker 1: in humans, there's no contagious cancers that we know of.

754
00:43:59,280 --> 00:44:03,440
Speaker 1: But the first example was the Tasmanian Devils. So this

755
00:44:03,560 --> 00:44:06,879
Speaker 1: was back in the nineties nineties. The Tasmanian Devils, they're

756
00:44:06,880 --> 00:44:10,000
Speaker 1: all in Tasmania. Southern Australia. They're very cute animals, but

757
00:44:10,080 --> 00:44:14,279
Speaker 1: like they're evil. They they're very you know, they're they're

758
00:44:14,360 --> 00:44:18,040
Speaker 1: placid more or less around humans, but they absolutely hate

759
00:44:18,080 --> 00:44:21,040
Speaker 1: each other. So when you get two Tasmanian devils together,

760
00:44:21,440 --> 00:44:24,520
Speaker 1: they're just like, really, go for it now, biting each

761
00:44:24,560 --> 00:44:30,400
Speaker 1: other's faces. And researchers started to notice that these animals

762
00:44:30,400 --> 00:44:33,799
Speaker 1: were getting big tumors in their faces and in some

763
00:44:33,840 --> 00:44:36,960
Speaker 1: cases it was killing them, and that they're already endangered

764
00:44:37,000 --> 00:44:41,160
Speaker 1: as it is, and this cancer started sweeping through the

765
00:44:41,200 --> 00:44:44,000
Speaker 1: populations and I was like, oh no, what we're going

766
00:44:44,040 --> 00:44:47,680
Speaker 1: to do. And a woman in Australia, she was working

767
00:44:47,719 --> 00:44:50,200
Speaker 1: for the for the government in a hospital. She she

768
00:44:50,360 --> 00:44:53,279
Speaker 1: was looking at cancer samples from humans and looking at

769
00:44:53,280 --> 00:44:56,040
Speaker 1: the chromosomes. It was a way back then of identifying

770
00:44:56,080 --> 00:44:58,440
Speaker 1: the kind of cancer you might have. And so she

771
00:44:58,480 --> 00:45:03,600
Speaker 1: started looking at these Tasmania devil cancer samples. Now, the

772
00:45:03,600 --> 00:45:06,360
Speaker 1: thing about human cancers is every human cancer is a

773
00:45:06,400 --> 00:45:10,239
Speaker 1: one off. It's a unique evolutionary event. It starts in you,

774
00:45:10,680 --> 00:45:13,040
Speaker 1: it grows in new it evolves in you, and it

775
00:45:13,040 --> 00:45:16,000
Speaker 1: it dies in you one way or the other. When

776
00:45:16,040 --> 00:45:20,960
Speaker 1: she was looking at these devil cancers, like they're all

777
00:45:21,040 --> 00:45:27,360
Speaker 1: the same from every animal. The chromosomes were absolutely the same,

778
00:45:28,000 --> 00:45:32,799
Speaker 1: and it's like that does not happen. That is that

779
00:45:33,120 --> 00:45:37,320
Speaker 1: she was like, this is a contagious cancer and U

780
00:45:37,480 --> 00:45:39,600
Speaker 1: and eventually they kind of pinned it down and it said, yes,

781
00:45:39,960 --> 00:45:43,960
Speaker 1: it was cancer cells transmitting from one devil to another

782
00:45:44,040 --> 00:45:47,400
Speaker 1: through that mechanism of biting and fighting and scratching. So

783
00:45:47,600 --> 00:45:50,080
Speaker 1: it's a you need with a contagious cancer. You need

784
00:45:50,080 --> 00:45:52,680
Speaker 1: to have a mechanism of transfer to get the cells

785
00:45:52,719 --> 00:45:56,640
Speaker 1: from one organism to the other. So with the devils,

786
00:45:56,719 --> 00:45:59,520
Speaker 1: it was it was biting and fighting. Um. And then

787
00:46:00,160 --> 00:46:04,000
Speaker 1: there was another cancer, contagious cancer. Which are we allowed

788
00:46:04,000 --> 00:46:07,120
Speaker 1: to talk about dog genitals? Oh? Yeah, I just I

789
00:46:07,160 --> 00:46:11,440
Speaker 1: just did. Um. Yeah. So there's a dog genital cancer

790
00:46:12,440 --> 00:46:19,160
Speaker 1: called canine venereal tumor as CTBT and so yeah, it's

791
00:46:19,239 --> 00:46:22,360
Speaker 1: again when when dogs have sex, it's not pretty, but

792
00:46:22,400 --> 00:46:26,280
Speaker 1: they get kind of tied together in the the gentleman

793
00:46:26,280 --> 00:46:30,719
Speaker 1: and lady department and that can cause some injury. So

794
00:46:30,760 --> 00:46:33,480
Speaker 1: again you have a mechanism for cancer cells to transfer

795
00:46:34,000 --> 00:46:37,719
Speaker 1: from one dog to the other. And this cancer it

796
00:46:37,760 --> 00:46:41,320
Speaker 1: transmits through populations. And there's a woman called Elizabeth Murchison

797
00:46:41,480 --> 00:46:45,120
Speaker 1: who's in Cambridge University. She started studying the devils and

798
00:46:45,160 --> 00:46:47,759
Speaker 1: then she started studying these dogs and they discovered that

799
00:46:47,800 --> 00:46:51,160
Speaker 1: these cancer cells in the dogs have been around for

800
00:46:51,600 --> 00:46:56,360
Speaker 1: thousands of years. The first dog with that cancer lived

801
00:46:56,480 --> 00:47:00,239
Speaker 1: and died thousands of years ago, and it's gone all

802
00:47:00,239 --> 00:47:03,880
Speaker 1: over the world. And that's like, it's like the oldest

803
00:47:04,600 --> 00:47:07,160
Speaker 1: I don't know, it's like the oldest mammal. I suppose.

804
00:47:07,760 --> 00:47:11,520
Speaker 1: It's just incredible. Um this they've worked out what kind

805
00:47:11,560 --> 00:47:13,359
Speaker 1: of dog it was. It was, you know, a little

806
00:47:13,400 --> 00:47:16,560
Speaker 1: kind of dog with like pointiers and a sandy coat,

807
00:47:16,719 --> 00:47:21,240
Speaker 1: and it's amazing. So when you're saying it's the oldest mammal,

808
00:47:21,320 --> 00:47:23,360
Speaker 1: in a way, you're saying that the tumor is, in

809
00:47:23,400 --> 00:47:25,960
Speaker 1: a sense a part of that original dog. It is

810
00:47:26,000 --> 00:47:30,000
Speaker 1: that dog. It is that dog's body exactly. The tumor

811
00:47:30,040 --> 00:47:32,680
Speaker 1: arose in the dog. It's got the genome of the

812
00:47:32,719 --> 00:47:36,719
Speaker 1: original dog. Like seriously messed up, I mean, and these

813
00:47:36,760 --> 00:47:40,839
Speaker 1: cancers are now evolving independently in different dog populations all

814
00:47:40,840 --> 00:47:44,000
Speaker 1: over the world. But yeah, it's it's an incredibly long

815
00:47:44,040 --> 00:47:47,799
Speaker 1: lived organism. I suppose. So that that was one devil

816
00:47:47,880 --> 00:47:51,560
Speaker 1: cancer which was relatively recent a dog cancer, and then

817
00:47:51,560 --> 00:47:55,480
Speaker 1: they found a new second devil tumor that had arisen

818
00:47:55,520 --> 00:47:58,600
Speaker 1: even more recently. So that's very unlucky for the devil's

819
00:47:58,680 --> 00:48:01,400
Speaker 1: and they think it's because again they're an inbred population.

820
00:48:02,040 --> 00:48:05,960
Speaker 1: So with this this fight e bity mechanism of transfer,

821
00:48:06,040 --> 00:48:08,960
Speaker 1: so you've got quite a high probability that this might happen.

822
00:48:09,600 --> 00:48:13,680
Speaker 1: And then there's all these weird shellfish that have cancer

823
00:48:14,239 --> 00:48:17,840
Speaker 1: and seem to transfer it between each other by shedding

824
00:48:18,040 --> 00:48:24,600
Speaker 1: cancer cells into the sea, which is just disgusting. Um

825
00:48:24,840 --> 00:48:28,160
Speaker 1: has made me rethink my idea of swimming. But there's

826
00:48:28,200 --> 00:48:32,520
Speaker 1: some really incredible examples of transmissible cancers in nature. And

827
00:48:32,560 --> 00:48:34,920
Speaker 1: again I think the more we look, the more we're

828
00:48:34,960 --> 00:48:36,840
Speaker 1: going to find. You know, each one of these papers

829
00:48:36,880 --> 00:48:39,480
Speaker 1: just gets published and less and less impressive turn or

830
00:48:39,760 --> 00:48:42,759
Speaker 1: is more and more more and more turn up. But

831
00:48:42,840 --> 00:48:46,080
Speaker 1: there are some examples in humans, and I talk about

832
00:48:46,120 --> 00:48:49,319
Speaker 1: a couple in the book. So there's one which is

833
00:48:50,360 --> 00:48:55,000
Speaker 1: they're absolutely horrendous. Is a guy called Chester Southam who

834
00:48:55,040 --> 00:48:57,600
Speaker 1: was in New York, I think in the fifties, and

835
00:48:57,680 --> 00:49:02,520
Speaker 1: he was doing experiments on prisoners, mostly black prisoners in

836
00:49:02,560 --> 00:49:07,360
Speaker 1: the US people in care homes can existing cancer patients.

837
00:49:07,360 --> 00:49:11,000
Speaker 1: People are very desperate and not consenting to these experiments properly.

838
00:49:11,040 --> 00:49:14,319
Speaker 1: And he was putting cancer cells into them and in

839
00:49:14,360 --> 00:49:18,040
Speaker 1: some cases they did developed humors. Mostly they didn't, which

840
00:49:18,080 --> 00:49:20,919
Speaker 1: shows the human immune system will fight these cells off,

841
00:49:21,560 --> 00:49:25,040
Speaker 1: but some of them did. And also there's a very

842
00:49:25,080 --> 00:49:30,440
Speaker 1: sad story of a woman who developed melanoma. And at

843
00:49:30,480 --> 00:49:32,279
Speaker 1: the time, this is around about this the sixties. I

844
00:49:32,320 --> 00:49:36,200
Speaker 1: think it was an idea that you could transplant some

845
00:49:36,320 --> 00:49:41,120
Speaker 1: cancer cells into someone to get an immune reaction going uh,

846
00:49:41,800 --> 00:49:44,480
Speaker 1: and then give that kind of blood back to the

847
00:49:44,520 --> 00:49:46,440
Speaker 1: patient and it would help to treat their cancer. It's

848
00:49:46,440 --> 00:49:50,400
Speaker 1: sort of an early idea immunotherapy, so basically getting someone's

849
00:49:50,440 --> 00:49:54,080
Speaker 1: donor immune system to generate some antibodies to neutralize the

850
00:49:54,120 --> 00:49:57,759
Speaker 1: cancer when you donated them. And so this woman's mother said,

851
00:49:57,800 --> 00:50:01,160
Speaker 1: all right, I'll do this. You transplant me with a

852
00:50:01,160 --> 00:50:05,120
Speaker 1: bit of my daughter's cancer. I'll generate the antibodies, and

853
00:50:05,160 --> 00:50:07,239
Speaker 1: then you can take my blood and give it to her.

854
00:50:08,000 --> 00:50:12,879
Speaker 1: And unfortunately, the daughter actually passed away very quickly, and

855
00:50:13,239 --> 00:50:16,359
Speaker 1: a few weeks later it was discovered that the mother

856
00:50:16,560 --> 00:50:19,160
Speaker 1: actually did have the cancer growing in her, and and

857
00:50:19,200 --> 00:50:22,120
Speaker 1: then shortly after that the mother passed away from the

858
00:50:22,160 --> 00:50:26,000
Speaker 1: cancer that had killed her daughter. And you're like, it's

859
00:50:26,120 --> 00:50:30,920
Speaker 1: rare and probably because they were related. You overcome the

860
00:50:31,440 --> 00:50:36,680
Speaker 1: problems of immune rejection, but you're like, ohhs, well, it

861
00:50:36,680 --> 00:50:42,319
Speaker 1: could happen. Ah. And then there's the most absolutely disgusting one,

862
00:50:43,239 --> 00:50:52,160
Speaker 1: which is this is really sad and awful but also gross. Um. So,

863
00:50:52,160 --> 00:50:54,840
Speaker 1: there was a man who walks into an HIV clinic

864
00:50:55,239 --> 00:51:00,520
Speaker 1: in Colombia complaining of feeling very unwell and so HIV

865
00:51:00,760 --> 00:51:03,640
Speaker 1: for a long time, so his immune system was very suppressed.

866
00:51:03,640 --> 00:51:06,960
Speaker 1: He hadn't been taking his medication, and he was feeling

867
00:51:07,040 --> 00:51:09,239
Speaker 1: very unwell. And they looked in his body and they

868
00:51:09,239 --> 00:51:15,880
Speaker 1: found all these little nodules in his body and and

869
00:51:15,920 --> 00:51:18,480
Speaker 1: they were like, well, these don't look like human cells.

870
00:51:19,280 --> 00:51:21,279
Speaker 1: This is very weird. And they were well, maybe it's

871
00:51:21,560 --> 00:51:24,520
Speaker 1: a parasite or something. And they gave him some some treatment,

872
00:51:24,560 --> 00:51:26,600
Speaker 1: and he went away and and he came back in

873
00:51:26,640 --> 00:51:28,359
Speaker 1: his life, it's still no better, and there's more and

874
00:51:28,400 --> 00:51:31,680
Speaker 1: more of these weird things. And they looked more closely,

875
00:51:31,680 --> 00:51:36,560
Speaker 1: they got them analyzed, and it was he'd been infected

876
00:51:36,560 --> 00:51:41,120
Speaker 1: by tapeworm. But the tape worm had a cancer and

877
00:51:41,200 --> 00:51:46,320
Speaker 1: the cancer had infected the man, and you're like, whoa,

878
00:51:47,200 --> 00:51:52,239
Speaker 1: that is a just the stuff of nightmares. Um, be

879
00:51:52,680 --> 00:51:55,239
Speaker 1: highlights how powerful the human immune system is at the

880
00:51:55,239 --> 00:51:58,160
Speaker 1: best of times. And see is like, oh my god.

881
00:51:59,440 --> 00:52:03,080
Speaker 1: You know, also tape worms can get cancer, so it

882
00:52:03,120 --> 00:52:05,879
Speaker 1: sort of highlights a lot of the principles at work here.

883
00:52:06,120 --> 00:52:09,200
Speaker 1: And very sad for that man, but unfortunately he couldn't

884
00:52:09,239 --> 00:52:13,359
Speaker 1: be treated in the time. Um but it's like, this

885
00:52:13,480 --> 00:52:19,600
Speaker 1: is an incredible biological phenomenon really, that we were only

886
00:52:19,640 --> 00:52:22,719
Speaker 1: just starting to understand. Yeah, I mean, these are all

887
00:52:23,440 --> 00:52:26,759
Speaker 1: just unbelievable examples and and go in the column of

888
00:52:27,520 --> 00:52:29,680
Speaker 1: you know, the case you make that we should shift

889
00:52:29,719 --> 00:52:33,040
Speaker 1: towards that thinking of cancer in an evolutionary and ecological

890
00:52:33,040 --> 00:52:36,879
Speaker 1: way instead of a purely molecular way. So if that's

891
00:52:36,920 --> 00:52:40,719
Speaker 1: the dark side, what about thinking about cancer in an

892
00:52:40,760 --> 00:52:44,319
Speaker 1: evolutionary and ecological way gives you hope? Do you see

893
00:52:44,480 --> 00:52:48,360
Speaker 1: lines of research extending from that framework that give you

894
00:52:48,400 --> 00:52:51,799
Speaker 1: hope for the future and of cancer treatment and and

895
00:52:51,880 --> 00:52:55,399
Speaker 1: the fight against cancer? Yeah, so you know, you can

896
00:52:55,440 --> 00:52:58,080
Speaker 1: get very sort of nihilistic about this, and I oh yeah,

897
00:52:58,120 --> 00:53:02,239
Speaker 1: resistance always emerges. Evolution is so powerful. But then I

898
00:53:02,280 --> 00:53:05,920
Speaker 1: look at the kind of researchers that are really getting

899
00:53:05,960 --> 00:53:09,280
Speaker 1: to grips with evolutionary therapy, and it's a growing bunch.

900
00:53:09,760 --> 00:53:12,280
Speaker 1: It's all started, particularly, I think, from the Mopic Cancer

901
00:53:12,320 --> 00:53:16,160
Speaker 1: Center in Tampa and Florida and a man called Bob

902
00:53:16,200 --> 00:53:19,080
Speaker 1: Gattenby and his team there, and they are just really

903
00:53:19,120 --> 00:53:24,560
Speaker 1: incredible people. So, I mean, I'm a biologist, I am biased,

904
00:53:24,640 --> 00:53:28,760
Speaker 1: I will say against mathematicians and physicists. But it turns

905
00:53:28,800 --> 00:53:31,880
Speaker 1: out the secret the secret weapon in the war on

906
00:53:32,000 --> 00:53:35,839
Speaker 1: cancer is maths. So there you go. So he's brought

907
00:53:35,920 --> 00:53:40,560
Speaker 1: together all these mathematicians and biologists and they're actually doing

908
00:53:41,120 --> 00:53:46,280
Speaker 1: evolutionary modeling on cancer populations, trying to understand the rise

909
00:53:46,320 --> 00:53:50,320
Speaker 1: of the fall of resistant and sensitive cells, trying to go, Okay,

910
00:53:50,440 --> 00:53:53,680
Speaker 1: if if resistance is going to emerge when you treat,

911
00:53:54,360 --> 00:53:57,480
Speaker 1: can we predict how that's going to happen? How do

912
00:53:57,560 --> 00:54:02,520
Speaker 1: we kind of let cell populations balance them cells out

913
00:54:02,600 --> 00:54:06,399
Speaker 1: and stay in control rather than just you know, nuke

914
00:54:06,440 --> 00:54:09,240
Speaker 1: it from orbit, which is kind of the conventional idea

915
00:54:09,239 --> 00:54:13,719
Speaker 1: about cancer therapy. And so they've they've done a most

916
00:54:13,719 --> 00:54:17,680
Speaker 1: successful clinical trial so far is in prostate cancer. And

917
00:54:17,719 --> 00:54:20,800
Speaker 1: it's it's an absolutely fascinating trial of an approach that

918
00:54:20,840 --> 00:54:24,319
Speaker 1: they call adaptive therapy. And the way it works is

919
00:54:24,600 --> 00:54:28,279
Speaker 1: you assume that within any cancer at any size, there

920
00:54:28,320 --> 00:54:31,279
Speaker 1: are going to be sensitive cells to the drug and

921
00:54:31,280 --> 00:54:33,440
Speaker 1: there's going to be resistant cells to the drug. And

922
00:54:33,480 --> 00:54:37,120
Speaker 1: it's a drug called abbiratarone that they use, and so

923
00:54:37,200 --> 00:54:41,640
Speaker 1: what you do is you you also have to have

924
00:54:41,680 --> 00:54:45,000
Speaker 1: a marker that will tell you how much tumor is

925
00:54:45,040 --> 00:54:48,680
Speaker 1: in anyone's body at any given time. And for prostate cancer,

926
00:54:48,719 --> 00:54:50,600
Speaker 1: we have quite a good marker. It's called p s A.

927
00:54:50,719 --> 00:54:52,840
Speaker 1: So you can look at someone's p s A level

928
00:54:52,920 --> 00:54:56,440
Speaker 1: in their bloodstream and say, okay, that's a proxy for

929
00:54:56,480 --> 00:54:59,520
Speaker 1: how much cancer is in their body. And so they

930
00:54:59,560 --> 00:55:04,160
Speaker 1: start eating this these men with prostate cancer advanced prostate cancer,

931
00:55:04,239 --> 00:55:08,040
Speaker 1: so they're there. Probably their their life expectancy is about

932
00:55:08,080 --> 00:55:10,359
Speaker 1: eighteen months on this drug before it starts to get

933
00:55:10,360 --> 00:55:14,080
Speaker 1: really gnarly for them. And and they treat them with

934
00:55:14,080 --> 00:55:17,160
Speaker 1: this drug and it starts to work and their tumors

935
00:55:17,200 --> 00:55:20,880
Speaker 1: start to shrink, and then the difficult bit is you

936
00:55:20,960 --> 00:55:24,000
Speaker 1: wait till it's shrunk to half the size it was

937
00:55:25,560 --> 00:55:31,120
Speaker 1: and then you stop treating and you wait. So the

938
00:55:31,200 --> 00:55:34,000
Speaker 1: idea is you've knocked down all the sensitive cells, or

939
00:55:34,040 --> 00:55:36,000
Speaker 1: as many of them as you. You feel the urge too,

940
00:55:36,280 --> 00:55:38,960
Speaker 1: and there's still some sensitive cells there which are keeping

941
00:55:38,960 --> 00:55:42,960
Speaker 1: the resistant cells in check. And then you wait and

942
00:55:43,040 --> 00:55:46,080
Speaker 1: you wait for them to grow back. But because being

943
00:55:46,160 --> 00:55:48,960
Speaker 1: resistant to the drug is kind of it's it's it's

944
00:55:48,960 --> 00:55:50,719
Speaker 1: not very good for you, these cells are less fit,

945
00:55:50,760 --> 00:55:52,880
Speaker 1: they struggled to grow as much. So it's the sensitive

946
00:55:52,920 --> 00:55:56,120
Speaker 1: cells that grow back as so you treat them again.

947
00:55:56,560 --> 00:55:58,880
Speaker 1: And so you ride this kind of roller coaster of

948
00:55:59,440 --> 00:56:02,640
Speaker 1: start the drug, let the tumor shrink, stop the drug,

949
00:56:03,160 --> 00:56:06,560
Speaker 1: let the tumor grow. Start the drug, let the tumor shrink.

950
00:56:06,840 --> 00:56:08,840
Speaker 1: And they have men who have been on this regime

951
00:56:09,080 --> 00:56:12,719
Speaker 1: for four years. I mean gradually in the end the

952
00:56:12,800 --> 00:56:16,120
Speaker 1: tumor does, the cancer does start to evolve because that

953
00:56:16,200 --> 00:56:19,480
Speaker 1: population of resistance cells does start to get bigger, very

954
00:56:19,520 --> 00:56:22,399
Speaker 1: slightly every time. But this is you know, if this

955
00:56:22,480 --> 00:56:25,080
Speaker 1: was a drug and you were saying, I've gone from

956
00:56:25,200 --> 00:56:28,640
Speaker 1: average eighteen months through to four years, you know, if

957
00:56:28,640 --> 00:56:31,880
Speaker 1: this was a drug, the industry would just be throwing

958
00:56:31,920 --> 00:56:35,279
Speaker 1: itself at trying to to get this you know, get

959
00:56:35,280 --> 00:56:36,920
Speaker 1: this to the clinic, get this to work, get this

960
00:56:37,000 --> 00:56:40,960
Speaker 1: to everyone. So that was that was a really powerful

961
00:56:41,000 --> 00:56:45,839
Speaker 1: demonstration of an evolutionary therapy of understanding and accepting you've

962
00:56:45,880 --> 00:56:48,920
Speaker 1: got these cell populations in there and they're kind of

963
00:56:48,960 --> 00:56:53,480
Speaker 1: how to balance them. There are other sort of adaptive strategies,

964
00:56:53,520 --> 00:56:56,480
Speaker 1: evolutionary strategies. There's one called the Suckers gambit, which is

965
00:56:56,520 --> 00:56:59,400
Speaker 1: where you treat cancer cells with a drug that you

966
00:56:59,440 --> 00:57:03,839
Speaker 1: want them to develop evolved resistance too. But you know

967
00:57:03,960 --> 00:57:06,960
Speaker 1: that for them to have evolved resistance, they have to

968
00:57:07,000 --> 00:57:10,000
Speaker 1: have activated certain molecular pathways, they have to have gone

969
00:57:10,040 --> 00:57:13,640
Speaker 1: down an evolutionary route in one direction, and then you

970
00:57:13,719 --> 00:57:16,240
Speaker 1: hit them with another drug that they can't get out of,

971
00:57:17,120 --> 00:57:18,920
Speaker 1: so you're sort of you you get them into a

972
00:57:18,960 --> 00:57:23,840
Speaker 1: blind evolutionary end. It's like a double punch, yeah, exactly.

973
00:57:23,920 --> 00:57:27,400
Speaker 1: You know, there's there's lots of ideas out there about

974
00:57:27,480 --> 00:57:30,680
Speaker 1: using the drugs we have, maybe even using drugs that

975
00:57:30,720 --> 00:57:34,760
Speaker 1: are less you know, less good. I suppose less potent, less,

976
00:57:35,520 --> 00:57:38,960
Speaker 1: less toxic, because you don't want to just nuke everything.

977
00:57:39,600 --> 00:57:42,160
Speaker 1: You want to start thinking about how to balance cells,

978
00:57:42,200 --> 00:57:46,680
Speaker 1: how to control cell populations. But this comes to the

979
00:57:46,720 --> 00:57:51,080
Speaker 1: really difficult thing, which is the psychological element of this,

980
00:57:51,200 --> 00:57:55,320
Speaker 1: because this is not the cure for cancer that we

981
00:57:55,320 --> 00:57:58,280
Speaker 1: were promised. This is not the magic bullet. This is

982
00:57:58,320 --> 00:58:01,640
Speaker 1: not eradicated from your body. There may be some approaches

983
00:58:01,680 --> 00:58:04,160
Speaker 1: where we actually can and you know, the earlier you

984
00:58:04,160 --> 00:58:07,760
Speaker 1: can diagnose cancer if you can treat it with surgery. Um,

985
00:58:07,880 --> 00:58:11,720
Speaker 1: some cancers can be treated really effectively and cured at

986
00:58:11,760 --> 00:58:15,840
Speaker 1: an early stage. But for cancers, once that evolutionary process

987
00:58:16,000 --> 00:58:19,600
Speaker 1: is really kicked off, you have to approach them with

988
00:58:19,640 --> 00:58:23,920
Speaker 1: an evolutionary mindset, and that may mean driving them to

989
00:58:24,000 --> 00:58:28,160
Speaker 1: extinction with the right combination of sort of extinction events

990
00:58:28,200 --> 00:58:32,800
Speaker 1: at the right time. Um. But it's a it's not

991
00:58:32,880 --> 00:58:36,600
Speaker 1: going to be this kind of perfect cure that I

992
00:58:36,640 --> 00:58:39,440
Speaker 1: think people want that we've been led to expect, and

993
00:58:39,480 --> 00:58:43,360
Speaker 1: it certainly won't be one magic bullet drug that like, Yep,

994
00:58:43,440 --> 00:58:46,000
Speaker 1: that's it, that's that's the cure. That's it. We can

995
00:58:46,000 --> 00:58:49,800
Speaker 1: now sell this and give it to everyone because as

996
00:58:49,800 --> 00:58:53,520
Speaker 1: I said, you know, every every individual cancer is a

997
00:58:53,640 --> 00:58:56,200
Speaker 1: is a one off, it's a special snowflake. It's an

998
00:58:56,200 --> 00:59:00,840
Speaker 1: individual evolutionary event. So we need to understand that where

999
00:59:00,960 --> 00:59:03,920
Speaker 1: is it going what's it doing, what are what are

1000
00:59:03,920 --> 00:59:07,440
Speaker 1: the contingencies in there? And how can we either drive

1001
00:59:07,480 --> 00:59:11,040
Speaker 1: this cancer to extinction or drive it to a place

1002
00:59:11,440 --> 00:59:13,960
Speaker 1: where we can control it for the rest of someone's

1003
00:59:14,160 --> 00:59:18,640
Speaker 1: natural lifespan. And you know, that's not a cure for cancer,

1004
00:59:18,720 --> 00:59:22,160
Speaker 1: but to me, that's you know, I think that's getting there. Yeah,

1005
00:59:22,600 --> 00:59:25,360
Speaker 1: I really like that thinking of the body, not like

1006
00:59:25,480 --> 00:59:28,320
Speaker 1: as a malfunctioning car with a part that needs to

1007
00:59:28,400 --> 00:59:32,040
Speaker 1: be replaced or fixed, but as an environment with natural

1008
00:59:32,040 --> 00:59:35,880
Speaker 1: populations within it that in the relationships between them need

1009
00:59:35,960 --> 00:59:39,680
Speaker 1: to be managed. Yeah, sort of tending the garden is

1010
00:59:39,720 --> 00:59:42,640
Speaker 1: the idea, but you can take the ecological thing further.

1011
00:59:42,680 --> 00:59:45,800
Speaker 1: There are different sorts of cancers. You know. Some are lush,

1012
00:59:46,080 --> 00:59:49,720
Speaker 1: exotic rainforests that are really going for its summer arid deserts.

1013
00:59:49,720 --> 00:59:53,840
Speaker 1: Some are more like, you know, kind of neatly tendered gardens.

1014
00:59:53,840 --> 00:59:57,600
Speaker 1: But we've got to understand what each person's cancer is

1015
00:59:58,040 --> 01:00:01,360
Speaker 1: really like and how it's behaving, not just a shopping

1016
01:00:01,400 --> 01:00:03,600
Speaker 1: list of mutations that you can try and fire magic

1017
01:00:03,640 --> 01:00:09,680
Speaker 1: bullets at, but a much more holistic understanding and accepting

1018
01:00:10,000 --> 01:00:13,440
Speaker 1: that evolution is going to happen, always has done. That's

1019
01:00:13,440 --> 01:00:15,880
Speaker 1: why we're here, that's why the diversity of life is here.

1020
01:00:16,520 --> 01:00:19,560
Speaker 1: But if we can harness it and work with it,

1021
01:00:20,040 --> 01:00:22,360
Speaker 1: then I really think we can start to make some

1022
01:00:22,400 --> 01:00:26,800
Speaker 1: progress in in some of these most difficult advanced cancers. Alright,

1023
01:00:26,840 --> 01:00:28,680
Speaker 1: I guess we will wrap it up there. But again,

1024
01:00:28,760 --> 01:00:32,240
Speaker 1: the book is Rebel Cell. It's a fantastic reed. We

1025
01:00:32,440 --> 01:00:34,880
Speaker 1: we really think you'll like it. And also you can

1026
01:00:34,920 --> 01:00:38,520
Speaker 1: check out cats podcast, the Genetics Unzipped podcast. Is there

1027
01:00:38,520 --> 01:00:40,200
Speaker 1: anywhere else they should look for your work right now,

1028
01:00:40,280 --> 01:00:47,040
Speaker 1: Cat um, my first book, Herding Hemmingway's Cats, is available.

1029
01:00:47,520 --> 01:00:49,400
Speaker 1: I've got another book called How to Code a Human

1030
01:00:50,080 --> 01:00:54,040
Speaker 1: and you can find me at on Twitter. I'm Cat

1031
01:00:54,120 --> 01:00:58,000
Speaker 1: underscore Arnie. Pretty much yeah, every everything is pretty much there.

1032
01:00:59,560 --> 01:01:01,760
Speaker 1: All right, Well, that does it. Thanks again to Cat

1033
01:01:01,840 --> 01:01:04,840
Speaker 1: Arnie for joining us for this discussion. Again, if you're

1034
01:01:04,840 --> 01:01:06,560
Speaker 1: trying to look her up, you can find her on

1035
01:01:06,600 --> 01:01:10,080
Speaker 1: Twitter at at k A T Underscore A R N.

1036
01:01:10,240 --> 01:01:13,160
Speaker 1: E Y. And if you're looking for her book, Rebel

1037
01:01:13,240 --> 01:01:17,720
Speaker 1: Cell Cancer Evolution and the New Science of Life's Oldest Betrayal. Uh.

1038
01:01:17,760 --> 01:01:20,880
Speaker 1: The UK version is coming out on August six. The

1039
01:01:20,960 --> 01:01:23,960
Speaker 1: US version is coming out on September twenty nine. You

1040
01:01:24,000 --> 01:01:26,640
Speaker 1: can pre order now, I believe, If not, keep an

1041
01:01:26,640 --> 01:01:29,200
Speaker 1: eye out for it, and you can also look it

1042
01:01:29,280 --> 01:01:33,240
Speaker 1: up on her website at Rebel cell book dot com

1043
01:01:33,360 --> 01:01:35,720
Speaker 1: or check out her work on the Genetics on Zipped

1044
01:01:35,720 --> 01:01:38,920
Speaker 1: podcast at Genetics n zipped dot com. It's just such

1045
01:01:38,920 --> 01:01:41,440
Speaker 1: a great book title. I just keep coming back to

1046
01:01:41,480 --> 01:01:43,720
Speaker 1: how much I love that book title. It really is

1047
01:01:43,760 --> 01:01:46,160
Speaker 1: great and uh and it has some resonance throughout the

1048
01:01:46,160 --> 01:01:49,240
Speaker 1: book with some other themes and metaphors she discusses in there,

1049
01:01:49,280 --> 01:01:51,680
Speaker 1: such as the Society of Cells. So, Robert, I really

1050
01:01:51,680 --> 01:01:53,400
Speaker 1: do recommend you read it if you get a chance.

1051
01:01:53,480 --> 01:01:55,920
Speaker 1: I I really enjoyed this one, all right. I'll have

1052
01:01:55,960 --> 01:01:59,640
Speaker 1: to look for in September. In the meantime, Yeah, everyone

1053
01:01:59,680 --> 01:02:02,040
Speaker 1: out there would like to listen to additional episodes of

1054
01:02:02,080 --> 01:02:04,360
Speaker 1: stuff to blow your mind, Well you can find us

1055
01:02:04,480 --> 01:02:08,640
Speaker 1: absolutely wherever you get your podcasts and wherever that happens

1056
01:02:08,680 --> 01:02:11,960
Speaker 1: to be. We just asked that you rate, review, and subscribe.

1057
01:02:11,960 --> 01:02:14,080
Speaker 1: Those are three things that you can do that just

1058
01:02:14,120 --> 01:02:15,960
Speaker 1: really helps out the show. Another thing you can do

1059
01:02:16,040 --> 01:02:18,000
Speaker 1: is just of course just tell people about the show.

1060
01:02:18,480 --> 01:02:21,320
Speaker 1: Huge thanks as always to our excellent audio producer Seth

1061
01:02:21,440 --> 01:02:23,880
Speaker 1: Nicholas Johnson. If you would like to get in touch

1062
01:02:23,920 --> 01:02:26,000
Speaker 1: with us with feedback on this episode or any other,

1063
01:02:26,080 --> 01:02:28,600
Speaker 1: to suggest topic for the future, or just to say hello,

1064
01:02:28,880 --> 01:02:31,560
Speaker 1: you can email us at contact at stuff to Blow

1065
01:02:31,600 --> 01:02:41,520
Speaker 1: your Mind dot com. Stuff to Blow Your Mind is

1066
01:02:41,560 --> 01:02:44,240
Speaker 1: production of I Heart Radio. For more podcasts for My

1067
01:02:44,280 --> 01:02:47,360
Speaker 1: heart Radio, visit the iHeart Radio app, Apple Podcasts, or

1068
01:02:47,360 --> 01:03:00,560
Speaker 1: wherever you're listening to your favorite shows. Bio Way Way

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Speaker 1: Way to prop