WEBVTT - Ep 205 Cancer Part 4: Where do things stand today? 0:00:00.080 --> 0:00:03.640 Throughout this series, we'll be discussing many aspects of cancer 0:00:03.720 --> 0:00:07.160 diagnosis and treatment, and we will be sharing several personal 0:00:07.200 --> 0:00:11.280 stories related to cancer. Some listeners might find this content upsetting. 0:00:11.680 --> 0:00:12.960 Please listen with discretion. 0:00:14.960 --> 0:00:17.200 My name is Christina and I'm a healthy, cancer free, 0:00:17.239 --> 0:00:19.119 thirty year old woman who was about to undergo a 0:00:19.160 --> 0:00:22.400 double mistact tomy. Let me tell you why. My aunt 0:00:22.400 --> 0:00:25.040 Helen was diagnosed with breast cancer at age thirty four 0:00:25.120 --> 0:00:27.840 and ultimately passed away ten years later when I was thirteen. 0:00:28.480 --> 0:00:30.600 Just a few years later, still relinking the loss of 0:00:30.600 --> 0:00:33.879 our beloved Helen, another aunt was diagnosed with ovarian cancer. 0:00:34.400 --> 0:00:36.159 My whole life, I had looked at my aunts and 0:00:36.200 --> 0:00:39.120 saw myself fall blue eyes and big foreheads and curly hair. 0:00:39.640 --> 0:00:41.600 If their fate was cancer, it was bound to be 0:00:41.640 --> 0:00:45.519 mine too. And it wasn't just my aunt's. Six other relatives, 0:00:45.520 --> 0:00:47.760 from great aunts to distant cousins had been diagnosed with 0:00:47.800 --> 0:00:50.479 either breast or ovarian cancer. It was high time for 0:00:50.560 --> 0:00:52.840 genetic testing, and we discovered that my aunt and father 0:00:52.920 --> 0:00:56.480 carry the Brocketuo mutation. This mutation is associated with a 0:00:56.520 --> 0:00:59.080 forty to eighty five percent lifetime risk for breast cancer 0:00:59.320 --> 0:01:01.840 and fifteen to forty percent risk for a varian cancer, 0:01:02.120 --> 0:01:05.640 along with increased risks for other cancers including prostate, pancreatic, 0:01:05.680 --> 0:01:09.720 and melanomas. As a teenager, I wanted to be tested immediately. 0:01:10.160 --> 0:01:12.479 This was around when the Affordable Care Act was being passed, 0:01:12.480 --> 0:01:15.040 and my doctors recommended that I wait until protections for 0:01:15.080 --> 0:01:18.559 pre existing conditions were fully in effect before diagnosing myself 0:01:18.600 --> 0:01:22.000 with one. Finally, at nineteen, I received confirmation of what 0:01:22.080 --> 0:01:24.520 I had felt for years. Just like my aunts, I 0:01:24.560 --> 0:01:27.600 was positive for rokutwo. I heard constantly at the time 0:01:27.600 --> 0:01:29.920 that nineteen was too young to test, years before any 0:01:29.959 --> 0:01:33.080 screenings would be recommended, but I wanted those years to 0:01:33.120 --> 0:01:35.600 sit with my diagnosis and process it as slowly as 0:01:35.600 --> 0:01:38.280 I wanted to. I'm so grateful for the protections that 0:01:38.360 --> 0:01:41.440 allowed me to do so. My cancer screenings began at 0:01:41.440 --> 0:01:44.360 twenty four, and for six years, I dutifully scheduled breast 0:01:44.360 --> 0:01:47.400 exam skin checks, and an annual date was a clunking, 0:01:47.520 --> 0:01:51.680 thumping MRI. I'm treated by an excellent hereditary cancer clinic, 0:01:51.720 --> 0:01:54.120 and my team is optimistic that any breast cancer would 0:01:54.120 --> 0:01:56.680 be caught early and be survivable. But that's not good 0:01:56.760 --> 0:01:59.320 enough for me. I don't want to survive breast cancer. 0:02:00.040 --> 0:02:03.800 They never have it at all. Hereditary cancer causes incalculable 0:02:03.800 --> 0:02:06.360 loss in trauma to the families that it tears. Through 0:02:06.800 --> 0:02:10.000 both modern genetic testing, younger generations can use that trauma 0:02:10.040 --> 0:02:13.080 to ford a different path forward. My journey has always 0:02:13.120 --> 0:02:15.919 been mapped onto my aunt Helens. The age I started 0:02:15.919 --> 0:02:18.480 cancer screenings and planning for my mistectomy is all based 0:02:18.480 --> 0:02:20.880 on her timeline and the hopes that mine can be different. 0:02:21.520 --> 0:02:24.160 My double mistectomy will reduce my lifetime risk of cancer 0:02:24.200 --> 0:02:27.360 by ninety to ninety five percent. It's not one hundred percent, 0:02:27.440 --> 0:02:29.360 but it's nothing less than a gift. 0:02:30.160 --> 0:02:30.520 Hi. 0:02:30.680 --> 0:02:34.280 I'm clear from South Africa and I'm undergoing treatment for 0:02:34.480 --> 0:02:38.079 cholorectal cancer. I knew something was wrong for at least 0:02:38.120 --> 0:02:40.799 a year before I did anything about it. As a 0:02:40.840 --> 0:02:43.400 friend said, we're more scared of the treatment than the disease. 0:02:44.120 --> 0:02:46.760 When I finally went for colonoscopy, I'm pretty sure I 0:02:46.840 --> 0:02:49.560 knew I had cancer. It's always been my biggest fear, 0:02:50.080 --> 0:02:52.080 But in a way, it's freeing knowing that the waste 0:02:52.080 --> 0:02:55.200 has happened after barely interacting with a medical system. For 0:02:55.200 --> 0:02:57.560 forty one years of my life. I have now had 0:02:57.600 --> 0:03:01.000 two major surgeries, spent weeks in US. You have an 0:03:01.000 --> 0:03:05.920 iliostomy and am undergoing chemo. Finding chemo very frustrating because 0:03:05.960 --> 0:03:08.720 no one knows how each person will react, so hard 0:03:08.760 --> 0:03:11.400 to tell if it will get worse or better. I'm 0:03:11.400 --> 0:03:14.000 trying to stay very positive and interested in the biology 0:03:14.040 --> 0:03:16.000 of it all, and also trying to be a good 0:03:16.000 --> 0:03:19.160 example and educate my students. I teach high school science 0:03:19.160 --> 0:03:22.360 and bio. I really wish people were more open about 0:03:22.360 --> 0:03:25.360 gross body processes because I'm sure if we talked more 0:03:25.360 --> 0:03:29.040 about poo, more people would be diagnosed earlier. As it is, 0:03:29.120 --> 0:03:31.240 I'm telling everyone to go for krodnoscopies. 0:04:17.360 --> 0:04:20.520 Thank you all again so so much for sharing your 0:04:20.560 --> 0:04:24.120 stories with us. We are truly touched and cannot believe 0:04:24.160 --> 0:04:27.040 how many people wrote in We're willing to be vulnerable 0:04:27.640 --> 0:04:32.200 and share such an intimate part of their lives with us, 0:04:32.640 --> 0:04:35.400 because it really adds more than we can possibly say 0:04:35.400 --> 0:04:37.840 to the series, So thank you, it really does. Thank you. 0:04:38.400 --> 0:04:40.479 We have a lot more stories that will also be 0:04:40.520 --> 0:04:43.480 sharing that we have shared throughout this series and throughout 0:04:43.480 --> 0:04:46.599 this episode. We really wish that we could have included 0:04:46.600 --> 0:04:50.200 every story. Thank you so much to everyone who wrote 0:04:50.240 --> 0:04:52.840 in and who recorded your stories and who shared them 0:04:52.839 --> 0:04:55.360 with us. We really just can't say thank. 0:04:55.240 --> 0:04:57.040 You enough, even though we've tried. 0:04:57.120 --> 0:04:57.559 We tried. 0:04:58.960 --> 0:05:01.840 Hi, I'm Aaron, and I'm Aaron aman Updyke and. 0:05:01.960 --> 0:05:03.880 This is this podcast will kill you. 0:05:04.000 --> 0:05:07.719 Welcome to episode four and final for and final of 0:05:07.800 --> 0:05:09.320 our series on cancer. 0:05:09.640 --> 0:05:12.040 It's been a journey. 0:05:12.480 --> 0:05:17.440 Yeah, that's that's the word. Yeah. Yeah, We've covered a 0:05:17.440 --> 0:05:19.919 lot of ground so far in this series. If this 0:05:20.080 --> 0:05:23.800 is your first time tuning into the Cancer series, you 0:05:24.720 --> 0:05:25.920 can listen to these out of order. 0:05:26.000 --> 0:05:28.000 Honestly, this would not be a bad place to start. 0:05:28.040 --> 0:05:31.080 We could have started here, we could have, but we're 0:05:31.160 --> 0:05:31.920 ending here instead. 0:05:32.080 --> 0:05:34.000 The point is that these are all pieces of a 0:05:34.040 --> 0:05:36.599 big puzzle, and there are still pieces that we haven't 0:05:36.640 --> 0:05:39.200 filled in yet, pieces that remain to be filled in 0:05:39.240 --> 0:05:41.599 by science and medicine. But we can tell you what 0:05:41.640 --> 0:05:45.160 we've covered so far. So the first episode we talked 0:05:45.160 --> 0:05:48.680 about what cancer is, both conceptually and clinically, kind of 0:05:48.720 --> 0:05:52.640 the definitions of cancer. The second episode we talked about 0:05:52.720 --> 0:05:56.039 the evolution of cancer and cellular aspects of cancer, So like, 0:05:56.080 --> 0:05:59.440 what's actually happening within that cancer cell to make it cancerous. 0:06:00.000 --> 0:06:03.360 Third episode, last episode all about treatment, history of treatment, 0:06:03.560 --> 0:06:08.120 existing treatments today, possible treatments in the future. And today 0:06:08.880 --> 0:06:11.880 we're talking about kind of the big picture of like 0:06:12.480 --> 0:06:15.840 what the status of cancer is around the world today 0:06:16.640 --> 0:06:18.919 and ways that we might be able to see that 0:06:19.000 --> 0:06:21.760 status change in the future thanks to things like screening 0:06:21.800 --> 0:06:22.360 and prevention. 0:06:22.520 --> 0:06:25.560 Some of our favorite things to talk about, Yes podcast, public. 0:06:25.880 --> 0:06:28.800 Public health, and as much ground as we have covered 0:06:28.800 --> 0:06:31.120 so far in the series and as much as we're 0:06:31.160 --> 0:06:35.000 covering today, it is not everything that has to do 0:06:35.040 --> 0:06:38.000 with cancer. So we want everyone to know that. First 0:06:38.040 --> 0:06:40.599 of all, we have a very very long list of 0:06:40.600 --> 0:06:42.920 sources for every one of these episodes. So if you 0:06:42.960 --> 0:06:46.200 are inspired to learn more about cancer, about cancer, treatment, 0:06:46.240 --> 0:06:49.960 about the epidemiology, about any aspect of cancer, go to 0:06:49.960 --> 0:06:51.640 our website, this podcast with Hey dot com and check 0:06:51.640 --> 0:06:54.200 out the sources list. And these are not the only 0:06:54.240 --> 0:06:55.640 cancer episodes that we're going to do. 0:06:56.040 --> 0:06:56.480 Correct. 0:06:56.640 --> 0:06:58.560 This is sort of what we see as is sort 0:06:58.600 --> 0:07:01.320 of laying the foundation and a jumping off point for 0:07:01.400 --> 0:07:05.440 us to be able to explore individual cancers in the future. Yeah, 0:07:05.520 --> 0:07:08.560 So we would also love your feedback on what episodes 0:07:08.600 --> 0:07:10.320 you'd like to hear more about, what topics you really 0:07:10.360 --> 0:07:11.239 want to learn more about. 0:07:11.400 --> 0:07:13.680 Yeah, it really, it really does help us. Like we 0:07:14.080 --> 0:07:17.200 are already planning next episodes, not just for cancer, but 0:07:17.200 --> 0:07:19.440 for many other things. And it's like, what do what 0:07:19.720 --> 0:07:21.560 do you all want to know about? 0:07:21.680 --> 0:07:25.600 Yeah, what questions arise? Yes, tell us right, see what. 0:07:25.560 --> 0:07:25.920 We can do. 0:07:26.040 --> 0:07:28.920 We'll see what we can do. Also, you know, we 0:07:28.920 --> 0:07:33.400 we're approaching cancer from a very biological perspective, historical perspective. 0:07:33.840 --> 0:07:38.680 The focus is on cancer as this phenomenon, thing, this thing, 0:07:38.920 --> 0:07:42.280 and so in throughout these episodes, we haven't really touched 0:07:42.400 --> 0:07:45.120 very much on the personal experience of cancer and what 0:07:45.280 --> 0:07:48.240 that can look like for somebody, whether that's somebody who 0:07:48.640 --> 0:07:52.040 has been diagnosed, someone undergoing treatment, someone who's loved one 0:07:52.080 --> 0:07:55.120 has been diagnosed. Maybe you're a caretaker, maybe you're the 0:07:55.160 --> 0:07:58.120 friend or colleague. And our first had accounts have been 0:07:58.160 --> 0:08:01.160 so invaluable for to share aring just some of those 0:08:01.200 --> 0:08:04.480 perspectives on that experience. So again, thank you. 0:08:04.560 --> 0:08:04.920 Thank you. 0:08:05.240 --> 0:08:08.000 We really truly can't say it enough. These first hand 0:08:08.000 --> 0:08:11.200 accounts mean so much to us and they make this 0:08:11.360 --> 0:08:14.360 series what it is and our podcast and our podcast 0:08:14.360 --> 0:08:14.840 in general. 0:08:14.920 --> 0:08:18.400 Yeah, so thank you, thank you. One piece of business 0:08:18.400 --> 0:08:22.200 before the last piece of business and that so last week, 0:08:22.200 --> 0:08:24.680 if you listened to our treatment episode, I shouted out 0:08:24.680 --> 0:08:26.960 a couple of episodes of Advances and Care, which is 0:08:27.000 --> 0:08:31.440 another podcast that I host that interviews physician scientists at 0:08:31.440 --> 0:08:34.040 New York Presbyterian and talks about some of the incredible 0:08:34.040 --> 0:08:36.599 cutting edge work that they do. And I want to 0:08:36.640 --> 0:08:39.040 shout out another episode that's related to kind of the 0:08:39.080 --> 0:08:43.120 topic today, which is Screening Prevention, Epidemiology of Cancer, and 0:08:43.160 --> 0:08:48.000 that is episode thirty five titled rise in Early onset 0:08:48.080 --> 0:08:52.560 colon Cancer being Studied through single cell Sequencing. Oh very cool. 0:08:52.800 --> 0:08:56.800 It features research done by Joel Gabrie to look for 0:08:56.920 --> 0:08:59.360 clues that underlie this issue, like why are we seeing 0:08:59.640 --> 0:09:03.240 colon cancer rise in younger adults? 0:09:03.320 --> 0:09:03.480 Right? 0:09:04.160 --> 0:09:05.240 Because it's a scary thing. 0:09:05.160 --> 0:09:07.320 It really is, and it's a lot of headlines. So 0:09:07.320 --> 0:09:09.360 there's a lot of good information there. So check out 0:09:09.360 --> 0:09:10.120 Advances and Care. 0:09:10.160 --> 0:09:12.920 Advances and Care available wherever you get your podcasts. 0:09:13.400 --> 0:09:17.720 Last, but not least, Quarantine any time if. 0:09:17.559 --> 0:09:19.240 You were this is the last time we're going to 0:09:19.320 --> 0:09:22.320 say that, yes, then it will just be taken for 0:09:22.360 --> 0:09:23.120 granted after. 0:09:22.960 --> 0:09:26.120 That starting Yes, we figured this was this series was 0:09:26.160 --> 0:09:30.360 a good time to stop including alcohol in our quarantini recipes. 0:09:30.400 --> 0:09:32.400 We're still going to call them quarantinies because it's too 0:09:32.400 --> 0:09:33.440 good of a name to pass up. 0:09:33.679 --> 0:09:33.920 Nice. 0:09:34.160 --> 0:09:36.680 This week's quarantini is the Crab. 0:09:36.840 --> 0:09:39.640 The Crab, the crab. It's an afo gatto, which means 0:09:39.880 --> 0:09:44.079 espresso and ice cream delicious, so good. 0:09:44.200 --> 0:09:45.400 It just sounded good to us. 0:09:45.400 --> 0:09:45.640 It did. 0:09:45.760 --> 0:09:46.679 That's the whole thing. 0:09:46.720 --> 0:09:48.120 There's nothing deeper behind it. 0:09:48.280 --> 0:09:50.760 The crab means cancer like that is, if you listen 0:09:50.800 --> 0:09:53.400 to the first episode you would know. But anyway, I 0:09:53.520 --> 0:09:53.760 think a. 0:09:53.720 --> 0:09:55.360 Lot of people know that because it's like a what 0:09:55.400 --> 0:09:57.480 do you call it? Star sign thing? 0:09:57.679 --> 0:09:58.319 Astrology? 0:09:58.400 --> 0:10:03.080 Yeah, astrology, yeah, astrology, not astronomy that start sign. 0:10:03.200 --> 0:10:04.520 Yeah, yes. 0:10:04.640 --> 0:10:08.199 Anyways, So check out our social media like Instagram and 0:10:08.320 --> 0:10:11.680 whatever all those other ones to see that recipe, and 0:10:11.760 --> 0:10:13.840 also check out our website, this podcast with killia dot com, 0:10:13.840 --> 0:10:15.599 where you can find I already said the sources to 0:10:15.600 --> 0:10:19.079 all of our episodes, but also transcripts. 0:10:18.280 --> 0:10:21.840 And mermobile and merch and linked links. 0:10:21.640 --> 0:10:24.079 First account contact us form. 0:10:24.520 --> 0:10:25.000 There's more. 0:10:25.160 --> 0:10:27.920 There's got to be something cool that's there that we've missed. 0:10:29.320 --> 0:10:31.720 Anyways, moving on, we should update our website. 0:10:32.000 --> 0:10:34.280 Moving on break. 0:10:34.440 --> 0:10:36.720 Sure, yeah, yeah great, but then tell me all about 0:10:36.800 --> 0:10:38.720 where we got to how we I'll do all that. 0:10:38.840 --> 0:10:39.400 Yeah, thank you. 0:10:56.080 --> 0:10:58.679 My story of brain cancer starts when I got COVID. 0:10:59.320 --> 0:11:02.440 COVID was still at best. Weeks after I developed a 0:11:02.480 --> 0:11:05.480 weird loss of my voice that wouldn't go away. After 0:11:05.520 --> 0:11:08.079 seeing an E and T and getting tests, I was 0:11:08.120 --> 0:11:11.679 diagnosed with focal cord paralysis, most likely from the virus. 0:11:12.559 --> 0:11:15.320 One scain done was an MRI. I took it home, 0:11:15.440 --> 0:11:17.960 took a look, and that's when I saw a hazy 0:11:18.000 --> 0:11:20.880 blob in my frontal lobe, which I named abby normal. 0:11:21.880 --> 0:11:24.360 I could tell from my doctor's reactions it was serious. 0:11:24.800 --> 0:11:27.120 I was shuffled from doctor to doctor, and a couple 0:11:27.080 --> 0:11:29.320 of weeks ended up at a brain tumor center, being 0:11:29.360 --> 0:11:33.240 told it's most likely brain cancer and they recommended surgery. 0:11:34.000 --> 0:11:36.959 During that time, I was convinced I was dying. All 0:11:37.000 --> 0:11:38.840 I could think about was I'll be dead that year. 0:11:39.640 --> 0:11:43.600 I wanted Abby out. I wanted surgery yesterday. I needed 0:11:43.640 --> 0:11:46.240 to know what this was. A month later, I was 0:11:46.240 --> 0:11:48.680 in surgery, having a two and a half centimeter piece 0:11:48.840 --> 0:11:52.840 of my frontal lobe removed. Recovery was rough, between the 0:11:52.840 --> 0:11:56.120 brain healing effects and very high doses of steroids. I 0:11:56.200 --> 0:11:58.760 gained twenty pounds and had an odd urge to steal 0:11:58.840 --> 0:12:02.200 stupid things. I still remember the half dead plant with 0:12:02.280 --> 0:12:04.240 a post a note that said plant on it. I 0:12:04.360 --> 0:12:08.000 so desperately wanted to steal from a local smoothie place. 0:12:09.480 --> 0:12:11.520 Three and a half years later, I no longer want 0:12:11.559 --> 0:12:14.480 to steal. That was short lived, and I don't notice 0:12:14.480 --> 0:12:18.840 my missing friend. I have oligodendroglioma, and probably had it 0:12:18.880 --> 0:12:23.040 for several years before discovering it accidentally. I consider myself 0:12:23.120 --> 0:12:28.520 lucky finding it so small before seizures. After recovery, I 0:12:28.559 --> 0:12:31.480 went on my surviving death tour. I said yes to everything, 0:12:31.520 --> 0:12:34.720 and I had a blast. I realized who my friends are. 0:12:34.840 --> 0:12:37.160 I saw how amazing of a support system I have, 0:12:37.640 --> 0:12:40.520 and I will always remember and be grateful. I will 0:12:40.520 --> 0:12:44.839 also always remember that plant. I see my doctors two 0:12:44.920 --> 0:12:47.319 times a year looking for growth, and chances are i'll 0:12:47.360 --> 0:12:50.439 have more treatment. While I do believe it will one 0:12:50.480 --> 0:12:54.480 day kill me, that knowledge is oddly freeing. Even if 0:12:54.520 --> 0:12:59.040 it sucks. My cancer doesn't define me, doesn't define my life. 0:12:59.120 --> 0:13:00.520 I'm still living it to its fullest. 0:13:02.760 --> 0:13:06.800 Hello. My name is April Rideout. My brother James Carl 0:13:06.880 --> 0:13:11.960 ride Out was diagnosed with a acute lymphoblastic leukemia all 0:13:12.520 --> 0:13:16.040 in twenty seventeen, and the cancer returned in twenty twenty one. 0:13:17.080 --> 0:13:19.920 He passed in March to twenty twenty three from complications 0:13:19.960 --> 0:13:23.440 related to graph versus host disease. I like to share 0:13:23.480 --> 0:13:26.120 his story of his first cancer diagnosis and his own 0:13:26.200 --> 0:13:29.720 words from twenty eighteen to twenty nineteen at a dinner 0:13:29.760 --> 0:13:32.960 honoring the nurses who cared for him with love, kindness, 0:13:33.080 --> 0:13:36.840 and understanding. Before I was diagnosed, I was a happy, 0:13:36.880 --> 0:13:40.640 go lucky staff accountant doing motor fuel tax, married to 0:13:40.679 --> 0:13:43.199 my beautiful wife Amanda, and we just got a wonderful 0:13:43.240 --> 0:13:46.400 dog named Indy. But come the beginning of July in 0:13:46.440 --> 0:13:51.079 twenty seventeen, I started not feeling right. I had dizzy spells, 0:13:51.280 --> 0:13:53.280 I had pain in my right foot along with other 0:13:53.320 --> 0:13:56.800 symptoms as well as lightheadedness. I started to look like 0:13:56.880 --> 0:14:01.040 Uncle Fester, to be honest, and on July nineteen, twenty seventeen, 0:14:01.160 --> 0:14:03.800 my boss Larry told me to leave because I looked 0:14:03.840 --> 0:14:05.959 like crap and I had to go to the doctor, 0:14:06.000 --> 0:14:08.600 and my wonderful wife suggested that they do a blood test. 0:14:09.200 --> 0:14:11.200 Come to find out, the doctors there told me to 0:14:11.200 --> 0:14:13.800 go to the er, and then from that er they 0:14:13.800 --> 0:14:16.200 did an additional blood test and found out that I 0:14:16.240 --> 0:14:19.400 have leukemia because I had over one hundred and ninety 0:14:19.440 --> 0:14:22.960 seven thousand white blood cells in my body, and if 0:14:23.000 --> 0:14:25.240 I waited even one day, I would have passed away. 0:14:26.600 --> 0:14:30.600 Lying in the hospital in complete terror. I seriously thought 0:14:30.600 --> 0:14:33.240 my life was going to end that day. Horror was 0:14:33.360 --> 0:14:36.240 all across the room, from my immediate family to my wife. 0:14:36.640 --> 0:14:39.280 But after the news had struck, we started working on 0:14:39.320 --> 0:14:42.960 a treatment plan. One week later, we determined for research 0:14:43.080 --> 0:14:46.800 and diligence that Virginia G. Piper was the answer and 0:14:46.840 --> 0:14:49.440 we moved me there from the hospital I was at. 0:14:49.800 --> 0:14:52.240 For the course of my many stays there, the constant 0:14:52.240 --> 0:14:54.720 pleasure was the nursing staff, and because of them and 0:14:54.760 --> 0:14:57.160 the doctors and the treatment plan, which was a stem 0:14:57.200 --> 0:15:00.560 cell transplant, I have been remissioned for for a year 0:15:00.600 --> 0:15:04.360 and beat the crap out of cancer. Thank you for 0:15:04.400 --> 0:15:07.840 the opportunity to share James's words. He always wanted to 0:15:07.880 --> 0:15:11.000 publish a book on his experiences with cancer, and this 0:15:11.080 --> 0:15:12.960 is a lovely way to honor that wish of his. 0:15:13.880 --> 0:15:17.200 Every year, my family keeps James's memory alive by attending 0:15:17.240 --> 0:15:20.600 and raising donations for Blood Cancer United's Light the Night event. 0:15:21.160 --> 0:15:50.560 Thank you. Let's spend a moment taking stock of what 0:15:50.560 --> 0:15:51.440 we've learned so far. 0:15:51.720 --> 0:15:52.560 I love that idea. 0:15:52.640 --> 0:15:57.320 Okay, we have learned what cancer is, uncontrolled cell proliferation. 0:15:58.120 --> 0:16:01.800 We've learned why it's so common. It's an unavoidable consequence 0:16:01.880 --> 0:16:06.440 of multicellularity. We've learned how we treat the forty percent 0:16:06.440 --> 0:16:09.440 of the population that will develop cancer in their lifetime. 0:16:09.960 --> 0:16:14.480 And we've learned that, despite these treatment advances, seventeen percent 0:16:14.520 --> 0:16:18.400 of the population will die from cancer. But what we 0:16:18.520 --> 0:16:22.320 haven't addressed yet in any great detail are those numbers 0:16:22.720 --> 0:16:26.800 forty percent and seventeen percent. For much of the twentieth century, 0:16:27.200 --> 0:16:30.480 cancer research efforts were directed towards finding a cure for 0:16:30.560 --> 0:16:33.360 that forty percent, and as you shared with us last week, Aarin, 0:16:33.760 --> 0:16:36.960 we have made incredible headway in that regard for many, 0:16:37.160 --> 0:16:41.920 though not all, types of cancer. Despite these innovations, cancer 0:16:41.960 --> 0:16:47.400 treatment can be grueling. It can be expensive, prohibitedly so 0:16:47.760 --> 0:16:51.760 in some cases, and that expense mostly refers to the US. 0:16:52.160 --> 0:16:55.880 It often includes debilitating side effects, It can lead to 0:16:55.920 --> 0:16:59.200 long term issues, including increasing the risk of developing a 0:16:59.200 --> 0:17:04.119 second cancer, and it comes with no guarantee. What has 0:17:04.240 --> 0:17:08.600 received far less attention in cancer research historically is how 0:17:08.640 --> 0:17:13.119 to reduce the number of people getting cancer or needing treatment, 0:17:13.280 --> 0:17:16.600 or needing advanced treatment in the first place. Right, Like, 0:17:17.160 --> 0:17:21.040 that's received a much smaller piece of the pie as usual. 0:17:20.880 --> 0:17:21.680 With public health. 0:17:21.960 --> 0:17:27.640 Yes, yes, which and there's more, there's understandable blah blah blah. 0:17:27.640 --> 0:17:30.720 People need solutions right now. Yeah, I know there's a 0:17:30.760 --> 0:17:34.080 lot that goes into it. Yeah, given what we know 0:17:34.720 --> 0:17:37.640 about what we've learned so far about the evolution of cancer, 0:17:37.880 --> 0:17:40.800 we're unlikely to ever bring that forty percent all the 0:17:40.800 --> 0:17:43.080 way down to zero, that lifetime risk of forty all 0:17:43.119 --> 0:17:46.480 the way down to zero. But with prevention, we can 0:17:46.480 --> 0:17:49.600 make it part of the way there. Cutting edge treatments 0:17:49.720 --> 0:17:53.280 might increase survival for those with cancer, giving people more 0:17:53.320 --> 0:17:56.160 precious time with their loved ones. But if we can 0:17:56.200 --> 0:17:59.720 intervene earlier through screening, we may be able to shrink 0:17:59.720 --> 0:18:06.280 that's seventeen percent significantly significantly. Prevention and screening, though cornerstones 0:18:06.320 --> 0:18:09.560 of cancer care fail to get the appreciation they rightfully 0:18:09.600 --> 0:18:13.359 deserve naps. I mean, and that's historically as well as today. 0:18:13.400 --> 0:18:17.320 It continues to today. This is not surprising again, like this, 0:18:17.320 --> 0:18:21.000 this concept about public health being invisible until it fails. 0:18:22.040 --> 0:18:25.000 So I'm gonna spend We're gonna spend this episode making 0:18:25.040 --> 0:18:27.520 cancer prevention and screening more visible. 0:18:27.680 --> 0:18:27.840 Ah. 0:18:27.880 --> 0:18:34.040 I love this. Cancer prevention, prevention of any kind requires 0:18:34.119 --> 0:18:38.600 linking cause to effect. Yes, yes, Why did death from 0:18:38.680 --> 0:18:42.840 infectious diseases drop over the twentieth century? Largely because germ 0:18:42.880 --> 0:18:45.800 theory gave us the mechanism, and then we applied that 0:18:45.920 --> 0:18:51.280 knowledge to prevention via vaccines, sanitation, and hygiene. Cancer's cause 0:18:51.280 --> 0:18:54.879 and effect relationship is quite a bit more complex than that. 0:18:54.800 --> 0:18:56.640 If we didn't make that clear in episode two. 0:18:56.960 --> 0:19:00.880 Yeah, and namely because there isn't just one cause and 0:19:01.000 --> 0:19:05.320 one affect one mechanism, but there's a dizzying number of 0:19:05.400 --> 0:19:08.119 all of these different things, some of which are completely 0:19:08.119 --> 0:19:11.200 beyond our control, or at least beyond our control as 0:19:11.240 --> 0:19:15.359 we know it right now, or as individuals. As individuals, Yes, 0:19:15.520 --> 0:19:19.159 like a random mutation that might just happen It happens 0:19:19.160 --> 0:19:22.359 all the time. Actually, so how can we ever prevent 0:19:22.400 --> 0:19:26.399 that or link that? So disentangling that web has proven 0:19:26.840 --> 0:19:30.280 quite the challenge, but we have had some success. And 0:19:30.359 --> 0:19:32.639 as I go through a few case studies in our 0:19:32.720 --> 0:19:35.760 centuries long quest to understand the drivers of cancer, I 0:19:35.800 --> 0:19:37.800 want you to take note of two things. 0:19:37.800 --> 0:19:38.119 Okay. 0:19:38.600 --> 0:19:43.600 Number one, establishing a causal relationship is often difficult and 0:19:43.840 --> 0:19:48.600 it takes time. And number two, knowledge alone is not enough. 0:19:48.680 --> 0:19:49.320 Oh my gosh. 0:19:49.359 --> 0:19:52.720 There also has to be political will and public buy 0:19:52.760 --> 0:19:54.160 in for it to have an impact. 0:19:54.359 --> 0:19:55.239 I already love this. 0:19:55.400 --> 0:19:55.639 That's it. 0:19:55.680 --> 0:19:59.280 I mean, that's the end of the episode. Now, okay, 0:20:00.240 --> 0:20:02.840 if you lived in London in the eighteenth century, you 0:20:02.920 --> 0:20:06.320 probably kept your home warm by burning coal see our 0:20:06.359 --> 0:20:10.840 London smoger. So in which case you probably had a chimney, 0:20:11.240 --> 0:20:14.359 in which case you probably hired a chimney sweep to 0:20:14.440 --> 0:20:19.080 clean out the accumulated soot. That chimney sweep was probably 0:20:19.280 --> 0:20:21.160 between four and ten years old. 0:20:21.280 --> 0:20:22.119 Oh my gosh. 0:20:22.320 --> 0:20:25.960 Yes, oh, was forced to work naked and bathed about 0:20:25.960 --> 0:20:26.560 once a year. 0:20:28.359 --> 0:20:33.000 Oh wow wow. Okay, yeah, four and ten year olds 0:20:33.000 --> 0:20:33.920 four and ten year olds. 0:20:34.040 --> 0:20:38.680 Yeah, there are many issues with the situation. Yes. Yeah, So, 0:20:38.760 --> 0:20:43.240 as English physician Percival Pot described in seventeen seventy five, quote, 0:20:43.520 --> 0:20:46.560 in their early infancy, they are most frequently treated with 0:20:46.680 --> 0:20:49.879 great brutality and are almost starved with cold and hunger. 0:20:50.280 --> 0:20:53.320 They are thrust up narrow and sometimes hot chimneys where 0:20:53.320 --> 0:20:56.520 they are bruised, burned, and almost suffocated, and when they 0:20:56.520 --> 0:21:01.320 get to puberty, become peculiarly liable to a most noisome, painful, 0:21:01.400 --> 0:21:07.480 and fatal disease. End quote. That disease was chimney sweeps cancer. Okay, 0:21:08.920 --> 0:21:10.399 have you ever heard of cancer? 0:21:10.400 --> 0:21:10.640 Okay? 0:21:11.480 --> 0:21:15.680 Pot's description of the quote unquote sootwart and subsequent metastasis. 0:21:15.680 --> 0:21:18.720 So it started out as a footwart and then metastasized. 0:21:19.200 --> 0:21:22.880 It ranks among the earliest, if not the first observations 0:21:22.920 --> 0:21:28.320 of occupational cancer. Really really yeah, in babies and baby So, 0:21:28.440 --> 0:21:31.399 what would happen was that these chimney sweeps would, uh, 0:21:31.960 --> 0:21:36.200 it would be exposed to all of the everything. Yeah, constantly, 0:21:36.280 --> 0:21:38.880 there would be like a sore that arose, a sootwart, 0:21:39.080 --> 0:21:42.119 and then that would eventually metastasize as they went into adolescence. Oh, 0:21:42.320 --> 0:21:45.640 was they went through puberty? Yeah, And so his report 0:21:45.760 --> 0:21:48.040 on this. He wrote a report that was like describing 0:21:48.200 --> 0:21:52.359 what happened, describing the inhumane conditions, and it spurred the 0:21:52.359 --> 0:21:55.440 publication of other case studies and people were like, oh, yeah, 0:21:55.440 --> 0:21:57.280 I've seen this. I had chalked it up to something 0:21:57.320 --> 0:21:59.960 else before. Yeah. So it was like a lot of 0:22:00.080 --> 0:22:01.680 these case studies that came out and came out and 0:22:01.720 --> 0:22:04.320