WEBVTT - Ep 203 Cancer Part 2: Why does it happen? 0:00:00.080 --> 0:00:03.440 Throughout this series, we'll be discussing many aspects of cancer 0:00:03.480 --> 0:00:06.560 diagnosis and treatment, and we will be sharing several personal 0:00:06.600 --> 0:00:10.680 stories related to cancer. Some listeners might find this content upsetting, 0:00:10.880 --> 0:00:12.240 Please listen with discretion. 0:00:14.480 --> 0:00:16.400 In the fall of twenty twenty four, I had just 0:00:16.440 --> 0:00:19.120 sent my oldest off to start his freshman year of college, 0:00:19.440 --> 0:00:21.880 and my youngest was starting high school. We had a 0:00:21.960 --> 0:00:24.080 very busy summer, and I was trying to settle in 0:00:24.120 --> 0:00:26.960 to our new normal. I'd started to gain weight earlier 0:00:27.000 --> 0:00:29.520 in the year, and even more recently, had started becoming 0:00:29.640 --> 0:00:32.600 very fatigued. When I talked to my godecologist about it 0:00:32.640 --> 0:00:35.920 at my checkup, we discussed that I was probably beginning perimenopause. 0:00:36.479 --> 0:00:39.080 Most of my symptoms seemed to line up. However, in 0:00:39.159 --> 0:00:41.960 late September, on a Sunday afternoon, I got a horrible 0:00:42.000 --> 0:00:45.479 stomach ache after eating lunch. The stomach ache persisted off 0:00:45.520 --> 0:00:47.360 and on for a few days, and I thought maybe 0:00:47.440 --> 0:00:51.199 I'd had food poisoning. It eventually got somewhat better, but 0:00:51.280 --> 0:00:53.280 I was still sore, and even made the comment to 0:00:53.280 --> 0:00:55.040 my coworkers that I felt like I had done a 0:00:55.040 --> 0:00:58.680 million crunches. I started to have cramping again one week later, 0:00:58.800 --> 0:01:01.200 again on a Sunday, but this time I was also 0:01:01.240 --> 0:01:03.639 having chills and nausea, so I went to an urgent 0:01:03.720 --> 0:01:05.839 care clinic where they did an X ray and said 0:01:05.840 --> 0:01:08.760 that I was constipated. However, they wanted me to follow 0:01:08.800 --> 0:01:11.760 up with my PCP the next morning. I was unable 0:01:11.760 --> 0:01:13.520 to see my PCP, but I did see an on 0:01:13.600 --> 0:01:17.240 call provider and she sent me for a CT scan. Thankfully, 0:01:17.280 --> 0:01:19.679 I was able to get it done that day. On 0:01:19.720 --> 0:01:21.800 my way home from the CT scan, the on call 0:01:21.840 --> 0:01:24.399 provider called me and told me to turn around and 0:01:24.440 --> 0:01:27.520 go to the emergency room as soon as possible. Her 0:01:27.560 --> 0:01:32.240 exact words were, your scan looks rough. I was septic 0:01:32.360 --> 0:01:35.280 and had emergency surgery the next day for a perforated bowl, 0:01:35.800 --> 0:01:38.240 and they also removed a suspicious part of my colon. 0:01:38.600 --> 0:01:42.440 It came back as stage two colon cancer. Genetic testing 0:01:42.480 --> 0:01:44.839 revealed that I had Lynch syndrome, which is a genetic 0:01:44.920 --> 0:01:50.040 condition that increases one's odds for gicholorectal, ovarian, uterine, and 0:01:50.080 --> 0:01:53.640 other types of cancers. I also tested positive for pot 0:01:53.800 --> 0:01:57.840 one tumor predisposition syndrome. Because of these markers, in the 0:01:57.880 --> 0:02:00.920 fact that my grandmother passed from ovarian cancer. I chose 0:02:00.960 --> 0:02:05.160 to have a complete hysterectomy, including ovaries. I also have 0:02:05.240 --> 0:02:08.760 to have yearly klonoscopies and egds, and other monitoring that 0:02:08.800 --> 0:02:12.359 needs to be done, including skin checks every six months, 0:02:12.480 --> 0:02:16.520 regular CT scans, and lab work. I feel very thankful 0:02:16.560 --> 0:02:19.480 to be ned or no evidence of disease at Jessha 0:02:19.680 --> 0:02:22.359 fifteen months, but I've made it my mission to inform 0:02:22.360 --> 0:02:25.360 and encourage my friends and family members to get their colonoscopy. 0:02:26.040 --> 0:02:28.520 I was forty five at the time of diagnosis and 0:02:28.639 --> 0:02:30.919 was able to start my screening that year, but I 0:02:31.000 --> 0:02:33.600 kept putting it off because I was too busy, and 0:02:33.639 --> 0:02:35.960 if I'm completely honest, I didn't think anything like this 0:02:36.000 --> 0:02:39.600 would happen to me. I considered myself relatively healthy. I 0:02:39.760 --> 0:02:43.160 ate right, I exercised, but my genetics had other ideas. 0:02:44.960 --> 0:02:48.480 Began in the fall of twenty twenty four with the 0:02:48.520 --> 0:02:51.840 weirdest diagnosis I could have never imagined for myself, and 0:02:51.919 --> 0:02:55.080 I've imagined tons of diagnoses. I'm a nurse and a 0:02:55.120 --> 0:02:56.840 burgo and an oldest child who grew up in the 0:02:56.880 --> 0:03:01.080 eighties and nineties who copes by catastrophizing, so trust me. 0:03:01.160 --> 0:03:03.720 I've diagnosed myself with plenty of things over the years, 0:03:04.280 --> 0:03:07.600 but not metasotic breast cancer. Of all the things that 0:03:07.800 --> 0:03:10.680 was not on my lifetime BINGO card. Among the many 0:03:10.720 --> 0:03:13.240 things that breast cancer has forced me to change it 0:03:13.360 --> 0:03:16.600 was that I have to be okay with vulnerability and frailty. 0:03:17.120 --> 0:03:20.680 I've never been comfortable with those things before. My body 0:03:20.720 --> 0:03:23.040 has really been through the ringer this past year, from 0:03:23.080 --> 0:03:25.720 surgery to chemo, to radiation now oral chemo. 0:03:26.280 --> 0:03:27.040 It has been. 0:03:27.040 --> 0:03:32.560 Poked, prodded, scanned, chopped up, stabbed, poisoned, and irradiated. I 0:03:32.600 --> 0:03:34.680 should have known what was in store for us when 0:03:34.720 --> 0:03:37.920 I was getting my implanted chemo port and they had 0:03:37.960 --> 0:03:40.400 to tape my breast to the side rail so that 0:03:40.440 --> 0:03:42.800 it wouldn't move and mess up the procedure. 0:03:43.640 --> 0:03:44.840 That was just the beginning. 0:03:45.040 --> 0:03:47.320 I have literally lost track of the number of people 0:03:47.320 --> 0:03:50.920 who have seen my breasts, the number of imaging procedures 0:03:51.040 --> 0:03:54.320 or scans I've had done. I never felt worse in 0:03:54.360 --> 0:03:56.480 my life than I have this past year, and I 0:03:56.520 --> 0:03:59.360 went to nursing school. There have been times I wanted 0:03:59.360 --> 0:04:02.120 to die just to let the cancer take me. My 0:04:02.200 --> 0:04:04.680 body betrayed me and not just by trying to kill me. 0:04:05.120 --> 0:04:07.440 It also made it so I had no control over 0:04:07.480 --> 0:04:10.120 things like my bowel or my bladder. I crapped in 0:04:10.200 --> 0:04:12.160 my pants when I thought it was just gas, or 0:04:12.400 --> 0:04:15.360 like that time when I peed on the sidewalk while 0:04:15.400 --> 0:04:16.880 walking my dogs. 0:04:16.920 --> 0:04:17.640 Super fun. 0:04:18.520 --> 0:04:21.320 Even now, my chemo brain is legit and I don't 0:04:21.320 --> 0:04:24.160 remember what it's like to not be nauseated. I've had 0:04:24.200 --> 0:04:26.720 to learn that I don't have to put a brave 0:04:26.760 --> 0:04:27.160 face on. 0:04:27.560 --> 0:04:28.640 I can be vulnerable. 0:04:28.760 --> 0:04:31.560 I can ask for help and I can share when 0:04:31.560 --> 0:04:34.000 my instinct really has always been to protect others from 0:04:34.040 --> 0:04:37.480 the ugliness that I've been facing. It doesn't diminish who 0:04:37.520 --> 0:04:40.120 I am as a caregiver. It really is okay to 0:04:40.160 --> 0:04:43.600 prioritize myself and my needs. That I can take time 0:04:43.680 --> 0:04:46.240 to listen to my body, and I can pause and 0:04:46.279 --> 0:04:48.599 I can rest. I have literally been fighting for my 0:04:48.720 --> 0:04:52.680 life and it's okay to take a day off. Thanks 0:04:52.720 --> 0:04:56.280 cancer for these epic life lessons. I'm better at advocating 0:04:56.279 --> 0:04:59.120 for myself now and listening to my body and its needs. 0:04:59.640 --> 0:05:02.920 It is okay to give myself grace. I do have 0:05:02.960 --> 0:05:06.320 to say, though I would give breast cancer zero stars. 0:05:06.440 --> 0:05:07.599 I do not recommend it. 0:05:52.680 --> 0:05:56.039 Thank you everyone who has shared your story with us, 0:05:56.320 --> 0:05:58.839 and also just a big thank you to everyone who 0:05:58.880 --> 0:06:02.320 wrote in to share your story. It is every time 0:06:02.360 --> 0:06:04.919 I just pinched myself and I'm so grateful that so 0:06:05.000 --> 0:06:08.279 many of you are willing to share these vulnerable experiences 0:06:08.480 --> 0:06:11.760 and because this really is like these first hand accounts 0:06:11.800 --> 0:06:15.200 are the backbone of this of this podcast. They bring 0:06:15.400 --> 0:06:18.440 so much that we couldn't that we could not, yeah. 0:06:18.279 --> 0:06:20.640 They absolutely do. This podcast would not be the same 0:06:20.680 --> 0:06:24.000 without your first hand accounts. So thank you so much, 0:06:24.040 --> 0:06:25.760 and we have a lot more that we'll be sharing 0:06:25.800 --> 0:06:28.280 with you throughout this episode and throughout the series as well. 0:06:28.640 --> 0:06:31.720 So thank you again to everyone who submitted your first 0:06:31.720 --> 0:06:33.720 hand account. We really wish that we could have included 0:06:33.760 --> 0:06:35.920 every single story that we had the privilege to hear, 0:06:36.000 --> 0:06:36.480 so thank you. 0:06:36.560 --> 0:06:37.719 It means a lot to us. 0:06:37.600 --> 0:06:39.240 It does. Hi. 0:06:39.440 --> 0:06:41.920 I'm Aaron Welsh and I'm Erin Onmann Update. 0:06:41.760 --> 0:06:43.720 And this is this podcast will kill you. 0:06:43.839 --> 0:06:47.560 Welcome to episode two of our series on cancer. 0:06:48.440 --> 0:06:50.320 It's a big one, it really is. 0:06:51.320 --> 0:06:54.360 If this is your first time tuning in to this series, 0:06:54.960 --> 0:06:56.400 go check out the first episode. 0:06:56.520 --> 0:06:57.880 We've got four total. 0:06:58.080 --> 0:07:02.960 Tom and for you, And each of these episodes covers 0:07:02.960 --> 0:07:06.599 a different aspect of cancer, and really are intent with 0:07:06.640 --> 0:07:09.000 this just just to lay the foundations of knowledge so 0:07:09.040 --> 0:07:10.960 that in the future we'll be able to then you'll 0:07:10.960 --> 0:07:13.240 be able to like, oh, yeah, I know what cancer 0:07:13.360 --> 0:07:16.760 is because in this episode on lung cancer, because I 0:07:16.840 --> 0:07:17.880 listened to the cancer. 0:07:17.640 --> 0:07:18.720 Series exactly exactly. 0:07:18.800 --> 0:07:19.000 Yeah. 0:07:19.040 --> 0:07:21.800 It gives us an opportunity to explore the big picture 0:07:22.040 --> 0:07:24.200 of what this all means. What does that mean? How 0:07:24.240 --> 0:07:26.720 are these episodes organized? Great question, I'd love to tell 0:07:26.720 --> 0:07:29.120 you if you didn't listen last week. Last week we 0:07:29.160 --> 0:07:32.440 really explored the concept of cancer from both like a 0:07:32.440 --> 0:07:36.920 biological perspective, well more clinical perspective, as well as like 0:07:37.120 --> 0:07:40.720 through history, how that has changed and our current conception 0:07:40.880 --> 0:07:43.640 of it. In this episode, we're going to be going 0:07:43.720 --> 0:07:47.680 over the evolutionary aspects of cancer, the cellular aspects of cancer, 0:07:47.800 --> 0:07:49.440 like why is cancer so prevalent? 0:07:49.600 --> 0:07:49.800 Right? 0:07:50.200 --> 0:07:54.920 Next episode treatment, last episode, Yeah. 0:07:54.440 --> 0:07:55.840 I mean that encompasses a lot. 0:07:55.920 --> 0:07:58.600 Yeah, And the last episode, the fourth and final, is 0:07:58.600 --> 0:08:02.520 all about screen prevention, kind of understanding the landscape of 0:08:02.560 --> 0:08:04.880 cancer today and where we might go from here. 0:08:04.800 --> 0:08:07.960 Exactly exactly, Yeah, And that's all quite a lot of 0:08:08.000 --> 0:08:10.440 ground to cover, but there's a lot that is going 0:08:10.480 --> 0:08:14.080 to be unexplored. And like you said, Arin, this is 0:08:14.120 --> 0:08:16.920 really the jumping off point. These are not the only 0:08:16.960 --> 0:08:19.360 cancer episodes that we are ever going to do. We 0:08:19.440 --> 0:08:22.400 have lots of plans to cover so many individual types 0:08:22.400 --> 0:08:26.720 of cancers, and we also have a massive list of sources. 0:08:27.000 --> 0:08:30.040 If anyone gets inspired and wants to learn more about 0:08:30.120 --> 0:08:34.800 cancer from a big picture perspective or individual cancers, my goodness, 0:08:34.880 --> 0:08:36.480 do we have sources for you. 0:08:36.720 --> 0:08:39.080 So many opportunities to do that. Yeah. 0:08:39.160 --> 0:08:43.440 Yeah, And as you'll hear, no two cancers or experiences 0:08:43.440 --> 0:08:46.040 with cancer are exactly alike. And so again we are 0:08:46.080 --> 0:08:48.280 just so grateful to the providers of our first hand 0:08:48.280 --> 0:08:51.920 accounts too. Really just showed us like a sample of 0:08:51.960 --> 0:08:55.200 what it means to have cancer, to be diagnosed with cancer, 0:08:55.240 --> 0:08:58.320 to be going through treatment, to lose someone to cancer, 0:08:58.360 --> 0:09:00.800 to be a caregiver, just so many diferent facets of 0:09:00.840 --> 0:09:01.559 this experience. 0:09:01.600 --> 0:09:02.920 That's so much of our lives. 0:09:03.000 --> 0:09:06.320 Yeah, that you know we're in these episodes, we're really 0:09:06.360 --> 0:09:08.880 talking about the biology of Like we're talking about from 0:09:08.880 --> 0:09:12.760 a biological and historical perspectives. We're not talking about these 0:09:12.800 --> 0:09:15.480 experiences and so that is where these first accounts have 0:09:15.520 --> 0:09:16.440 been so integral. 0:09:16.520 --> 0:09:19.320 So thank you again, thank you, thank you. They really 0:09:19.320 --> 0:09:20.280 do mean everything to us. 0:09:20.480 --> 0:09:23.400 Yeah, okay, one more piece of. 0:09:23.360 --> 0:09:25.000 Business, last piece of business. 0:09:25.080 --> 0:09:27.240 Quarantine ey time. We're still doing it. 0:09:27.240 --> 0:09:29.439 We're still doing it. If you didn't hear last week, 0:09:29.720 --> 0:09:32.720 we are no longer doing alcohol in our quarantine recipes. 0:09:32.760 --> 0:09:34.840 So you could consider them all plus e Brita's, but 0:09:34.880 --> 0:09:36.559 we're gonna call them Quarantini's. 0:09:36.880 --> 0:09:38.559 Just whatever strikes us. 0:09:38.600 --> 0:09:43.240 And this week we're drinking the Crab The Crabs Nafagatto. 0:09:43.240 --> 0:09:46.160 Espresso ice cream. Let's go get one after. 0:09:46.000 --> 0:09:49.559 This, Subscribe to our socials to Yeah, let's go get one. 0:09:49.600 --> 0:09:54.240 Subscribe to our socials to see how it's made. And 0:09:55.480 --> 0:09:57.680 check out our website where you can find all the 0:09:57.800 --> 0:10:00.720 other sorts of TPWKY things. 0:10:01.080 --> 0:10:03.280 This podcast would kill you dot com ye check it out, 0:10:03.520 --> 0:10:08.440 rate review, and subscribe. We're also on YouTube. 0:10:07.920 --> 0:10:08.840 Now for the real. 0:10:08.679 --> 0:10:10.079 Stuff, the real stuff. 0:10:10.440 --> 0:10:14.000 Okay, let us get in to the biology of cancer, 0:10:14.040 --> 0:10:14.640 shall we? 0:10:14.640 --> 0:10:17.320 We shall after this short break. 0:10:34.400 --> 0:10:37.360 On August twenty eighth, twenty five, I got a call 0:10:37.360 --> 0:10:40.640 from my dermatologist. He told me a biopsy on what 0:10:40.679 --> 0:10:43.320 I thought were hives had come back as malt lymphoma 0:10:43.600 --> 0:10:45.360 and asked me to come into his office so we 0:10:45.400 --> 0:10:49.319 could talk. What followed her months of emotional whiplash. At 0:10:49.320 --> 0:10:52.840 first I didn't understand the diagnosis. Then came long stretches 0:10:52.880 --> 0:10:55.800 of waiting, waiting to learn. My next steps were waiting 0:10:55.800 --> 0:10:58.760 for answers and finally get in information without a clear plan. 0:10:59.559 --> 0:11:03.000 Eventually a treatment plan came together, but the uncertainty leading 0:11:03.080 --> 0:11:05.679 up to it was one of the hardest parts. Malt 0:11:05.760 --> 0:11:10.480 lymphoma stands for mucosa associated lymphoid tissue lymphoma. It's a 0:11:10.520 --> 0:11:13.480 slow growing form of non Hodgkins lymphoma, and in my case, 0:11:13.480 --> 0:11:15.720 it appeared in my skin. I was told there are 0:11:15.720 --> 0:11:19.400 a few possible causes, including infections and genetics, but for me, 0:11:19.600 --> 0:11:23.400 the most likely explanation was simply bad luck. This type 0:11:23.440 --> 0:11:26.440 of lymphoma is considered rare and is more commonly found 0:11:26.480 --> 0:11:29.240 in men in their fifties and sixties. I was thirty one, 0:11:29.520 --> 0:11:32.720 active teaching and competing in country dance, and otherwise healthy, 0:11:33.120 --> 0:11:37.920 which made the diagnosis feel especially surreal. After consulting both 0:11:37.960 --> 0:11:40.959 my local oncologists and a noncologist at the Mayo Clinic. 0:11:41.200 --> 0:11:44.760 My husband and I decided on localized immunotherapy rather than 0:11:44.800 --> 0:11:49.440 surgery and radiation. I traveled to the Mayo Clinic in Scottsdale, Arizona, 0:11:49.520 --> 0:11:53.360 for treatment with RUTUXAMIV, which involved injecting the medication directly 0:11:53.400 --> 0:11:56.600 into the tumors. At the time, I had nine tumors 0:11:56.600 --> 0:12:00.160 across my arms. The process involved numbing injections followed the 0:12:00.240 --> 0:12:03.600 drug itself totally, about twenty to thirty injections per session. 0:12:04.400 --> 0:12:06.880 I have a high pain tolerance, but right after treatment 0:12:07.000 --> 0:12:10.360 my body started shaking and I felt extremely cold. It 0:12:10.440 --> 0:12:13.000 lasted about five minutes and then I was flying, but 0:12:13.080 --> 0:12:16.280 it was still unsettling. I remember looking at my husband 0:12:16.280 --> 0:12:18.160 and saying I wasn't sure I could do it again. 0:12:19.040 --> 0:12:22.480 I did. After three sessions, the tumors began to shrink. 0:12:23.080 --> 0:12:27.200 Six weeks after my last treatment, they have almost completely disappeared. Now. 0:12:27.200 --> 0:12:31.080 I continue regular monitoring. Any new bumps are considered a 0:12:31.080 --> 0:12:35.040 reoccurrence and something I may live with long term. While 0:12:35.040 --> 0:12:39.400 I'm grateful for an overall favorable prognosis, the experience permanently 0:12:39.480 --> 0:12:41.959 changed how I think about my health and my relationship 0:12:41.960 --> 0:12:42.480 with my body. 0:12:44.679 --> 0:12:47.839 When I was thirty two. In twenty sixteen, I was 0:12:47.880 --> 0:12:50.800 diagnosed with breast cancer. I found a lump in the 0:12:50.800 --> 0:12:54.360 shower once my local doctor, and within ten days I 0:12:54.400 --> 0:12:59.320 had been diagnosed. What followed was just a whirlwind. I 0:12:59.360 --> 0:13:03.199 had a right sided mystept to me and full node clearance. 0:13:03.600 --> 0:13:06.240 I had an immediate d AP reconstruction whether they took 0:13:06.280 --> 0:13:09.000 the fat from my stomach and made a new breast 0:13:09.000 --> 0:13:12.319 out of it. I had egg retrieval because we hadn't 0:13:12.320 --> 0:13:15.920 had children, and then I had six rounds of chemotherapy 0:13:16.520 --> 0:13:20.920 and radiation for three weeks. In twenty twenty five, nine 0:13:21.000 --> 0:13:24.719 years later, I'd had a sore hip and it was 0:13:24.760 --> 0:13:27.480 starting to affect my day to day life, so I 0:13:27.559 --> 0:13:30.920 went to the doctor. I saw the physio, who wasn't 0:13:30.920 --> 0:13:34.959 worried about it, went home, went on a trip where 0:13:35.080 --> 0:13:37.319 it felt like something had moved and I assumed I'd 0:13:37.360 --> 0:13:39.360 slipped a disc. So I came back went to the 0:13:39.360 --> 0:13:43.280 physio again, a female physio this time, and she referred 0:13:43.280 --> 0:13:46.920 me immediately. When I saw the physio at the hospital again, 0:13:47.000 --> 0:13:50.160 he wasn't too worried. I didn't have any massive red flags, 0:13:50.480 --> 0:13:52.240 but he sent me for an MRI just to make 0:13:52.320 --> 0:13:55.880 sure because I had a history of cancer. And at 0:13:55.920 --> 0:14:00.839 the end of March, I got a phone call to say, unfortunately, 0:14:01.800 --> 0:14:06.760 I had several deposits in my spine and in both 0:14:06.840 --> 0:14:09.800 hips and it looked like secondary breast cancer. 0:14:10.559 --> 0:14:11.199 I had to have a. 0:14:11.160 --> 0:14:14.200 Bone biopsy while I was awake, which I do not recommend, 0:14:15.600 --> 0:14:18.360 and I find out that, yeah, it definitely was cancer 0:14:18.600 --> 0:14:21.920 and I would have to be treated. At this point, 0:14:22.000 --> 0:14:24.080 I had no idea what that meant. I didn't know 0:14:24.120 --> 0:14:26.080 if it had spread. I didn't know if I had 0:14:26.120 --> 0:14:31.360 weeks or days or months left to live, and it 0:14:31.680 --> 0:14:38.520 just absolutely it was horrendous. That was nine months ago. 0:14:39.160 --> 0:14:42.960 I am medicated. I'm on a treatment called ribocyclip, which 0:14:43.160 --> 0:14:46.040 is a tablet, so I take it almost every day. 0:14:47.080 --> 0:14:49.960 It's really non invasive, and I'm now at the point 0:14:49.960 --> 0:14:52.000 where I only have to go into the hospital every 0:14:52.040 --> 0:14:56.120 two or three months. I hope that I continue to 0:14:56.200 --> 0:14:58.960 improve or stay stable, which is what my last couple 0:14:58.960 --> 0:15:01.480 of scams have showed. I know some people have been 0:15:01.480 --> 0:15:03.920 on this drug for eight ten years and I just 0:15:03.960 --> 0:15:07.359 still go in. So I really hope that I continue 0:15:07.400 --> 0:15:11.080 to live and thrive like I am doing now for 0:15:11.120 --> 0:15:11.880 a long time. 0:15:11.720 --> 0:15:12.240 To come. 0:15:37.880 --> 0:15:41.320 So I actually want to start this week's episode exactly 0:15:41.400 --> 0:15:45.720 where I started last week's episode, not where I ended it, okay, 0:15:45.800 --> 0:15:47.920 but where I started it, which is with the definition 0:15:48.000 --> 0:15:50.280 of cancer, Okay, which is the logical place to start. 0:15:50.360 --> 0:15:52.120 Yeah, yeah, It's like, yeah, sure. 0:15:51.920 --> 0:15:55.520 So I'll go back to that National Cancer Institute definitionat quote, 0:15:55.640 --> 0:15:59.000 cancer is a disease in which some of the body's 0:15:59.120 --> 0:16:04.600 cells row uncontrollably and spread to other parts of the body. 0:16:04.720 --> 0:16:07.840 So what does that really mean? If you've ever built 0:16:07.840 --> 0:16:10.400 a Lego Kit, you've built a Lego Kit at some 0:16:10.440 --> 0:16:11.160 point in your life. 0:16:11.200 --> 0:16:14.440 I've built Legos, but I don't know if I ever 0:16:14.480 --> 0:16:15.720 had a kit, Okay. 0:16:15.440 --> 0:16:17.880 So if you have ever built, if anyone listening and 0:16:17.920 --> 0:16:20.920 watching has built a Lego Kit, you could imagine that 0:16:21.000 --> 0:16:22.480 it comes with a set of instructions, Like if you 0:16:22.520 --> 0:16:24.480 want to build a rocket ship that really looks like 0:16:24.480 --> 0:16:27.680 a rocket ship, you're gonna need to follow the specific 0:16:27.680 --> 0:16:29.280 instructions that come in that Lego box. 0:16:29.360 --> 0:16:32.680 I mean, I've built many ikea pie the same kind 0:16:32.680 --> 0:16:33.920 of okay, very. 0:16:33.800 --> 0:16:36.520 Similar idea, just more pieces, et cetera. 0:16:37.240 --> 0:16:40.160 But in the box there are also a lot of 0:16:40.320 --> 0:16:44.080 different kinds of pieces of legos or Ikea bits, right, 0:16:44.520 --> 0:16:46.600 some of them all look the same. There's like fifteen 0:16:46.600 --> 0:16:49.480 different dowels, there's like twenty four different four by four 0:16:49.520 --> 0:16:52.840 squares or whatever. Yeah, and some of them look a 0:16:52.840 --> 0:16:55.560 little bit different from each other. And in order to 0:16:55.920 --> 0:16:59.120 build the thing you are trying to build, you have 0:16:59.200 --> 0:17:01.960 to follow those instructions really explicitly. 0:17:02.520 --> 0:17:05.600 I kind of I have to admit I love putting 0:17:05.600 --> 0:17:08.199 together Ikea furniture. You would love a Lego kit, then, 0:17:08.280 --> 0:17:09.240 I'm sure that I would. 0:17:10.800 --> 0:17:15.080 Our bodies are kind of the same. We have to 0:17:15.160 --> 0:17:20.120 function as one entire organism, a rocket ship, an Ikea 0:17:20.160 --> 0:17:21.360 piece of furniture. 0:17:20.960 --> 0:17:21.480 If you will. 0:17:22.080 --> 0:17:26.240 But we are made up of trillions of individual cells, 0:17:26.760 --> 0:17:29.040 and we started out as just one cell, which is 0:17:29.080 --> 0:17:32.120 a little bit different than Ikea furniture because our cell 0:17:32.200 --> 0:17:34.840 had to divide and divide a bunch of times. But 0:17:35.000 --> 0:17:41.000 this process of cell division is extremely tightly regulated. Yeah, 0:17:41.040 --> 0:17:44.320 because if every cell in our body just divided non stop, 0:17:44.720 --> 0:17:46.440 it would be madness. 0:17:46.119 --> 0:17:47.520 It would be a problem would be. 0:17:47.640 --> 0:17:50.200 We wouldn't be here in short. 0:17:50.359 --> 0:17:54.119 Yeah, So we have sets of instructions that are encoded 0:17:54.160 --> 0:17:59.639 into our DNA which have patterns, instructions that our cells 0:17:59.640 --> 0:18:02.919 are going to use to make the right types of 0:18:02.960 --> 0:18:07.359 tissue in the right types of places to grow and 0:18:07.400 --> 0:18:09.879 to replicate when it's appropriate to grow and replicate, and 0:18:09.920 --> 0:18:13.879 to not build a castle on top of your rocket 0:18:13.880 --> 0:18:15.439 ship out of all of your lego bricks. 0:18:15.600 --> 0:18:20.160 Right, it's like instructions on instructions on instructions. You will 0:18:20.200 --> 0:18:22.520 grow and replicate, but not only that, you're going to 0:18:22.560 --> 0:18:24.040 become this specific. 0:18:23.600 --> 0:18:26.000 Type of cell, specific type of specific type of organ 0:18:26.080 --> 0:18:28.040 in this specific little bit. 0:18:28.000 --> 0:18:29.439 And then you're going to forget how to do all 0:18:29.480 --> 0:18:31.199 those other things that you used to be able to do. 0:18:31.480 --> 0:18:32.040 We'll get there. 0:18:32.440 --> 0:18:36.040 So our cells determine when and how to divide based 0:18:36.080 --> 0:18:38.800 on a lot of different sets of instructions, and there 0:18:38.960 --> 0:18:42.800 is redundancy built into this process, and that is to 0:18:42.880 --> 0:18:47.040 protect against the inevitable mistakes that occur in the process 0:18:47.080 --> 0:18:50.680 of cell replication. So we have a lot of checkpoints 0:18:50.800 --> 0:18:53.239 in what is called our cells cycle and how our 0:18:53.280 --> 0:18:58.280 cells divide. Our cells rely on signals and communication with 0:18:58.400 --> 0:19:03.000 other cells. Like you mentioned, cells also differentiate, so they 0:19:03.040 --> 0:19:06.560 specialize into different types of cells in order to organize 0:19:06.600 --> 0:19:09.520 into tissues and organs, and then they only do that 0:19:09.560 --> 0:19:12.000 one certain thing your heart cell is just heart selling. 0:19:12.200 --> 0:19:14.240 It's not out here trying to be a skin cell anymore, 0:19:14.600 --> 0:19:17.000 even though they came from the same place. Right, Okay, 0:19:17.480 --> 0:19:23.080 So cancer cells kind of take all of the pieces 0:19:23.200 --> 0:19:26.600 out of a lego box, throw out the instruction manual, 0:19:26.720 --> 0:19:30.240 ignore any guidance on what these rules of building are 0:19:30.280 --> 0:19:34.240 supposed to be. So to really understand how this is happening, 0:19:34.280 --> 0:19:37.240 we can look through some of the rules of cell 0:19:37.280 --> 0:19:40.960 growth in detail and see how cancer cells are just 0:19:41.119 --> 0:19:44.840 breaking every single one of them. And and I know 0:19:44.880 --> 0:19:46.879 you're going to get it into this a little bit more, Aaron. 0:19:47.240 --> 0:19:51.159 They also leverage these rules in a way that benefits 0:19:51.200 --> 0:19:56.680 them and not us, So I'm I'm excited about that. 0:19:58.240 --> 0:20:00.000 So one of the rules that our. 0:20:00.080 --> 0:20:04.040 Cells typically follow is that they only grow and divide 0:20:04.119 --> 0:20:06.199 in the presence of what are called growth factors or 0:20:06.200 --> 0:20:09.800 growth signals, meaning that they're waiting for signals from cells 0:20:09.840 --> 0:20:13.480 and around them to determine if it is actually the 0:20:13.560 --> 0:20:17.760 right time to divide. Cancer cells either ignore these signals 0:20:17.920 --> 0:20:22.120 entirely or they just make their own. They just make 0:20:22.160 --> 0:20:24.480 their own growth signal, and then they're like, hey, we're 0:20:24.480 --> 0:20:27.320 telling you to grow, keep growing, So what we see 0:20:27.359 --> 0:20:29.400 and you talked about this in last week's episode. Arin 0:20:29.480 --> 0:20:32.560 In a lot of cancers are what are called oncogene mutations, 0:20:33.119 --> 0:20:36.280 and this means changes in certain genes that are involved 0:20:36.320 --> 0:20:41.760 in turning on growth, replication, and development signals all the time, 0:20:42.000 --> 0:20:45.960 which allows for this continuous cell division and growth of 0:20:46.040 --> 0:20:50.600 these masses of cells. So we see mutations in oncogenes 0:20:50.760 --> 0:20:53.240 in a lot of cancers. Almost all cancers have at 0:20:53.320 --> 0:20:57.480 least some oncogene mutations, and there are a few that 0:20:57.600 --> 0:21:00.560 are quite prevalent, like a few big ones that are 0:21:00.600 --> 0:21:03.960 prevalent in nearly all cancers. So you might have heard 0:21:04.000 --> 0:21:06.439 of some of these when you're looking at cancer things. 0:21:07.240 --> 0:21:10.199 Some of these are like RAS or ris yep, and 0:21:10.240 --> 0:21:13.880 there's a bunch of different versions of RAS, and these 0:21:13.880 --> 0:21:17.560 are things that basically, when they are switched on, they 0:21:17.640 --> 0:21:20.800 just allow for cells to continue to grow uncontrollably, and 0:21:20.880 --> 0:21:22.680 they're switched on in a lot of cancers. 0:21:22.720 --> 0:21:23.680 Gas Pedal to the floor. 0:21:23.760 --> 0:21:24.879 Gas pedal to the floor. 0:21:25.560 --> 0:21:28.199 Another mechanism that you also talked about a little bit 0:21:28.240 --> 0:21:31.919 last week's episode is that all of our cells typically 0:21:32.600 --> 0:21:38.080 have the ability to turn off cell division if they 0:21:38.080 --> 0:21:41.520 need to turn it off. Entirely, and they're able to 0:21:41.680 --> 0:21:45.119 recognize if our cells and the DNA within our cells 0:21:45.160 --> 0:21:48.639