20 Episode results for "Leukemia"
16 Silent Symptoms of Leukemia That 85% People Ignored, Never Too Late to Check It
"Sixteen silence symptoms of leukemia that eighty five percent people ignored never too late to check it. Leukemia or cancer of the blood cells can cause subtle and surprising symptoms throughout the body. These are some signs. You may need to get checked. What is leukemia? Leukemia, a cancer of the blood and bone marrow malignancy that causes an abnormal production of certain blood cells as the unhealthy blood cells crowd out healthy ones. The blood and immune system function begins to falter, and you may notice physical symptoms into thousand nineteen doctors will diagnose an estimated sixty, one, thousand, seven hundred eighty people with leukemia, and about twenty, two thousand eight hundred forty people will die from the disease according to. To the National Cancer, institute, the disease can get worse quickly if you have type known as acute leukemia or progress more slowly and get worse over time, if you have a type known as chronic leukemia, while the following symptoms can be subtle signs of leukemia, the same symptoms can also be caused by many other diseases and conditions many of them benign. If you're concerned, see your health care provider for an evaluation. To, read full article, you can read through the link in the description below.
Childhood leukemia / chronic cough / cancer center patient navigators
"From the studios of the Mayo, Clinic News Network. This is Mayo Clinic radio, exploring the latest developments in health and medicine and what they mean to. Welcome everyone to Mayo Clinic. Radio Leukemia is cancer of the body's blood, forming tissues, including bone marrow and the lymphatic system, usually white blood cells are potent infection fighters, but in people with leukemia, the bone marrow produces abnormal white blood cells which don't function properly. Many types of leukemia exist in some forms of leukemia are more common in children on Today's program will discuss childhood leukemia with a male clinic expert also on the program. What is chronic cough? And how can it be treated and the important role of patient navigators at the Mayo Clinic Cancer Center helping patients and their families deal with a cancer diagnosis. You're listening to Mayo Clinic Radio on the Mayo Clinic News Network. Back, your male clinic radio I'm Dr Tom Shy and I'm tracy. mccray leukemia is the most common childhood cancer. It makes up about one third of all cancers in the pediatric population in the United States about thirty five hundred children are diagnosed with leukemia each year. Leukemia is a cancer of the blood forming tissues of the body, including the bone marrow and lymphatic system that's correct and leukemia starts in the soft inner part of the bones, called the bone marrow, and any of the cells inside your bone marrow, concern into cancer and once that. That happens. The cell reproduces to form lots of new cancer cells, and the bone marrow ultimately gets overwhelmed, and the cancer cells can spill out into the bloodstream and spread to other organs, unfortunately well, joining us in studio to talk about leukemia in children is Mayo Clinic Pediatric Oncologist Dr Shaquille conduct contact so much for being with US thank you for inviting me. You know it's a bit upsetting when any child gets cancer, but I think a lot of us didn't realize that leukemia is more common than any other cancer in children. Yes, actually it's the most common followed by brain tumors. Those are the two most common causes of cancer in children. And off the leukemia. What we call acute lymphoblastic leukemia. LYMPHOCYTIC LEUKEMIA is. More common than the other types of leukemia. Do we have any idea how this starts are? A CHILD GETS A. That is a lot of research ongoing about the cost. Basically what happens is as you pointed out it starts in the bone marrow. It says defect in your stem cell. which differentiates into the different? Blood types. And these cells when they become abnormal than the divide, multiply and cause and abnormal clone our population, so sell gone bad now stem cells, produces white blood cells, red blood cells platelets. Yes, so and you can get leukemia involving any of those types of stem cells there a couple of types of stem cells. That's one type the basic stem cell, but differentiates into the different. Types of blood cells. To give an example, there is something with the red cells called. Retro Leukemia. And there are some disorders of platelets which are separate in the white cells. When they become abnormal, the either. Are lymphoblastic, which is a type of white cells. Are Milo blasts, which are the other types of white cells, and those are the two main types of leukemia, so if it's lymphoblastic, it involves the production of white cells, and if that's Milo blasting, those are the cells that produce platelets and the red blood cells no. Another type of white cells or another type. So That's how you classify it. lymphoblastic or my lineup plastic, and then you also class sub classified an acute or chronic pain so acutely cumia is something which happens betty suddenly. And ready rapidly. And that's the one B C mostly in children that chronic types of leukemia's. To give you an example, there is a chronic myeloid leukemia and call chronic lymphocytic leukemia. We never see cll in children. It's an adult disorder and it goes on for years, so it's really very chronic. is a little more aggressive than cll, but now with The advent of I don't know if you've heard of leave. AC Matin average at Ti. Tyson kinds impetus. People can new kinds of chemo gap. People can live for years on that. So the most common type to affect children is a L. acute lymphocytic leukemia. Yes, and then the second most common is a. m., l., another acute form, but this time Milo plastic or Milo Siddiq leukemia absolutely when it comes to leukemia so often you hear people especially when it comes to leukemia in children say well. It's the good kind to have or in it's. It's the really bad kind to have as the pediatric oncologist. You look at any kind of leukemia as the good kind of the bad kind. Yes, we go in and tell the parents that we have bad news. Your child has leukemia, but the good news is that dismayed curable and we'd have come a long way in stratified being the risk factors for alleyoop Kimia. So. We now have low risk standard risk, high risk, very high risk leukemia. Stratification in all and the treatment is tailored accordingly. What's the average age of child you see? You can see any age from? Infants to actually young adults, but the average age is between two and ten years. What are the symptoms of minority? Small. Yeah well. How do you? Why do the Perez bring them in? Mostly fevers. Sometimes pain in the bones that refused to walk. Bleeding or bruising, because the platelets are low. So, what happens, is the leukemia cells you know, expand into the bone marrow said they get rid of the normal cells, so that's why you have anemia. Hemoglobin can be very low. And your platelets can be very low, so all those symptoms come in. They have liver and kidney issues, too. Because of the high leukemia burden because their kids and they don't know to pay attention. How do you have any idea of how long the child is likely had leukemia before they get sick enough that their parents bring them in not very long because the parents usually are feeling very guilty about it, and we try to tell them that it's not their fault. And it was something that happened, but it is progress pretty rapidly so I wouldn't say six months ago that the child had UPN is that the same in adults resent more in children that at progresses that quickly. And I think in adults, also acute leukemia as at the same. You didn't used to be able to say to the parents, did you the prognosis is good and this is almost certainly curable I mean. How long has it that you've been able to say that? I think about. Maybe twenty years, plus because I had a great nurse practitioner here. Who Actually said that we used to have a diagnosis of leukemia and prepared the kids parents for the funeral of child. And we have come a long way. I, mean we. Will Standard Risk Ninety five percent. Loris Ninety five percents a Bible Standard is about ninety high risk is still be have to work on that, and but still it's about seventy. That's what I was going to say. In the seventies and eighties, it was if a child had leukemia. But that, so what has changed the parents who had children with leukemia participated in a lot of clinical trials and helped us get to where we are at. Amazing, so you said a little bit earlier that you're learning more about the risk factors for new Kimia. What are those when we gave the treatment? which are so treatment is very variable. It's six months of very intense chemotherapy and the first part is called induction. May you try to bring them in remission? We used to do a bone marrow at the end of treatment. And look for just the leukemia cells in the bone marrow. Now we have something called MED, which is minimum residual disease based on molecular testing. So if you have positive might be you become high risk. But if you have negative mit end of induction, that's a very good sign so I think we have be making a lot of progress in treating leukemia's. It sounds like it and it sounds like it's become quite sophisticated to. Our guest, an expert on childhood leukemia Dr Shaquille. Short break when we come back, we'll talk more about how they actually make the diagnosis in their child and more about treatment. You're listening to Mayo. Clinic Radio on the Mayo Clinic. We'll be back with more Mayo Clinic Radio Right after this. Welcome back to male. Clinic Radio I'm Dr. Tom Shives and I'm Tracy mccray. Our guest is an expert on childhood leukemia Dr Shakeel Khan. We've learned the fact that there are about thirty five hundred cases of leukemia in the United States every year. The most common is a L. L. or acute lymphocytic leukemia. We've also touched on the fact that the prognosis is so much better than it used to be us. How you make the diagnosis. The parents bring the child, and you said the most common symptoms being fever bolaise pain when they come to you. How do you make the diagnosis? Be something what we call a complete blood count a peripheral smear, maybe look under the microscope to see the cells and a lot of times. That tells us what's going on, so you can actually see the cancer cells. Yes, you can when? Because if they have blasts and the pair of full blood. That means that bone marrow is packed with leukemia cells, so if say they come with very high white counts, we send it for a test called flow site, maitree and get the diagnosis done. So I wake up. I would think it would be low. If you're a bone marrow and producing what it should, it can present in both ways. You can have very low counts. And? You can have very high counts because the leukemia burden is so high. That you see them in the full blood, if you have a white count of greater than fifty thousand, that means that you are very very high risk and normal would be what eight to ten thousand Yep. You're really high blood count manger at Higher, risk, for not been surviving this disease. Now that actually tells us that when we start the treatment. If you have a very high white count, you can get into trouble with renal failure. Things like that. Kidney failure, so we actually. Tried to. And do make you know. Give them fluids medications to try to prevent that, so let's move onto treatment than because children are growing. Do, they tolerate treatment. Actually. That's why I do pediatric oncology and. Take care of her. Kids have editors. Other words. They don't have order lung disease exactly I. Don't know. If, you're an adult and here's how I felt for. You know the last twenty five or thirty years. A kid doesn't know could just knows I want to start playing again? Vc a lot more issues with young adults because they can think. Through, these things so were Yup. Minding Jelly is very important. If you have a positive attitude, it makes a big difference so chemotherapy still the mainstay of yes, it is, and you have newer better agents. Is that why the survival is better? Actually. Most of the drugs have been around for a long time. The, standard, treatment for leukemia be used standard drugs like win Christine steroids as bad genie's Doxorubicin, but we do have new drugs for patients who relapse? And we have new modalities for the patients who relapse because. Even when I save eighty percent occurred. There's twenty percent to will relapse so so we are getting better at that, too. And I do stem cell transplant. So that is one option, but we don't do a transplant for. And even for. Now because we have all these good outcomes with the regimens. Be Us I'm thinking a lot about what you said in the first segment about. The parents like it that the prognosis is so much better in the outcomes are so much better now because of the parents who said Yes to some trials. That really! Impresses me. Can you expand a little bit about that? So that people understand what those parents went through and what it meant just so? Even now we have ongoing clinical trials to do better. and. I'm always impressed with our parents. Because when they come, they're overwhelmed and then we bring all these information to them about this. Regimen via trying to see if we can do better and things like that and go over fifty page consent form, which is required by. The I. R. B. and FDA. And I'm always impressed that the. I've never had a parent by couple may have been felt uncomfortable everybody. Signs that up, you know why because they have realized that there were a lot of. Kids before them, and they'll be a lot of kids after them. Who Will Benefit from it so i? Think parents are amazing in that way. It's it selfless, I. Mean if your child has been diagnosed to be able to say yes, let's give this a try. That's amazing. Yes, it is so you said that you start with chemotherapy and all of these children, but sometimes when they relapse, you use other modalities. One was a stem cell transplant. Explaining to us what that is. So what happens is the the treatment. Let's go with the treatment for acute leukemia all. It's actually two years of treatment for girls and three years for boys. We know from all these trials that that's what they need. Six months very intense, and then we have what we call maintenance chemotherapy, and if you see a China that time you won't even know, they have leukemia because they are. Normal they leading normal lives, they come once a month to get some chemotherapy and every three months to a spinal tap, and for prevention because spinal fluid. Is a sanctuary. You, not nervous. System is a sanctuary and. Testes are a sanctuary for leukemia cells, and we know that from experience. We do preventive things to prevent that. And that's why I think. Boys need a little longer treatment, although now in standard risk, they are trying out that boys and girls have equal treatment, so we are, it is evolving. But for the standard was that two years for girls and three years for boys de stem cell transplant. You serve recurrent stem cell transplant. Rick reserved for Prince if you. You fail induction that you cannot go into remission. You have very high risk features. Like for example Philadelphia positively. Which is a type of chromosome abnormality, so it is reserved for very high-risk patients, and what is a stem cell transplant? So a stem cell transplant, what we do is as I told you before. This is a defect in the stem cell. So? We would. Be, basically replace it with a normal stem cells. From another donor so in leukemia there is no concept of giving your own selves back. You have to have an alternate donor like a match sibling. Okay, awed, an unrelated donor, and now we are actually looking at Hapu. Identical transplants means a parent or a sibling who is not a match can be a donor to so. So basically what you're going to do is you're going to wipe out the recipient's immune system. And you do that with Chemo, Chemo and Radiation Times, and we then give them the new metal. and. That process is the hot process. You can get infections. It's it is. A life threatening. Procedure so that's why it's not done on every body, and it's only done when. It's indicated. And then the new stem cell takes up and has new cells, and that's when we say that the patient has grafted when they their bone marrow starts booking again. Then we're that stems transplant is a blood transplants blood transfusions like an injection of cells into their own. No, it does like it has given like a blood transfusion. It overall survival. You said it's really good. What is it now in? Let's all. Said depending on the risk factor is you know between? Seventy to ninety five. And Am L. Acute? Milo said I. Think! It's about sixty, five, sixty, sixty five. All right leukemia in children fortunately fairly rare, but still there are thirty five hundred cases per year in the United States. It's potentially devastating obviously for the child, and of course for their parents, but there are new lots of new better ways to treat this including the stem cell transplant and fair to say the prognosis better than ever right after this. Thanks so much for being with us. Happy to be. Still to come on Mayo Clinic, radio we'll learn about treatment for chronic cough and the role of a patient navigator at the Mayo Clinic Cancer Center. You're listening to Mayo Clinic Radio on the Mayo Clinic News Network. We'll be back with more Mayo Clinic. Radio right after this. Welcome back to Mayo Clinic. Radio, I'm Dr, Tom Scheib and I'm Tracy, mccray. We all had a cough one time or another hopefully now, but for some people the cough doesn't stop, and if it lasts for eight weeks or longer in adults and four weeks or longer in children, it's called a chronic cough also pain if that happens. Fun and it's more than just an annoyance. It can interrupt your sleep and leave you exhausted, and in severe cases it can cause. lightheadedness and even rib fractures. Hello here to tell us more. What causes a chronic cough and what can be done about it? Is Mayo Clinic pulmonologist lung specialist doctor, Kaiser Limb, welcome to the program. Thank you for having me. Good to have you I. Guess the first question is why do we cough? So cough is a defensive reflects. If you think about it, were bipeds and were upright, so the way we handle food. It's a ninety degree. Turn into the SAFA GETS so cough has evolved for us to protect our airways. If you hearken back two hundred fifty years ago, when people die of pneumonia, they essentially drown in their own mucus, so cough is geared to clear our respiratory track of particularly materials like food mucus that would be our natural defense and noxious gases. So that our Alveoli sacs were the oxygen extraction place isn't harmed. Well! I know that sometimes doesn't go away and I would assume the most common reason is tobacco. So. A smoker's cough is always a challenge. But there's also a large segment of the public. In after you exclude active smoking, they would still have this persistent cough. The irony is that people would smoker's cough you. Don't come to our clinic. Because they immediate, they know cost. And they know how to stop it so when if we take the smokers out of the equation? How many? How often does it happen that someone has a chronic cough that they just can't get rid of. It's a common enough. The one of the statistics site something like twenty six million ambulatory visits for cough. Of that percentage, a large number would be chronic cough. We have a large population of chronic cough patients. We have over thirty five hundred patients a year. No kidding, and what the common causes other than tobacco. It's gotta be allergies. I'm going to take a guess at allergies if you think about cough as the bark of a dog and the dog is your voice box and your. Your respiratory track it signaling you that there's something irritating so things like post nasal drip reflux inflammation of the Airways as well as the Alveoli sack. Can all lead to cough? The wheeler sack are the little sacks at the end that yes, exchange oxygen. Yes, so there's a an entity called interstitial lung disease were in cough may predate the diagnosis by as much as eight months. And you, said reflux explain that. How does reflex cars you to cough? So reflux is a phenomenon. Think about the burping reflex so. Is when abdominal stomach juices, And it depends on how high they get. They could irradiate the lining of the August. They can also go all the way up into the firing, sore throat area. You have the acid and the non acid elements which can cause. Damage to the lining of your voice box and Causey retaliation. If you determine to to figure out if it's a chronic cough. How is it diagnosed? Just count up on your fingers a number of days. You've had a coffin then you're chronic so. The American College of chest, physician, and a lot of the national guidelines have established that a cough that lingers for more than eight weeks falls into the category of of chronic cough, and this is an important designation because like right now. How do you know it's not influence? How do you know it's not the virus the eight weeks and the persistence beyond that tells you that it's in a different category and comes with. With it, its own set of differential diagnoses now I assume in a nonsmoker. It's important for you to determine the cause before you initiate any kind of treatment. How do you do that? How do you determine the actual cause? So the approach unfortunately is a systematic elimination of possibilities. There isn't a cough meter to plug the patient in. It's a systematic elimination of of possible diseases, and that's where the frustration is so. If you're in primary care. First thing you would do is to to do two things. Get a chest X ray. Make sure that there's there's nothing going on like cancer like pneumonia. Second thing is to make sure that the patient isn't taking a common anti hypertensive which is associated with up to twenty twenty four percent of chronic cough for those who take medication ace inhibitors, yes. Part of the challenge is then. How do you systematically approach it? And this is where the history comes in where in you have to ask and inquire about disease states. Can you have a habit of coughing? We try not to use the term because humane. Not realize how much negative emotion goes into that term because people will look at somebody suffering from chronic cough and say it's all in your head and discounts are suffering and the burden of disease and. If the habit is something that you have acquired to get attention and it's a totally unfair statement so. Personally in our clinic, we try not to use that term. We talked about some of the complications including rib fractures, but having a chronic cough that really interfere with someone's lifestyle. We looked at patient, perceived burden of disease, and we were very surprised in the early two thousand. When we found out how much people were suffering? So people would coffin. There would have rib fractures and rib fractures are very hard to diagnose with cough because it's not displace, it takes three weeks before the callous starts to form, and that's when the chest x ray becomes abnormal. There's actually a Mayo Clinic. Preceding publication on cough induced fractures. Wow, pretty amazing, and that's painful. Last four weeks and makes it even harder to cough, but. What? How do you treat a chronic cough so first thing you do? is you go through a systematic evaluation? Do the have posted so drip through. They have reflux. Do they have asthma? Do they have a condition called ESPN bronchitis, depending on what the chest sex ray shows do you need the scan to find out whether they have sarcoidosis bronchial actresses with picked up rare diseases. Diseases like vascular artists what we that lead to subotic noses, we've also picked up things like giant cell arteritis, wherein in the manifestation with just be cough and more prosaic in post, postnasal drip and reflux. You have to be a pretty adept diagnostician to figure this out because you've named myriad of diseases that could potentially cause a chronic cough. That's why the cough up pro. Is An interdisciplinary one, so I work very closely with esophageal group, and in close collaboration with three rhino surgeon that we have an EMT. No, Search Yup. We also work with throat, specialist, or two of them here at Mayor Rochester and We also work with the allergies I'm. A board certified allergists myself so. You have a cross section of several sub specialties coming together to serve the patient, and we also have euro gynecology by the way. You're going to need that because if you cough too much. We know what happened. So one last question cough suppressions suppressants over the counter. Do they work? They don't all right. That's a simple answer. Chronic cough cough that doesn't quit their multiple causes and the cough. Itself can cause a variety of problems. There is treatment, but determining the underlying cause absolutely crucial. Thanks to male clinic lung specialist Doctor Kaiser Lamb. Thanks for being here. Thank you for having me. We're going to take a short break. When we come back, we'll learn how patient national can help you and your family during cancer treatment. You're listening to Mayo Clinic Radio on the Mayo Clinic News, Nethon. We'll be back with more. Mayo Clinic Radio Right after this. Welcome back your male clinic radio I'm Dr. Tom is and I'm Tracy mccray, you know if you've just been diagnosed with cancer, it can be difficult and confusing time that's for you, but for your family it really has to be one of the most stressful moments in people's lives and I know Tracy. You've been there, but you were young, but do remember Oh. Certainly, they told you you. You had cancer. Yes, I was I was nineteen and my I remember never having seen my parents react or act the way that they were acting when we all learned that news. Yeah, it was definitely a big moment in my life. Did you have any inkling that you might have cancer or they told you? The doctor in my hometown said I think you're sicker than the average bear. And when we? When we heard that then that's when I knew it might be a little bit different, yes. At Mayo. Clinic Cancer Center there are people who can help. However, and I did not have access to people like this, and so I'm really excited to talk to these patient navigators. That's what they're called. And what do they do? How can they help? We're going to find out today joining us in studio or to patient, navigators Jerry Lensing and Angela. Young welcome to the program. Both of you thank you. Thank you good to have you both here now. I know you work in the cancer center, but I honestly never knew that there were people called `patient navigators, so tell us what you do. Well! Our job is rather all encompassing. We have individuals that come in. They want basic information, but then we have those that are either newly diagnosed or have been dealing with a treatment process for a number of years, so everything is different every day. in terms of what their needs are, and what what we can supply for them. When a person comes in a it has just been diagnosed upstairs. They tell them come down and see the people in the low in the lobby in the cancer center Go meet a patient navigator when they come walking in. What did they say to you Angela? What does that first appointment that I? It's not appointment, but that first time like. Yes, so we really just kind of meet the patient and family where they're at. It might be just needing some additional information about their diagnosis. Many a times were meeting patients out of very vulnerable time where they find out. Maybe they need to stay at Mayo Clinic for extended periods of time for treatment, or trying to manage maybe coming back and forth from home to Mayo Clinic intermittently for treatment. And how are they going to manage that financially? all the things that go with distance treatment distance from a treatment facility. So, we really work with them individually to figure out what is their treatment plan? What can we do to help them along the way Jerry? I would imagine mostly. Everyone has to kind of go through the seven stages of grief. That's what I've told people. My family certainly went through that. Would you say that that's right? I think that's true. I just don't think that people really realize that. That's what the process is We talk about the new normal today. Today is what today is, and you deal with today work through what you have to deal with today and don't make big plans, but just no, it's a process and I am sure that most patients and their families after they hear the word cancer from their physician or healthcare provider. They forget everything else. That's been, said I mean you must get a thousand questions when patients come down to see you some of which had already been answered, but they have forgotten. Numerous times and I think the one of the bigger issues is understanding. The whole staging process you know they may can come in, and they have liver cancer. When in fact, it may be started someplace else, and it was a different primary, so just explaining the and using different examples to help them understand that process, and what that means, if it's very interesting, is because it's very confusing for patients because we talk about grade, and we talk about stage and grade has to do with what the tumor looks like under the microscope aggressive. It is how fast it grows. And stage has to do with where the cancer is located whether it's still localized in whatever organ or if it has spread elsewhere, and how far it spread very difficult concept for patient understanding. It's so good to hear that you help them with that. We we do our best. It's it can be a mystery, and you may get that question from that same person five different ways, but you know it's important to provide the support that they needed. Explain the way that they understand and have them. Explain back to you what they understand, so you know you've gotten the message to them. Then let's face it. Sometimes. Physicians don't explain it very well. I would just say that. you know for you for any of the other physicians. It's just a different way to look at what is happening to this patient's life. And I did not appreciate. How much caregiver needed support again because I was nineteen, so I didn't think about my parents or my siblings at all. How do you help the caregivers or the immediate? Family Angela. Well, interestingly enough I would say the majority of the people that visit us in the Cancer Education Center our caregivers. They are the family. The support people that are there with a patient not to say the patients don't come in, but they often find the closest chair just right in through the doors and sit down. It is the caregiver that tends to be that information seeker. They are the ones that are going to want to know more about what to expect what things to anticipate, and when it is okay to reach out to the care teams and notify them of some new change so I would say, we work very closely with caregivers, and they are equally Supported if not probably more just because they are the ones reaching out to us, I would like to think that all of the patients that might hear. This would come to Mayo Clinic for their treatment, but the fact is. Did you know that we're heard on over two hundred forty radio stations so all across the country? People are listening to this right now. And I was not treated here at Mayo Clinic I was up in Fargo. What advice would you have for? The patients who are listening for family members who are listening things that you have learned if they never get an opportunity to come to the Mayo Clinic Cancer Center and speak with you What would you share with them? Both of you Jerry. Why don't you go first well? There are resources out there I mean. If they've come here for a second opinion and they they want additional resources. We can certainly help them if they re. Treatment is being taken care of at home or in their home area. We certainly do that and we get a number of phone calls into the center, asking questions, and that sort of thing, and we do our best to provide them with the resources that they may need so from anywhere. You would take a phone call right. Right and we are very blessed in that we do have a patient navigator located in Arizona as well, and the goal is by the end of the year to have one place in Florida, so we are in a couple key places on in the mail system, so yeah, we're here. Here's someone would call the main Mayo Clinic number and ask for the Cancer Center S to speak with a patient navigator. Is that how you would do it? I would say that or they happen to find the Cancer Education Center on the web on the Mayo Clinic Dot Org website, and then our phone numbers published out there as well, and then that comes right into where Gerry Nice it or so Angela. What would you say to other folks who are the past so I would save? Somebody's not able to come to male clinic and feasibly that's a reality for many people. I would say it's. It's okay to advocate for yourself. As caregivers advocate for that patient, ask questions. It's okay to ask questions. If you're going to get on the Internet and do some searching mixture, you're on the the credible nonprofit organizations you know in in. Do your research on those credible websites. Reach out to you know there's lots of patient advocate foundation out there that are there to help you as well if you're not able to get in contact with A. Greater there are many people across the country in similar roles as Gerry Nice so I would say ask in your system that you're being treated. Is there somebody that's there to help me? That can be a patient, advocate or somebody that can support US along the way. What do help with virtually everything? With regard to a POW, a patient's life has changed because of cancer for example financial hardship and he could you help with that or direct them to someone who can so a lot of times? What we're doing is were we honestly were meeting patients where they're at when they come. Are there I? Need is how am I gonNA pay for my hotel. I just found out. I need to stay seven more days. I don't have the money for that. That 'cause I just paid my mortgage back home, and now I'm here an extended period of time and I'm not getting paid, so we're oftentimes working with them to get financial grants. Get them connected to resources to help cover. Those expenses were fixing those immediate things right now. a patient that stays at Mayo, clinic where we build that relationship. oftentimes, we're looking more long-term to see what other programs and in community resources we can connect them to. That can help them. More long-term is well. Likewise patience that may be as going home. We try our best to connect them to those kinds of resources, so they have that same support back home as well. And we try to encourage them to connect with US early in the treatment process, because a lot of those organizations will not help you St. Min is completed and I also indicate that if you're not. Capable if you're not feeling up to assign it to a family member or someone that you trust, that could oversee that part of your care. It's you're supposed to focus on getting better. You should spend your time getting better, and if you have someone that you trust, that can take on that responsibility by all means. Share it with them because they're looking for a way to help you from the mouth of patient navigators. Patient navigators help patients who've been recently diagnosed with cancer by the way. Do you see most every cancer patient at the Mayo Clinic couldn't now? The ones that you referrals? So you, patients get referred to you from physicians or other health care providers. Yeah, so we have physicians nurse practitioners. They're care team nurses. We work closely with social work at Mayo, clinic and like Jerry mentioned we do get a fair amount of phone calls coming in people that are looking to get a second opinion at Mayo Clinic. Thinking ahead. How am I gonNa Ford? Where am I gonNA stay when they get on the Internet and they start looking at how much are hotels are in Rochester? That's frightening, so they call. What's your phone number? Five zero, seven, two, six, six, nine, two, eight eight. Five zero, seven, two, six, six, nine, two, eight, nine, two, eight. All right, we'll give better. Get back to your office. You're. Patient navigators at the Mayo Clinic, what a great service! At a difficult time at people's lives are thanks to patient Navigation Jerry Lensing Angelo? Thanks so much for being less. Humid serpent, and that's our program for this week. You've been listening to Mayo Clinic Radio on the Male Clinic News Network. Our producer for the program is Jennifer. For Mayo Clinic Radio Thank you for listening.
Progress in the fight against Blood Cancer
"Here's today's health and wellness podcast. I'm Mark news. Thanks for joining us. Progress is reported in the fight against blood cancers. Dr Gwen Nichols with the leukemia and lymphoma society says, there's promise in something called car teeth therapy. This is genetic engineering therapy where you use your own immune system of the patient's own immune system to help fight their tumor cells. Doctor nickel says, blood cancers can take many forms. Ludd cancers include leukemia and lymphoma as the leukemia lymphoma society name suggests, but also myeloma and a number of other blood cancers that are somewhat rare that involve the blood, the bone marrow and the lymph nodes. Nickel says, some blood cancers are now being cured, and hopefully more will be soon you can learn more at these -ociety is website at l. l. s. dot ORG. That's today's health and wellness podcast.
IVFML: Becoming Family
"Rachael duplicate is LEGO only with bigger bricks. Perfect. For small hands and growing imaginations, bright colorful bricks that help your child to create a world of imaginative building the new logo Duclos steam train has arrived with pushing go motor and five new action bricks, the control everything from the lights, the direction of travel and even the horn and download the free dupe low app for even more fun. Learn more at LEGO dot com. Slash stoop low. That's LEGO dot com. Slash stoop low. Five years ago, my husband and I started trying to get pregnant, but it wasn't as easy as the nursery rhymes made it sound three insemination to miscarriages to IVF cycles, testicular surgery and fifty goddamn thousand dollars later, we became the proud hosts of an infertility podcasts season. One was about us, but for season two, we're hearing other people's stories and learning all the different ways to build a family. Yup. We're both going to be the child's biological parents, but we are both going to be moms a mind better for everyone. You know, because of course, you know CNN is going to be the mom, but what are you going to be like. I'm going to be the other mom. She just looked at me and she psych. We found traces of leukemia and your blood another doctor walked in, and then he tells me, I know this is a really hard time for you, and I really don't know how to say this, but when you get your chemotherapy. There's a chance that you might become infertile looking at your paperwork right now. The brutal honest truth is you are definitely not ready to support an African American or a Latino child in your family. Look at the medical stuff. Look at the money, how many more years to we want to be putting ourselves through this. And for us, it was like none, no more years. You know, you look at your baby and you're like, thank God. You're here. You know, like, thank thank God. You're here. And where would my life be without you n. it's called I, the FM l. becoming family and it's out next week available wherever you get your podcasts. Make do PLO is LEGO only with bigger bricks. Perfect. For small hands and growing. Imagine nations, bright colorful bricks that help your child to create a world of imaginative building. The new LEGO Duclos steam train has arrived with pushing go motor and five new action bricks, the control everything from the lights, the direction of travel and even the horn and download the free dupe low app for even more fun. Learn more at LEGO dot com. Slash dupe low. That's LEGO dot com. Slash do PLO.
Basant Bahar . Ft . Arunika . AudioBook 1 . Indian Ink Writers Community . IINK Podcasts
"Those two up sundry percent bihar indian ink writers community. I suck up written person. Dig- bush halo. Bruce liu Ami bully mooney goal hon. Grenade asha shoot. He'd rely judas it. Aw merge she basha dick. Hi should who isn't By shoddy needed best. The debt deal though kidney in the high on me should Hulliber sheesh muni Tissue gula quiche Goody leukemia quiche can too high buca Totally though boosted by.
Wichita Life Podcast #20 - Hannah Soderstrom
"They put me in. ICU that night 'cause I mean basically flat lines and they brought in the pastor to come. Pray over me because I thought I mean they thought I was going to die. welcome to another episode of the Rich Paul. II podcast is linked. Today's episode is brought to you by L. Primo Espresso Cafe premo is located at central in woodland in Wichita and is the oldest copy shop in Wichita stop by and check out their lavender cream soda or even their cinnamon so I cold brew. This is part one of an interview with some members of Kimia and Lymphoma Society this episode. I spoke with Hannah and her father. Scott Hannah is a survivor of acute lymphoblastic leukemia and is currently a junior in high school. This is not something I know a lot about but here are a few statistics about blood cancer every three minutes one person in the US is diagnosed with blood cancer an estimated one hundred seventy six thousand two hundred people in the US are expected to be diagnosed this year the leukemia and Lymphoma Society. It helps lead research to help cure cancer. We talk about his experience of Chemo treatment and experience overcoming this illness. Hannah story is really really inspiring and I'm excited to share it with all of you during a conversation with Hannah and her father Scott all right so this is landed and I'm here with Hannah and her father Scott. How are you guys doing. I'm doing good. How are you very good so can you guys just tell a little bit about yourself. you're in high school. What year you are where you go that kind of thing. Yeah I am a junior at mays high school and I am super excited to finally be back in high school because for the past couple of years I haven't been able to go to school due to my illness and so so going to school full time is definitely a new thing which shouldn't be a new thing for a kid but it's definitely a fun experience because I'm just more grateful to be there and not lay in bad sick. Absolutely so what do you like to do hobbies. What do you do currently in school. I'm I'd take debate. I love talking and just this speaking in front of people. I know that's a fear for some people but it's something that is really in my comfort zone so I like to do it so I tried to express as much as I can very cool. Oh all right so part of the reason we're here is just to kind of. Tell your story get it out there. words of wisdom stuff. You've learned just the experience in general so can you just talk about what you had what illness he did have and going to a little bit yeah so I had acute lymphoblastic leukemia which is a type of blood cancer and when I was I diagnosed. They described it like well. Daddy remember how they describe to you. Remember the me will the leukemia tax the sales that would typically fight any kind of infection or sickness or illness that you have and so it it masks so cells in your body thinks that has those sales but in theory or in reality it doesn't have those sales and that's why people get into trouble disease and so you know getting getting the illness. I it's difficult to diagnose it. Mass itself is just a normal flu or just exhaustion. Sometimes it can be difficult to find an until you take that blood test and the big deeper into it okay and so how did you find out about the whole real. What did that look like finding out while I was in eighth grade at the time I was just starting eighth th grade year and being thirteen. I honestly just had thought I had the flu and I was doing normal things. I was really big into music theater at the time dance so I would go to dance classes. I would go to tech week for music. Theater and I do shows and honestly I just thought I was just exhausted physically and my mom. That's what what she thought and she's like. Oh it's just the flu you'll be fine and we were like okay we can at least we can get through this one week we can put on the show and then rest a little bit and so we did dot and then after the show was done we went to the doctor and they're like Oh. I think you have mono some probably run a blood test and so they run the blood test and they're like Oh. I think you need to go to the hospital and so we ended up going to the hospital thinking I I still had mono well. We get there and they bring us into this nice room and it was really really cool because I had a gift basket on the bed already. I was like Dang. This is really cool. I can say to stay here overnight and they're going to give me food. It's GonNa it'd be good and then all these nurses start walking in and then a doctor and two doctors and residents the time I didn't know what residents were but but all these doctors started coming in my room in one comes out from behind them and he sits at the foot of my bed and he says Hannah you diagnosed with acute lymphoblastic leukemia and my first reaction is I told him I go well. That was like ripping off a band aid like it. Kinda was like bitter how fast they were able just to diagnose life. I am my mom started crying. Obviously 'cause baiming parents were my parents. Both were just very emotional that day and I didn't know what it was to be honest honest so I was so confused. I think I was shocked because I knew it was bad and I knew it wasn't like going to be easy. I just knew I had to learn about what I was going to go now through and learn how to do it and how I was going to beat it so and never once doubted that I would not be that I always try to keep till up to the positive side. What was it just fear when your initial thought when you heard it or was it just confusion because when I hear that I I don't know what that means. I don't know if that's like life threatening. Is that what it looks like. That's exactly what I thought. I was like. Okay what does that. I just didn't know what it was so the child life specialist had come in and she came in with her little baggy and she put it was called hauled leukemia soup something like that and she basically put all these fake cells and to abandon. She's like this is what is happening in your body right now and it was trying to explain explain it to me and I was like this is really weird. Okay and of course they diagnose it as limp lymphoblastic leukemia. We didn't even know what that was. That was fear obviously of okay. What is that and I never even mentioned for cancer so we didn't really assimilate the to and and of course once we started doing research than we realized Oh this. Is You know yeah props to my dad. I mean he stayed up all night some nights just researching and trying to figure out what was the best cure and over the best methods. What should I be eating which should not be eating looking at other survivor is watching a facebook's and saying how they battled it and I mean honestly could be a MED student. I don't know why he doesn't got his. Phd So what are the different stages to this type of leukemia or not with leukemia. If you're diagnosed with accumulates kind of all the same you can get diagnosed later and that is more Dudley because the later you find out the harder it is and when you're older. It's the harder because if you get it when you're really young it's easier. It's it's not easy but it's a lot easier on the body compared to someone who is older so when I was diagnosed I was a high risk because I had been getting older and I had been developed as a teenager and so just being labeled as almost an adult was just considered high risk. Wow that's really interesting so what she said you. You kind of looks looks at the positive side of things. Is that something you've always been support from family. What where did that come from. I mean I like to think of myself as a positive positive upbeat person. I hope people see me that way but honestly I really couldn't have done it without my family. My family was there with me. The whole time you know many might many nights at the hospital just laying there by holding my hands scratching my back you know literally away and just being there for me sure yeah the the support network definitely comes through family was was very important important in in our church. We had a lot of people from church that that were always there for us. So of course just working in friends added that Al- uh-huh yes it's important so you find out kindness her during a recent research on your own. Do you jump straight into treatment or what does that process. Look like you Kinda. China do have to jump straight into treatment once they once they even think you gotta you gotTa jump in. 'CAUSE IT's fast. It's fast spreading cell so you don't WanNa wait on that. So I think the second day I was in the hospital. They started putting stuff in me. yeah they do some preparatory stuff. I mean she needed report so she had surgery to have a port put in other than that they get started running sure so what what all is that treatment entailed and is it pills shots. That's what is that look like well. I mean the first thing they did was enter a IV of courses so a lot of fluids going through me first my body just for the new like the Chemo to go basically because you cannot be dehydrated when it goes in so obviously the first thing they did was sailing and then intravenously they put a lot of different types of chemo and I and one of them this is gonna sound really crazy but one of them likes capi and all the nurses out here. You'll all know exactly what it is but it's smells disgusting and then they'll bring in another one and then they'll be like okay. We'll be have to shut the windows because it's very sensitive to sunlight and I don't want you to like breathe near it and don't touch it and like this is going in my body. You're this inside of me and you're like not wanting me-media even go near it so it's Kinda crazy how like they'll put the gallon on gloves like heavy duty gloves and I'm mike putting the sense to me. Jay Straight straight chemicals straight poison. It's kind of crazy. Can you talk a little bit more about like the Chemo itself because I I personally don't know what that looks like. Ed a lot of people. I don't really know what that looks like. They just know it is hard on the body. Chemo's not just one drug I realized before I thought Chemo was all just one that you just got chemo chemo but there are different types one of them was called on Johnson and it was labeled as the Red Devil the one yeah that's the one that's I mean. It's read it goes in red and then like whenever your body would release fluids on you sweat or when you peter cried you we would all be read like you would have if you are white shirt. It'd be pink by the end of the night. It's kind of crazy. I mean it's crazy. I found it fascinating but it was also a major stomach. Feel like cookie dough and and that's what made me throw up and that's one of the Chemo's that made me lose my hair and it's just because that one was so hazardous so I mean there were Chemo's that I took that it didn't affect anything I mean besides just killing the blood cells killing the off and so they're chemo's that I would take later on in treatment that I would would still be taking chemo but I'd still have my hair because it wasn't so bad on like the cells that produce hair cells and kills and stuff like that but chemo is a drug that does not target a certain thing it just goes in and kills everything so that is why lose my hair. It wasn't because of the cancer it was because of the Chemo and so with that. I lost all my hair but I also fun. Fact pimples are fast growing cells so I had the clear skin so that was pretty cool either. There were pros. I'm telling you there were very thin linings but can you can look at the bright side very thinly and so I had pretty clear skin. That was fun. Fine not shaving. My legs was nice. I never had to worry about my hair. Always had the best hair yeah and the regiment calls for let's say for three month period you take three different drugs over that period of time and then for three or four months after that take three or four different drafts and then along with that that drug that you've taken you could take a steroid it just depends on on share of the phase that sure in the chemo really stands for just a drug regimen. It's not a particular drug. It's a drug regime that you're under so all these different different drugs that you're taking some of them are a little bit more lethal than the others so to speak so like she said there's there's some that just go in and they go after the the fast growing cells and attack them pretty heavy in an thorough steroid on top of that so it accelerates it basically and some you know she could take an handle. Some just completely knocked her out. No energy no desire to eat anything because it's just GONNA come right back up so you know there were periods where she lost a lot of weight and we are with every day and so we can you know we don't really see how how intense it is because it's more gradual test but I mean there was some periods where we would look back at pictures and and be like wow I didn't realize how bad it was but they can become harmful. One of the more lethal ones was methotrexate and you have to do that. One heavy doses so you would get Oh it was like a gallon sized bag of just this yellow fluids and when it went in you like your finance at one end but like later on throughout the day you'd start feeling really bad while my body didn't react well to that drug and so oh it caused mouth sores all down my what is what was that called. Gastro track so I wasn't able to swallow anything. They weren't able to put a feeding too dumb either because I wasn't eating because it hurts so bad. Microbes was so bad that I couldn't even open them so my lips were honestly like glued lewd shut for solid fourteen days and so I wasn't eating and I hardly streaking they put sailing through me while they decided to put vitamin K N which is a healthy right vitamins but you can definitely get allergic to that really quick and so caused an electric shock and of course it says you know if administered through IV. There's a rare instance where you could have an electric shock. She had that so. I just have overly bad luck. I don't know I may may need to try the lottery if I can win those little slivers that Oughta a lot of the treatment you. Can you do that at home or do you have to go in every time if you have to go in moons of its in but a lot of it was you know outpatient fortunately Orlando Dr that that believed in his much outpatient time as possible and and and there's there's truth to that you know if if a child or an individual can be outside at home and in the comfort of their own home they tend to have a little bit more better feel about about taking. Can I definitely felt better in my bed than a hospital right. I can imagine so. You're going into your junior year. You found out about this eighth grade and then I believe you just finished your treatment. This spring that right last February was my last treatment. Put congratulations on that. So what does that look like moving forward and you still have check appointments every so often. What does that look like every month for a blood test and they'll test just my red blood count my wife made by platelets to see if anything is out of the ordinary sorry and they'll check my They'll just check those counts. I mean if anything's out of the Ordinary Celje that's once a month that'll be for for a year I think and then it goes to quarterly visits than six months. Visit annual visits slowly. Yep So is there. A good shot that it's gone then or is there. Are there any statistics on like. I don't know the specific leukemia or anything about the remission. I don't know we've we've run. We've had a bone marrow test and that shows that she's in full remission with which means. It's gone certainly a chance of remission. I mean there's never you're never kind of out of the woods. Fully there's always that chance but based on the results. It's in the numbers. Things look good chance so the two torso three years. What school was just doing it on your own while you're hospital? Could you go to school at all. I mean my parents tried not necessarily to forced me but to urge me to go and socialize as much as possible and I mean I'm a very social person but during those times I just wanted to be at home Nestle and ends. I would go every once in a while very slim chance that I'd go an eighth grade year. I think I how all in all I think I went to school like two months like adding it altogether. I'd go like twice a month. If it was a good month and of course when I would go everybody would get excited excited and they'd WanNa come up and hug me and everybody would come up and see me in that just geared my parents because one kids are Germany. They're they're carriers not. GonNa lie so everybody coming up to me was very dangerous because they were carrying germs that they didn't even know they had or had or could give to me and and I mean in a just made me like nervous overall because it was just a lot at one time and taking all these different drugs. I was never in my like I was never myself. 'cause I mean my mind was just everywhere from taking these drugs so I was either really really hyper or like really tired or just kinda confused all the time. It was never like a set mindset aid to tell tell you that but you're like that all the time anyway like thanks so are. Are you caught up then. Are you like at the kind of same base starting point of your near then or are you set back a little bit. Actually we were just talking about this on the car right here I. I loved my teachers very much in middle school in freshman year. There are very nice and they would never overload meet with work but I just realized that I never hardly did any work. The sideline is now allowed to really no preordained of the pastors over me. I'm kind of Ning Dai which one hundred percent is possible. I can do it but it's also something that I look back on and was like hey maybe I should have done that worksheet or maybe i. I should've just tried in considering the state of being it wasn't you weren't retaining knowledge like hey. I'm going to need into no next year to help me next year. Get through what we can to get it done absolutely next honestly at that point. We were just thinking about survival yeah but yeah now it's now. It's a new challenge you. What's been the hardest part of the last few years. Is there uh specific thing or just everything all at once. The hardest part was probably Valentine's Day that couple years ago was when I had the anaplastic shock from methotrexate in they I mean they put me in. ICU that night 'cause I mean basically flat lines and they brought in the pastor her to come pray over me because I thought I mean they thought I was going to die so they had they had to do the code blue button and all the doctors rushed into my room and I was brought into a cat scan and that was probably the scariest moment of my whole treatment most difficult time aside hi from that. It's it's just trying to live some. You know instant seven normal life during a period. That's absolute turmoil so I mean that's. You've got another child. That's healthy and you know you're trying to you know make sure that he's yes well cared for as well but at the same time you know that's almost impossible so and those those are the tough challenges as far as parents go but yeah and I know for her is is just just battling. Those different drugs not only physically but emotionally does a lot to yes. Oh Yeah you can't really be yourself. So how has it changed. Who you guys are Hannah. Scott or just the family dynamic. How has the last couple of years change you guys for the better or worse Why keep telling my dad. I've had the best summer ever 'cause I just I look at all the little things and I'm happy about them like sunny days. I get so happy going to the pool. I haven't been able to swim in two years. This is the first summer I've been able to swim so trust me. I was at the poor every day and I got a lecture that I'm getting too much sun but I I have enjoyed every moment of it. Yeah I mean you you take a lot for granted but also just realize I mean life is precious. Things like you know. A Quiz at school aren't so important so maybe maybe you could chill out a little bit more about stuff like that. So what advice would you have for other people with the with specific kind or just in general or I mean especially especially middle school or high school age because the majority of people will never have to go through that let alone at that age it. It's it's a scary diagnosis. It's beatable the best thing that an individual that gets is it can do is be positive as much as possible. We we've seen some some people go through it and you know I mean your first instinct instinct. Is You know why me and you Kinda get down down about it okay. This kinda sucks for me and my life but at the end of the day you gotta deal with it. I think Hannah really understood that. It's kind of like okay. I've been dealt the hand here. I'M GONNA play it in do the best I can with it and and beat it so and you just take something that's honestly awful and you just turn it into something that can motivate people so if you can try try to do that. That's what you need to do. And of course there are kids. That couldn't get over the why me why me I feel so bad for myself and that was heartbreaking because you could see how much worse they were doing because of how they like thought and I'm like mentally like that's just the worst state of mind. You can be enduring that so you don't want to be in that state of mind. You need to get over it. You need to get upon it and just go with it and learn how to cope with it and and have family with that was how I stayed so positive yep. We've we've met some amazing people through this and that's been then one of the huge blessings and at the end of the day she's she's created a nonprofit to try to help kids that that come out of treatment and try to get them a normal life again and so that's a piece that we're we're still pushing ahead with so yes some incredible the things that have happened through it. Can you talk a little bit more about that. What's The nonprofit the name of it what you're the goals so what I was I I G- knows the doctors very strong about creating facebook page just so my mom was overwhelmed with text message of how I was doing and so people could see little updates and so they're like yeah. A lot of kids do like bite for by Hannah Hannah's battle very basic like Hannah's journey it just something very basic. It doesn't have to be crazy okay but I am a very crazy person and so I like to go over the top with everything and at the time I really liked the little mermaid and so I was like how even mermaids let's get leukemia because they told me it doesn't matter who you are. You can get like there's not a single thing. We don't know much about the illness anybody can get it so I was like okay even mermaids get leukemia and so that was the name of my battle page and so going along with it became really catchy and it caught on and so what I do fundraisers with the Leukemia Lymphoma Society during the light the night walk. My Ten is a mermaid theme and it's really fun because all the little girls especially the little girls and I love seeing seeing them. They're adorable but I decided to roll with that as my nonprofit and so like you were talking about how getting back into the swing of things was says it's it was honestly really hard for me. At first because I mean I had to make all new friends 'cause my friends aren't the same as they were in seventh grade and I had to go and just basically start over and I just started from scratch and I was like this is really hard because I started from scratch physically really emotionally and mentally I hardly had any muscle and so just getting everything back up. Again was really hard so I was like. I don't think it should be this hard for everyone and so I was like we need to create a nonprofit that helps at the end of treatment because there's so many that helped daring in at the beginning but there's none towards the end and so I wanted to create something that I could help someone so what my nonprofit does is is basically if a kid wants to go and take baseball during the end of their treatment or at the end they don't have enough money to pay for it. We can help them and basically pay for a first year batting practice or if they want to do cheer pay for for their children of foremen tumbling lessons just something that can help them get back and it doesn't even have to be like a sport. It can be like guitar lessons if they want to. Go play guitar just something to help them get social again. That's really cool. So how does the light tonight tie in with that and then what's your favorite part of light tonight. will leukemia. Lymphoma Society actually reached out to us while I was going through fighting cancer and they're just an amazing organization organization. That was like hey we do this thing called light the night and we would really like you to come speak. If you were if you would be willing to and I was like of course like that would be something. I'd really be interested interested in because I thought hey I like public. Speaking I could give it a whirl and so I wrote my own speech and I talked about how being diagnosed as a basically what we're talking about here now and I really enjoyed it the light the night walk was nothing like I expected. Honestly I kinda thought Oh it's just GONNA be a lot of kids and adults like me feeling sorry for themselves. We're just GONNA sit there and cry for no. It was a lot better than what I thought it was going GONNA be. It was honestly like I just don't know how to explain it. What did you think I mean. Definitely you get exposed supposed to see how many people are affected by the blood cancers for sure not only that you know people have lost battles have beat battles finals and are going through the battle and all of the family and relationships intertwined with those folks and that was pretty cool to see and then of course you know what what a great setting downtown. Wichita with all the lanterns and walking around seeing although entrants in walking was really beautiful. All the different colors 'cause like the survivors would have the white one set correct survivors would have a white one and all the other family members would have red ones and it was really cool to see how many white ones is there were and red ones because honestly a you don't know who's affected until you're like sitting there and you're just like wow they went through and they look amazing. The girl right across has a white lantern and she literally looks like she has been the healthiest person in the entire world YEP YEP I and they've been they've been a beacon of health throughout the whole process. We've certainly not only referenced the website but reached out to to the folks that are involved with L. S. and and they've helped us along the way as well so been a great resource cool. I'll definitely link up the late tonight details. We'll talk about more here in a little bit but and also your nonprofit. That's really cool so we'll just make a couple of other questions real quick so these these are some questions. I kinda tag on every podcast. If you guys WanNa talk about him we can if not no worries. Is there something you often recommend. People like books movies. TV shows anything anything that I am probably the biggest Disney fan you'll ever meet. I absolutely love Disney. One hundred percent recommend going to Disney world wants in your life. Life doesn't matter how old you are. You should go to go on the bucket yeah. It's a bucket list item. Four Scher doesn't matter how grumpy you are you need to go. They'll cheer you up right away. What something you recommend is in relation to anything YUP ANYTHING YOU WANT. I'm the least reliable source that's all right. What's your favorite Disney movie favorite favorite child. That's right all you have to do. You have a favorite failure in any aspect of your life so it could be. I mean anything during the treatment or before that or any eh part of your life. That's a tough one. I'm one hundred percent perfect. I never never I one one hundred percent the biggest Klutz I'd trip five times a day fun fact I mean just this week and I was taking like taking pictures with my friend and Lake we wiped out completely and I have huge scars so I am just the biggest clots you'll probably ever meet. That's a big failure. What is your definition of success. If you had to have on doing what makes you happy would be my definition of success. Yeah Happiness that that true happiness no matter what you're doing Do you have a life model you live by or what some of the best advice that a you've ever received. Hannah I received so much good advice. Honestly I can't pick one and honestly I can't think of one but just doing like flag. I said earlier just doing what makes you happy Yolo. You'll only mhm gotta live everyday. She's full of those wonderful. ZINGERS zingers go bigger. Go home until you make it. It's hard when you get put on the spot to just say on a daily now. Yolo yeah all right so again one of the best. Do you have any habits that you've we've developed over the past couple of years. That's most improved your life drinking water thous one thing they're like a water bottle beside you at all times and I was like no that's disgusting gusting and I was so bad about drinking water. He would yell at me every day. My Dad would be like hey how much water drink and I'd be like couple sir. Perhaps we were. We were pretty real sergeant. Israeli really John Sergeant because they they hammered at home. You can't drink enough water. Yeah and I'd go when they're like. You're dehydrated unlike I know but yeah that's one thing that I just have learned drink so much water and now if I don't have a water bottle in my hand and I'm like. Please give me some water. That's a good one. Do you guys have a favorite part of Wichita or a hidden Jim in Wichita. My favorite part in which shaw is honestly right when you drive in and you see the keeper of the plains and all the sky the skylines and the bridge of course. I was walking down the keeper. I really like it. Is there anything you wish wish. I had that it doesn't or anything you would improve about Wichita. If you could uh Disneyworld we could disneyworld. I don't know I mean I always talk about how I WANNA move to a bigger intercity and I WANNA get Outta here. It's too small but honestly if I had to change that I wouldn't because it's it's it's fine the way it is It's like very unique to itself in. I mean I love Wichita. I do like it. I don't hate it. I just want to be moved to a different city and I talked to my dad about this all the time and my mom's like no. You're never leaving me but my parents have accepted that. I just would like to move yeah but I do love Wichita readiness and she cheat braces it and she gets out in it and she's involved. continually does steph within the city so very good tie there. I'm just last one. What does Wichita mean to do. You have to think about this term. You need well. Of course I mean like it's home but when I go and I describe it to everyone will meet in the future and in different cities his I'll just say that's where I grew up. That's why it's so meaningful to me. I grew up in the city and I just May seem a small to some people. It's I mean it's small me but like it's why it's so important for such a tight knit city. Honestly you could be on the east side and still see someone. You know like that's what's Nice about. It is even though we think we're big. We're really it's a small world. We know a lot more people than we think we do and we can go out and and still be friends with everyone and I think that's also just like a mid. West thing as people and are not afraid to say hi here and are very friendly compared to the the east coast and so it's something that I do love about Wichitas that we have little sayings like sorry say that a lot t shirts shirts with that I do that ally and I realized that now after a sealed is t shirts but I'm like I didn't realize I was like a wichita thing kind of fun but and just the good home feeling Yep Yep. It's a place that took care of her. nurtured her growing up and took care governor a time of crisis so very thankful for that awesome well. That's all I have Hanan. Sky Really appreciate you guys coming on. Tell your the story a little bit and it's motivating so hopefully some people in Wichita and gets all over it can be inspired by your story and I'm sharing nonprofit hoping more people involved. Thank you guys. Thank you for listening to this episode of the Wichai podcast. If you enjoyed please share it with a friend and leave review whatever podcast pop from us. I'm putting all the podcast on Youtube now as well. We'll start doing video podcasts for some episodes in future CITGO which saliva podcast on Youtube and subscribe today. If you want to support the podcast head Ettore Patriot page. Thanks for listening.
Leukemia & Lymphoma Society's (LLS) Man of the Year Candidate Emanuel Petrisor on Career Change After Brothers Diagnosis
"Uh? Thank you for tuning and episode one hundred nineteen of the virtual couch. I'm your host Tony over a licensed marriage and family therapist, certified lab approach writer speaker has been father of four ultra marathon runner and creator of the path back and online pornography diction recovery program that is helping people reclaim their lives from pornography. Diction if you or anyone that you know is struggling with pornography. Diction please point them to path back recovery dot com. And there you can download short e book that describes five come mistakes people make when trying to put pornography diction behind them. And again love the feedback suggestions for podcast all of it. Thank you so much, and if you want to help even more please take a moment to subscribe to the virtual couch podcast wherever you listen to podcasts. And please think of somebody that you can share an episode with maybe you've enjoyed or you might feel that would be helpful for them. And lastly, if you have a moment, please write a quick review wherever you get your podcasts that helps a lot the podcast landscape is changing daily there's over six hundred thousand podcast, which is mind blowing. And I feel so blessed to have the support that. Do. And then even though podcasts out for a while. It's almost as if again, people are just now finding them a lot of people so going on behind the scenes big podcast players trying to position themselves for world domination and the currency of the non celebrity podcast, that'd be yours. Truly is ratings and reviews subscriptions, so thanks advance. And if you're up for subscribing rating reviewing and on that note, you can find me thoat, Tony overweight. Calm and there you can sign up for more information about coming programs and all that kind of fun stuff on Instagram virtual couch. There's a YouTube channel for the ritual couch, and that's all the business. Let's get today's episode. Have a very special guest today is name is manual Petra sore and full disclosure. He's a friend of mine. I am on team. Emmanuel and last year. Yes, me be part of team Emanuel, and he is up for a man or now I'm reading about what is man or woman of the year. I was gonna say Emmanuel's up for man and woman of the year. But he's only upper man of the year. Let me be very clear about that. And of the year is what is man of the year or one of the year, the leukemia and lymphoma society, a woman of the year campaign. It's a ten week philanthropic competition for leaders and local communities all across the United States and candidates and their teammates. And so I'm on the teammate part on team. Emmanuel we raise funds for the leukemia and lymphoma society in honor of local blood, cancer, survivors, the boy and girl the year. So the title enter one of the years of war to the candidates team raises the most ones during the competition and the top man woman, Canada, the country or rewarded with the national titles. Of course, we were trying to see if manual can become initial man of the year, and for those who aren't familiar the leukemia lymphoma society, it's the world's largest Voluntary Health agency, dedicated to blood cancer. So the leukemia. Lymphoma society is mission is cure leukemia. Lymphoma Hodgkin's disease, my Loma improve the quality of life or patients and their families and the funds go to the life. Saving blood cancer research around the world and provides a lot. Free information support services. So with that said, I want to get to the interview with a manual, but I will have links and the show notes of if you do want to donate, you can donate to the leukemia lymphoma society, and if you do it under manuals link that I'll share then he has this chance of becoming man of the year for the nation. And then who knows maybe some day for the world. But he really does have a very unique story. And that's why please if hanging there listen to this podcast. It's not just a, hey, give him money. As a matter of fact, I don't think he even says that till the very end, and I try to pry it out of them because Emmanuel has a very special story that basically changed his life changed his career, and it has to do with family member of his that that that had been diagnosed with leukemia. So without further ado, let me get to that interview with the manual, but I think you'll really find it fascinating. And I think there's a lot of inspirational things here of of when you do kind of put yourself behind a cause for your career. And then the. The passion that can follow an SU. So let's get to my interview with Emmanuel Petra sore potential man of the year. Record this time. So we just had the most incredible conversation that will never be able to do right? Yes. Exactly. So my guest on the virtual couches Emmanuel Petra sort I sound so defeated. Now, the first go round I was so excited to see. You wasn't it. Yes. You let me try to get my guest today on the virtual couches of manual Petra sort. Now some over a friend of mine, and he has an incredible story. This kind of put them in a position that I really wanted to have him tell the story on the virtual couch and Emmanuel virtual couch, and how about you tell that story again. Right. Sure. Don't feel bad about pets or a lot of people have our time. What are the? Petrous three shore is the way you're supposed to say. Okay. Here's a little shoot in there. There's Americanized version, which is patroller my the younger siblings in our family used patroller. Okay. And I use Petra sort. Okay. All right. So manual you. Go by eating even the nickname that I was affectionally given since I was working healthcare from my call. Okay. E men's here type of being go play on Eamon Saturday. Okay. So take back. Where'd you? Where'd you? Grow up was born in Romania. I was five years old when we immigrated to the United States nineteen eighty five and then we live in Chicago. What do you remember about Romania? I remember a couple of things of Romania. But like the one thing that really stood out was my grandfather's house. He lived. Like on a hill and remains cold weather. What's compatible too? Celsius celsius, right calculator. I should know because we use that unhealthy. Right. I believe. It like ten degrees celsius, really, really cold. So for us California really zero I've heard of like negative negative negative celsius there. My the thing that I do remember is like sledding off my grandfather's property, but aside from that not much Chicago nineteen eighty five TV there from eighty five to ninety and also very similar snow story. I remember walking to school in the snow air flights or both. Five miles into no shoes. That kind of that. I told my kids, of course. How many siblings came over five five? Okay. Was the middle. Joe trenton. Trenton while you're on the couch, and we could talk middle child syndrome. That'd be another day. Okay. So then what? Right. You the Sacramento, we moved my parents, we moved here in one thousand nine hundred eighty my mom had respiratory issues. So asthma and the felt that it would be better for her to move to warmer climate than Chicago have to ask you. This isn't part of the what we're gonna talk about today, but respiratory issues, and so people come out here. But then you have people that live here that have a lot of allergies. I mean is that soon what people's perceptions and actual facts are two different things. Right. So people believe. Okay. Well, it's sunny weather. It's warm weather. That's go there. You know, Sacramento valley is actually one of the worst place for restore place. Great. So there's a lot of allergies big valley. Allow the pollen comes in as nowhere to goes sells a lot of people will come in developing allergy. They'll leave allergy goes away. L? So I've heard of a couple of colleagues who. Their children develop allergies, moved to LA of all places. It's gone. But it's like all the pollution in LA. But the actual the way Sacramento valley said that this when you remember about your early years in Sacramento, your ten or so yes, ten years old when I came here. Like. My early childhood in Sacramento is fairly normal. Just playing the kids going on going out hanging out. So kind of leads into the. What did you wanna do when you grew up at that point when you were kind of going through school? So before a win an Agung might degree. I was fascinated by history still amyloid history buff I wanted to be history teacher, and it was in the remaining community as more prestigious thing to be an educator. Okay. So I wanted to be a teacher, and I started it was two years in to my degree when the situation happened with my brother Tang talk about that that's kind of. And I think you and I were talking before he into people people are have situations occur in their lives. And you know, I know it's not just in Disney movies. But then they can go one of two ways. Right where they can look at that situation. And think I can't believe this is happening to me. And maybe started withdraw or they can do what they can turn it into something positive. Okay. No, sometimes sometimes all the times, you usually can't control the circumstances. Or what happens to you you control how you respond to. And in this situation. My brother Benjamin right here. He developed leukemia. I was eighteen years old minnows Twenty-one at that time or he was twenty news diagnose, and I was eighteen. And then at that time, you know, they said, well, here's this is what's going on as keep me over. Like, what's what's keeping? None of this stuff happens to us. We relatively there's cancer-free in our family. My grandfather lived to one hundred one grandfather one hundred ninety five eighty nine that kind of longevity and our family and. Go going in. They diagnosed him brought up Bruce altogether said, hey, look, there is destroying plan where you can do a cell donation or bone marrow and the results are very positive if you do it. So are the siblings all got tested, and he and I match actually he I end my little brother, a younger brother, David he mashed as well, do you? Remember what that was like after hearing that learning more while leukemia was and then learning that there was something you can do. Yes. I like the unknown because nobody in my family ever were healthcare. There's no healthcare connection. And it's like a little bit of distrust towards gesture medicine coming from a country where the state can have control over you, and whatever the deemed fit. Looking back. Now, it's like I've been in healthcare for almost twenty years now. So I know the patients rights and kind of things coming from a country where there was no patience rights. It was whatever the state said you can have. That's what happens so still a little bit that mentality is trust this trust. Yeah. And of course, you're scared. You're like what's going to happen? You know, our life's go up and down and I'm with him and my younger brother matched as well. So then what happens from there? So that time I said, well, okay. Let me go ahead and do the donations since I'm older and. I did the stem cells so put in central line, Kathy gave me e pigeon some medication that gave you for your body to hyper produce, these stem cells that your harvest at okay and those about a week and a half process of the of the shots. And then after that about another week, we can half of harvesting the cells today harvest it, and then we did donation for Benjamin. And in the middle of that. That's when it kind of had this pithy of while these people like really impact people's lives and touch them and their most difficult time crisis of their family. And we'll way remember they they're talking joking were they I mean, what was that? Like the healthcare by the things that I really liked. Appreciate about them. Is there is chaos all around? We don't know what's going on. They're very steadfast, very knowledge. -able? They're very honest with us about what's going on. But at same time, they're very compassionate. Like, we can help you guys this. We're willing to help the there's been successful transplants. And they just just growled us to help families stay together in the midst of all of this. So so you start at that point. Did you start thinking about what if a career in healthcare or was that still? Did you just appreciate what they were doing for you? It was it was right at that point where I. After I donated I went back to my guidance counselor. And I said, hey, you know, feel like I want to switch my major. And I told him said, it's versing. He laughed was like what are you talking about? No, I feel like this is what I wanna do my life. I want to be able to touch people's lives like these touch might. Yeah. That was long ago twenty years ago. Nineteen ninety eight. Okay. So we're there might be so far the path here. But nursing I mean was that is that a still eight primarily female-dominated job or that time was it or, you know, the people think wait, wait, you can go be a doctor or you know, yet still was. It actually still. Okay. It's still I think like the numbers now are either twenty to twenty five percent male. Okay. It's growing now than it was before. But it it's interesting. It's typical that men overall go towards the high adrenaline high trauma or high word. Hi. Stimulate type environmental they'll go to the ER. They see us actually the ICU that work in the hospital work in Sutter health. We have five Icees and my ice you that. I'm stationed at is the medical is you. Medical generic issue? Okay. So so you're saying most guys than tend to go for that go for drill higher and higher trauma, higher stimulant type environment in our ICU the medical issue. I believe it's about thirty to forty percent male. Wow. Okay. Sometimes I'll come into work, and it's just like a list of guys seven guys working together. It's stuff in the ER as well. So I right now, I work in the medical ICU on the rapid response team on the represent team is associated with the whole hospital as well as with e r so we have a it's basically a team of professionals that do pre code assessment and diversion so that we don't get to place where patient actually codes in dies. Okay. That's end. This is a little again. I now you are here. I gotta ask questions voice went to ask an ER nurse ice universe win. Do you? Remember when it kind of clicked where? You were just calm in those situations. You remember your first days on the job or what that was like? Oh. I don't know. I remember my first death. Okay. I still remember that exactly. Remember the room number? It's from thirty four eighteen remember the situation. Remember was working with remember the a lot of the highlights or the traumatic points of my first couple years of training. I think just being kind of person that I am or a lot of people in healthcare. We we we strive for that that kind of environment because we can focus in those situations where everything is falling apart. We we are able to differentiate them on essentials and focus on what they sensual and keeping the personal life. Okay. Did it when you remember that first death? Was there part of you thought? Okay. I can't do this. I don't wanna do this. Or was it just I knew this was coming. It was inevitable. I never got to appoint. Whereas I can't do this. I did get a lot of points where it's like. Whoa. This real this business what actual life is like and what the death and dying process like on those points. But I've never gotten to a point where it's like, oh, I don't wanna do this. Yeah. Yeah. What was the schooling? Join that part. Very awkward tall. Twenty one year old night be skinny guy. Several years seven, ladies or ten ladies forget who in our crew. Yeah. Two guys two or three guys graduated. So where did you where did you end up? I out of school in ICU straight nights you. Yeah. The same icy. I got hired in the same ICM working now, which was the ICU on the floor below where we did the transplant. Okay. L talk about that. I mean more about the the rather. So yeah, he he developed leukemia. My brother, and I matched we kind of reluctant to go forward with this. I for my brother would do anything. So all we did the transplant put in the central line catheter. That was a little bit were deal. It was started bleeding too much like filler die whatever I do. But they just trudged through it. And then you know after about. Out. Four or five months everything successful transplant land. Well, my brother. Stop taking the anti rejection medication and his body rejected. The transplant. So. So he know of the change direction that you were heading down that. Yeah, we're talking about that time. Yeah. We did. We we mentioned that I told him I think I wanna do this and something that was he was aware of how how do you think of your brother and your job now? So every time I go into work. You know, it's funny because the the unit that we did the transplant a lot of the whole. Employees who work there though. Call me Benjamin, I'll call them Benjamin back like him walk out of the hey, Benjamin Benjamin that's not Benjamin e man out. We have something going on or say to like, one of the female, nurses, and they're like, no, that's that's that's not, you know, people there that then you end up working with them eat you remember that while a so like Toby, gene Dulcie those who's actually the educator. She's on she's on our team for the leukemia. Lymphoma society, she's educator for that department. Okay. Shoes actually a patient on the same unit with member. Other jury members story we're talking about. He was having a hard time with the treatment throwing a lot. And she offered to take them down to buy a slice of human eat pizza. Okay. So so while I've got you here ICU nurse. Stories. I mean, do you just have stories for days? Are you the one that you had a party? Somebody says tell me I see you stories. Yeah. There is a. People are different breed of people where the kind of people it's like the bodies are our career rights. We we see a lot of things. Yeah. I've seen lots lots of interesting things, we we. We're not judgmental. Of course. And and really at the end of the day. It's like you're here with me for this amount of time in my job is to deliver you healthy out of this situation. Regardless of what you make whatever you came in with whatever you did to yourself or to your body. That's not my role my role right now is to take all of them all that I've acquired over these years and get you healthy and deliver you with a heart rate and blood pressure in the day. I love that therapist saying so people come to be with their their things that they are going through and the, but with mine, it's a lot harder at times to try to sort through the reality. They're afraid of being judged. You know, how much am I going to let this person know in the ICU? It's there, you know. What's one? Yeah. Here stories that don't quite match up. But correct. Correct. And then and then, you know, you'll get the you'll give them that live from really really really is. That would happen is or my this is the one that like. It kind of gets me. The question marks. We're gonna give you drugs. We're gonna give you medication that actually can interfere with some of the drugs that you can't tell me that. Because if I don't know I give him something I can actually kill you. And I want to my mind my job or my career is trying to save you my I'm not gonna judge you taking this. We need to tell me what you've taken beforehand because if you if you've taken something that I don't know. And I come I mean, one of them that I'm just going to throw out the taboo, one is the blue Bill and a lot of people. Yes. But if you're if you are on something like that. We need to know a head of time. Because those dedication originally it was created for the blue pill for those who don't know. It's faivre. Is created for blood pressure management? Okay. So what it does is basil later opens up your veins and in doing so it actually drops her blood pressure threshold of you come in having that in your system and your in what we call hypertensive crisis. And I'm trying to take care of hypertension. And I don't know that you have this and give you some other medication to correct this Tiny's period of your life with the when you have high blood pressure. I'm actually working with that together drop your blood pressure. And then then you just go from one extreme to the next. And now we have to resuscitate Jutras give you all the fluid to maintain your blunt purview. So you you've been able to start to read people's faces body language when it's you taking anything. Yeah. You get really good at like looking at the eyes and just paying attention to more of this little details. I look at the vital signs when you come in. You know, this is pretty conducive of this. Well. There's you know that old saying it's like a duck walks like a duck talks the quacks like a duck must be a deck. So at a situation where you know, your college colleges coming back your vital signs are are indicative of that say like, I mean, I know that you've taken this you tested positive for this. I'm not gonna I'm not here to rescue or. I love it in my world. I wish I had battles. I just have to keep going with tell me more about that until they keep growing, and we should suggestion. Okay. So tell me about this next part is fun because as someone who knows you you are you are dynamic. You're funny. All the things that you're not one that is out there saying, hey, everybody, you know? Right. And so. Yeah. Right. Exactly. So so why why are we talking? I mean, your stories of mazing, but. So why were here? I. In my role in the Reverend Vence team one day responded to call in the bone marrow transplant unit, and it was a patient of Dr on my team Docker coupon. And after taking care of the situation. I asked to have the patient transferred that ice you needed higher level of care. In speaking and Dole's educator was on the unit that day as well. I told them that this is the room where I did my stem cell donation, and because of this room, that's where my healthcare group started really in this room, and he like will to Miller about that kind of give them back story about a week after that. Dole. See who's the educator for college approached me about? Prety to be nominated for leukemia. Lymphoma society man of the year. And I said, well, that's interesting. Let's get together and talk about what were what were your initial thoughts. What does that mean, you have people that you know, that have done that? I have people that are known that have done that now at that time. So I. Oh, I. I've done a lot of projects for sorta. I sit on the Partnership Council just like the ICU border governing body for issue all of our projects or any of the best practices that we do. We started from the Partnership Council, which is the managers and a lot of the work, experienced, nurses. Thanks you. So I thought it was gonna be a poach for another project done couple products throughout the hospital as well. And when she told me about said, oh, well this light right up. Exactly. My whole life story this how I got here because of this. But I knew it was going to be a time commitment. So I didn't jump on it right away. I just said we'll let me think about it. And and she made a another meeting with her and Kathy Kathy is the campaign record for leukemia. Lymphoma society man of the year module here. Sacrimento, and we got together she presented me with some information's facts. Then I didn't say yes at that time either. Okay. Let me think about it. So in mulling over thinking one day about two or three days after we had that meeting those looking through my daily devotional. Okay. And there was a Colt by Mahatma Gandhi. And I share that with you earlier was in a to really find yourself. You have to lose yourself in the service of others. And I decided you all right. Well, kinda ready gave my life to this. 'cause I've been twenty years working in a healthcare provider for people in exact same hospital where this catastrophic thing happen to our family kinda like check check check. I kind of did my calling right? And when I got that what I received that quote. It was one of those things. It's like all right. You have to do this one. This is the next that for you the story about where you see that quote again. So yeah. I made my my mind to actually accept the nomination. At that time about six months ago. In putting my campaign material together going back and forth, printers and working with ls. And with a my core team and putting information together when I receive all that information back that they received it back. I went to clock in the day. I went the clock in it's right next to the time clock was the exact same pool by on Gundy, the Lega when God tells you to do something and got to do it. So. Okay. So now now the phone begins. So what happens next? So you are the nominee of the man of the year or you up against other people. Yes. So leukemia lymphomas man of the year campaign is ten week campaign. It's kickoff is Thursday March twenty people are loading this today. I mean, this it will be out today or that day. Yes. Yes. Yes. So it's out today March twenty eighth and it's ten weeks. My my role right now is to promote awareness for blood cancer to promote awareness, leukemia and lymphoma society, and to fundraise my job is to try to. Out raise the guys that are in this competition with me there are four or five guys in for females. Okay. Okay. So where do people go to donate where do they find out more about you the 'cause what can they do? So there's two places where they can go and look the first place. If people are interested is on my Facebook page, which is Eamon twin twin team in twenty nineteen. Just all over the show notes. And that sort of thing is that on Facebook. And those that Facebook page will linked to the came in the Volna societies the pages. Well, or you can go directly to the leukemia. Lymphoma society's man of the year campaign. Search for candidates and put in my name, Emmanuel Petrus or okay? And so any other things you wanna share? I mean, I'm excited to be part of your team and people this is a time to really get out. The word about the leukemia lymphoma society, do you feel like there are other things that that people don't know about leukemia lymphoma that you know, from your work in you. So there there's lots of things people don't know and me being somebody who late. This is what brought me until they're even I took me a while to absorb all of this information. The interesting thing about the new came in and. Type of cancers. They're like the starting point for a lot of the research that goes on right now and the good part of the LS, Cumulus wholeness society. Is I believe you seventy nine to eighty percent of all funds race goes directed research of the. Therapies that were approved by the FDA last year. Forty percent of them where Peru for blood cancers. So a large majority of all of the research starts in the blood cancer realms when wants a successful here. A lot of the other cancer disciplines will borrow that research and transferred to more specific you'd be breast cancer at bone or the kind of thing, but the origin. The starting place has been the blood cancers. Because of the research that's going on. The last ten years. The success rate from leukemia for childhood leukemia has has gone up from ten percent tonight percents viability. How we were only ten percent away from action saying that we have what we what we would consider a cure game. That's in percent crazy. Yeah. Ten percent. And it can happen in our lifetime. And I think he can apple with our campaign. Okay. All right. I will have everything in the show notes. Look, let your say manual sort Mandy year. Elgin. Bristol. Out a day grind. Placed. They push side things. Exciting count. Take. Pushed shot.
St. Jude Walk/Run 2020
"This year we're participating in the st. Jude walk or run virtually event to help cure Childhood cancer. We're hoping to raise $500 to benefit Saint Jude Children's Research Hospital Saint. Jude has increased the survival rate for acute lymphoblastic leukemia or a l l from 4% before opening in nineteen sixty-six to to 94% Today. We're hoping everyone considers making a tax-deductible donation of any amount no matter how big or small and honor of these fifty eight years of Excellence to donate now visit. That's m s t j u d e b u c k e y e and help kids fighting Childhood Cancer. They deserve a happy birthday. Healthy and normal life just like every other child. You can simply just follow the link in the description box of this episode and send in your donation amount helps and gets these children that much closer to a normal life cancer-free.
The Obscure Virus Club
"This episode of revisionist history is brought to you by a._t. And t. business and i'm having a conversation with a._t. And t. business president chief marketing officer mokaba about the coming five g. revolution we started the conversation two episodes ago and in this episode sewed hijacked the conversation and make mo talk about my personal obsession. You got to think about medicine yep people. Do you have anyone who thinks about sports we do. We have an entire team who thinks about venue experiences. No two words have lifted my heart quite like venue experiences -periences. We'll be back with moe in a little bit and now as a gentleman episode of revisionist history <music> <music> <music> in the second half of the twentieth century. A group of scientists became obsessed with an obscure family of viruses. There weren't aren't many people in the obscure virus club. They all knew each other to rest of the world role. It's is it them read the letter vote and deere bob. I regret that you're paper on the tesol. Retrovirus is not acceptable for publication in the journal viral aji exhibit a. a in the archives of the obscure virus club a rejection letter. I completely agree with reviewer number one. There's little points of perpetuating this controversy chrissy about the presumed vile nature of this material not thank you very much. This is fascinating but you're not quite there yet. Just no. I hope you on his dan. We only accept definite of data to resolve this question therefore i have no alternative but to reject his paper outright outright on advise you. We cannot consider the present manuscript in any form in any form if you're in the obscure virus club you got this allot. It didn't stop them. Thank god my name is malcolm blob well. You're you're listening to revisionist history. My podcast about things overlooked and misunderstood. This is the final episode of season for a season of jesuits employers and gangsters and disputatious musicians iconic class and skeptics and i want to finish with the story of the obscure virus club. Maybe the biggest band econo- class of all this is a bedtime story for the season of revisionist history and as with any story you have to wait till the very end to understand what it's all about to the obscure virus club had junked members honorary members hangers on and but i want to focus on the three people at its core ludwik gross howard temin robert gallo pop bob gallo is the only one still alive eighty two years old still at the office every day. He has pictures of his compatriots on his walls. I think he he sent this to me now. There is life yeah. Just a you know unforgettable character but that debt captures you know yeah first ludwik ludwik gross head of cancer research for the veterans administration in the bronx gallo remembers asking him whether he wanted to get rich gross told him no he hit everything he needed and he counted it off i. He had his car hit escaped poland in his car. After the nazis invaded the job everywhere when he came to see me at an age drove from new york and then his first experiments were in the backseat trump number two who i have my television i can see perry mason mason attic. The three i have my work and there were four and my wife i the that's the cross at scientific meetings in the nineteen fifties. People wouldn't sit next to ludwik gross. Everyone thought what he was crazy. Next came the ringleader of the obscure virus club howard temin the remarkable a couple howard temin we can do. I can do it right now but again gets conscious vernon. Where are the controls controls. You don't have any damn controls. You're making juve any cleans. The here like you the same hairdo doc howard temin ludwik gross robert gallo and what did they have in common. I mean what's in common. We got pissed on. We all had our time or i would say three scientists shunned by their peers. That was the price of admission to the obscure virus club in one thousand nine eleven young physician named francis peyton rouse set up a cancer research laboratory tori new york and what is now rockefeller university. A woman came to see rouse. She had a poultry farm just outside the city and she brought with her a hand the large lump on his chest. The lump was cancer a sarcoma. That is a tumor of the connective tissue. We don't know why cancer doctor it would be curious about a dying chicken but he was rows remove the tumor grounded up mixed with saline solution and injected the solution into healthy chickens and what happened the healthy chickens develop. The same tumors russ was perplexed. Cancer is is not supposed to be a communicable disease. It's caused by a malfunction of the genetic machinery inside a cell. It can't be passed from one person to another like the flu but this is exactly what seemed to be happening. The chickens tumor rows concluded had to be caused by virus. People didn't believe him. They said well. Maybe that tumor isn't really cancer or so. What this is just some weird thing that happens with chickens rosca discouraged. He stopped working on viruses viruses entirely years later this same problem whether cancer could spread like a virus came to obsess ludwik gross huruk with mice mice sometimes mice came down with the kimia marine leukemia which is a lot like human leukemia gross bread mice to show how the disease was communicated from one generation to the next he became convinced that the leukemia was caused by a virus passed from mother to offspring but the same thing happened other scientists didn't believe him here. Was this strange emigrate in the bronx imagining cancer causing viruses in mice. Why couldn't that just be a set of faulty genes being passed down. He proved it was arlt. Z's everybody's aw cages filthy and there's no old technology whatsoever you know really what he's doing and it was all bad my bad mouth completely essentially virtually straight gross finally won the lasker award one of the most prestigious prizes in medicine in nineteen seventy four when he was seventy in the obscure virus club. You often had to wait your entire career for validation. After gross comes howard temin the remarkable howard temin timing. I'm in was the second of three sons of a lawyer an activist from philadelphia. The biologist david baltimore met tim and when they were both part of the student summer program at the jackson in laboratory in maine. If you had a question or there was a lecture you didn't understand something you could go to howard and howard knew everything he was an amazing zing intellect and so i spent the summer in a sense as his student he was famous. It's worth more actually because they said he had read every book in the library and they had to buy more for him. I wasn't the only one to notice that there was something very special obey. This is the kind of person he was timid donated his bar mitzvah money to a refugee camp years later when he visited the soviet union he smuggled in hebrew prayer books. I met tim and once when i was a cub reporter for the washington post i happen to be in madison wisconsin constan at the university of wisconsin where he taught his whole career. I went to see him. I don't remember the specifics of what he talked about and i've lost my notes. Would i remember with absolute. Clarity is the feeling i had after leaving his office which is that i had never met someone so completely in command of his zone thinking i've only ever gotten that sense of command of mastery from watching great athletes never biologists was squeaky voices <music>. Tomlin's wife rail says that when tim and i got to scancen he would sit in on seminars and other departments and as soon as he got here he drew attention of people because he would sit up in the front and then he would ask the most pointed brilliant important written questions of the speaker so everyone said well who is he who is he but once you met howard temin you remembered howard temin one of his former graduate students sandy. Weller says she could barely keep up with him. He wrote his bike to work every day he took. You never took the elevator. I believe he had to go to the ninth floor. He walked nine floors and several times made me that way or just assumed i would do that with him. If we were going up to the seminar on the ninth floor tim and could have done anything walked into any field in science and left his mark but he became obsessed by the chicken tumor that payton rouse had discovered covered fifty years earlier now known as row sarcoma virus and so when i was interested in doing was understanding how that virus earth's closest canceled. That's ten minutes in an oral history taken a few years before his death in the nineteen fifties. You could not have picked a more obscure obscure topic to study than a cancer virus. People were still avoiding ludwik gross ick conferences. The university of wisconsin had a virology position open at author cancer institute. No one wanted it. You said when you came to wisconsin that the virology position had been offered to several people and they haven't been interested how come these people had turned down edition viruses at that time. We're not considered very important in cancer research. They it had always been assigned show for cancer research. His first office at wisconsin was in the basement next to the sump pump and my ass. This was in in what had been a transfer room. A little is slated about the size of just. Where are you sitting a couple of square feet but none of that mattered tend was hooked rows. Sarcoma was a weird enthralling puzzle. He began to notice all kinds of anomalies for example. Sometimes the virus would mutate it would take on strange new shape and then afterwards the sell it infected would take on the same strain shape as if the virus weren't just occupying the sell it infected the way say a flu virus does the flu. It just sits inside your cells multiplying until your immune system drives it out. The flu is a squatter but row sarcoma seemed like it was conquering conquering the sells. It was infecting inserting. Its own genetic information into the d._n._a. Of its host how it did that made no sense at the time time the field of genetics had something scientists called the central dogma the central dogma held a genetic information only moved in one direction d._n._a. Gave instructions to our rene which then use those instructions to make proteins dna to aurigny rose. Sarcoma coma was an r._n. A virus according to the central dogma then it was impossible for it to insert its genetic information into the d._n._a. Of the cells it was infecting affecting our renee didn't move in that direction. We knew the basic lifestyle almost fires but now the cancer using viruses stood out as as different than and hard understand david baltimore again what was different and hard to understand about them. Well the fundamental. The thing was that they had a arnez their genome and yet they were able to establish a permanent position inside the cell and run run the cell so he turned it from a normal cell to cancer and so here it was behaving a bit like d._n._a. Here was an arnuhar's and tha-that that didn't make sense howard had been driven by that question for ten years. Previously david baltimore watched his old friend howard temin stand up at conferences and try to convince everyone else to take this weird anomaly seriously why did that question assume such importance for him because he was thinking twenty four hours a day about these viruses has he obsessed over the puzzle of rows sarcoma tim and decided started it could only mean one thing the central dogma must be wrong. One of the fundamental facts about human genetics taught in every science textbook book and every science classroom in the world had to be in error. There must be a class of viruses like rouse sarcoma virus that could somehow work worked backwards from aurigny to d._n._a. It was as if he said yes. The earth rotates around the sun in an anti clockwise manner but the only explanation for what i'm seeing with rows is that on occasion the earth must stop and go clockwise and then he spent about how ten years at the university of wisconsin trying to find an experiment that would convince anybody else and he couldn't you had an intuition a hunch but no one was going to overturn the central dogma because some guy from wisconsin had a hunch. It wasn't right. I'm talking to mokaba president chief marketing officer of eighteen business about two five. I ci revolution. I made him talk about the implications for my favorite activity watching sports and use those to tantalizing words venue and you experience. Tell me more about the venue. It's okay so <hes> example of five g. Coming to life in venue is you can deploy oy literally hundreds of cameras around the venue and so now as a fan when you go in five g. enabled because of the capacity in the latency you can process the video coming off of those cameras locally inside the venue local cloud instance and then you can give the fans the ability to choose what which angle they want to watch from which is really cool and i love music and so for me. I'm excited about being able to go to a concert inside a venue and <hes> i wanna watch it from the league. Guitarists rhythm soloing yeah yeah or because latency is essentially instantaneous. It wouldn't be like you're you're so you can watch it in real time from whatever perspective you want exactly does that mean it doesn't matter where you're sitting so as long as you have five g. coverage broadly available across the entire venue you can be in the sweets can be in the club. You can be the the the emotional experience of being in the arena which is what you want s but also the luxury of watching it from your own perspective which could only remotely be duplicated at albany. Even tom is you. Don't get to choose angles at home. It's better than <music>. Science is a social process assess people within a field are in constant contact. The show notes that gossip they compete for the brightest graduate students for grant money for prizes when you say something that the group doesn't believe you pay a price and with every year that passes with you saying one thing and the group saying another the price gets it's higher. First of all people thought it was crazy. I mean he didn't prove his theory for six years. After proposing timmons former graduate student didn't sandy weller and that six years was a very difficult period for all of his students and for him he was a pariah. They thought his students were nuts. Let's for working with him. At one point howard temin wrote francis crick sir francis crick nobel prize winner of watson and crick the co discoverers discoverers of d._n._a. The authors of the central dogma itself ten rights crooked letter gently suggesting that an amendment to the central dogma might be in order chris back very condescending arrogant letter well. I'm sure you think this is true but you must realize you're wrong and to talk to howard to me. That's just such most people would have given up but he doesn't because he's howard temin. The word that comes to mind is righteous which has a negative tone to it. I don't mean to be negative. This is timmons daughter miriam but he has strong moral compass and that was incredibly incredibly confident person was blessed with that was not shy about speaking his mind. Where do you think the what was the source of his confidence. That's why i asked my uncle michael time in this of his stick with fitness was and his answer was well. He knew he was right and then one day in nineteen seventy he came home to his wife raila full of excitement he i was going to be away on our anniversary which was may twenty seven and he was explaining why he had to leave that we would celebrate later. I said well that's fine. That's fine and he said that actually he had something that was a bombshell that he was going to to announce at the meeting but he couldn't tell me what it was. <hes> she said. Let me guess you found it. He nodded after years of trying temin had located the part of the virus that enabled it to work backwards and by an incredible stroke stroke his old friend david baltimore had found it too by then baltimore had fashioned his own equally brilliant career had almost exactly accu the same moment the two old friends independently discover a little enzyme looking in a distant corner of this strange class of arne viruses an interpreter something it speaks orrin a and can translate into d._n._a. So that the virus had a mechanism for inserting its own genetic information and into the cells it infected ten and finds the enzyme in rows sarcoma virus baltimore went looking for it in mouse leukemia virus ars the same virus that had haunted ludwik gross ten and baltimore call it reverse transcriptase and the class of viruses that had had obsessed them all for so long now had a name retroviruses because by virtue of their onboard translator. They had the ability to work in reverse. How hard was it to find. This particular. Enzyme said is it true view a really yeah. It's really the israeli the notion of today's as experiments two days so it's just the idea of knowing where to look and what to look for and what to look for right you have to designed very specifically design your search so that it will show up this ends up right. If you don't look exactly the right way. You're not gonna spot it right just like that. The great puzzle was resolved when i got to the point where i knew that the enzyme was in the virus particle. The first thing i did was to call howard and say i want to tell you about this what did he. How did he respond he. She responded by saying. We're doing those experiments to write in one thousand nine seventy baltimore and tim and jointly published a famous series of papers in the prestigious journal nature five years later they were awarded the nobel prize along with teacher were not odell beco- ten in trades in his two first class tickets to sweden for coach seats so he could take his two daughters by seven when he got the nobel prize and one of the things i remember that his pants were too long and they were sort of all bunched around the bottom of his talks at the ceremony. Yes did you go to the cinnabon. Yes you did guess. I kind of remember meeting. The king and i definitely remember a banquet very very fancy in this enormous wide staircase where the laureates came down and their spouses all paired with somebody else so my father had a. I believe at danish princess on her arm. If i'm remembering correctly in a long pink dress i remember that my mother was escorted by some lesser prince person and the waiters you <music> all in this procession with the most beautiful food. It was the seventy fifth anniversary of the nobel prize so all previous laureates were invited. There was a huge huge banquet in the golden hall by tradition. One representative from each set of new laureates was allowed to speak ten was chosen he he stood up with his baggy tuxedo trousers and his squeaky voice and he went up to the microphone in front of these twelve hundred people and thank thank them very very much for the prize. You have given us for cancer research. His wife rail was sitting in the audience with their daughters and and then tamin said here we are being rewarded for our work in understanding cancer and giral smoking. The king was smoking. Queen gene was smoking. Everybody there was smoking so they were just a guess that he would get up and say hat in front of all the royalty to put out through cigarettes <hes> yeah i think many of them did because i was down in the floor and the table i was sitting next to the prince of denmark was my partner that night eight and i looked and they people just looked shocked when he said it i remember the look on the faces and then they stubbed out the cigarettes <music> the story of the obscure virus club could end here baltimore and tim and getting their medals from the king of sweden then tim and calling up the whole crew for their hypocrisy happy ending but there's a whole other chapter to come <music> mokaba had been talking for the past three episodes about five gene what it is and what it means so this something. That's going to hit the business world. I yes our perspective on it. My perspective is absolutely businesses are first businesses. Were calling in saying. Hey we want to understand how this technology allows us to drive. Different outcomes take out costs create new revenue change the experience for our workers or our end customers and so they wanna play with it right. It's it's an entirely new era and if i'm a consumer <hes> civilian wondering when this technology starts to move beyond the business world to the individual consumer if you had to guess about a time line then guess what i'd say the future starts with today and just like we were talking about. We've already forgotten when did waste come out. When did airbnb come. When did these things that feel like magic. Now you know they weren't even things. We'd imagined a few short years ago. The consumer experience is going to be the same way a few years from now. We're all gonna wake up and be like hey my toothbrush talks to me. David baltimore and howard tim discovered reverse transcriptase and shattered the central dogma bob gallo. The third charter member of the obscure virus club was still in his early thirties and the son of italian working class immigrants lean ambitious raw a rising star. The national cancer institute he went to to a scientific conference in paris was stuck in a cab when he looked out the window and saw howard temin. He's walking the streets and i also you remember nineteen seventies now hero the hero howard temin the hero walking down a paris street and one window shopping or something by himself different where you are you. Are i think sometimes we overestimate estimate the importance of ideas and science. Yes you read a paper in nature and changes the way you think about the central dogma but what is it that really changes just the way you think about the central dogma when you meet the person who challenged the central dogma and because that person is so remarkable you realize oh i wanna be like that but gallo met howard timid and decided then and there to join the obscure virus club it was here when i was a child that was joe dimaggio adult so you <hes> even not that much older than me. That's a decade or so but <hes> i couldn't identify with like that. I just appreciated nevada. I always fascinated by him. I was just taken in by. It and i decided you know i you know listen. Dante's guy says you gallo specialty was leukemia cancer of the blood cells and what drew him to retroviruses retroviruses was the fact that so many of them were leukemia's ludwick grosses mouse to kimia being the first and most famous but soon people found others bovine leukemia feline leukemia gibbon ape leukemia plus chicken and mouse so five different animals systems all infectious the viruses what no one could find was a human retrovirus. There was a growing feeling that they simply didn't exist the baby. Humans were somehow protected against against this kind of infection. Begala didn't buy it. There had to be one. He decided to focus on a specific subset of leukemia lukaemia that affected the blood cells known as t. cells at the time. No one knew how to grow t. cells in the laboratory and if you couldn't grow t-cells you couldn't find your study anything that infected them. Gallo's lab figured out how to grow cells then he began searching and in nineteen seventy nine he he founded in the blood of a twenty eight year old african american from mobile alabama gallo called what he found human t lymph atro- pick virus one h._t. L._v. one it turned out the man's whole family had leukemia to gallo then found found a man in the merchant marines with a history of sexual contacts in japan and the caribbean same thing kimia and a weakened immune system in his blood gallo could see traces of a virus with that telltale bit of reverse transcriptase a human retrovirus spread by mother to child sexual contact and blood to blood transmission previously unknown most definitely obscure gallow submitted his findings to the journal viral aji deleting scientific journal in the field and what happened the same thing that happened to howard temin and linda gross the world wasn't ready to accept the idea of human retrovirus. The paper was rejected. Gallo keeps that letter on his is wall deere bob. I regret that you're paper on the tesol. Retrovirus is not acceptable for publication in the journal of virology. There's little point through perpetuating this controversy about the presumed viral nature of this material. Oh my goodness at it wake you giving the date september fifteenth in nineteen eighty september fifteenth nineteen eighty. That's the key fact because what's happening in the fall of nineteen eighty. It's no it kills else and it's spreading young previously healthy men were starting to die of a mysterious disease aids disease that has medical science baffled yeah. If you did not live through the early days of the aids epidemic you have no idea what it was like it leveled the gay communities of major your cities around the world people were wasting away their skin disfigured by strange lesions preacher stood up and denounced homosexuality from their pulpits doctors refuse to treat gay patients public. Health officials started talking about quarantines in those early years. I once heard a presentation at a scientific the conference from a demographer trying to figure out if aids could cause the population explosion in africa to go into reverse. No one knew what it was is or how it spread. It was a mystery except to the obscure virus club who thought it looked a lot like the leukemia viruses they had been studying for years. There's a what point in this process. Did you say i think it's a retrovirus wouldn't have gone in voted goal for what was a retrovirus. Oh by the by definition the day i got into thinking it's a richer. The paper by bob gallo rejected by the journal of virology in september of nineteen nineteen eighty was about human t lymph atropine virus one h._d. L._v. one and the possibility that this strange new retrovirus had found its way into humans now a year later bob gallo looked at aids and thought it was behaving a lot like a cousin of h. T. v. one for why why what led you to suspect it was a veterans are experienced with h._d. L. v. one and feeling a guinea verse. What is that experience blunk sex mother detroit blow it infected t cells check. It caused immune dysfunction. Check it spread from mother to child. Check it spread spread through blood to blood contact or sexual transmission check by nineteen eighty-three gallo's lab had isolated and described the aids virus and and figured out how to grow in the laboratory by nineteen eighty five the had developed a test for it by nineteen ninety five. There was a class of drugs available to treat h._i._v. That meant the virus was no longer a death sentence that is stunningly short amount of time to detect understand and treat a new disease lease and why was the progress so fast because we had head start in the mountains that have been said and written about aids. The usual tone is one of horror at the indifference and incompetence and resistance that greeted the epidemic mkx all of that is true but you can also make the case that we got lucky not lucky in some ephemeral way but massively unequivocally quickly ethically lucky lucky because ludwik gross insisted doggedly year after year that virus could cause cancer because howard temin him and insisted that the central dogma was wrong because ten in baltimore found a crucial little enzyme called reverse transcriptase because bob gallow got it into his head that if they were mice retroviruses and chicken retroviruses and cat retroviruses there had to be human retroviruses you and then he found a human retrovirus and learned how it worked and learned to isolate it and grow it in the laboratory and every one of those lessons turned out to be perfect preparation for the most terrifying retrovirus ever known if h._i._v. arrives as a force ten years earlier what happens scientifically medically disaster. This is david baltimore again. The worst thing that can happen in and it was proved in the h._i._v. Epidemic is not to know what's causing disease because is that gives liberty to fantasy we could no it was infectious and no it was a virus but not be able to we couldn't find it couldn't find ended. Remember what david baltimore said of the experiment in nineteen seventy two led him to reverse transcriptase. It took two days it. It was a trivial thing but only because he knew what he was looking for. If you're faced with a retrovirus and you don't know what you're looking for your lost cost you can't find a less you know. It's this particular class of right. It was the search for reverse transcriptase in the virus. There's particles that opened up the knowledge that it was a virus those causing the disease. The world may not have been ready for h._i._v. Eh but the obscure virus club was little bit. Gross died in nineteen ninety nine nine at the age of ninety five of stomach cancer caused by infection with the bacterium helicobacter pylori which he himself had researched howard temin tamin died five years earlier in nineteen ninety four at the age of fifty nine of lung cancer the obscure kind. You can get even if you've never smoked. Bob gallo is still very much alive with pictures of his old friends on the walls of his office now. They're us wife yeah. He's just he's. This is not long before he died <hes> so young it was so sad. It's awful attend. Memorial service gallo told the story of his first encounter with his friend and years before in paris. I found a copy of his eulogy. It's like the beginning of a love story. I was in a traffic stall taxi. Eh with a few others and we saw howard walking alone and he was poking his nose in and out of the store windows. He was smiling. He was looking quizzical physical. He was the picture of happy boyhood. Curiosity retained in a man. I think maybe you've you've been incited at salon. You miss how astonishing it is. <hes> is true that is true by my wife looked. Put it in the mystery so you know it does something more powerful than you were b. or anything else or look what is dead ball toward discover transcriptase. There is no field start with that too. I would start here. What if any of these people peyton rouse house ludwik gross howard temin robert gallo in their pursuit of truth had been motivated by the expectation of reward where would would we be or if they listen to what others said as opposed to trusting in what their own experiments revealed or if they had only been willing to wonder five years in the wilderness instead of ten many of the stories in this season of revisionist history have come down to the same issue how we should act in the world in novel and difficult circumstances how we should think about what matters for a profession or think about those who choose crooked path or dissent from orthodoxy or borrow the traditions of others or engage with someone loathsome mm-hmm i could go on but if you are looking for one example to be your guide start with this one the grace and persistence instance of howard ten and the obscure virus club. Thank you for listening to season for of revisionist history every week under business history. I say the names of the people behind the revisionist history podcast and for this episode. I wanted to let you hear them say their names for themselves. This is my mitee. Nothing would happen without them. Mia low bell jacob smith julia barton flawn williams camille camille battista get special thanks to carly make laura heather fain megi taylor beth johnson maya caney and and jacob weisberg l. hefei by the way you can hear a longer version of my interview with david baltimore on the solvable podcast cast which pushkin produces with the rockefeller foundation revisionist history is brought to you by pushkin industries. I'm malcolm guardrail <music> this. This is the final episode of season for of revisionist history but that does not mean we're done next week. We're going to bring you a special treat. It's an excerpt from my new book talking to strangers which comes out september tenth. We've created a special kind of audio book based on what we've learned learned over four years of doing this podcast and next week. I'm gonna bring you a chapter from talking to strangers to whet your appetite. It's a spy story story about one of america's most notorious traders. I know you'll love it.
Prime Ministers Prizes for Innovators and Innovation 2019
"And so he returned to the PM's prizes from last week for teaching and innovation the Twenty Nineteen Prize for new. Innovators went to Dr Luke Campbell with his neuro phone headphones adept to your ears and hearing I started my career as a medical doctor then moved into hearing science and is a Hole Institute in Melbourne with an exciting and immensely valuable innovation the blood cancers nothing the impact will grow to hundreds of thousands of people around the world with millions even billions internationally they say when our young doctor I looked after a patient diner is better perhaps we might have chanced of making a difference chronic lymphocytic leukemia is the most common leukemia in Australia and in in countries over a thousand people diagnosed with every the aim was to take a fundamental discovery around the understanding of how Dr Luke Campbell with neuro phone and so many applications he's the professes Pita Sabota- David Juan Guillaume. Listen and Andrew Roberts at the Walter big discoveries and making big differences we all had this idea of course we weren't sure that was going to work very excited by the challenge of doing it they felt that we have breaking new ground homeless every time we got together looking forward we're anticipating the trials will show Veneta claims to be a significant advantage in some L. and not so well and automatically reaching themselves to be the perfect headline for you we had a lot of advice from experts in the field he said melt away that to me swab is something very special has happened one of the great things about this award is recognizes the value and importance of teams in making the leukemia and she did very badly that was one of the reasons why I wanted to get into recess because I thought if I understand this disease it the first person in the world to know that the drug was working was the first patient to receive with announce of taking the first dose that the Prime Minister's new innovator the main prize for innovation went to a team from the Water Analyzer Whore Institute in Melbourne for an anti-cancer drug was path guitar-strumming there you're going to hear his extra tam extra richness extra magical quality to the castings and your music is being taken to the next level patient said to me doc. I think it's work to white to Lennox die to the blood tests that the patient was rod it was causing leukemia have now ended up making headphones Nara has traded headphones with special census built-in could automatically scan your ear where Keller Sanjay here neutralising that protein it's almost like a position that will allow you to for many side effects that you see with conventional intensive chemo and Radiation Gillies Hill of certain Kansas Kansas does often have too much of the protein that destroyed targets that pricing keeps US alive. Destruct makes the cells die technical work and deliver product people sometimes what's the benefit a person. I sound what am I going to hear differently and for me I think about Hotel California receiving this award is really proud moment for everyone here why can't Nira and everyone is being journey to get here aunts who develops and where we can target and to transform that discovering to the product or new minister that can help patients vinicio targets D I work scientifically but technically it's going to be too hard for you to mass-produce these costs it's kind of weird for a consumer product really pad team the right to shrink that down and make everything.
A "living drug" that could change the way we treat cancer | Carl June
"This ted talk features immunologist. Carl June recorded live at Ted Med twenty eighteen tedtalk had talked daily is supported by Patriot software dot Com a cloud based provider of accounting payroll software for business owners. Patriots Accounting and payroll software is affordable and can be used wherever there is internet or data access including your smartphone best of all Patriot maintains nearly perfect five out of five star customer reading get two months of accounting in payroll free by going to Patriot software dot com and entering Promo Code Ted. That's Patriot software dot com so this is the first time I've told this story in public. The personal aspects of it and Yogi Berra was a a world famous baseball player who said if you come to a fork in the road take it researchers have been for more than a century studying Eddie and immune system as a way to fight cancer and cancer vaccines have unfortunately been disappointing. They've only worked in cancers caused by viruses like like cervical cancer or liver cancer so cancer researchers basically gave up on the idea of using the immune system to fight cancer and the immune system in any case did not evolve to fight cancer evolved to fight pathogens invading from the outside so it's job is to kill bacteria and viruses and the reason the immune system has trouble with most cancers is that it's a can't it doesn't invade from the outside. It's evolves from its own cells and so they're either immune system does not recognize the cancer as a problem or it attacks a cancer also czar normal cells leading to autoimmune disease is like colitis or multiple sclerosis. So how do you get around that are answer turned out to be synthetic attic immune systems that are designed to recognize and kill cancer cells so that's right. I said Synthetic Immune system you do that with genetic engineering and synthetic biology we did it with a naturally occurring parts of the main system called. B He sells. NT cells and these are building blocks t-cells have evolved to kill cells infected with viruses and B. Cells are the cells that make antibodies that are secreted and then buy into to kill bacteria so well. What if you combine these functions yes in a way that was designed to repurpose him to fight cancer? We realized it would be possible to insert the genes for antibodies from B. cells into t cells else. So how do you do that well. We is issue virus as a Trojan horse to get past the T. cells immune system the result is kamera fantastic fire-breathing creature from Greek mythology with a lion's head goat's body and a serpent's Serpent's tail so we decided that the paradoxical thing that we had created with our b-cell antibodies are t-cells carrier and HIV HIV Trojan horse should be called. Chimera can antigen receptor. T. Cells are car T. cells the virus also serves genetic AAC information to activate the T. cells and programming them into their killing mode so encarta sales are injected into somebody with cancer what happens when those is car. T. Cells and binds to their tumor target. The act like supercharged killer t-cells on steroids they start this crash defense buildup system in the body and literally divide and multiply by the millions where they didn't attack and kill the tumor. All of this means that car T. cells are the first I living drug in medicine cartels break the mold unlike normal drugs that you take they do their job and get metabolize and then you have to take Mcginn car T. cells stay alive and on the job for years. We have had cartel stay our patients in the bodies of our cancer patients nations now for more than eight years and these designer cancer t-cells cartels have a calculated half life of more than seventeen years. There's so one infusion can do the job. They stay on patrol for the rest of your life. This is the beginning of a new paradigm in medicine. Now there was one one major challenge to these T. Cell infusions the only source of t cells that will work in a patient or your own. He sells unless you happen to have an identical twin so for most of us were out of luck so what we did was to make car. T. Cells we had to learn grow the patient's own cells and we developed a robust platform for this in the nineteen ninety s in one thousand nine hundred eighty seven Evan. We first tested cartels patients with advanced. HIV AIDS and we found that those cartels survived in the patients for more than a decade and then approved their immune system and decrease viruses but it didn't cure them so we went back to the laboratory in over the next decade made improvements to the car T. cell design and by two thousand ten. We began treating leukemia patients and our -treme treated three patients with advanced chronic lymphocytic leukemia in two two thousand twelve. It's a form of incurable leukemia that afflicts approximately twenty thousand adults every year in the United States. The first patient that we treated was a retired marine sergeant and a prison corrections officer he had only weeks to live and had in fact already already paid for his funeral. The cells were infused and within days he had high fevers he developed multiple organ failure was transferred to the ICU and was comatose Coz. We thought he would die. In fact he was given last rites but then another fork in the road happened so so around twenty eight days after the cartel fusion he woke up and the physicians finally exam and the cancer was on the big masses that have been there had melted bone marrow biopsies found no evidence of leukemia and that year our first three patients we treated to three have had durable remissions now for eight years and one one had a partial remission the cartels had attacked the leukemia these patients and had dissolved between two point nine and seven point seven pounds sounds of tumor in each patient thereby bodies had become veritable bio reactors for this car. T. cells producing millions wins and millions of car T. cells in the bone marrow blood and tumor masses and we've discovered that these car T. cells can punch far above their weight class to he's a boxing analogy just one cartesian how can kill a thousand tumor cells so that's right. It's a ratio of a one two thousand. The car not sell dodger daughter. Progeny cells can divide and divide invite in the body until the last tumor cells gone. There's no precedent for this and cancer medicine. The first two patients who had a full remission remain today leukemia free and we think the cured these are people who had run out of options and by all traditional methods they had they were like modern day Lazarus cases. All I can say is thank goodness for those forks in the road. Our next step was to get permission to treat children with acute leukemia. The most common form of cancer kids the first patient patient enrolled on the trial. Was Emily Whitehead at that time she was six years old she had gone through a series of chemotherapy and radiation treatments over several years and leukemia had always come back and in fact you to come back three times when we first saw her. Emily was very ill. Her official diagnosis was advanced incurable leukemia cancer headed dated or bone marrow or liver spleen and when and we infused her with the car T. cells in the spring of April two thousand twelve over the next few days she did not get better she got worse and in fact much worse as our prison corrections officer had in two thousand ten she in two thousand and was admitted to the ICU and this was the scariest fork and the whole road of the story by day three she was comatose and on life support for kidney failure lung failure and coma her fever was US high as one hundred six degrees Fahrenheit for three days and we didn't know what was causing those fevers we did all the standard blood test for infections and we could not find an infectious cause for fever but we did find something very unusual inner blood that had never been seen before and Madison Chad elevated levels of a protein called Interleukin six rile six in her blood. It was in fact more than a thousand fold above the normal levels and here's where yet another fork in the road came in by sheer coincidence one of my daughters I has a form of pediatric arthritis and as a result I'd been following as a cancer doc experimental therapies for Arteritis for my daughter and in case you would need them and it so happened that just months before emily was the hospital a new therapy had been approved approved by the FDA to treat elevated levels of Interleukin six and it was approved with arthritis at my daughter had it's called totalism ebb and in in fact it just been added to the pharmacy at Emily's Hospital. You know for arthritis so when we found emily had these very high levels of I'll six I called and her doctors in ICU and said why don't you treat her with this arthritis drug they said I was a cowboy for suggesting that sensor fever and low bread pressure had not responded to any other therapy her doctor quickly ask permission to the Institutional Review Board her parents and everybody of course said yes and they tried it and the results were nothing short of striking within hours after treatment totalism. Ab Emily began to improve very rapidly twenty three days after her treatment she was declared cancer free and today she's twelve years old and still in remission so we now call this violent reaction with high fevers and coma following in Cartesian outside to kind of release syndrome or CR s we have found that occurs in nearly all patients who respond to the therapy but it does not happen in those patients who fail to respond on so paradoxically our patients now hope for these high fevers after therapy in which feels like the worse flu in their life life when they get Carter South there they hope for this reaction because they know it's part of the twisting and turning passed back to health unfortunately not every patient recovers patients do not get cr s or often those who are not cured so there's a strong link now between CR s and the bill immune system to eradicate leukemia. That's why last summer when the FDA approved carty sells for leukemia they also co approved the use of totalism APP to block the aisle six results effects and the accompanying CR s in these patients that it was a very unusual event in medical history. Emily's daughters doctors have now completed further trials and reported that twenty seven Anada thirty patients the first thirty we treated or ninety percent had a complete remission after carty cells within a month a ninety percent complete remission rate in patients with advanced cancer is unheard of and more than fifty years of cancer research in fact companies often declare success cancer trial fifteen percent of the patients had a complete response rate are remarkable study appeared in the New England Journal of Medicine in two thousand and thirteen and international study has since confirmed those results and that led to the approval of by the FDA of for pediatric and a young adult leukemia in August two thousand seventeen so as I ever approval of a gene therapy Cartesian therapy has also been tested now how in in adults with refractory lymphoma this disease afflicts about twenty thousand a year in the United States and the results were equally impressive and have been durable terrible to date and six months ago the FDA approved the therapy of this advanced lymphoma with Cardi cells so now there are many labs and and physicians and scientists around the world who've tested Kartini cells across many different disease diseases and understandably. We're all thrilled with the rapid pace of advancement. We're so grateful to see patients who were formally terminal to return to healthy lives as only has we're thrilled to see long remissions that may in fact be a cure at the same time we're also concerned about the financial cost can cost up to one hundred and fifty thousand dollars to to make the car. T. Cells for each patient and when you add in the cost of treating CR asked and other complications that cost can reach one million dollars per patient. We must remember that the cost of failure though is even worse the current non-cured of therapies for cancer are also expensive and and in addition the patient dies so of course we'd like to see research done now to make this a more efficient and affordability increase in portability all patients fortunately this is a new and evolving field and as with many other new therapies in services prices will come down as industry learns to do things more efficiently only when I think about all the forks in the road that have led to car T. cell therapy. There's one thing that strikes me is very important. We were reminded the discoveries as of this magnitude don't happen overnight. Kartini cell therapy's came to us after a thirty year journey along a road full of setbacks and surprises and all this world of instant gratification and twenty four seven on demand results scientists require persistence vision and patience to the rise above all that they can see that the fork on the road is not always a dilemma or a detour sometimes even though we may not know it at the time the forecast the way home. Thank you very much for more than a dot com.
Young cancer patient designs sweatshirt to raise money for fellow patients: Good news in the news and an invitation to joy
"This is the daily article podcast published by the denison forum or culture changing christians to receive the daily article directly to your email inbox. Week day morning. Visit the daily article dot com. Now here's today's news. Discerned differently as you consider your urine giving opportunities. Please pray about donating to the denison forum as a one hundred percent. Donor-funded christian nonprofit ministry. We rely and financial gifts to continue our mission building. A movement of culture changing christians. All gifts will be matched up to a total of one hundred fifty thousand dollars and are tax deductible for this year. Consider giving today at daily article dot. Org with all the bad news in the news lately. I thought we could use some good news. A ten year old leukemia patient has designed a sweatshirt to raise money for families impacted by pediatric cancer. Her design includes the words be strong and courageous taken from joshua one nine a nightclub closed by covid nineteen restrictions in lausanne. Switzerland has been converted into a temporary blood donation center. Gen z americans currently between eight and twenty three years old have relied on faith more than any other generation during the pandemic. The percentage of north korean citizens who are exposed to the bible is steadily increasing each year despite extreme persecution. The version bible app is now available in fifteen hundred languages. Franklin graham reports that samaritans purse. And the billy graham evangelistic association saw one point. Three million people give their lives to christ through online ministries in twenty nineteen this year. The number is one point. Seven million franklin explains that due to the pandemic. The people's hearts have been softened. A little bit people who have not listened before are listening now on the other hand. There's plenty of bad news available today. Let's consider some christmas related stories. A nurse who works with covid nineteen patients received an anonymous letter from a neighbor chastising her and her husband for displaying christmas lights in their home. Their displays subdued a wreath and a row of lights along one roof line nonetheless. The writer called her decorations a reminder of divisions that continue to run through our society a reminder of systemic biases against our neighbors. Who don't celebrate christmas or who can't afford to put up lights of their own in other words if i don't like or can't afford something you can't have it. Imagine applying that mantra to the rest of life. Churches across the country are canceling singing christmas tree programs due to covid nineteen restrictions as a result of pandemic related financial stress. Forty five percent of americans responding to a survey said. They would prefer to skip christmas. This year. Shopping centers and photographers are stationing santa claus behind plexiglass shields seating him high in a sled or putting him inside protective snow globes no sitting on santa's lap this year. It seems christmas should be a season of joy. The angels announced the birth of christ by praising god and saying glory to god in the highest the shepherds who met the baby jesus returned glorifying and praising god for all they had heard and seen how can we haven't share the joy of jesus in this season as we celebrate his birth. The answer is to not wait until the world is more joyful when the pandemic is finally over other fears and threats will take its place. The answer is to seek joy a sense of well being that transcends circumstances rather than happiness which is based on happenings it is to make joy a choice rather than a circumstance. So how do we choose joy. Today i identify the source of truth. Join jesus spoke of my joy which would be hours. The prophet zephenia assured us that our lord will rejoice over you with gladness. David testified in your presence. There is fullness of joy. Your god is a god of joy second settle for nothing less than the joy of the lord we can rejoice in the lord always because the lord is always the source of joy as craig denison notes we are not made to carry burdens that steal our joy and keep us from the abundant life. Jesus died to give us. If we are not experiencing the joy of the lord today the fault is not his third submit to the spirit who produces joy scripture commands us to be filled and controlled each day by the holy spirit when we make this choice. One fruit of the spirit. That results is joy. If you have the joy of the lord it's because you are filled with his spirit if you do not have the joy of jesus today it's because you're not filled with his spirit for more go to our website and watch my latest video. What does the bible say about the fruit of the spirit bernie. Carbo was a baseball hero hitting a clutch three run homer for the boston. Red sox in game six of the nineteen seventy five world series however as he writes in christianity today he was totally miserable addicted to drugs struggling in his marriage and constantly at odds with his manager and coaches after his world series heroics. He spent the next few years bouncing from team to team until his baseball career ended at the age of thirty two years later a prominent baseball player identified carbo as introducing him to cocaine. His mother committed suicide after the story broke and his father died three months later carbo and his wife divorced than his second marriage ended as well. He was ready to end his life when his phone rang. It was bill. Lee a teammate. From the red sox lee connected him with others who got carbo into rehab where he suffered a panic attack. He ended up in a hospital room next to a retired pastor. Who helped him learn what it means to live for christ every day and to rely on him for forgiveness in strength carbo eventually became the co founder of diamond club ministry which brings the gospel to young people and their families th revenge baseball camps in speaking engagements. He closes his article. Today i share the story across the nation. Because i want others to know there is hope. There is a way out of the deadly seduction of abusing drugs. There is a way out of the anger and anguish. That life can bring not only does jesus christ offer the way out but he also offers the way in to a life more joyful and abundant than anyone could imagine. Will you choose his way today. Would you consider sharing this podcast with a friend family member or co worker in order to help build a community of culture changing christians. Thank you for listening to the daily article podcast today.
Who Is Your Hero? He Was Mine
"It's Brennan Bouchard. And welcome to another episode of the Brendan show. Hey on behind the scenes and event right now. And I was asked to talk about who my hero is in my life. And I get asked this a lot. I realize I've actually never shot video on this. So love to tell that story. Limit my hero is my dad and many guys were with me as I built my brand my business in my life when my dad passed away so dad passed away in two thousand nine to acute myeloid leukemia. He was healthy and good. And and literally like on mother's day. He wakes up he's walking down the hallway, and he kind of felt a little off, and he grabbed his side. And my mom's said what's wrong with this? I just feel funny sat down his his back inside was hurting throughout breakfasts. He was feeling funny. I'm said, well, let's figure out what's going on. So we went to hospital and within two hours. They let them know. Hey, done some tests here, and your spleen is enlarged wanted a few more tests. We think you you might have you know, who came in. And of course, he's had no context of this. And literally the doctors gave him seven days to live. Hadn't been sick or anything. And if you know about leukemia, there's two kinds and AM L Q one it mealy just takes over your body and very few people live, let alone months dad who was a marine and spent twenty years in the marines did three tours and Vietnam cannery sergeant he made it fifty nine days and. During that time. I got to be with the most of the time. And I remember just. Just so fearful of losing him because he'd been such a hero in my life. And I asked him if I could interview him, and I was having to be literally traveling when I found out that they said his third round of chemo didn't work, and they were suggesting he go home and enter hospice and pass away. And so I called him. I didn't know if I was going to get there on time. I was so terrified just having a trip, and I said Chi interview over the phone, and I recorded and showed that with you because if your parents or here or your caregiver your loved one, your grandma somebody really care about the it'd be a beautiful thing for you sit down and interim I just interviewing with falling recorded it. And I asked him like thirty questions about life has asked that, you know, about how he grew up, and what he learned from his parents where he hope, you know, what do you hope for life? What do you love what made him successful or struggle with? How do you my mom? You know, what he wanted? Each of us kids to know about life. And what message you wanna leave us these things and he shared something with me in that area. That was so amazing because he's actually always said it throughout our lives in different ways. And I never really realized it, and they was just I didn't realize how intentionally been because when asked what something you know, what some advice you wanna give all of us. And he basically said seven things that I realize said them he'd been teaching us that all our life, and what he said to us. You know, be yourself. Be honest. Take care of your family. Treat people with respect. Be a good citizen. Follow your dreams. Do your best. You know, he was always saying these things to us. And just even as I say them. I it's weird to be hearing. So it's hard to talk to you guys little about, but it's like. It really was one of the greatest blessings I gave myself as recording in because now every year on on the day that he passed and every year on his birthday. I try to listen to the audio. I mean, sometimes I can't because it's hard to hear his voice, and I miss him so much, but I also am grateful. I have that. So encourage you to record interview, the people you love, but also because you know, so cooled as they started my career many guys were with me the very beginning. When I wrote my first book called life's golden ticket. And my dad got to see that published and I decided I wanted to bring life school and ticket like to life. So if you ever read life's going tickets, it's a parable as the story about a man who experiences some transformational magic at the circus. And he's like kind of opens up and changing the search. I don't want to little story. But so I decided bring the book to life, and I literally rented like the Mexican national circus had like their tents and. All of their performers, and we took over the city in Long Beach and had all these people come to attend this event, which was like a personal development seminar in a tent revival. Right. But my dad got to come and see and being the old gunnery sergeant he was up five AM in the morning carrying boxes helping us put together. You know, just doing everything to help out the staff and the team and motivating them, and he was so proud to see his son do his thing. And even though the thing was kinda fallen apart. Oldham? I didn't know what I was doing. I never done that kind of seminar had no money. I was constantly stressed and everything else. He got to see his son do his thing. And I just tell you know, what the greatest gift that you could ever give in your life isn't about how much money you make what you succeed at the people around. You get to see you do your thing. And that would be my dad's last summer with me he would come out at the end and after volunteering look so hard, and he came out and his hand are moms hand and raise it up in dad was just so happy, and I know not not everybody gets that blessing with their parents or with their loved ones or with their caregivers or the people admire, but it's one of the great moments in my life. Because my dad was my hero growing up because he told me those things and I became who. I am because he told me those things and I still work and try to connect with him. Motioning spiritually all the time. Because I'm always remember what he taught me what I wanted to live life. So he's proud. And I'm I'm honored. He got to see his son tried to live his dream. No matter what level at the cheap. I mean, one of the greatest gift you can give is live your dream like chase the things that inspire you. Because other people seeing that it reads a magic into the world. So I hope maybe this episode makes you guys think about someone you admire who you love and the messages they taught you and that you try to carry it on in some way and your life to. If you're ready to take your life to a whole new level. Make sure you grab my book high performance habits. How extraordinary people become that way. It's available on Amazon right now. And when you order your copy, you really supporting my channel and the message, and you're also getting a book that will reveal to you twenty years of my research into what is it that helps people go to a new level of success in their life. What is it really take? What habits are proven to help you reach long term success in your career, your health your personal life. Your relationships is called high performance habits. How extraordinary people become that way. It's available on Amazon right now.
NOCTURNAL COOKIES with VIKRAM PARALKAR
"Just a little love note to all of our loyal free cookie listeners into anyone who might be new to the show. This is an ad free podcast and we WANNA keep it that way we wanna make sure that we can just give you guys the awesome content, the great interviews and stuff that you have to fast forward. But in order to do that, we need your support. So if you could join us over at Patriotair Dot. com forward slash free cookies and become a patron of the show. There are many tears that you can join. You can throw a dollar you can do five and it turns out we're going to start putting some content up for those of you who are hard core reporters or make this worth your wild. So if there's some of you out there who just listen to the show and you feel like, Hey, you know what I could. I could spend two three bucks a month. Great. If you guys needle something. As incentive we're going to put some videos up on patron that are going to be exclusive to those of you who are free cookie monster's and I mean we're talking some good content like I'm GonNa, take you inside my sneaker closet like that kind of content you know and I will contribute recipes and perhaps every now and then our dog will give you so ugly. So again, monologue tree on dot com forward slash free cookies. Thank you. Thanks. I'm Katherine, Buick and Vega, and this free cookies of Umass podcast filled with stop conversations and offering delicious takeaways earn. Today, we are really leaning into the thoughtful delicious takeaway aspect because we are joined with Vikram. Car Author of Night Theater, which just came out this year and he is position scientist end he moonlights as an author. This is like this is like my dream interview because he's written this really philosophical interesting book. But it's kind of dark and scary. But so we can talk about the process of writing that book in the ideas in it, but he also is a working physician U. Penn treating patients with leukemia. So he has all this inside about how we talk about death in our society and how he interacts with with patients zine of science and spirituality. Yeah and actually you'll hear you'll hear Katherine within the interview she she asked him a question in part of the opening of it is this idea of of humans and weather at our core we are good. Rotten Apple Snow White. or The apple from from. Eden. Wasn't that a bad apple. There was A. Bad Apple was the apple fi was either the battery or was Adam the battle but all the way back to lily's because Lewis came before either. But was the apple was the act of eating that apple back in Eden Bad Julia the apple was very shiny and alluring and that was the problem but it but it probably. person was bad at their core than it probably wasn't honey crisp because those are the best apples it had to have been a red delicious. But at that point in time probably organic probably I think all of life was organic at that time. But we digress. The when. which could be the new name of this podcast but we grant but we digress what were we talking about? When. Catherine tees up this question to Vikram I lit up because this is actually a conversation that Catherine has attempted to have with me a couple of times over the last few weeks. It is Katharine almost out of nowhere pausing whatever TV show were watching and she'll just look look at me usually umbrella academy on Netflix shout out to umbrella. Put your pause it, and she'll look at me and be like I just I'm. Just decided that humans are just rotten at our core rotten we're awful and I'm like I don't think that's true and then I will have to defend all of humanity. You're welcome and explain that. Yes we are driven by our insecurities in ego and but at our core, we are not rotten and then capital get annoyed at me that I've dismissed her theory out of hand. And will continue but no look around our world right now, and a lot of it is is tied to what's happening with the pandemic in people's behaviors around it and reactions to it as well as racial injustice and. And Catherine has anyway caffeine is here. We'll. We'll let her. Present her argument you I do believe that because we're in two thousand and twenty and everything that's happening with Kovin and politically, and and with the highlight it's not new the racial injustice but the attention and potential changes that we're looking at right now it is easy to kind of peel away the layers and look at humanity underneath it and think how messed up everything is right now but historically speaking. One of your arguments I'm sorry I think exactly where we like to watch by goons and we'd like to watch a lot of historical period dramas. And read books is not just netflix although twenty twenty is the urban. I just think historically speaking. We are fatally flawed and I know rotten at our core is maybe a bit hyperbolic but. We are so easily skewed towards doing evil deeds and being selfish and being corrupt in choosing ourselves over other people and we were even watching the movie. We watched last night with Edison current war you're watching the current ROHR's words. Shooting the current. Lions and they're like which one can roar louder. The wars. We were watching that and obviously this is a dramatic interpretation but still. Edison was portrayed in the beginning as. Very ambitious but ethically sound and he had very stern principles about his creation and that he would never create something that would ever cause harm endured death to human and then fast forward he starts experimenting on Animals and then once the animals get experimented on he inevitably inevitably caves in helps basically create the electric chair. and. Even that I didn't say anything to Kate while we were watching it but don't think my little mental notebook wasn't like tick rotten at the core where in against humanity check just saying that I do think so many people if put in positions of power where they get a taste of it, and then they want to maintain that because you know falling from grace is something that people just can't handle that eve they or Lucifer that they will do what serves them over the greater good and I'm not saying, I, think that's applicable to every person but historically speaking. Do. Our countries and and if you look at the rulers like look at the war. War after war after war after conquer after empire and it's all just selfish and it just makes me wonder whoever created us whether it was accidental or not or whoever is like holding the control buttons and the puppeteer strings for us. I. Could. fucked up game. Because that was one of your one of your points it was like, how can you look at all of humanity in all of our our cyclical self annihilation making the same mistake over and over and over again in different outfits? Put on a t-shirt because sometimes our outfits are like. Steel breastplates in sometimes are outfits are little crown. So I would either go or a Victorian personally sometimes are outfits or chain mail I mean either most of the time outfits have to do with protecting ourselves against being murdered by another human. But I don't think I think ultimately you probably have the same position on this although when we do quote unquote argue about it I do seem to be the defender of humanity and I also. I also have articulated the position and it's not like extremely well-thought-out out. Because, I have come to believe in the Buddhist principles that you have. That yes. Not. Just humanity is suffering human suffering but every rear to suffer again and again and again yes. Again, and again is the key point that I'm getting is the ideas around reincarnation that worm that were meant to learn lessons. So my explanation for why we make the same mistakes and why we are caught in a cycle of self annihilation is not so much that humans are evil to the core. But that it is almost reprogrammed that way it is part of the system that whether you you're born in the twelve hundreds when the outfits will kind of the Dark Ages. So I'm not sure what the outfits worked, but doc you just a little earlier I know. But but what was that age? Anyway that was like the Cathedral Age I was like the Ken Follett pillars of the Earth Age. I don't know what we call today's can follow it edge the. That's what it's called. So during the Ken, Follett Age and when when the the uniforms or the costumes were like little tights and drapey and point being like where we going with no point being like whatever time you were born into, you will be experiencing the same things as another time that someone else was born in to. To be able to learn about sacrifice and loss and anger, and evil and freedom, and joy you need to be set in the same circumstances and so to me, it's not evidence that humans are evil and that we do the same things in every era an epoch. But that we have to learn those lessons regardless of when we're born into and so it's almost like we. Are caught in an endless loop, but it has less to do with our evil nature and more to do with. That's what the the lessons are about individual lessons or lessons for humanity because it seems more likely that it's about individual spiritual lesson if we are indeed put into cyclical experience where the point isn't to fix it and make it better, the point is to survive it. Well or maybe do you think there's any validity to if more people were Jordan's that? Things would work out well that that is the costume of the age right for. For a lot of people at sneaker culture. So in a couple of hundred years, they'll be like well, if you dropped into the twenty twenties and you were walking Jordan's like most people were you still had to deal with the same loss in evil. That you would in another generation I don't know where we're going here because we can't in the end we can't probably during this little segment of free cookies answer some of these questions or and human lifetime really it turns out we won't know until we've moved onto what other Rome was awaiting us, and which is something that is spoken about in theater, which we are about to bring the author before we bring turns out, he doesn't have. Any answers either but we tried before but he is very, he has interesting philosophies about about how he thinks about them and that's really all we can offer is new ways of thinking about certain ideas. But before we turn it over to Vikram, I, think we should get to a very black and white question which is different than a black and white cookie, which is also delicious. So are black and white questions cookie or cake anyway. Yes. At their core are humans bad catherine are you are you willing to say that I feel like segments GonNa end until I agree with you. So I am going to go with like a delicious apple if left unattended to for too long indeed will rot. But perhaps if it is given the proper attention. And eaten slash cared for by other people who appreciate its beauty then perhaps it will never. Be That is the word of Catherine. and. From far I'll car was born and raised in Moon by author of the previous book the afflictions he's physician scientists at the University of Pennsylvania where he treats patients with leukemia and researches disease he lives in Philadelphia. Right and we are joined Vikram. Thank you so much for coming onto the show and talking with us. To be heard thank you for inviting me. So we were we've been very excited to have this conversation with you. This season we've been focusing on books novelists, but your background is so fascinating since you a physician scientists, U.. Penn and you are a beautiful writer. You're quite the wordsmith as well and so I love that you're just a at what does the term? Jack Crafts is that what I'm looking for? nope. That's how it goes jack-of-all-trades because all trades I'm really bad with idioms by the way you should know this about me clearly. But This is just such a great reader. Our cousin is a librarian and she recommended this book to us and I can't wait to read the books and the afflictions in your other books as well. But how have you always been interested in writing or was this something that came up because of your job? How did this all start for you? Sure once I should say I'm I'm really happy to have been recommended by librarians. I got in my I got my start with reading books from my school library and actually the British Council Library in. Mumbai. So as a kid, I was always just very very voraciously interested in books and in science. and. Very often, I'll be reading scientific. Books brief history of time in the books by Richard Dawkins that I also would be reading. As many works of fiction as I could devour as a teenager I used to love Article Montoya Agatha Christie and I just devour them and I think as I went into my league teams. I, began to. Sense that there was this world of literature that was out there and that's when I began to Gabriel Garcia Marquez and Dostoyevsky and Nabokov and Virginia Woolf, and other authors that I had never encountered as part of my schooling. This was also the time when I was going into medical school. And during this period I continued to be interested in writing and literature is the editor of by magazine Dr The college maxine. From when I was in med school and I decided to come to the United States to pursue a career as you mentioned as a physician scientists and I. Treat patients leukemia and I do research laboratory in to trying to understand how blood cells develop and how mutations go cells can lead to leukemia. But I'll tell this time I continued to read I continue to be interested in writing I was writing short stories. And I think it was within maybe the last ten years so that I began to feel. That my writing was at a level where I was comfortable sharing it with the broader world and that's when I began to look to publish my writing and so the afflictions establish about five years ago and the theater just came out who over the last year or two and India the UK in the United States. How. Do you? How do you perceive how you're writing impacts your work in the Chemo and your science and how? Does your. As a doctor impact, your writing. I actually think of them as fairly separate aesthetic persons, but there are linked of course in many ways Venue doctor you're constantly just struck by questions about the way in which we the way in which the normal functioning of the body is such a I would say an unspoken assumption. In all of our A-. The endeavors of life you know our ability to. Fall in love our ability to meet some on their ability to handle the job ability to pursue our the vocations of our life, our ability to travel this all of this defense on our body doing the things we wanted to do, and when you have many have some kind of disease that has stabling the body. You have all of these ripple effects that To every aspect of life and so health and disease are actually teams and everything. All major literary idea that you can conceive whether it's the desires of the individual their ability to relate to other people, and also their place in society and I'm just constantly struck by. By just how rich and interesting the the idea of health and diseases when it comes to. Human. Exploration and human character in and human condition and so a lot of my writing sort of falls in the interface of health indices of trying to understand how people who. Are In who who don't exactly fit into the normal world the healthy navigate this world, as well as people who are practitioners of medicine who are who are tasked with trying to help people returned to help. How do they navigate this world a and that's what a lot of my. That's what a lot of my writing focuses on. But that said, I, should say that my literary influences available. Medicine. So. Most of the writers I greatly admire aunt medical writers and so. I would say when people read my writing shouldn't read it because of medical teams. That just happens to be the substrate upon which some of my writing is built but I hope it can speak to just human ideas. and. Human. Longings and desires. I think you do an excellent job with gene spirituality with medicine in story and Actually believe this is a quote from the afflictions but you you have a quote, this a sickness and suffering are integral to the human soul which. Seems to encapsulate while you're just talking about really for me books even the Buddhist principle that living being human suffering and A. Part. Of I'm always drawn to darkness and I don't know what that means about me as a person. I don't mean I'm necessarily drawn to dark things but I love darkness and there was something about the night theater. I loved how unabashedly you explored. Dr Crevices of the soul and what humans will do and how they feel so. I was just wondering. This is kind of a big question but like what is your interpretation of humanity? Do think that at a base level? We are these dark creatures or is there because your your interpretation of the afterlife and the Night Theater is very interesting to in a bit bleak. So just wondering. Is that symbolic of kind of what you see and humanity or is there a chance for us? especially. Twenty. Twenty. Well Gos- question at a very interesting. I I actually I think the funniest analogy I started. This was a dude you know does this Theme in the Simpsons where the character sideshow ball surrounded by. And stepping on one week after the other and the racist keep on hitting him in the face and I was thinking about that such an amazing analogy for what Colbert is the world is dealing with covert. Despite ample warning, overall, just a stepping on breaks all over the place. Humanity is an interesting. A case of life that has emerged on earth because we are the only kind of life that is actually able to reflect on our existence on our history and so there are. So, many different creature out there who are driven by motivations that did themselves not understand what the purpose basic needs to live and to reproduce and pass on their genes. But human beings have reached a point where the process of evolution and the process of trying to improve our survival has allowed our minds to now reflect back upon this process and think about it think about its flaws and think about all the. Good, and Evil impulses that have been in that have been netted into us by the constant rifle survival, and so I think you even of course have be have light and dark within ourselves. You know we have the ability to see love and we have the ability to protect, and we also have the ability to form tribes the ability to destroy, enter, demonize, and these. These ideas are just constantly. the forces that we are fighting against, and we will be well continue to fight against Even if you know one day does human civilization in the stars and. You mentioned the the idea of the afterlife in my book. So for those, not read the book, the afterlife. Knighted and I suppose this little bit of spoiler. actually a bureaucracy where a bread. The the dead in the afterlife. Are Trying to find a way out of the allies back into the world of the living but all the face with his Leo's Leo's bureaucrats who do not give them any meaningful answer and this idea actually came from my. Literally. In heroes and inspirations, which is Franz Kafka and Cosker. Pinpointed something that was very. Fascinating and interesting and something that I don't think had been quite spelled out by any author before that point, and perhaps it is something a feature of humanity that emotion the post industrial era, which is that when you have system. which becomes large enough it large enough and is trying to govern large collections of people. The individual disappears within that system, and all that remains is a set of rules and all you have to follow those rules and you'd be punish violate those rules. You don't understand those rules. The rules often are completely disconnected from human desire and human. Motivation and the rules and become the most important thing in the system and Bob the human being, and I specifically wanted to introduce that idea into the the book because the book really is centered upon the individual On the family of the dead who wanted to come back to life and upon the surgeon who is somewhat of a misanthrope but who's thrown into the situation where he has the opportunity to help the dad refund tonight. But fall once he has no guidance from any system there is no system of ethics at. The right thing to do is there's no system of medicine that will. Guide him to this night. There is no a system of rules that tells him whether what he's doing is right or wrong. All he has is himself and his own conscience in the might of this. it at night in the village little village clinic, and he has to decide whether he is going to help. These individuals return to life or not, and how far is going to go to do that, and so I particularly wanted to include that because I do think at the end of the day, the locus of morality has to be the individual. We are all responsible for our own decisions. And irrespective of the system would enrich, we are embedded. We are the ones who make choices about. Our lives and our the choices. The directions in which we take of ourselves. That's interesting because you you mentioned how in in the book, the the surgeon doesn't have the rules and regulations and bureaucracy to tell them how to handle life and death in this situation and it got it. I was just thinking just now at least the system I know the American system when it comes to hospitals and doctors, it almost feels like we have those rules and bureaucracy to some degree as a distraction from actually talking about death like. That patients want to know percentages and they want to know. That there's almost there's something comforting in the speaking of death as. Rules and bureaucracy rather than actually getting to the heart of. Our our humanity and that it's all inevitable from us. I'm not sure if this is totally connecting but that's kind of what it made. Me Start Thinking about the and. I was wondering as someone who has. Having. Come to the US from India and knowing two different cultures. Do. You have any understanding or any insight into why it seems maybe in America and it could not just be America we struggle so much in conversations around death. That's actually a really interesting question. You know I mean there are so many differences. In the way death and the idea of death and rituals around data approach debt is seen in India versus in in the Western world that it's very difficult to make direct It's difficult to pinpoint single ideas. But the one thing I can say is that in India. I think that's just the acceptance of the idea that you're not immortal and there will come a time when your body's going to fail, and then the question becomes to what heroic degrees do you go to keep. The individual alive and what level of suffering is acceptable to let that happen. In the United States sometimes I feel as though there is a denial of the idea of death. That if you can just go to the next therapy and the next therapy in the next experimental treatment, you can somehow keep. The process of life going on forever and at some level this drives innovation drives research drives, patients who want to be on clinical trials, which helps generate data for drugs up now become the standard of care for the next. Set of patients who come along and so this clearly a married to that kind of approach. But on the other hand, you also have a situation where. An enormous amount of money is spent and lots of painful procedures that performed in the last two weeks of a person's life and a as a result. Many patients sometimes cancers who? Could have the opportunity to pass away at home with their families end up. Spending the last days in the intensive care unit poked and prodded and unable to get sleep because of beating machines. And I think one of the one of the fields of medicine has recently Well, it's been of course there for a long time, but recently, it's actually a become very prominent on college is the field of Palliative care palliative medicine and the goal of Palliative care is not to determine what is the next treatment to give you but it is to determine what are the goals of your life what is your overall approach to the end point of the disease that you might have and this applies not just to cancer. Patients who have. Significant. Heart failure or have very severe lung disease where there's no hope for an organ transplant something that is going to a bring them back to complete health and where they're looking at a slow decline in dementia, for instance, and I think the Palliative care is a discipline where the doctors are trained to have these conversations with patients to talk to them about what is it that you want? Where if if you had to die, where would you want to? Would you want to be at home? Would you want it to be in a hospital? Would you want her to be in institutional facility of some kind and I, think the fact that these conversations are happening when people are healthy. Is really useful and I think I think these difficult conversations these are important conversations and I think they have the really should begin much before someone is facing a terminal illness so that as a society we have prepared for. The inevitable when it does come and we can allow the transition into debt to be peaceful. And can also recognize when it's worth sharing. Then it's worth accepting side effects and treatment and the point where you cross the line into medical utility and they say, oh, sorry, go ahead. Well, I would say I mean this is just one. This is just I'm just feeling the last unit. The does more superficial being of the such a complicated. Deep Conversation that we actually have all the time I was on service. The. Hospital just a week and a half ago and I feel as though I was having this conversation every day with patients with leukemia, some of whom have just been diagnosed and been thrown into this chaotic disorienting illness. Some have the opportunity for cure some who have a disease that has very low probability of cure some who have already been multiple regimens and whose disease has not been controlled and so. I surveyed difficult conversation, but these are. Important conversation to have absolutely and the concept of being able to have these conversations like you said when you're healthy and to to think ahead if we take it back to theater and for the listeners who haven't read the book, the concept is that there's family of three who were murdered who come to the surgeon. Because there's basically this window of time that if he can fix their. That they will come back, they will fill with blood and their organs will start to work again in the morning and they could potentially come back to life. I don't think I gave anything away I. think that's like that's established early on the. Excellent and there's the hook you guys. But this the concept of the afterlife that you paint the bureaucracy and then this concept of denial of death and then what you just introduced as. The privilege of having these conversations before you get into palliative care and. I thought what was so interesting about the characters in your book, and like you said that the afterlife they're all these rules that you're supposed to follow, and there's no explanation for why these rules exist except for that, you just do it and yet these three family members somehow got to come back to. Earth. To a human to the surgeon who very much is the only place in this novel that I felt God existed and your surgeon to me. Was God. And because in the afterlife, it doesn't seem that God. was there it? It actually felt much more like purgatory than the existence then of like pearly gates or whatever interpretation you WanNa have a passing on and I just I'm curious when you're writing your story did you have that moment of? Thinking that your main character this is a wildly unique interpretation of God yet. This is where you come for an he's supposed to be the savior and the story. When you know. It's an interesting perspective that you. Bring because I so I personally a haven't lived in God since I was twelve or thirteen years old. But I see why I see exactly why people yearn for the idea of God and why God remains such a powerful idea in, of course, most religions of the world but even people who. Very, often don't want to be to connect with any specific religion still have an idea dating their mind and I think there is this. There is this desire for human beings to look outside of ourselves and to see an order in the universe that is going to protect us. And the idea that this order has been imposed by some of benevolent being that is going to protect us and in a way what I wanted to specifically do with theater is just strip away all of these any possible cosmic order. And if you if you remove not causing all right Lisa benevolent cosmic order, then all you're left with is the the conscience of the individual and the actions of the individual. So it is true that in the story, the the the the surgeon is the most powerful character in the way. The most from character whose decisions are going to affect the lives of everyone around him but the same time he's not. He's not he's not benevolent at. This the question, the question of. He's very loud. But what he isn't is he clearly is not omnipotent. So he can't do everything he wants to do and he's not invincible he himself is vulnerable to all kinds of. Factors around and I think in a way that that perhaps maybe the best you're going to get with a dating. Someone who despite his or her limitations is struggling to be good. Perhaps that is what? Got You know perhaps that is what if there exists God. Perhaps he or she has their own limitations. And struggling to run adjust world despite them. In the book, the the surgeon. Speaks very candidly with his patients with this returned family who is trying to fix. He's he tells them mostly I think at every turn the truth about what he has been able to do inside their bodies and when morning comes and they are filled with blood what will happen and it got it. Got Me thinking about your real life and when you are sitting down with patients who you might have to deliver a diagnosis to that is going to be. Difficult to say. How do you balance? Humanity and knowing that people need the truth. While also. Needing to. Be Various I duNno. How whether it's you need to be soft and cushioned the landing them. How do you approach? Those interactions with your patients in is there ever an urge to tell them less than the truth just because sometimes the truth can be so painful? I I will say that the definitely is the urge to. Simplify the setting. Make the future vague. Present only the goal of what you plan to do for the next day or two without talking about the big picture. The temptation certainty exists I tried to resist it whenever I can the well. What I tried to do I when I go into a patient's room I, I tried to give them all of the information of that they're capable of understanding. This varies from patient to pitch in patients who have pre existing medical training or understanding of genetics and may have the ability to absorb a lot of as sophisticated information, and they may be patients who may just need things in the much more colloquial and sort of everyday level. And, they may not want or may not be able to sufficiently absorb really complicated information. But the first thing I tried to get patients to a point I I I tried to get patients to actually understand what is it that is going on, but and this itself I have to say is sometimes so difficult because very often. There these connotations or words like cancer, for example, that people have. If you have cancer, it means X. Y. and z the darn many different kinds of gases that are chronic cancers. There are some cancers that don't require treatment for long periods of time that are cancers are curable cancers that aren't there councils that are rapidly growing their counselors that are slowly and so trying to help a patient understand exactly what is the disease that they have? What is doing right now? Do they need treatment at the moment and then what is the disease going to do in the future I? Think that's how I tried to begin and I constantly try to. Assess the patients. What is it that they want to know right now? How ready are they to? Hear about the big picture and in general I do try to present to. Asians the. The biggest pitcher possible in that this cancer is curable but yes, there are there are. A certain number of patients who cannot cure this cancer new end up succumbing to the deceased. And I think it is important for patients to hear that so that they can they can be concretely prepared for for the treatment plan that is to come. And I think it is important for people to really understand what they're getting into because sometimes these chemotherapy regimens can also be quite complicated, but I don't think there's a one size fits all rule. And I think it's helping people understand the gravity or not of their diagnosis, and then helping them understand exactly what the treatment is going to be what it's goal is. And then guiding them to that process. But actually the the fact that you mentioned this reminds me an interesting study that was done several years ago. where? Patients with metastatic solid tumors, for example, metastatic breast, cancer, metastatic lung cancer, which is incurable and ritual. Claimed the life of the patient. These there was there was a study that was done where doctors were asked did you convey the incurable cancer? The fact that is life limiting gio patients and the patients after the appointment Ross are you aware of the fact that you have a cancer that is a Gerbil life limiting and the discrepancy between that was really shocking. Oncologist felt that they were conveying the information to the patients but sometimes, patients simply will not during it or not receiving it in in the way that the oncologist felt they were conveying it and this is where I think. EUPHEMISMS can sometimes be it'd be talk about language language can luminated, but language can also concealed. So for example, if I say, well, if this cancer is treated very well, we can get into trouble down the down the road. Now. This may be vague way of saying. If it's incurable, it may result in. A life threatening complication and make all your deck. But the patient may simply Jarrett has all well, that may lead to some kind of. Trouble, but I'm sure there'd be treatments for those troubles as well. And so this is I think that this is this is. This is something that all oncologists work on. An and I personally find. Every interaction I think I get better at judging patient is capable of receiving what the patient. Is Willing to hear at this point. And at what point should you get to a? Actual. Percentages, numbers and concrete data dot com. To to flip to the kind of good doctor coin a little bit. There's a part in night theatre where the surgeon gets visitor. And the visitor asks him what gives you greater satisfaction cutting people or stitching them back up. And then continuing to explain how all animals have the ability to tear open all have the ability to destroy, but only humans can mend which. Struck me so deeply. Getting. Goosebumps thinking about it right now and since neither cater I are doctors. This is not a conceit that we've really chewed on before and. I, of course, I'm going back into the darkness again warned you elect dark things but that was such a in my mind. Beautifully honest question because as a doctor like I said earlier I mean is godly. You do have this godly power of healing someone in curing someone and protecting them and. I don't I don't necessarily want to ask you that question because I don't know if you're interested in answering it but I would like to know where that question came from for you. When this particular case, the question was asked by. Character and this I, don't I don't want to give too much away but this is the character whose particularly trying to psychologically manipulate and terrified surgeon in that setting, and so he's he's asking him in a very in a very specific context in the book but I do think that the it does speak to a certain it does pick one particular aspect of medicine sometimes. Goes unappreciated, which was that doctor's constantly do things that are actively life threatening to a normal human being. So, for instance, my job involves giving very toxic chemotherapy to patients. The hope is that it will lead to a cure of this cancer that the patient has, but you would never give these medicines with someone who has nothing wrong with them. Because these these medicines, themselves can cause severe infections. Can cause. Can kill some patients can cause long term complications too hard to deliver to the kidneys, and so I think there's just as this aspect that doctor's constantly have to be aware off of the weight of the responsibility that is on their shoulders off the fact that they are the prescribing something or they're performing surgery or they're offering some kind of medical procedure that has the active ability to harm but you're doing it because you expect in the long term that it is going to. Give rise to a positive that that is what you offer it, and so I personally every time I you know right? Not Right now ordering chemotherapy is the click of a button on the computer but every time I do this, I forced myself to said back and just think about exactly what it is I'm doing I'm giving a medicine which has highly toxic side effects to another human being. And I think that is my way of just reminding myself of the fact that. Every patient puts an enormous amount of trust in the doctor because. You'll talking about informed consent about the patient making decisions. But really unless you're an oncologist, you cannot actually truly be giving informed consent because you truly don't understand whether this is the right regimen, give what the risks and benefits of the regimen are, and so what you end up in the situation is just a doc patient basing trust in the doctor. And giving the doctor the ability to cause them. And then I think is an enormous. Responsibility and weight on the shoulder of every doctor that the really I think sometimes medicine becomes a routine and I hope doctors don't forget that aspect of medical care that you have someone else's life in your hand. And you are making great decisions on their behalf. I would only asked this question if you had already planted it. As one of the themes of the book and I and I read that you did consider it one of the themes of the book and I. Sit By that because I, know it's a huge question. In in the book. You have this family who is jumping through so many hoops to get back to life and the existence of this afterlife plane and. One of the one of the themes that I read that the book is about the you know this could be right or wrong is trying to touch on the question of do our lives truly matter in the scale of the Cosmos and the scale of how vast the the. Is. And here's this one little story. This one little microcosm of how much a human being and human beings will go through to be given this life or to return to this life. So. How do you think? How do you think of that of that question as you were working through this book and as as you work each day at U. Penn, how do you think of that of that question of of whether our lives truly matter in the scale of how big the universes? This is something that I I. Think I became. Aware. Of. Just. How vast the cosmos was the nineteenth I, read. I read an I think I read a book about Edwin. Hubble. This was back when I was in my early kings describing how the galaxies wall goofy rushing part from each other, and that's how we learned that the university expanded and that's when I learned that. Our Galaxy has a hundred billion stars, which was one followed by eleven zeros, and there are a hundred billion galaxies in the observable universe and we don't actually think that the. University entire universe because it doesn't seem like there's an edge it. This was just how far we can see and so that probably. Continues to be a university on that but this is just what we can see, and so in essence we are our star is one off one followed by twenty, two, Zero Stars better in this universe and I do think it and be are, of course, on this little planet that's rotating around star and each one like a speck of dust on the planet and. One perspective job would be to say that. Maybe lives don't matter maybe the universe wouldn't care if the anti just went up and flame or you let the sun went supernova and wiped out, the universe may not get. But that's one perspective of seeing it but another perspective would be well, it turns out in the solar system. We have probably the only beings that have the ability to look back upon ourselves look at the entire history of. The Planet of life of the universe. In fact, we are the only beings that are even capable of asking the question of whether rematch. The Planet Jupiter, it's co-. The molecules. Meccan in its atmosphere not asking this question the if there's an ocean on Europa, unless there is life there that's very sophisticated that question is not being asked in Europe, but that question is being asked or. And we are able to look at each other gable to ask does. Be Able to look at ourselves able to. Appreciate. How wondrous it is that we actually do exist and how unlikely a how unfathomably unlikely it is that we do exist. And in the distance, we have the ability to make human connections and to matter to each other and so even though we may not matter in the eyes of the Cosmos doesn't change. The fact that we matter to our parents. We matter to our children matter to our spouses and our friends. And to the world and I think trying to find Meaning in human connection is to me far more important than trying to find meaning in the eyes of the Cosmos I should say that one of the things that religions trying to make human life significantly is of the cosmos you matter because the Cosmos wants you matter. Well, if it turns out that there is no one in the cosmos was looking down upon you and carrying about you if that is going to strip away all meaning in your life, then that would mean the idea of meaning was somewhat impoverished to start with. But. But I would say that this is something that I think. That sort of eggs essential idea of us being as individual individual creatures in species that is completely isolated in the cosmos. I do think it is something that has a lot of. Force for a lot of people certainly has been in in contemplating the idea of meaning in contemplating our place in the skulls Mus, and Thinking about our chievements and whether they matter and I think they do matter. But I think this also creates excellent fodder for literature to explore well, within this cosmo's that contains the humanity. What are a couple books you're reading that? You think matter? That you would want to recommend recently it's not like you have to give us your greatest hits. Maybe it's the couple books and twenty twenty that you think matter. Well. Let me record a book that I just started reading which I would have. I should have read a couple of years ago is the underground railroad, Golsen Whitehead, which won the Pulitzer Prize. was three or four years ago and his second book the Nickel Boys just? One. Price again so he's huguenots Tupelo crisis, but the book is just extraordinary. Need. To Pulitzer prizes I feeling talk. Stamp of approval probably GonNa read all your work. Collection. Yes. Interrupt please on right and an extraordinary book because I think it it as something that. You very immediately does something that I think going to the idea of mattering. I think the the most powerful thing that a book can do is create a character and bring that character life immediately and make their concerns. In this case, it's a child who's born into slavery and make their concerns. So important that the fact of these tend to ten to the twenty two stars existing doesn't change the fact that that child's life matters. and. So that I would give this as an example of if you want. If you want an antidote to cosmic nihilism. Really engages you in life of one character. Okay I'm not sure I've ever had a comedown as drastic from asking the question of whether we matter in the cosmos to this next question. But this is. The name of this podcast is free cookies and cookies are made of matter. Matter Cookies do matter what is what is your favorite cookie? Oh, in chocolate chip. This is not even a question. Jock chocolate chip I I'm kind of I'm I would be. Like chocolate ice cream chocolate sprinkles with chocolate. Sauce on top of it you messing. Chocolate absolutely chocolate chip. Now you get a chocolate chocolate chip cookie like do you want the? The Traditional Or are you so hardcore chocolate that you would do with chocolate chocolate chip cookie That's what I meant to chocolate. Chocolate. Sprinkles. frosting. And then joke about it. Okay. I think you've already answered the question but I'm going to ask even more you walk into a bakery. There's. There's the chocolate chocolate chip cookie, but then there's also some specialty cookies have you explored in your mind since we've asked this question, any specialty cookie that you really are into as well you know you could be like a bikini buttercup on is on top of it anything like that. Interesting I haven't thought about that but maybe going into team of this discussion, the spot cast. There's a dark chocolate. I'll. I'll. I'll go with that I. Think. It's been reinforced. Well we'll be sending you a gift package of all things trump. Dark chocolate dark dark. Dark. Matter. My goodness well. Let both. Matter is doesn't it doesn't actually draft novel matters won't have any taste A. Dark chocolate will have a taste. Yes. Yes. Definitely. Well, there's hope for humanity. Vikram thank you so much for taking the time to come chat with us. This has been awesome. Thank you so much or pleasure to chat with your keep up the good work. Thank you. Take care. Bye Bye. That'll do it for this week's episode of free. Are Humans evil or good. That is the question address on this week's episode of freedom cookies. Cookies rotten or cookie core does a cookie of a core cookie core. Scream cookie sandwich could be a core and some bakeries make cookies with course and the core. Cynthia. Wong. By the way if you live in Charleston South Carolina, you need to follow life raft treats and on Mondays at six PM she opens up for orders only local. So this is far Charleston peeps, but she's GonNa. figure out how to start shipping soon, I'm telling you, I only say this because she made a cherry and peach and when you cut into it, it's got ice cream and cookies and it looks like the pit in it's just nuts she's a genius she's a she's a God amongst. Pastry a screen people. You know what I have tried to make if somebody was desperate to try Cynthia Wong, who is a James Beard? Award finalist. Pastry chef if somebody in Los Angeles wants to try Cynthia Wong's creations you can order them I will pick them up and I will pack them in like ice and ship them to you if you are willing to go to med men and pick up some Kiva edibles and send them Charleston South Carolina it'll be like a trade it's totally legal listen fine come at us if if there's somebody from the government listening to this episode and they're going to pinpoint the person that then privately emails me like more power to them. We're. Going to make this trade I'm willing to do it but. That we have a podcast after that, you can support us at patriotair dot com slash free cookies. You can also follow us at free cookies podcast on instagram and also check out. F.. Be Radio because that is the podcast of our producer Lindsey Collins Of your show on Apple podcasts please please go rate and review the show, and we will highlight your wonderful words right here on this podcast. But you know what? It takes to rate and review a show with good words a solid corker, a solid core of humanity and a love and meaning and connection among people and I wrong prove me wrong. -CATION EGO insecurity, and thirst for power but rather connection to one another and the spirituality that draws us all together in this one humanity.
NEJM This Week July 30, 2020
"Welcome, this is the new. England. Journal of Medicine I'm Dr. Lisa Johnson, this week July thirtieth twenty twenty. We feature articles on your seven Mab for the prevention of RSV disease RSV vaccination during pregnancy to protect infants, uterine artery embolism, or my Olmec Mechta make for uterine fibroids, a trial of a therapeutic anti yellow fever, virus antibody, and bad acid trip for sarcomas. You article on chronic lymphocytic leukemia, a case report of a woman with chest pain. And shock and prospective articles on healthcare as an ongoing policy project on COVA DHS color line, and on the illusion of inclusion. single-dose nurse seven. AB. For Prevention of RSV in preterm infants by 'em Pamela. Griffin from Astra Zeneca Gaithersburg Maryland. Respiratory Sincil virus RSV is the most common cause of lower respiratory tract infection in infants and a need exists for prevention of RSV, in healthy infants. Seven mob is a monoclonal antibody with an extended half life that is being developed to protect invents for an entire RSP season with a single intramuscular dose. In this trial, one, thousand, four, hundred, fifty, three, the infants who had been born preterm were randomly assigned to receive a single intramuscular injection of Nur, seven, APP or placebo at the start of an RSP season, the incidents. Incidents of medically attended RSV associated lower respiratory tract infection was seventy point, one percent lower with nurse seven, APP prophylaxis, then with Placebo two, point, six percent versus nine point, five percent of infants and the incidence of hospitalization for RSV associated lower respiratory tract infection was seventy eight point four percent lower with Nur. Seven mob than with Placebo Zero Point, eight percent versus four point. One percent of infants. These differences were consistent throughout the one hundred, fifty day period after the dose was administered and across geographic locations and RSV subtypes. Adverse events were similar in the to trial groups with no notable hypersensitivity reactions. A single injection of nurse mob resulted in fewer medically attended RSV associated lower respiratory tract infections and hospitalizations. Then placebo throughout the RSV season in healthy preterm infants. Respiratory Sincil, virus vaccination during pregnancy and effects in infants by Shabbir Maddie from the University of voters. Ron. Johannesburg. South Africa. This study four, thousand, six, hundred, thirty, six, healthy pregnant women at Twenty, eight weeks through thirty, six weeks of just station with an expected delivery date near the start of the RSV season were really assigned to receive a single intramuscular dose of RSP Fusion F Protein Nanoparticle vaccine, or placebo during the first ninety days of life. The percentage of infants with RSV associated medically significant lower respiratory tract infection was one point, five percent in the vaccine group and two point, four percent in the Placebo Group vaccine efficacy. Thirty nine point, four percent. The corresponding percentages for RSV associated lower respiratory tract infection with severe hypoc seem were zero point, five percent and one percent vaccine efficacy, forty, eight, point, three percent. Percent and the percentages for hospitalization for RSV associated lower respiratory tract infection or two point one percent Ansari Point seven percent vaccine efficacy forty, four, point, four, percent local injection site reactions among the women were more common with vaccine than with Placebo Forty, point, seven percent versus nine point, nine percent. But the percentages of participants who had other adverse events were similar in the two groups RSV F protein nanoparticle vaccination in pregnant women did not meet the pre specified success criterion for efficacy against RSV associated medically significant lower respiratory tract infection in infants up to ninety days of life. The suggestion of possible benefit with respect to other endpoint events, involving RSV, associated respiratory disease in infants, warrants, further study. H Cody Meisner from Tufts University School of Medicine Boston writes in an editorial that the development of a safe and effective. RSV vaccine has been a goal for decades however negative experience with a formal in inactivated R., S. V., vaccine that was evaluated in young children in the nineteen sixties. The vaccine had simulated production of non neutralizing antibodies and t cell response that resulted in enhanced RSV disease in a subsequent season led to ongoing concerns about potential untarred effects of a non live RSV vaccine. These concerns resonate today with efforts to develop A. A vaccine against SARS covy to another aren a respiratory virus. Ideally, a safe and effective RSV vaccine will induce a more sustained adaptive immune response than the response that occurs after natural RSV infection. The results of the two current trials support the development of a monoclonal antibody with an extended half life to deliver passive immunity, as well as provide a basis for further study of Nanoparticle or alternative RSV vaccines to induce a protective and durable neutralizing antibody response both approaches offer hope that an effective means for preventing RSV infections may finally be incite. Uterine artery embolism or Myo. Mechta me for uterine fibroids by Isaac Magnon data from Saint George's Hospital, and medical school London. Uterine fibroids. The most common type of tumor among women of Reproductive Age or associated with heavy menstrual bleeding, abdominal discomfort, sub fertility, and a reduced quality of life for women who wished to preserve their uterus and who have not had a response to medical treatment, Myo Mechta me and uterine artery embolism. Are Therapeutic options. The FEM trial evaluated Mile Mechta me as compared with uterine MBA's -ation in two, hundred, fifty, four women who had symptomatic uterus in five royds and did not want to undergo hysterectomy procedural. Included open up domino laparoscopy or history gothic Meiomi McNamee in the intention to treat analysis. The mean score on the health related quality of life domain of the uterine fibroids symptom and quality of life questionnaire at two years was eighty four point six in the mile metonomy group and eighty in the uterine artery embolism. Peri operative and post operative complications from all initial procedures. Irrespective of adherence to the assigned procedure occurred in twenty, nine percent of the women in the Mile Mechta, me group, and in twenty, four percent of the women in the uterine artery. Mba's -ation group among women with symptomatic uterine fibroids. Those who underwent Myo Mechta me had a better fibroid related quality of life at two years than those who underwent uterine. Mba's -ation. In an editorial Elizabeth Stewart from the Mayo Clinic Rochester, Minnesota writes that a key reason to compare uterine artery MBA's -ation with mile. MECHTA. Me Is to assess reproductive outcomes. Uterine artery. Mba's -ation is used infrequently in women of reproductive age because of concern about potential adverse effects on fertility despite very low quality evidence to support the superiority of Mile, Mechta me with regard. Regard to pregnancy outcomes. The FEM trial is among the first major trials to evaluate alternatives to hysterectomy that included an assessment of the intention for pregnancy and that enrolled women in whom future pregnancy was desired as such. It is a big step forward although the numbers of pregnancies within two years after randoms Asian were low nine pregnancies and six live births after uterine. Uterine artery embolism and five pregnancies and four live births after mile. MECHTA me. There were no consistent between group differences in the levels of biomarkers of ovarian reserve. These findings set the stage for a larger randomized trial powered to detect live birth rates. The low number of pregnancies in this trial may reflect several factors statement of a desire for pregnancy with the real. Real intent was uterine preservation fertility impairment associated with fibroids or impaired fertility with increasing age. Since the mean age of the trial participants was older than forty years when the chance of live birth is low trials, comparing outcomes among uterus sparing treatments should be undertaken to give women and their providers. The data they need to make key decisions about these alternatives to hysterectomy. Phase. One trial of therapeutic anti yellow fever virus, human antibody by Jenny low from the Duke National University of Singapore. Medical, school Singapore. Insufficient vaccine doses and the lack of therapeutic agents for yellow fever put global health at risk. Should this virus emerge from sub Saharan, Africa, and South America Phase One, a of this clinical trial, assess the safety side effect profile, and pharmacokinetics of t y zero fourteen, a fully human iggi. One anti yellow fever virus monoclonal antibody in phase. One, b? Participants were randomly assigned to. To receive T Y zero fourteen or placebo twenty, four hours after live yellow fever vaccination y f seventeen, D two, zero, four during phases. One, A and one B adverse events within one hour after infusion occurred in one of twenty seven participants who received t y zero fourteen and did none of the ten participants who received placebo at least one adverse event occurred during. During the trial in twenty two participants who received ty zero fourteen, and in eight who received placebo at forty eight hours after the infusion. None of the five participants who received the starting dose of t y zero, fourteen of two milligrams per kilogram had detectable y F. Seventeen D- 204 vironia. These participants remained a VI- remix throughout the trial by Ramia was observed at. At forty eight hours after the infusion into of five participants who received Placebo and at seventy two hours into more placebo recipients. Symptoms associated with yellow fever vaccine were less frequent in the T Y zero fourteen group. This phase, one trial of ty zero fourteen did not identify worrisome safety signals and suggested potential clinical benefit which requires further assessment in a phase two trial. Treatment of chronic lymphocytic leukemia, a review Article Bouillon Burger from the university, of Texas, MD Anderson Cancer Center Houston. Chronic lymphocytic leukemia cll is the most common leukemia in adults in western countries with a male predominance and an average age at diagnosis of seventy two years. CLL cells proliferate in secondary lymphoid organs, lymph nodes, and spleen. Where B. Cell receptor signaling promotes the expansion of the monoclonal B lymphocytes B.. Cell receptor signaling is the target of kinds inhibitors which have transformed cll therapy during the past decade Bruton's tyrosine kinase btk. K.. And Eissa Form Selective Pi Three K inhibitors disrupt B., cell receptor signaling, and other circuits between cll, cells, and the tissues pro environment BC L. to an anti pop todd at molecule. Strongly expressed in cll cells has emerged as another important therapeutic target, the transition from chemotherapy. Chemotherapy based regimens to new molecular targeted agents is based on a series of clinical trials showing a survival benefit from bt K inhibitors, it broke NIB and a calibrate NIB and the BC L. to antagonists vanita climax as compared with older cll therapies. These benefits are profound in patients with high risk cll and are less pronounced in those with low risk cll. However, the new treatment approaches also come with challenges that is the emergence of drug resistance, serious side effects, and high costs, combination therapies to achieve deeper remissions allowing for fixed. Or intermittent treatment will help to optimize the use of the new targeted drugs. A forty four year, old woman with chest pain dismay and shock a case record of the Massachusetts, General? Hospital by Christopher Newton. and. Colleagues. A forty, four year old woman presented with cough dystopia and chest pain eight days earlier and three days after her husband had begun to have fatigue a nonproductive cough and a fever, the patient started to have chills a sore throat, a nonproductive cough and my Aljaz. After two days of progressive symptoms. She contacted her primary care physician infection with SARS covy to was suspected rest isolation measures to reduce viral transmission and increased oral intake of fluid were recommended along with Acetaminophen and Dextrathoraphan why fantasies as needed. Three days later, the patient had diarrhea and back pain. But the coughing had become less frequent three days. Later, the patient started to have chest pain that was different from the rib soreness with coughing the patient was brought by ambulance to the Emergency Department, on examination, she attack accordia and hypertension evaluation revealed SARS covy to in in a nasal fringe swab, as well as elevated levels of Trapani and lactic acid, and a decline in urine output. Imaging studies suggested acute cardiac dysfunction three hours. After the initial presentation, the patient was admitted to the cardiac. ICU This patient with SARS covy to infection had severe, presumably reversible cardiovascular dysfunction in the absence of clinically significant pulmonary manifestations of infection urgent management decisions were made. A darker side to retinoic acid revealed by. SARCOMAS. A clinical implications of basic research article by Francis. Ball Quill from Queen Mary University of London. MONOCYTES, macrophages, and myeloid. DENDRITIC cells are central to the host response to cancer and generally not in a good way tumor associated macrophages. Often the most abundant cells in tumor micro environments are recruited and corrupted by malignant cells to eight, the growth and spread of the cancer. A recently published article describes how malignant cell derived retinoic acid may be a corrupting influence. The study shows that retinoic acid made by sarcoma cells promotes the differentiation of monocytes into tumor promoting macrophages rather than immune stimulating, dendritic cells. Interleukin thirteen is produced by some types of t cells in the tumor micro environment and stimulates the production of retinoic acid by malignant cells. Inhibition of retinoic acid signaling in the tumor micro environment increases dendritic cells and induces an anti tumor t cell response that is enhanced by immune checkpoint blockade. Fundamentals, of us, health policy, a basic training perspective series, and editorial. By Eric, Schneider from the Commonwealth Fund New York. With this issue, the Journal is launching a brief prospective series that will provide a primer on both the main challenges facing the US healthcare system and key policy solutions that can address those changes. The first article in the series describes what we know about US healthcare today and the policy context for what an engineer Mike Call are perfectly designed system appearing in alternate weeks three subsequent. Will examine depth each of three key challenges. The US healthcare system must tackle if it is to perform at a higher level inequities and access and care less than optimal quality and high end. Escalating costs to final articles will explore potential government and market based remedies for what ails, our system physicians and other healthcare providers have an opportunity to influence the policies that shape the system in which they work. We hope to offer a foundation for a common understanding of where we stand and where we need to go. Healthcare as an ongoing policy project, a perspective article by Eric Schneider from the Commonwealth Fund too many Americans. US healthcare evokes Winston Churchill's description of Cold War Russia a riddle wrapped in a mystery inside an enigma U. S. healthcare is a wellspring of medical scientific innovation. It offers top-flight medical training. Many of its hospitals offer the most advanced, medical and surgical care for dire acute rare, and once legal conditions. It's best medical centers are the envy of other countries and the United States spends more per person on health care than any other country yet, all is not well despite these assets, the United States lags behind other income countries on health outcomes such as life expectancy, childhood health. Health and avoidable deaths for too many Americans. The quality of CARE is not optimal access to basic care is out of reach for many. The costs of care escalating for decades are increasingly intolerable to those who pay the bills whether governments, employers or individuals. American healthcare is also inequitable with gaps in insurance benefits and quality of care consigning people of Color people living in poverty residents of rural areas, immigrants, and Lgbtq people to worse care than others. Many gaps widened even while the nation was prospering, Americans have struggled for over a century to solve this riddle and bring about a high performing affordable healthcare system. Some progress has occurred, but many Americans believe that additional reforms are needed. Cova adds color line. Infectious Disease Inequity and racial justice, a perspective article. By Michelle Evans from the National, Institute on Aging Baltimore Inequities in health healthcare access, and quality of care are ingrained in the US healthcare system. These inequities are not a sign of a broken system. In fact, in this sense, this system is operating just as it was built to operate. It promulgates poor health outcomes for black and Brown people as an ineffable legacy of slavery in New, York City and other major metropolitan areas. Black and Latin x people have substantially higher Kovic nineteen incidents and age adjusted death rates than whites. American, Indians and Alaska. Natives have the highest age adjusted hospitalization rates followed by African Americans and Latino next people, black people and other minorities who live in poverty in dense conditions on the street or on reservations or who perform essential jobs are at unusual risk for infection. The covid nineteen pandemic is a stunning reminder of inequities. In American life driven by structural racism, we must recognize and begin to dismantle the normalization and legitimization of race based actions that have advantaged white people and produced pervasive adverse outcomes for minorities. Now is the time to begin to build pathways to health equity as a long term goal. In the short term, we need to expand free minority neighborhood based COVID nineteen testing reduce the time for reporting test results, increase tracking, and tracing context and provide cost free temporary housing to isolate non critically ill and ace symptomatic people with co vid living in densely crowded conditions where spread is likely. The illusion of inclusion, the all of us research program, an indigenous peoples, DNA a perspective article by Lou Fox from the University of California at San. Diego. Many. Indigenous populations have been geographically isolated for tens of thousands of years. Over time. These populations have developed adaptations to their environments that have left specific variant signatures in their genomes. Result, the genomes of indigenous peoples are a treasure trove of unexplored variation. Some of this variation will inevitably be identified by programs like the National Institutes of health. All of US research program, NIH leaders have committed to the idea that at least fifty percent of this programs. Participants should be members of underrepresented minority populations, including US indigenous communities. A decision that explicitly connects diversity with the program's goal of promoting equal enjoyment of the future benefits of precision medicine, but there are reasons. Reasons to believe that this promise may be an allusion previous government funded large scale human genome sequencing efforts provide examples of the ways in which open source data have been commodified in the past. The initiatives ultimately enabled the generation of nearly a billion dollars, worth of prophets by pharmaceutical and ancestry testing companies. If the all of US program uses the same unrestricted data access and sharing protocols, there will be no built in mechanisms to protect against the commodification of indigenous peoples DNA. Are Images in clinical medicine features a fifty year old woman who presented to the Dermatology Clinic with a painless ulcer on her Palette and a swollen lip which were associated with intermittent fevers and general malaise. She had a three year history of nasal obstruction with purulent discharge for which he had received treatment with Intra Nasal, glucocorticoid antibiotic agents. Physical examination revealed a large ulcer with an aquatic base extending over the soft and hard palates. Surrounding erosions covered with fiber annoyed eggs. You date were noted in addition to a swollen upper lip and discolored nasal discharge, the results of laboratory studies. Studies. Showed a white cell count of two, thousand, two, hundred per cubic millimetre, a haemoglobin level of ten point, seven grams per deciliter, a platelet count of sixty, five, thousand per cubic milliliter and a ferret in level of eighteen thousand seven hundred, forty, five nanograms per milliliter histo-pathological analysis of a biopsy specimen showed lymphoid proliferation with positive staining for CD three CD fifty six and grandson be, and then by virus was detected on inside to hybridization a diagnosis of extra nodal natural killer. T cell lymphoma. Nasal type was made a bone marrow biopsy revealed evidence of him, Oh phagocytes. Which is associated with this disease chemotherapy was initiated. However, the patient died one month later. In another image a seventy, seven year, old man presented to the emergency department with nausea, vomiting and diarrhea. He had known medical or surgical history and reported no shortness of breath or cough physical examination was notable for decreased. Breath sounds in the lower third of the right side of the chest and chest radiography revealed an opacity in the right Hemi thorax focused assessment with ultrasonography revealed no evidence of a plural of fusion, but the right kidney could not be identified A. A cat scan of the chest showed a right buck dalek hernia containing the kidney as well as have had exposure of the call in a Bach, dalek hernia results from a congenital pasta lateral diaphragm matic defect. It is a common incidental finding and the Hernias, often small and contains only fat large bucked Alec Ernie's containing the kidney as occurred in this patient are less common. No specific treatment was initiated for the Hernia and the patients gastrointestinal symptoms abated with supportive. CARE. This concludes our summary Let. US know what you think about our audio summaries. Any comments or suggestions may be sent to audio at any am dot. Org Thank you for listening.
Wichita Life Podcast #21 - Shelly and Chris
"I think it's really startling to go there and see so many people and even again because A. L. L. Acute lymphoblastic. Leukemia is it's so prevalent. Among children's seen the number of children with white lanterns. It's just really I mean. It's it's jaw-dropping. My father is a two-time time survivor of blood cancer leukemia and I mean if you talk to him today. He will tell you that he's alive. Because of the research that Alyssa's funded advancements in treatments and therapies we need help leading up to the walk on the night of and we also would just love to see more people who are passionate about finding cures and passion about making a difference for people like Hannah welcome to another episode of the Wichai podcast this this is landon. Today's podcast is brought to you by Il Primo. Il Primo is the oldest copy shop in Wichita and is located at central. Lawn schools back in session and Il Primo offers is a great place to do your homework and steady so stop by Hark. Open your books and try one of their delicious smoothies actor Strawberry Banana smoothie. This is the second half of an interview I had with members of the leukemia and Lymphoma Society. I spoke with Chris and Shelley who run campaigns for LS. A lot of people have friends as a family who have been affected by blood cancer or cancer of all types. Chris and Shelly are no different every three minutes one person in the US is diagnosed with blood cancer an estimated read one hundred seventy six thousand two hundred people in the US are expected to be diagnosed in twenty nineteen. The leukemia and Lymphoma Society Helps Lead Research to help cure cancer. We talk about all of this as well as a big campaign. That's coming up that they host every year called light the night which is on October Twelfth Two Thousand Nineteen Dermot Conversation with Chris and Shelley from the leukemia and Lymphoma Society Eddie this land in and I'm here with Chris and Shelley from the leukemia and Lymphoma Society. How're you doing. How're you pretty good so we'll just start off. Can you guys just tell me a little bit about society so the Leukemia Lymphoma Society is we are the world's largest nonprofit dedicated blood cancers occurred so our mission is to cure leukemia lymphoma Hodgkin's disease and Myeloma and improve the quality of life of patients and their families so we we fundraise money through multiple different campaigns like like the night with we'll talk about and the money goes to patient financial assistance cancer research. We do a lot of advocacy work at the state and federal level so yeah. That's really where where I work is cool and is that so so he's at worldwide. US wide what is that like yeah so right now. We're we're in the United States and in Canada actually to go one thing. I think that's interesting about our research is that we really will fund the research. That's most promising all over the world and we again we believe that because we're following the best research and and wanting to find better cures and treatments for cancer so if that happens to be in Wichita Kansas that's your refund that if it happens to be in Berlin Dan then then we throw that so yeah requ do most major cities in the US and Canada have an office I quit star does or is that sparingly. We have forty two chapters. I yeah so there's yeah there's chapters all over the nation and most of the major cities. We have have a chapter an LS has actually in its seventieth year this year awesome what Shelly said about research since our inception. We've funded over one point three billion dollars cancer research so it's incredible. It just really really awesome work yeah. Is there any specific place that a lot of the research happens like. I don't know like you said Berliner. Wherever is there like one place in the we're older in the US that a lot of the progress has made or anything like that. No I mean it's spread out all over everywhere but we actually have some research grants that L. S. is funding at Ku. Med Center nice so some pretty local young. That's really cool so how do new people get involved with L. Last year. How did you get involved with us. so we work we get connected to patients in multiple different ways mainly through nurses and nurse navigators. If they get a new blood cancer diagnosis they refer patients to our information resource center which is basically Cleo one stop shop for cancer patients they caller information resource center and we can give them information on their diagnosis. We can give them if if they're in that situation they can give them clinical trial information they connect them to us local chapters and they give them all the information that they would need if they need to apply for our financial assistance programs whether that be travel assistance program where he helped patients get to and from their treatment or pay for lodging being our pay for food or we also have a copay since program sure where depending on the diagnosis we can pay patients insured right. Kobe's nice very cool. let's see what does what does the research look like. Is it. like I said at universities you said Kay med center. Do you have any other details on the research in that aspect of it looks like yes so it'll take place either in in a clinical setting or in a lab and there are different stages and hopefully our chief medical officer won't be mad at me for misrepresenting any of it but by it can take place in different stages so we have researched that is looking at how cancer the you know the Genesis of cancer and how it starts starts in antibody in the human body there's really no way to effectively prevent or screen for most blood cancers and so we really don't let has Hannah had said we really don't know what causes it oftentimes. We do know that acute lymphoblastic leukemia what Hannah was diagnosed with is the most common pediatric cancer Sir and so we you know some of it will be focused to that and then otherwise a lot of research will be focused on. How do we have better and more more effective cancer treatments. That's less cytotoxic so as Hannah was saying is I mean it's basically poison that is designed in the hopes to you. Can't kill your cancer. It will kill whatever's in its path. So how do we have precision. We've invested in. We're one of the first organizations to invest early early in precision medicine to Japan specifically target cancer cells so that we can save healthy cells and help people have a better quality of life after treatment. I'm not not only survive treatment but not have to deal with the lingering effects of you know liver problems kidney issues we want to see people thrive and and survivorship and not have to be crippled by that so that's a big aspect of it as well. We have two big focuses. The past several grow years one just announced recently one is for acute myeloid leukemia which had not seen really any advances for or forty years. We were using the same treatments for forty years and really having poor poor results on in terms of survival rates. Let's versus acute lymphoblastic leukemia in the nineteen sixties. It was a four percent survival rate and now it's in the high ninety percent so ninety percent survival rate so yeah so we're wanting to see how can we how can we have advancement in this specific type of leukemia that hasn't seen advancement and so so we have an AM L. AML Trial Ku is one of those sites and I believe there are eleven sites now and we've seen a lot of great results. What's already with people and their I think putting one drug to market now that came out of that trial and our next initiative is the children's initiative and so oh it is way to difficult to get new treatments past for children and any for any type of pediatric cancers diseases and were try. That's what's really stalling. Progress and cancer is so different and a Ch- a child that it isn't an adult and we're oftentimes I mean so we need a lot of a big focus on on how to help pediatrics patients and so we're I mean really leading the world's and in clinical trials and what that looks like in coordinating with a number of different organizations that you know the government. FDA and hospitals all over the country to figure out. How can we all come together and share information share resources because that's at the end of the day. What we want is to see cancer cures hundred percent. That's really cool so then the sleeve and a little bit to light the night. Can you talk a little bit about what that is when it is with Alex so so light tonight as Chris said is just one of our of our fundraising campaigns and again we are are these programs that we talked about travel. Assistance stance financial urgent need different things like that is funded by these campaigns so light. The night is is a really family focused and a patient survivor focused type of events so it's taking place on Saturday October twelfth and Exploration Place registration it opens at six and I think one of the most incredible and Hannah touched on this a little bit too. I think one of the most iconic and incredible parts of it is our lantern so it's an evening walk. We have three different colored. Lancer lanterns that registered participants get white is for survivors read as if you're walking in support of a patient or research and gold is if you're walking in memory of somebody you've lost and so that night again is just it is meant to be a where we are literally lighting the night bringing hope to the darkness of cancer and that's our tagline and that's our hope and that's really what we as at. LS strive drive to be for patients and for people who have been diagnosed with these illnesses and so that's a really fun night. It's it's a short walk past past the keeper of the planes that Mac to exploration place we have a program where we we have a mission speaker and we have a moment of the night where all of our survivors evers and we honor any cancer survivor research benefits a number of different illnesses and cancers where they come into into the middle with their white lanterns and we we have a beam of light that goes into the sky and it's an incredible moment to be a part of so so yeah that's like the night and it's actually the the fastest growing charity walk in North America as pretty cool over a million people across North America participator yeah so do you guys need help with if people wanted to volunteer. How would they get a hold of you guys. How could they get involved with that. Yes we would love people's health. We we would love love that so I can provide my you know my email and contact information but I would say we would we need help leading up to the walk on the night of and we would just love to see more people who are passionate about finding cures and passionate about making a difference where people people like Hannah and and that would be registered for the walk and raise money one hundred dollars just raising one hundred dollars or donating one hundred dollars. Will we'll get you an event t shirt and a pastor food tent the champions for a cure tent so I would say that's a great place to start and you know we're biased and that we've seen in the families and the faces of Actually Ben have actually benefited from our research or financial assistance but I will say it is great work and I would encourage which people come out and see what it's all about and and I would hope that they would see the magic of the night when they attend for sure. I think most is people unfortunately know somebody or have been affected by something like this. But is this open to people that don't have that and maybe they just. WanNa go just go somewhere and other people yeah yeah I would say yes. It definitely is and it's just a a great I think event to be a part of your community and it's a beautiful I mean Scott Scott talked about it but I mean being at exploration place right along the river seeing the keeper of the Plains at night with these lanterns it is a beautiful event so even if you're just looking to come out and see Wichita downtown Wichita and its beauty. I think it's worth coming out for that too and also again. Hannah got talk doc even for her seeing people who have also been impacted by this disease. I think it's really startling to to go there and see so many people and even and again because A. L. L. Acute lymphoblastic leukemia is is you know so prevalent among children's seen the number of children with white lanterns. It's just really really I mean it's brings job so that's a big thing yeah and it's also it's become a night for cancer survivors. Whether you have a blood cancer or brain cancer whatever it's a night of hope and inspiration so like showing before all survivors no matter what kind of cancer you've had ghetto the white lantern until you get to meet all types of people and that becomes you get connected to them and said it becomes a an inspirational inspirational and I will say to I. It's also a place to remember people you've lost and I hope that that is you know continues to be a space space where people feel like they can come in. Remember their loved ones we do. We have a remembrance pavilion. That is a place where you can come and write a memory or share are a memory but I think it's also one of those things just like for hannatised the other white lanterns to see other gold lanterns to it's also. I think in a weird ordway comforting to know I'm not alone and so many people have gone through this and so I think that I I've had the opportunity to be there in memory if someone to and it does provide a okay I can keep going keep doing this and and I think being there as someone who's lost someone you see these other. Lanterns is any WANNA keep going to help those people. That's really cool. I hope a lot of people here this and get get involved. Maybe attended attend sounds like an amazing event. I'll definitely link up all the everything about it on the website your email how people get involved everything like that so what was each of yours inspiration for joining the society because you both work for L. S. right so what was your inspiration for wanting to join yeah so what I do every day. I'm campaign manager for campaign director for a different campaign or man woman of the year campaign what I do. Every day is very passionate to me my father there is a two-time survivor of blood cancer leukemia and I mean if you talk to him today. He will tell you that he's alive just because of the research that was funded advancements and treatments and therapies you know he he was diagnosed for the first time when I was in kindergarten and and then again when I was in fifth grade so I don't remember a whole lot because I was so young but he like. I said he tells me now that you know when you relapse you typically don't get the same treatment that you did the first time so you have to go through a completely different treatment whether that's okay chemo and a bone marrow transplant put your mission the first time so if relapse from that the second time you have to get a stem cell. L. Transplant and each time those advancements are in most cases done and founded by research that we do so ah what I do is very important to me and obviously help my family a lot too yeah for sure yeah I got originally introduced to light the night when in nineteen ninety nine so my my best friend growing up her brother was diagnosed with t cell acute lymphoblastic leukemia so a more rare complicated weighted version of acute lymphoblastic leukemia and he was he put his cancer intermission three times but eventually passed away at the age of thirteen and they attended as a family their first light the night walk on his birthday they while he was alive and he got to experience that and them as a family and then passed away just a couple months later and I think watching my friends his family and you know all of us have gone through really hard things and in some ways if people just go hide under a rock the rest of your life you totally don't blame them for that but I got to see this family and I think I was eight seven or eight at the time they totally just went went into this. I mean fierce mode of we don't want to see this happen again and her older sister and you know with their parents organized is to light the nineteen and we were called the young hearts so if you can imagine like seven eight year olds and then a bunch of high-schoolers right around I mean I remember having wagons of like donuts and bagels that we would bring two houses and ask people for money as like an eight year old to raise raise money for our less and it just I mean I think what was amazing was it was so it was my first experience ever losing someone that I knew and uncared about and then like the night just became part of my child so we had things every year that we would do to raise money for LS and we would go to the walk doc every year and I think we had homecoming twice the same night in high school and we still went and are dresses. They went to homecoming afterwards also but you know so that was incredible and sadly we had other people in our community diagnosed with with blood cancer afterwards and we lost one of our friends friends in high school or junior year of high school to leukemia so I think it just made I mean obviously it made life really hard and and made me really angry in some ways but it also reminded me that man this work is still so important and to see those families continue to come to the Walker advocate for LS. I mean my friends family. This is their twentieth year of going to the walk and raising money for the Wiki me Lymphoma Society so I I think that in that way I was so lucky to have people that inspired me to do that and so it was very little of myself and a much more of them that it got me here but but I think what's incredible is now in our work. We meet families here that are affected you know in Wichita that are affected by this and it just keeps you going so so yeah. I mean it's crazy. That's why it's so important to participate in events like light the night or any other fundraising campaign that we we do because there are families that are going through this on Wichita their stories that people never find out about you know. We've served a patient in their family whose daughter was diagnosed at birth with blood cancer. A boy who was relapse six seven times you know had to go through different clinical trials and eventually passed away so their stories like that that are happening right here in this community that funds that are raised through events like this go and help those families or more advanced treatments so that families don't have to go through that anymore and if we continue to do that then obviously our end goal secure cancer and we think we can be close to that but let's let's get as close as we can. I don't think a lot of people know those types of stories unless it was somebody in your close family or somebody at school with you probably don't know about those so right. I think it is important to get those stories out there. with each of your personal experience. What was the hardest part so for example I mean you. You said you were pretty young. Chris Chris kindergarten fifth grade was what was the hardest part about that or did you even really realize it until later on yeah definitely things that I realize later on I think in the moment so you never forget like I'll never forget my dad's hair falling out in clumps on his pillow in the hospital but I think I realized a lot of things afterwards necessarily with my mom. I'm the oldest of the three boys so obviously she was hauling three boys are forced to the hospital to see their dad and having to take everything around the house while her husband's in the hospital so you realize those things afterwards yeah yeah. I think that it was a little different sprint from my experience being seven or eight or six to eight years old and then being in high school but and it's it's funny to think of through the eyes of a child old you know. I thought it was so cool that my best friend got to sleep over during the school days your school you know and so that was amazing to me that you know or it was for some reason it was so fun for us to go to the hospital and to play on the playground there and to see her brother and I don't remember being freaked out by him losing losing his hair or I I do remember seeing him you know in a state that never had seen him before and I thought it was weird that they have never had toilet paper in their house and that's because their parents were busy you know taking him to and from appointments and that's just you know and it's stuff that now I of course understand in a totally different way but as has a child it's just you know you cannot process it and then in high school. I think the hardest part was just trying to not be really angry. I was not not as cool calm and collected his hand. I mean no and no way I was really really angry and so it took some time for me to to get over that and to even get over it but to kind of let go of the anger to accept and and it's just weird being a high schooler and trying to do that. We're going into college and be like Oh. You never had people. All these people died. I mean why that's totally normal normal. I don't know so yeah it was just very strange so gave me a weird perspective and and also helped gave me a really great perspective in some ways but was that was my probably my biggest challenge. do you guys have anything else on your mind or stories or anything that POPs up about the society society or like the night don't thinks oh that's no problem. Just WanNa make sure I'm not missing anything so and so makes it up just a little bit. It just got a couple of other questions. I can ask everybody so. Is there anything that you guys often. Recommend people books movies podcasts. TV shows shopping show is gonNA answer these new any okay okay. Yes I listened to a lot of podcast these days because I drive back and forth between our Kansas City and Wichita offices so I have really enjoyed revisionist history by Malcolm glad well that has been awesome and then I'm kind of a science nerd so or history nerd in some ways. I Love Hidden Brain rain. I don't have never heard of that but I absolutely love that podcast to and then I had to stop listening to this because our our entire you you know day is filled with talking about oncology or cancer but the emperor of all maladies is a biography of cancer and it's phenomenal book. I'm it is very dense but phenomenal book and it really gives a perspective of just how cancer treatment in general has changed. It gave me such appreciate an appreciation for working at ls and just learning about about that so yes so that was that would I would say to to link those up. Do you have a favorite failure in any aspect of your life. I want to say this is my favorite failure. Let's see so in some ways. It's a failure because my body failed me. I played uh-huh Division. One field hockey and let's see so my senior year I tore my labor and my shoulder and I I remember so I tried to you know I got surgery right after right after season and tried to get myself together to go and trout for national team my coach was wonderful was really encouraging you to do that and I think it was a total epic failure because I literally gave myself itself probably four months to heal from a pretty major orthopedic surgery and then to go play really high level field hockey teeth so obviously return my labor and it was I did I did find during our the scouting tournament tournament but I was obviously not at my best and Retour my labor and so that was a total epic failure and pretty emblematic of me and general trying to do things my pace and not not waiting and patient. I think if my husband's listening he'll say they still do this but by yes yes. That's probably my favorite failure in that. It was so humbling to say literally my body is not doing this and I that's kind of my fault but you know again another place of having to accept and having to to move on and find new dreams and you're probably not from Wichita Kansas because I don't think anyone playfield talk here. I know he's I know East Coast. It was what is your definition of success. I think that I would say my definition of success is doing things with integrity and that's something then I try to tell myself that obviously we have goals and you know in our work career goals in our life but I would say if I'm doing everything that I do with with integrity and to the best of my ability then that successful even if I hadn't if even if I don't hit a benchmark that is placed for me for sure. Do you have a motto. Oh life motto you live by or what some of the best advice you've ever received yeah so the honestly another field hockey reference yeah. I would say one of the best I mean most incredible informative advice was my coach who gave us a list of standards for our team that I still use to this day and one of those that came to mind was uncomfortable comfortable being uncomfortable so trying to you know oh again. Put yourself in situations where it's probably uncomfortable but the more you do that the more comfortable you'll get in those and so. I think that's to me. It's just a reminder to challenge myself into not live in a comfort zone and you know not to put myself in harm's way by any means but to push myself and so that's one thing that one one of my life motto is. I guess what is a habit that you've developed over the past few years as most improved your life okay. I'm working on developing this so it's not I have not master. Congress is good but I would say pudding my devices to bed before I go to bed. That is something I keep telling myself. It is so difficult but I keep I keep telling myself that. Put your devices to bed before you go to bed and it's just good sleep hygiene. It's super healthy for a marriage or family whatever it may be even if you're single. It's the healthier healthier choice so yeah. That's what I'm working on developing practical tips. Do you have the phone in the the room. What does that look like it and it really depends I guess on on a person's willpower guess or just you know every individual person and I'm pretty good as long as as long as I set my alarm I can turn my phone over and I'm pretty good about not touching it again so I can leave it in my and my room I I would say I need to find a lock box to put my husband's phone. Away in both of us are trying to do this but by so really depends on your you know yourself and try different things but that really works for me is once. I set my alarm I put it down and I don't look at it again. I think that's a lot more self. Control than most people have included the first thing you do when you wake up exactly exactly yeah and I think about it. I'm like Oh. I don't check this. Check it anyways. It's hard but you know baby steps and I'm still working on it heck. One of the things that I've done is almost live by counter my phone yeah. We don't have a paper counter anymore or but if I didn't have a calendar on my phone what would I do yeah. It's a very good point wouldn't know what's going on so for both of you guys Wichita resident in an newly wichita visiting resident. What is your favorite part of Wichita or a hidden gem in Wichita. I don't know if this is technically a hidden gem but I love the restaurant and the public of the brickyard love it and maybe I think it's hidden because you have to walk down the bricks. It's kind of like an dark area but I love that restaurant a friend it's very good. Let me know I didn't even know. was there a couple of years ago and I go there very often. Actually I do have all say when Lesley's Coffee Co.. Is that the I've been there a couple times and love that place. We've just been once but it's awesome yeah. It's so cool and I am a big coffee person and and so that's been awesome demento cheese toast. Is there anything you wish which had that it doesn't or what would you improve wichita now. Obviously I feel like which tells growing now We're about to get a dave and buster's. Everyone wants a cheesecake factory. everybody wants yeah. Everyone wants a cheesecake and have which cheesecake now if they haven't had yet but I haven't tried that but no not not particularly but I'm excited about the new baseball stadium it'll be very excited then so I guess for each of You even shelly what does Wichita mean to you guys when when people say it's all I think of carrying community especially working in the nonprofit Rome. Obviously I work for us and the things things that we do are awesome but there's so many other nonprofits that support families and other initiatives that are great too and I think that's great aspect of Wichita that if someone needs support a family needs support your kid's been diagnosed with cancer whatever it is there's places you can go and people you can talk to that are there to help. You and I think that's an awesome uh-huh yeah. I'd say probably pretty similar. I think I've been I never imagined in my wildest dreams ever living in the Midwest and really did not know Wichita existed until a year ago and I'm so grateful that I'm here and that I have the opportunity to come down so frequently silently and so I think that that's the biggest reason as meeting different you know whether it's families we work with you know meeting actual caregivers givers or doctors and nurses so that's really my my sliver of a lot of who I spend time with but but I have been just so blown away by people's heart heart and and yeah willingness to give a helping hand and yeah how kind people are was I joked before we started this and said I was so weirded out when someone asked me how I was doing in line Tanya soup kitchen because I was like what is what do they want from me but that's so great like I need to soften my heart and and realize that it's okay for people to ask me how I'm doing so yeah so that's really what I would say similarly yeah carrying community. Ben Ben an incredible experience feel so fortunate to have met so many people down here for sure. I really appreciate you guys both coming on Christian. Shelly is talk about the society what you guys do research and light the night and hopefully it's going to be a great event again. Just keep building every year so I appreciate you guys coming on. Thank you thank thank you. Thank you for listening to this episode of the show. I've podcast you enjoyed please share it with a friend and leader of you on whatever podcast buy from us and putting all the podcasts on Youtube now as well. We'll start doing video podcasts for some episodes feature cigarette. A witch hunt ripe podcast. You WanNA support podcasts ahead over her paycheck.
A Story About The Dentist, The Hoover Dam and A Life Changed Overnight
"When something like this happens to you or somebody that you know a magnifying glasses held up to who you are and what your mark is on the world on people the millennial generation is as as follows well come by podcast back talk radio podcast? I am back in about a week and a half or so. I've got a good one for you this week. Actually it's about my life for the past couple of weeks. It's a story about a dentist. The Hoover Dam and lives changed overnight. It was <hes> couple of weeks ago and my daughter had been have not feeling very well or for the past six weeks or so and she called me up. She said you have to have this bleeding. Gum issue. My gums have been bleeding for a while and I'm going to go into the dentist. I said well you know great idea to have them figure out what the deal is so she went into the dentist thinking that it was probably you know on Ginger Vitus or some basic reason for the bleeding gums and the dentist indicated that was not the case and that it could possibly be diabetes well. If you know anything about diabetes. There's two types as type on type. Two Hugh type one is <hes> something that's with you. All that's the one that the kids diabetes is usually a type one. I think it's called juvenile and it's just one of the genetic things that happen. <hes> the other type of diabetes type two which usually usually comes from its adult onset usually and it comes from people not taking care of themselves eating crappy and <hes> blood sugar issues of resulting from that she's extremely healthy. She eats fantastic cleaner than I do and she's never had diabetes in her life in terms of type one thing so that was probably a stretch and so when he said that of course she called me she was very concerned about the diabetes. I reassure that this is not going to be the case is got to be something else so what the dentist did was. He recommended that she go get a some blood work done <hes> just to see what the deal was so. She had a friend of hers just because at this point I don't think she has a general practitioners. You've got a friend that she talks to quite a bit one of her best friends and she had referred her to the General Practitioner over down by where my daughter lives she went in and got the blood work done one and then was waiting for the blood work so this is a couple days ago and the next day the next morning I was leaving for Las Vegas because I have a place out there and I have a place here in Scottsdale and I go back and forth because my girlfriend's out they're in on that Tuesday before I left Vegas I talked to my daughter and I said well just let me know what's going on. When you get the blood work back and she just had done that that day so Wednesday morning I climb in the car and I take my four and a half hour drive to Las Vegas now? During this week it was spring break for her two daughters or daughters or fourteen and sixteen and she's really great about creating these activities and these specific specific memories which in hindsight I didn't do that as much with my daughter and I really wish I did and as something that <hes> I would suggest highly to you when or if you have kids is to make things Kinda goofy and Weird Jordan Fund now for instance this this situation when I went out there we were going to do for three or four days straight route. We're going to do a wild west spring break and it's because she didn't take her kids anywhere for their spring break. The people were going out to San Diego or Kabo and she was at home and she wanted to make it kind of a special goofy thing which included bandannas cowboy hats and everybody got a chance to be sheriff for. One day and to be able to make some choices in terms of what we were going to do and they had to wear this big old shiny sheriff's badge in public with Bandannas and with the hats so it was Wednesday morning warning and I again I climbed the car and I drove out to vegas now four and a half hours later I get there then it's off to the wild west spring break activity for that day which happened to be going to a ghost town now that goes town is not necessarily early close so I drove four and a half hours of Vegas now I'm driving another two two and a half hours into California and we go to the CALICO ghost town for the record. Wasn't that bad. I thought I was going to be kind of a touristy thing but it wasn't that bad so we get there and we're walking around and having a good time and at the same time that's happening. My daughter is going in and getting her blood work done at the doctor that her friend recommended my daughter historically over over the years has had ups and downs with health and she hasn't felt very well and so it's not necessarily a boy who cried wolf thing but I tend to let things play out with her if she doesn't feel well and usually she starts feeling a little bit better and so I just at at that time in Calico ghost town in California I had indicated to her. You know you're not feeling well. Just let the blood work come back and we'll see what's <hes> what the deal is where we need to do so enjoy. The rest of my day at Calico drove another two and a half hours back to Las Vegas in mind you this is the same day I drove out there so it's still Wednesday and we get back and we have a nice evening Thursday morning rolls around and the plan for Thursday morning because <hes> somebody else was sheriff and they decided on the new activity it was to go to the Hoover Dam now. If you know about Las Vegas in the area you know hoover. Dam is one of the largest dams I think it's one of the largest dams in the world and it's very very popular as a matter of fact. It's been a ton of different movies. The one that I can specifically remember is fools rush in with some a hike Matthew Perry and where the she would cross over the dam from Arizona to Nevada because she lives in Vegas so Thursday morning. We've got plans to go to hoover dam. I get a call before we leave while we're still at their house from my daughter and she is saying that the blood work came back came back really quickly and the doctor called her up right away and indicated it could be could be acute leukaemia now. If you know anything about leukemia which is a blood cancer and it's a it's a very severe blood cancer. Cancer is probably more than I even know because at the time I thought there's no possible way that you could be fine and healthy one day and then all of a sudden the next day you've got acute leukemia. I mean whatever that is specifically because I I didn't know of of course thinking about cancer. I had these thoughts about seeing the signs ahead of time or being a genetic thing where you get the stuff from your parents and there really isn't any issues in terms of that type of cancer in our family at aw on either side so she's for Rican out of course rightfully so because somebody just told her she has leukemia. I'm trying to talk her off the ledge but the doctor told her at that time he said you should immediately go to the emergency room over at the hospital here in the valley that specializes in leukemia so she was being driven over to the emergency room in Phoenix and I was heading off to the Hoover Dam on the Arizona Nevada border obviously thinking that she she would go there and then they would do a more extensive blood panel test honor and it wouldn't be this crazy leukemia thing so we get to the Hoover Dam and as me and my girlfriend and her two daughters are walking across across the Damn I'm literally in the middle of the damn right on the state border of Arizona and Nevada right where if you saw fools rush in the movie that is where at at the end spoiler. Boiler alert she he stops her in the car and it's raining and she has the baby. I mean that exact spot on the damn I get a call from my daughter's husband indicating that they have done the blood work it is indeed need acute leukemia and she has to immediately be admitted up to the oncology floor of the hospital and she's going to start chemotherapy the next day so that was something of course at that time I really don't remember I sort of zone out a little bit thinking that okay well. That is what it is instill at this point. I'm really confused thinking that leukemia is something that is you know genetic or there would be some sort of indication in I was a bit of denial at that point thinking. How is that even possible so when her husband did talk to me he indicated that I should come back like immediately so I let my girlfriend though and let her daughters no and they were very understanding and we got back to the car climbed in the car drove another half in our back to Vegas remind this is the the day after I drove out than we drove California then we drove back <hes> so I was in the car for what four and a half nine hours nine and a half hours there's the next morning we drove out forty five minutes to hoover dam? We drove forty five minutes back to Vegas. I got all my stuff together than I drove then I got the car and drove back to Phoenix and it took me about five or five and a half hours because I was going it was dark at that time and then I had to hit traffic so that night I rolled into the hospital at about eleven o'clock clock went up to the room and my daughter and her husband were there in my role over her life is typically bend the just chill and let's see what happens because there's a lotta stuff that can or could <hes> there's a lot of stuff that might not or won't in you don't know in the moment and so- speculating on worst case scenario or what if's <hes> is a horrible way to go about things plus the fact that it puts anybody's body in a reaction mode and it heightens the stress levels it heightens the cortisol you know those those stress hormones and it doesn't help your body to relax lacks and allow it to function as best it can especially in moments like that so we had a nice long talk and I went home that night because there was a meeting with the doctor the next morning to discuss the treatment plan it what we were going to have to do so I got back to the hospital the next morning this is Friday morning at about ten o'clock. We had a meeting with a doctor and he's fantastic in the staff is fantastic you just for the record and he sat down with us was a group of family members a win over what the situation was come to find out. There's two major types of leukemia. I won't go into all this stuff but just to give you kind of a background. There is acute and there's chronic chronic is something obviously that last or goes on for a long time sort of a maintenance thing in terms of treating it and a lot of people have lived with it for quite some time and there's then there's kind of off shoots of the chronic then there's acute and acute his basically exactly what it is. It's cute it comes out of nowhere and there's no genetic correlation which means there's no it because your family has it. You have a possibility of getting it it literally happens out of the blue and what the doctor had told us is is that people have a three and a one hundred thousand chance of getting something like this like a lotto pick in a bad way so she happened to pick a bad lotto ticket on this thing and that's exactly what she had and then he laid out the procedure and the procedure was for chemotherapy to start immediately which started that night and the way they're treating this. They'll do this five days of major chemotherapy which is a combination of chemicals that that literally kill off the bad cells as well as. Is the a lot of the good cells so white she out in leukemia is a blood cancer. Your bones create your blood and so the leukemia has to get into the bones and kill off all of these stem cells which are creating your red blood cells and your white blood cells and your platelets so because of that and because it's such a strong blast of chemicals she has to be in the hospital for a month straight with two worst parts for her. The the the number two worst part is the fact that she's going to lose her hair and actually bad John. It's happening now and she just had a shaving party and had a bunch of people there and it's a very traumatic thing regardless. If you're a guy or girl in a losing your hair is it's almost a realization that you are in this thing and this is actually happening to you but actually the worst part was the fact that she can't see her kids for a month because kids are little petri your dishes and this is such a highly susceptible situation to where any little virus because she has no immune system any little virus can get in there and do some real damage and she would have extremely difficult time. I'm fighting it that she's not able to see her kids for a month. I don't care if you're a parent or you're not if you can imagine not seeing your loved one for an entire month. That's a rough go. It certainly created a a lot more empathy for more so her but for me as well about people who go off to serve in the military and they're gone for a year at a time I mean that has to be you know you see it and they come back Jack and they have these amazingly fantastic welcome backs and hugs and the kisses and all that you think that's great but like anything else in life. If you don't live through it you just don't get all of it until he had lived through a little bit of that and this is a month and it's rough so I can't even imagine it for an entire year and so after the thirty days there's the process goes about eight or nine months and there's a lot to it includes a stem cell replacement therapy where she has to get brand new stem cells from donor. That's a match all of these things I I'd like to stress. I had no idea existed. I had no idea about donor matches in blood stuff. I had no idea that they know so much about this because the research has been so extensive on this that they know if they have if there's a derivative of chromosome and it's flipped than they have this much of a chance for the initial round of Chemo to work A. and if they don't have that then they've got to go through the stem cell and they have determined that right from the outset that she has the certain genetic makeup to where they're gonNa have to do this. Thirty Day then is going to have to be a couple of follow ups and then she's going to have to go in for another a month up at the Mayo Clinic which is one of the best in the world to do stem cell replacement which is replacing all the stem cells in the bone so they can all basically create a taking engine out of a car and replacing it with a brand new new engine to power the car. They're gonNA give a brand new stem cells from a donor that has a gene match of these ten specific genes once they do that then she'll start generating these in the fascinating part about this is if if she's an o positive which I think that's what we are in terms of blood type then whatever the donor's blood type is. That's what she's going to become the donors in a then she'll become an a blood type. Isn't that trippy because that's the type that's going to be made in her bones and the donors can be different blood types. It's just all the stuff is so fascinating and medical research in what has been accomplished in the last ten to twenty years is mind blowing so that leaves me up today. It's been a couple of weeks and I have to say overall for all. She has gotten some really great news at every little step along the way. It's great that she's young. She's twenty seven. It's a lot easier to fight it. The the median age the average age for somebody that has acute gets this. Acute leukemia is sixty eight so it's random that she has it but because she's a young adult. She's in the best possible place for her body to regenerate in a fight this thing the first round of Chemo Ema went well. It wiped it out. She's got a couple more weeks left in the hospital. She's handling things like an absolute trouper. She is a warrior and there is more support than she can ever imagine. That's one of the takeaways I would. I'd like to talk about when something like this happens to you or somebody that you know a magnifying glasses held up to who you are and what your mark is on the world on people and seeing the amount of love and support from so many people from so many different places from so many different aspects of life from the world that you live in. You've got your the world when you're young and then the world when you're in sports the whirlwind your and dance the world now the whirlwind. She's been a teacher that her teaching world her family world all these worlds coming together and having so much love and support from everybody really shows on the type of person that she is and and the mark should she has made in the world and I was talking to her and it was almost like Jimmy Stewart in. It's a wonderful life. If you haven't seen that Christmas classic movie at the whole thing about him wishing he wasn't ever born and in this angel gave him the wish and he rolled around and he saw how shitty the world was <hes> because he wasn't born and when all that changed back into real life he realized that he does matter and he does make a huge huge imprint on people and that's a big takeaway that I have embraced and I would hope that you would understand because if you are listening to this right now then you care about yourself and you care about about other people and you want to be the best version of yourself and I will tell you now without even sitting down and having a coffee with you yet is that you absolutely positively matter and you absolutely positively or making a positive impact on this world. I can say that with no reservations at all because if you're sitting down here with me and we're sharing this together then I gotcha there are three little takeaways outside of that that I would like to share with you about this story. The first thing is is that you know you'll never be ready for stuff that can happen. I had an ex of mine and and her one big flaw was the fact that she would always be one of those worst case scenario people and it just killed her and it killed the relationship. You can't brace against is to storm when you don't know what direction it's coming from because then you're putting all your effort into planting your foot in a particular direction or focusing all your efforts in a particular direction where a storm eat whenever it comes if it does or doesn't is you may never know where and when and how and what from what direction so it's it's pointless to sit there and spend your life any any point any time of your life in bracing for something. That's a possibility without a strong probability in the possibility probability thing is a really important concept and here's what it is the possibility of of me walking outside right now and getting hit by a bolt of lightning. There is a possibility. There's a possibility of it happening to you. There's possibility that you walking outside and finding a hundred dollar bill on the ground is a possibility right anything's possible or most anything. The probability of that is the chance that's the probability. It's buying a lotto ticket. You have a possibility winning. That's why they sell them. The probability of winning is the odds. Will you probably not but that's the probability so it's the whole thing about sitting there and trying to be ready for things in your life or trying to brace against things that might happen to you the with the probability of it being really low and that's the one thing that takes so much time and effort. I've worked with people so often a big hangup that they don't even know that they have of is that they are putting so much effort and focus and stress and energy into a thing with such a low probability level sure could be possible that you're gonNA flunk out of school. It could be possible that you get fired could be possible that your significant. We're GONNA OTHERS GONNA leave. It could be possible that your kid hates you. The probability of all of those things more than likely probably really low so don't get caught up in that the second takeaway that I have is focus on what is instead of what if I hate the what ifs because what if again ties into the whole possibility probability thing what what if this what if that will you know the one thing I realized in talking to my daughter and talking her off the Ledge at certain times and getting to the hospital and going through all this is focus on what is now. What is the case? What is the reality it is that you know you've got this and you're fighting it and you're in a great location and there are people that care about you? That's the focus the what if in regards guards to what if this doesn't work what if that doesn't work what if I have something that's incurable what if I can't find a donor what the those will kill you and it happens all the time with a lot of people even if you're a very optimistic person the what ifs always crawling depending pending upon the situation but the key is understanding that when they do crawl in pattern interrupts pattern interrupt out of the what ifs into what is now in focus on that what can you do now was the reality now when when you cross that bridge any of the what ifs kind of happen positive or negatively then you deal with them at that time but it's pointless too much energy too much stress too much anxiety is put into the what ifs try and keep those out the third in the last takeaway I have on all of this is interestingly enough and surprising enough. There's a benefit to all of this. The benefit I'm speaking of is value value and it's about valuing life. I'm not the type that philosophize in terms of every moment is precious and thank God for every moment of life I mean that's a great thing but in the moment comet when you're when you're half your workout in your yelling at your trainer or you're sitting in the dentist chair getting something drilled out of your head in those are the Times that I'm not going to be valuing that particular moment for what it is. It's more of a coping skills but it's an overall picture of valuing life and how it can change so quickly the benefit in realizing the fragility of our existence here is a big one because it certainly makes you appreciate things what you have any appreciate shit. The people that are around you your tribe the people that you care about in the people that care about you. That is my story about a dentist. The Hoover Dam and lives changed overnight. I'll be enjoyed it if you have any questions. Nations are comments anything fun any story of your own. Please let me know I'm always interested about that. You can reach me at Tony at Java Bud Dot Com J. A. V. A. B. U.. D. Dot Com. I like coffee and I like being a buddy does for the job but counts from the websites got a podcast videos some giveaway stuff. I've got some fun stuff coming up that have been kind of back Bernard here over the last couple of weeks but I'll get back on track with that something comes in your life that gives you a little bit of a detour detour stalls you out. Let it slip away you back to when he thinks of you.
CAR T: The Underdog Cancer Killer
"The ski choir podcast is brought to you by Permira Blue Cross a company that believes the power of innovation and technology will improve customers lives by making healthcare work better, see what's cooking inside premier as test kitchen at premier dot com. Slash innovation that's p. r. e. m. e. r. a. dot com. Slash innovation. Hi, everyone. Geekwire podcast producer, Clermont grain here as you may know, ARA geekwire summit is happening on October second, and third. So we are skipping the week in geek as we are preparing for that big event. If you're interested in attending, we still have tickets available. Good geekwire dot com. Slash summit to see all the details and all the speakers that we keep telling you about that we are so excited. For personally, I am excited for our health technology track and intendo of America president Reggie fees may. He is going to be such an interesting speaker until then I wanted to share one of the episodes in our health tech. Podcast with you. If you're interested in hearing more of these episodes, you can subscribe to it by searching health tech in your podcast app, right? Here's the show. I was diagnosed in two thousand six with non Hodgkin lymphoma. So it's a blood cancer, and I was in the category that is considered incurable. A very large majority of the scientific community sort of viewed this as fringe research. Received my infusion on July second. I had a scan July thirtieth, and I was supposed to find out the next day, but they called me that evening and told me that I, it was clear that it was totally clear. I was in remission. When you see someone go into complete remission, three weeks after this treatment just astounded, and I've seen huge tumors just melt away in the first couple of weeks. I think it may in some ways be essential to cure cancer. Wait, you're hearing about is not a miracle. It's a new kind of cancer treatment called car t. immunotherapy. Basically, this is where scientists reprogram your immune system to destroy cancer, and it is the hot thing in biotech, the companies that are making it are selling for billions and billions of dollars. And there's a reason it's saving the lives of patients like Stephanie Florence, who you just heard, but it wasn't always this way. Carty therapy started out as a black sheep in the cancer research world. A lot of people thought that it was impractical or it just wouldn't work and for many years and actually didn't work. So has car t. beaten the odds has it gone from an underdog to cancer killer or is all of this just hype? From geekwire dot com in Seattle. I'm Claire, McGrane, welcome to health tech where we tell you the stories behind cutting edge health innovation today. The dramatic story of Carty immunotherapy. We'll tell you how car t. went from the black sheep to the golden child and how Stephanie's nine year battle against incurable cancer was ended by her car t. treatment stay with us. Support for health tech comes from Seattle Children's whose pioneering research institute is not only changing medicine, but creating lifesaving therapies for pediatric diseases such as cancer type. One diabetes, sickle cell anemia and many more Seattle Children's hope care cure. I can still vividly remember one of my first leukemia. Patients who had no other options in head about one hundred percent leukemia their Bowmanville. And when we found out she was a complete remission less than three weeks later, it was really exciting mind blowing. You don't see that with any other treatment that's Dr David Maloney. He runs the basis family, immunotherapy clinic, the first clinic in the world designed just to give patients this new treatment, Stephanie Florence, who you heard in the intro. He was actually her doctor when she got Kartini treatment and like Stephanie was at the time the patients that David works with our very, very sick. What is it like working with these patient populations was challenging because you're trying to keep them alive. I mean, often these patients have had, no, they have no options and literally you're trying to figure out if you can keep them alive until you the cells already. Many of David's patients go from literally their deathbed to being cancer free and remember. Thirty years ago almost no one believed in cartesian therapy. So how did we get here to understand Carty? I'm going to ask three questions. I an obvious one. How does Carty immunotherapy work next? How effective is it? And finally, what role does it play in the holy grail of cancer research, a cure to cancer to answer those questions we actually have to start with a different cancer treatment bone marrow transplants. This treatment is normally used for patients who have leukemia. In fact, my interest above boomer transplant was really piqued by an article that came out in one thousand nine hundred ninety nine. That's Dr stand rebel. He has studied the immune system for a long time and he was among the first scientists to work on Carty technology. The paper he's talking about convinced him to join the Fred Hutchinson cancer research center where the study had been done, stand still works there today. In fact, he's now in charge of the entire immunotherapy research center at the Fred hutch. So I wondered what got him excited about bone marrow transplants. One of the ways that the bone marrow transplant curdle Kimia was the donor's immune system was eliminating the leukemia cells. We didn't understand exactly how it works, but what we knew was that t. cells that were transplanted with the bone, marrow graft were able to eliminate leukemia cells. And if you took those t cells out, you lost that effect. That was sort of what piqued my interest. I thought if we could really understand that maybe there were ways of using cells therapeutically for cancer more broadly. Okay. Hold up held up. Let's back up. What is a t. cell? Well, these are very specialized cells that are part of your immune system. They're like your body's navy seals. They hunt down all the tiny bugs that make you sick like the flu, and they basically boot them out. And here's the weird thing. T. cells are not the main reason that bone marrow transplants work. They're just kind of a side effect. So it was surprising that these t. cells were attacking patients cancer, and it was even more surprising that they were doing pretty good job to stand. This was a breakthrough reclaim pretty clear that this might be a potent new way of essentially engineering a an immune system that could tackle cancer or at least some types of cancer. If this sounds crazy, it's because it is normally people's immune systems can't really do anything against cancer, but STAN and his colleagues thought they could change that they could build a custom immune system that is designed to fight cancer, and they weren't going to do it with a drug, but actually with these living cells, this was not a popular idea in the eighties, a very large majority of the scientific community. You know, sort of view this as fringe research, but standard his colleagues believed that this could work. They thought they could save people's lives. So they kept working on it, but they did not start with cancer. Instead, they started with t. cells that attack viruses specifically a virus called m. v. and they were interested in people with compromised immune systems like people who have aids or people who are going through chemotherapy. They wondered if these people could be protected from the virus using other t cells that they know attack it. They worked on this idea for years and finally in nineteen ninety, they used the, I t cell therapy on three patients that were at risk of getting CMV the infused the patients with t. cells that they knew would fight the disease, and it worked none of the patient Scott CMV. This was the first time that scientists were able to definitively boost someone's immune SIS. System using these specialized t cells. And it meant they could probably do the same thing for cancer patients. You know, one of my colleagues at Johns Hopkins, rota, sort of news and views section and said, this is one of the most important studies in human immunology. Since we started investigating and I think that was the wow moment. The wow moment was we could really do this and we could actually manipulate immunity by transferring sells for me. That was the start of the possibilities where now I think really endless success. The idea worked time for champagne, right? Of course there was still a lot of work to do and still a lot of people who didn't think you could use these cells to fight cancer and speaking of cancer. That's going to be a lot more difficult than fighting a virus. There's a reason your immune system doesn't just kill cancer already. First of all, cancer puts up defenses against the immune system, but a bigger problem is the t. cells there just aren't t. cells that are. Designed to fight cancer at least not ones that exist in nature sustain and his colleagues decide, mother nature isn't going to build these cells for us, so we'll make them on our own. Now, where do you find someone who can help you build sell program it to your own needs? One of the top people at the time in gene therapy in the world was was at the hutch dusty Miller, of course, the world famous geneticists that happens to work right down the hall. So STAN asks dusty to help them genetically reprogram some t cells. You know, of course, he just handed me the vectors and said, go ahead clone, you gene in. And so we did some of the first retroviral transactions in the early nineteen nineties putting genes into t cells. Now, of course, in the beginning, we didn't have a lot of that receptors that were that were we knew the specificity of, but we knew we could genetically modify t so very easily in the laboratory. Okay. For me. And for you and everyone else who does not have a PHD in. Geology, let me translate withstand just said, first of all, the scientists discovered how to genetically modify these t. cells so that they target what the scientists want them to say a protein that would hang out on a cancer. So but number two, the t. cells need receptor to tell them what they should target. And number three stands colleagues only know about a few of these receptors and none of them would target cancer. And so I think that opened it up. We have to find these receptors that we can use standards being really optimistic here. This does not seem like a good moment for Carty work. He's affectively at a dead end. He can't learn anything more from the t. cells that our bodies naturally make. But another scientific advance is about to give STAN a boost. It's called signaling. Basically it's how proteins in our bodies talk to each other. Theoretically, if researchers could figure out the language of. Proteins, they could design their own receptor for t cell. In other words, they don't need to find a receptor that exists in nature. They can just create one again, not a popular idea. Nobody thought they would work in the clinic. I thought, oh, this is a really cool way to study signaling, and I was a little bit interested in signaling. So that's how sort of I got into it. But at that time, my concept wasn't that we could use these clinically. But again, that doubt did not stop the science in nineteen Ninety-three and Isreaeli immunologist created the I t cells with these manmade receptors, the receptors are called chimera enter receptors or car. In Carty it's this man made part of the cell that really locked everything into place. It made Carty a reality. And once all of the puzzle pieces were together, it took another twenty years of hard work to find tune the science and now Carty. Is having a heyday most of that hype centers on biotechnology companies like Juno therapeutics, Juno was spun out of the Fred hutch. And a lot of its technology is actually based on STAN and other scientists work. Unlike its two competitors, Juno does not yet have a car t. treatment on the market. They're still working through clinical trials, but despite that it was acquired by cell gene earlier this year for nine billion dollars. That is a lot of money for a company that is not making revenue and likely won't for a while and all of this hype and money that's going into Carty means that patients like Stephanie are able to take these incredible treatments. But unlike Stephanie, not everyone's cancer actually goes away. So now that we have Carty treatments, how well do they work? We'll find out after the break. Key choirs health tech podcast is brought to you by Seattle Children's research institute. I'm here with Dr Richard James, a principal investigator in the center for immunity and immunotherapy is at Seattle Children's research institute. I know that your work in particular focuses on b cells. What would you say is the most exciting thing about your work day to day at Seattle Children's? What is really neat about what we're doing is that we're trying to take a cell that we know a lot about. We've spent thirty or forty years researching, and we've learned a lot about how that sell works, and we're trying to take those insights and translate them into something useful on that super exciting to me. We're trying to take these cells in harnessed them to make drugs or protein drugs. So kid won't have to regularly inject themselves with a drug as in the case of hemophilia or other types of diseases like that. They can get one treatment that's ten to fifteen year treatment that provides the drug using your own. Cells to find out more go to Seattle, Children's dot, org, slash research, welcome back today. Retelling the story behind Carty immunotherapy. These treatments can work wonders for patients literally waiting on death's doorstep. So how well do they work before we talk about how well Carty fights cancer. We need to mention that it has some pretty severe side effects. One is called cytokine release syndrome, and it's similar to a really bad flu. Another side effect is less well understood. It's a neurological toxicity and it can be fatal. Remember, Juno therapeutics the company that was acquired for nine billion dollars about a year before that deal happened. Juno actually had to pull the trial of its first car t. therapy after five patients who took the therapy died, they all had severe neurological toxicity as we're learning more about Carty and how it works though. Side effects are getting less common and less severe, although they're still concerning. But what about the intended effect? How good is Carty at fighting cancer to start their only two car t. therapies available on the market for anybody to take one is for lymphoma and one is for leukemia, and this is the first big limitation of Carty so far. It works really well in blood cancer, but solid tumors like breast or lung cancer. They're different. They're much harder to treat with this particular therapy. There are clinical trials and new research into those cancers every day. But for now, we'll focus just on the patients with blood cancer patients like Stephanie, you heard Stephanie earlier in the show. She was diagnosed in two thousand six and by two thousand fifteen, she'd been battling incurable lymphoma for nine years. She had chemotherapy. She had a stem cell transplant. Plant and she was out of options. So she signed up for a clinical trial. Her T-cells were extracted sent to be genetically engineered in a lab and one summer day she had her new super powered car t. cells infused back into her body. I remember them bringing in my bag of t cells, and it was so tiny with tiny in with like, oh, that bag is so little. And it was like, that's my life hanging there. And remember Stephanie had cancer at the wiz considered, incurable head, come back again and again, and she told me she was knocking on death's door, but the car t. cells worked for her. A month after her infusion, there was no sign of cancer in her body. Three years of past, and there is still no sign that her cancer is coming back. I don't even know how to put it into words how ecstatic I was that I had been given a second chance. I've been dealt as bad as I have been even the get your fares in order talk. And I have really tried to just kind of deal with it a day at a time. But in that moment and hearing the news that I had responded completely, I definitely allowed myself that joy. To take it all win because. You don't get a lot of calls like that. We've treated patients that have failed all other therapies. This is STAN rebel. Again, one of the first people to work on Carty and we've really seen results that I think you would have to say a remarkable in terms of getting responses to these therapies. So in ALL are complete remission rate is over ninety percent. That means taking a patient that has, you know, who's bone marrow was riddled with leukemia and essentially radicalizing detectable Akina cells from the bone marrow with a single infusion of cells. I mean, you just don't see those kinds of results with therapy that's new that you're putting into patients for the first time. STAN mentioned a l l this is a common kind of leukemia. And as he said, ninety percent of ael l. patients that have taken Carty therapy go into remission for patients this sick, a ninety percent remission rate is unthinkable. Other kinds of leukemia have had similar jaw dropping success rates, the numbers for non limb. Foam a- Stephanie's cancer are not quite as good about forty percent of those patients go into remission, but still that's incredible. Given that most of these patients are basically terminal when they go for treatment, of course, even patients who go into remission aren't totally in the clear there is a chance that their cancer will come back or relapse, and this is becoming more and more of a problem for Carty as we see patients a couple years out from treatment, and we need to understand why we're not Aratu kidding all of the tumor cells in in those patients in what we can do to to improve that. And that's the focus of a lot of the work right now. So for patients with blood cancers, Carty works surprisingly well, it's putting a huge number of these people into remission up to ninety percent for some kinds of cancer. But some patients are actually too sick to get the treatment. Here's how the process works. Again, cells are extracted from a patient. They're genetically modified. And then they're infused back in. Well, that sounds really simple. It's actually not. So basically for a patient, they have to sit through an extraction and they get an infusion and that's kind of. In a lot of waiting and then a lot of worrying after the seltzer. And so in time line, it takes about two months to get through this from the beginning to the end. So it takes about one day to collect the cells. But there's usually a week's worth of tests before that. And then it takes about the three weeks to make the cells there than short course. At chemo, sales are infused, and then it takes about a month to get over any potential toxicities. These logistics mean that some patients are just too sick to get the treatment either because their cells can't safely be extracted or they can't live long enough to get their infusion, but there's an even bigger problem one that affects everyone regardless of how sick they are, the huge price tag. I think that prices is really one of the one of the major crises who are facing these drugs are expensive. The published prices for these drugs around three hundred seventy three thousand dollars for the lymphoma drug and actually higher for the leukemia drug. And that's a huge. Out of money, but you have to remember, that's that's only a part of the cost. You still have the delivery of the of the drug up to several weeks of hospitalizations, which obviously can be extremely expensive. So the price of the drug which has gotten everyone's attention clearly as a as a part of it, but they're the associated care is also an issue. So this is really limited by patients who have insurance or have you know some way of getting access to care member Carty is bland new. It's so new that insurance companies don't even have policies on whether they cover it or not. There's a time crunchier. You can't just sit around and wait three months to figure out whether you can get insurance coverage, seven, it comes to effectiveness overall. It's a bit of a mixed bag for certain patients. Carty is incredibly powerful. It can wipe out cancer in people who are incredibly incredibly sick, but the number of patients who can actually take a car. IT is not very big, at least not right now, patients who have solid tumors do not have any Carty options unless they can get into a clinical trial of an experimental treatment. And even some patients who do take the treatment don't see any effect or it's only a minimal effect. There's a lot of research into making Kartini treatments work for more patients. So for now, let's look bigger picture. Cartesian, still young. There's more science to understand and more wrinkles to iron out, but in the long run, could it be a key to curing cancer here stand again, we don't like to use the word cure since we're only a few years out, but you know, for a patient that really had a few months to live now being two, three, four years out after Cortizo sales and still in remission, I think is is, you know, obviously a great thing. Remember Carty is one kind of immunotherapy, but there are others. There are other drugs that use the immune system to fight cancer. In different ways, although none of them are quite as dramatic or have worked quite as well as Carty immunotherapy. If we look at it in general, I think will play a major role in an achievement curious. I think it may in some ways be essential to cure cancer. You may need to develop an immune response against the cancer. Now there is going to need to be innovation. There's going to need to be understanding that we don't yet have, but you know, I think we have the tools now that we didn't have even five ten years ago. Going back to that moment in time was like, I'm unhappy to be knocking on death's door and I was very happy to be participating in something that I felt like was advancing medical research and just so critical patients like Stephanie have helped to create that hope for a cure. She said when she was diagnosed, she felt incurable like there was something inside her that had on edge on her and was going to take her out no matter what she. He did, but now I feel like I am back to having a normal life and I no longer feel like I'm incurable. And regardless of what happens with cartesian, that winds up being cure for me or if it wins at being cure for patients down the road. I for the first time, feel like there is a chance for a cure. Since her cancer went into remission, Stephanie has turned her passion for photography into her own studio. You can actually see photos of her car t. treatment party complete with party hats at geekwire dot com. Slash health tech and also check out her studio at shot spice Stephanie dot com. STAN rebel is the scientific director of the immunotherapy integrated research center at the Fred Hutchinson cancer research center in Seattle, read more about his work at Fred hutch dot org. And David Maloney is the scientific medical director of the basis family. Immunotherapy clinic, a partnership between Fred hutch and the Seattle cancer care alliance. Health tech is produced and written by me, Clermont grain with editing and story help from Todd Bishop. If you want to give us feedback on the show, getting touch by emailing podcast at peak choir dot com, or we would really appreciate it. If you could leave us a review on apple podcasts. I know podcast hosts asked people to do this all the time, but you'd be surprised by how much of a difference it makes another big things goes to our sponsor Seattle Children's research institute. You can find out more about their work at Seattle, Children's dot, org slash research to see all of. Requires wires, coverage of science, tech and geek culture. Goto geekwire dot com. Thanks again for listening. We'll see you next time.
Want to switch to a Medicare Insurance Plan from a Medicare Advantage?
"Hi, this is Tracey mcmanamon. You know, I was reading my Email today. And I knew that I had to get this information out as quickly as possible. This is going to be great news for those of you that are currently on Medicare or Medicare Advantage program and want to switch to a Medicare supplement program. So stay tuned. I'll take you through the details. Here we go. Welcome to another episode of your medical benefits, presented by Tracy mcmanamon, president of one source benefits with twenty nine years of experience in Medicare. Tracey takes the confusion out of how Medicare works and shows how to make it work for you. Thanks for joining me again today. You know, I unfortunately, run across a lot of people that over the last thirty years, I've told them I couldn't help them based on their health conditions. Whether they be a cancer patients or heart attack patients they wanna get out of a Medicare Advantage program or they wanna switch Medicare supplement carriers or they want to enroll into a Medicare supplement plan for the first time. Now, finally, I'm able to do that with those that have health conditions. So today, I was really my Email. And I kind of glanced over these emails because I get a ton of emails from insurance companies wanting me to promote talk about sell their Medicare supplement or Medicare Advantage programs and today one in particular really caught my eye, and I'm just so excited that I couldn't wait to record this podcast share with you for the first time, and I've been at this for. Thirty years now. But for the first time, I think that I'm going to be able to help a lot of my clients move from one Medicare supplement or meta gap carrier to a different carrier or those that are on the Medicare Advantage program that couldn't get into a Medicare sup and program before well, guess what? Now, you might be able to. You know? Traditionally if you were to call me and say I want to switch Medicare that carriers or I want to get out of this Medicare Advantage program. My immediate response to to you would be well, tell me I will do if you're past the guarantee issue window, which is three months before three months after your birth month. I'm going to ask you a series of questions. Tell me about your health conditions. Do you have any conditions at all a lot of people? Just they tell me everything. It's just amazing. How much how much people tell me nowadays. But I have to know because I have to be able to give them. Good advice in terms of what I think is going to be best for them. In the past. If I heard that a person had cancer or had heart attack within the last five years. In most cases, that's an automatic decline. And I wouldn't even encourage a person to begin to write their name on an application because I know at the other end if I were to submit that application, and they had cancer within the last five years that the the carrier's gonna deny that application as soon as it comes in the front door. So I'm very honest with the people, and I tell them right up front. Look, I'm sorry. But there's nothing that I can do for you. And you know, chances are I'm not the only person that's told them that they've probably called a an association or they've called someone else and they've tried to help them. And they probably heard the same thing if you have a cancer, then there's nothing that we can do if it's within the last five years will now a major insurance carrier who has been in the business for over thirty five years has been in business since eighteen fifty has lowered. The qualifying conditions to two years. So if for the past two years, you've been treatment free from bypass surgery or artery disease melanoma, leukemia Hodgkin's lymphoma, a TI, I think we all know what a TI is stroke. If you've been treatment free for two years or more not five but two there's a very good chance. This company is going to accept you. Now, I'm not gonna make any promises, and I'm not gonna tell you who the company is either, by the way, you have to call me. But today in eighteen states this program was just released now could be in your state, and it might not be in your state, but just call me, and I'll be happy to tell you if it's in your state. But this is going to be groundbreaking for those that have had a Bill Anoma, or like, I said, a, you know, leukemia and had been treatment free for two years or more some of the cancers breast cancer lung cancer again treatment free for the last two years. Not a problem. Now, again, you you can't have nine different health conditions. But yet one of those was cancer, and it was seventeen years ago. You know, they're still going to be some other underwriting factors that are going to come into play. But so many people. Once they've had a difficult health condition. That's normally or I shouldn't say normally, but that's many times, they're only health condition and their treatment for either taking care of themselves. They're not smoking there. High. Wade is very good there. Plus hall is good and you know, lifestyle conditions. We call them are all very very good. I just can't wait to call some of the people back that have called me over the years and said, can you help me I had leukemia six years ago. Well, now, it's just two years. If it's within two years, I can't help them. But if it's two years or more, I'm going to call those people and offer them this particular program. This carrier offers all of the plans that you would be most interested in certainly plan F plan G in most states, not every state, but in most states clan is another good plan. So let's talk about it. Let's see if we can help you get out of that bad. Situation that you might be in you've been wanting to change Medicare supplements. Now's the time you've been wanting to get out of that Medicare Advantage program. Now's the time give me a call. You know, if you've heard my other podcast, you know, offer free consultation. I don't charge a fee, we get paid by the insurance carrier. But I'm here to help people. I've been at this for thirty years, and I want to help people as much as I possibly can. I've been blessed already. I'll continue to be to be blessed. If I help people the right way and do the right thing. So give me a call. I'm on eastern standard time, I'm at eight seven seven five four nine one two one two eight seven seven five four nine one two one two or go to my website, one source benefits dot com, again, we'll tell you who the carrier is. But I'll submit the application for you with your assistance. We'll find out what they have to say. And then finally finally you may be able to get out of that bad situation. Medicare's great deal. Medicare is awesome program. I love Medicare. That's why I've devoted so much of my life to better care. But over the past many many years there was nothing I can do while Dow can let's give it a try eight seven seven five four nine one two. One to thank you so much. God bless you. Thank you. For listening to another special episode of your medical benefits with industry expert, Tracy mcmanamon to take advantage of the free consultation session on your own Medicare benefits. Call him today at eight seven seven five four nine one two one to thank you for listening. And God bless you.
380: Dr. Jason Fung - A Revolutionary New Understanding Of Cancer
"Coming up on the ultimate health podcast. So what is it about smoking. What is it about as best as what is it about certain types of viruses that cause these genes to move from a sort of multicellular organism state normal state to the sows becoming a sort of survivalist. That is you activate the core of your survival programming. And the answer is that certain types of damage so has the chronic and it has to be sub lethal and the reason asked me sub lethal is because if you have a single sort of catastrophic event everything dies and when everything dies cancer doesn't survive so it has to be sort of sub lethal and has to chronic because that's what happens in evolution. Evolution is not a single one time thing that is if you have a single shock like you know a meteorite falls and everything dies if too overwhelming and too it simply is not there on a long enough basis to exert a selection pressure so any type of chronic sub lethal damage. In fact when you look at almost any type of chronic before damage it can cause cancer. Hello and welcome to alternate podcast episode. Three hundred and eighty. I'm jesse chapas. And i'm here to take your health to the next level each week or bring you end up conversations with health and wellness leaders from around the world and this week. I'm speaking with dr jason fong. He's a physician author and researcher his groundbreaking science-based books about diabetes and obesity. The diabetes code the obesity code in the complete guide to fasting have sold hundreds of thousands of copies and challenge the conventional wisdom. That diabetic should be treated with insulin. This conversation is based off dr funds. Latest book the cancer code. A revolutionary new understanding of a medical mystery. Believe it or not. We're almost four hundred episodes into the show and cancer isn't a subject we've really went deep on yet so jason came on the show today and did just that. He took a complex subject. Broke it down. Made it easy for us. All understand and i know you're gonna love this. Highlights include the eight hallmarks of cancer. The truth behind the high price of cancer drugs nutrition cancer. How will be city is a big risk factor for cancer and how the entire cancer field is changing so many people these days are impacted by cancer either directly or if not most of us at least know somebody in our life that has cancer had it so after you're done having listened. I'd really appreciate it if you could share this episode with somebody in your life that could benefit from the information. Thank you without further ado here. We go with dr jason. fung jason. Welcome back to the podcast. It's great to have you on paul. Thanks for having great to be here. We're gonna have a great discussion today. I really loved the new book. The cancer code. And i gotta admit when i dug into the book. It was really what i expected. I was thinking would be more along the lines of fasting. How that could help prevent maybe treat cancer given your background fasting but it was so much more than that. I mean that would have been a great book but this goes really deep into cancer and the evolution of our thinking of cancer over so many years so congrats. I really enjoyed this. Oh thank you very much. And i think that's sort of when i started looking at the issue of cancer. That was sort of how i got into it. Which is why you know most people. I would think think it's going to be about all about sort of fasting and nutrition and cancer but as done sort of deeper into the topic of cancer. There's just so much else going on because clearly cancer is a much more. Broad problem than just attrition because we know things like smoking for example has nothing to do with nutrition. What you eat if you smoke your risk of cancer just goes way way up saying with the best for example. You've exposed as fast as it doesn't really matter what you eat. You're you're great risk of developing a museum which is the type of lung cancer. So that's sort of while it was sort of how got into it as it developed as looking through it more became More and more the question which is never really answered. I think that is really important. Is the sort of how we think about what this problem really is. That is what is cancer. And that's i think one of the greatest remaining medical mysteries because most of these other diseases that we face we sort of know what's causing that. So even when we get a new virus like poof nineteen for example within a few months. We've got this virus like look you know it's still kicking our bod but we've sequenced. We figured it out. It's this is the virus. This is the sequence you know. The dna sequence. This is how it gets in. We've said okay it's the ace two receptors. You know you get at the site of storms. We know so much about it. Even within six months of this sort of brand new disease coming up which has greatest fascinating. Yeah something like hiv. For example it took us years to figure out the actual virus going from age hiv to sort of treatment whereas now you know thirty forty years down the line. We figured out what this virus looks like. We figured out know where detaches we figure so much. Stop so quickly but the problem is that with cancer. What is this disease. Such a strange disease because it's a common disease. It's the second biggest killer of americans yet. If you were to ask the question of what is this disease. People have no idea. Most experts have no idea like you ask the american cancer society and it says well. It's a disease of genetic mutations and that's not really correct because if it was simply a matter of genetics that is You know just bad luck genetically then. Why does environment play such a huge role in this genetic disease. That is if you have a disease. Such as cystic fibrosis sickle cell anemia. All these genetic diseases they passed on sort of mother to child or they have a significantly higher risk in we can identify the genes that are associated with it on the other hand. It doesn't matter if you're japanese if you're african if occasion If you smoke you're much more likely to get lung cancer. So it's not a genetic disease in that sense yet. People have been saying it's genetic disease donate disease and the problem with that. Is that if you don't understand what causes it. Your research sort of goes in the wrong direction that is looking for these genetic mutations and they progress in cancer has really slowed to a halt. Like if you think about how many genetic sort of tours for cancer we have. It's very very few the number of medications that makes a difference to cancer. You can count on one hand in most of those were developed in the early part of the sort of late nineties early two thousands rates with that was twenty years ago and whereas all these great genetic cures for cancer. We just don't see them in because it's not nearly a genetic disease and we have to sort of understand further and this is this is really an exploration of how the way we think about cancer has changed over the last little bit because there's been a huge paradigm shift from being a genetic disease tomorrow logical evolutionary disease which has huge implications for treatment. Let's go back way back to the beginning and talk about the earliest cases in history of human having cancer. How far back does that go. Yeah it goes right back to the beginning so really. In some of the earliest mummies that have been sort of excavated. We can find cancer so really as far as we can tell it goes back right to the beginnings of humanity in fact and this is one of the things that sort of spurred more research into this line of thinking. Is that when you look at it. Very closely cancers actually goes much further than humanity so if you're rooting around in human genes trying to find what caused cancer. You're not gonna find it because it goes way. It goes back in evolutionary time right to the beginning of multicellular life. That is you know. It's not just humans. I get cancer dogs at cancers get cancers rats cancers in even the smallest most primitive multicellular lifeforms. The recently identified hydra which is a small sort of microscopic being used to study them in high school biology condom on the microscope. And so on and even these various very primitive multi celled animals. They even get cancer. So what you're talking about is a disease which span is much more than just humans. You have to go way way way way back to the beginnings of multicellular life in order to find out an answer. That question of what is cancer. And at what point was it that humans really got interested in doing research on cancer. And and that whole field really kicked into high gear. If you sort of trace it what happened is that the sort of three great modern paradigm of cancer. So you know people have always been interested in the question of what is cancer you know what is a strange disease that is actually derived from our own cells that is it's not som- extrinsic invader like like cova nineteen like bacteria you know. That's something foreign to us that attacks us and we can understand that that's very easy to understand but you know if you have a lung cancer that lung cancer cell was derived originally from your own body. Your own normal. You know healthy liver long or whatever so you have. So why did it suddenly turn cancerous. Not sunday but why did it turn cancerous. What increases that risk so people have always been interested in it. The ancient greeks Thought about all diseases in this sort of imbalance of humors that is it was a too much black bile. Our theory of what cancer is it's an outcropping of excess of black by turns out it wasn't true of course but the greek physician caucases is sometimes called. The father of modern medicine actually named the cancer the disease using the creeper carquinez for crab is actually quite an interesting choice of words because of its one sort of impenetrable. Shell that is. It's really hard to treat and to its ability to sort of move all around the scuttle around the body or metastasized and very interesting and very appropriate choice of Word so fascinating you know that fell into disuse by the eighteen. Hundreds people thought about it. Being a degeneration of your lymphatic fluid which again was not true but on the other hand very perceptive in that it made people think about that. It was hard of our own body that had somehow become perverted. Then with the advent of the microscope. We could actually see that. It's a cellular disease. That is certain cells. Look very very strange. That is these cancer cells. Look a little bit like normal cells but a lot different than a normal cell and we started to identify. What part of the saleh's difference or you can look under a microscope when your biopsy and say while this is a cancer cell because it looks completely different even though there are some very very basic similarities like for example a breast cancer sow will have estrogen and progesterone receptors just like a normal breast cell so it can respond to certain hormones for example or prostate cancer. We'll have certain features that look like normal prostate cells but it is obviously Quite quite different. The next step sort of was to say okay. Well we can tell Disease a disease where the als really are. Just growing too much right. that's sort of. What cancer is you. Have a mask which is called a tumor of mass of cells. That just grows and grows even though it shouldn't so you know normal lung sal. It's very tightly controlled. Your long does not just keep growing in size until it pushes your neck off. Its shoulders hunted thing right. Everything has to fit in the proper way. And that's the way multicellular life exists speaks. Everything has to be very well coordinated between all the cells. You cannot have one. Sal that just keeps growing or moving wherever it wants. Because it's going to impact the other cells and than the whole organism will suffer so as a sales so that was the first grade paradigm of cancer. Is this disease of cells. That just grow too much and therefore the treatment is to kill the so what we did was we developed ways to kill south so we developed surgery which has been around long time. If you know if it's looks abnormal cut it off so the next step in the nineteen hundreds was radiation or people said. Okay while you can use radiation. We can burn these south. It will do very well. So they treated certain cia cancers and they did very well and then the third thing we did was. We developed chemotherapy. Which is a form of poison. A selective toxin is a toxin that kills cancer cells slightly faster than he kills regular cells. So therefore you can exploit the difference in successively in order to selectively destroy cancer so these three basic sort of Treatments for cancer. We've had since the sort of at least the nineteen forties when chemotherapy. The last of modality was really developed and they sort of formed the basis of most of modern cancer therapy even today even though it developed in the forties. But we've done of course is we've found better ways to combine them better ways to mix the regimen Tale of poison. We've developed slightly safer ways to administer these poisons but the idea is the same paradigm is saying these are all ways to kill cells. It worked very well but it started to reach the limits of what you can do with this paradox and the problem with this paradigm of a cell. That grows too much is that it doesn't answer the start of next deeper. Level of understanding. Which is. Why are these cells growing too much because until you understand you can't figure out what the next certes treatment paradigm is going to be. And this sort of developed through the sixties seventies. So the dna was discovered in the sort of fifties by watson crack as we develop more more starts understand the genes chromosomes and how these genes really control everything in our bodies the way that we grow the way that our fingers developed the way that you your heart moves. All that kind of thing is a lot of to do with gene certain genes control certain and there are growth genes. So there you know jeans that tell our body to grow their end are genes that tell us to stop growing while so we have very tight control of grows and what doesn't grow and so the next step was to say well. Here's the answer. We know that there's lots of different things that cause cancer. These are called carcinogens so we have tobacco smoke and we have as best. We have certain viruses that cause a cervical cancer like human papilloma virus and we said well. What's the sort of connection between all of these things where they all cause cancer. These different things. What's link in the link. They said was genetics. So all of these things caused damage to the cells damage to the dna which can cause genetic mutations so therefore a few smoking causing damage to the lung sow which is causing damage to the dna which is causing mutations in that gene. Now if you happen to hit a critical gene that controls growth. Then you're gonna have cells that grow out of control. And if the virus for example hits a critical gene that controls growth than into also is going to cause this uncontrolled growth so that was the genetic carradine and this is the sort of second big advance second great paradigm of the way we think about cancer. This is actually genetic problem which is causing the problem of too much growth. They see none of this second paradigm invalidates any of what we thought about the first paradigm. it's simply standing. The knowledge of how those cells came to grow too much by the nineteen nineties started to develop treatments based on this genetic caradon in the first heat treatments. Were simply spectacular. Like really really good. So in a disease called chronic myelogenous leukemia. We developed a drug called matinee which was based not on killing cells bought on controlling the genetic defects so in this disease. Leukemia chronic myelogenous leukemia. There was a defective protein which was caused by a specific gene so rather than just trying to indiscriminately kill cells. While we're gonna do is go in there and try and fix this protein so fantastic drug work better than anybody believe it was. One of the greatest. Sort of advances in in oncology was just amazing and shortly thereafter. It was a drug for breast. Cancer called Tuesday mab or perceptive. Which is another huge advance so again not all breast cancers but a certain subset of breast cancers then what they did was they developed genetic test to say. Hey if you have this gene mutation than you will benefit from this crop is again. Just really fantastic results. So by the two thousands the early two thousands of people were like this is it gets like cancer is dot. Were going to cure cancer. Because all we're gonna need to do is figure out the two or three genetic mutations that each cancer has developed a two or three drugs that we need to correct these mutations and cancer is gonna be history yeah still some cancers just like you know. We have antibiotic spelling. Keep sort of refining it. It was sort of this moment in history where most people were super super optimistic that we have actually finally turned the corner on this war of cancer. Right this war. That president nixon had actually started in the nineteen seventies so scientists decided to go all in at this point understandably because of the success. The success was just huge now. The technology of the time of course was relatively limited compared to twenty twenty so in the nineteen nineties. We had this huge human genome project which was one of the sort of going to be one of the great scientific wonders of the world. That was the way. It was so very expensive multinational collaboration and what the plan was was to sequence all of the genes of the human body and at the time of course it took a of time and money. Now you could go to like twenty. Three million gathered dust in like two days. You'd probably get your genome done by the computing power. Wasn't there so as a huge task and we thought okay we're we're going to sequence the genes and it's going to lay bare this map of cancer. He just needs to look after that. Just need to look so colon. Cancer affects this gene and this gene after the drugs. You take this drug Locks those genetic mutation boom. You're done just like the first couple of drugs seemed to do the trustees mab and matinee and then shortly after in the human genome brogden of course finished in the year. Two thousand and then shortly after that they didn't find all the cures for cancer so then they embarked on even more ambitious sort of cancer specific genome project which was called the cancer genome atlas so rather than sequencing a single person so remember the human genome progress was one person's entire dna. And that's a long time. We weren't gonna do that. The technology had advanced way past that we can do much more so they're gonna take thousands of cancers so you know -cation day patient be patient. See you know with colon cancer and then with lung cancer patients ape patient p patient see. They're gonna take all of those genomes. Remember all our genomes are yours is different from mine so they would take everybody's jammed they thousands of these in sequence all these tumor samples and then by comparing them. They could say okay. Well look in colon cancer. These three genes are the only ones that you have to worry. So that took you know another multi. Hundreds of hundreds of millions of dollars multinational kind of thing and i think wrapped up in twenty eighteen and basically the entire things been forgotten like there's no headlines in the new york times. There's nobody even knew that it's so lost interest in what this was gonna show because by that time the sort of genetic paradigm had already started to collapse and this is important because the way you look at cancers disease influences the treatments that you develop that has spent so much time and energy developing genetic cures. And what was the problem. The problem was that they didn't find like two or three genetic mutations what they wound of findings hundreds and hundreds of mutations in two thousand eighteen i think should that date they had found. Bow six million mutations in cancer by six new was there's idea that you had one or two genes which caused this one disease was way off so if you had colon cancer you had like a hundred different gene mutations and worse the patient sitting next to you who also has a Identical looking colon cancer would have one hundred genetic mutations that were completely different than your mutations the whole treatment paradigm the treatments just fell apart. Because it's not like you can develop one drug all of a sudden one patient e means a hundred different drugs none of which are available right. We have like five but the problem is that you can't use those even. If you could develop a hundred drugs you'd need a hundred different other drugs for the very next person in the chair sitting beside you so the whole idea was not gonna work it you know. It started off with a bang but it just petered out so all of these sort of miracle. Cancer cure is that you heard about in the early two thousands. When there's all this optimism they've marci fade away in fact you don't hear about it barely at all anymore because for that reason so when did paradigm to come to close it was sort of the two thousands because there's two things of course that you have to do as a way that you look at cancer it has to want explain why how cancer develops and the second thing is going to have to do. Is me too good treatment. Because otherwise it's not that useful so it needs to lead to understanding needs to lead to good treatment than if failed on both of those sort of things because there's a lot of problems with this genetic paradigm that is people said that it was a random genetic mutation so in fact the reason you gotta mutation in this growth gene for example was not because say you smoke tobacco and you've got lung cancer. Then you affected a specific gene that tends to cause growth while smoking is not a targeted genetic mutation rate. It doesn't target anything. It just causes on kinds of damage. So why did this gross gene in specifically get affected while people say well as rand up right. It's like it's just bad luck in the way that if you buy a lot of lottery tickets you have more chances of winning the lottery if you smoke. You're going to increase the rate of mutation and by chance one of them is going to hit a critical areas. That was the kind of idea but they had. It couldn't explain anything that is. Why did something like asbestos switches exposed everywhere caused me's athene yoma and not the regular type of lung. Cancer light Smoking right and why did 'cause this Theo mma and not colon cancer or skin cancer or something else. There was something very specific about what was happening. And it wasn't simply a random to network sort of mutation just by law. he was missing the specific cause. Yeah so they're missing the cause of what was causing these mutations. Their answer to what was causing these mutations was that it was just lock and the other thing is that the rate of mutation so cancer is a very common. Unfortunately if you look at sort of lifetime risk you're talking probably around one in ten people are gonna get. The rate of genetic mutation in humans is not nearly the rate that is high enough to sustain sort of one in ten people getting cancer. It's simply not dot. The rate of mutation generally is very very low so it couldn't explain a lot of stuff couldn't explain how it develops why all cancers look virtually identical. That is if you take a you know a a japanese women in the nineteen twenties. Compared to an african american woman in the twenty twenties you know opposite sides of the world. Completely different genetics. Well both of them can get breast cancer in those best cancers which involves sort of independently from their hosts look very very similar. So how does that happen. Like when you have something which evolves that is you take a normal sal and those you know forward it can go forward itching change in a million different ways just like if you have you know two children in usa paints. It's almost inconceivable that they will paint exactly the same thing so if you take a japanese women in the twenty s an african american woman and twenty. He say okay. Now you're sal is gonna mutate. What are the chances that those two cells are going to mutate into the exact same thing. It's like the chances are almost zero if this was what was happening. So if we had to believe that it's simply a genetic mutation. You have to explain how you can have whole waiting rooms full of people whose cancers have evolved in exactly the same way. It's simply not feasible like you can't do it. It's like saying okay. You know fifty people and you give them paint these a paint. Something and every single one of them comes back and paints a picture of a pink elephant this role. Why would everybody paint the pink elephant like there's something happening here that is targeted and is not simply random because somebody will paint the flower and somebody will the house right. It's like the same thing with genetic mutations when you say okay mutate cells can mutated any differ way. Why would it develop as a cancer. Why wouldn't have mutate. So i can shoot. Laser beams out of i is right. It's simply there's no snow a priori reason why certain mutations are favor according to that mutation and these are some of the questions that sort led to this sort of next paradigm of cancer which is developing which answers a lot of these questions and leads to sort of hopefully more treatments that are more Successful in the future. Let's get into paradigm three. This is when you have the chronic injury that sub lethal so talk about win this whole paradigm shift began and what that looks like the shift into that it started sort of in the two thousands and this is you know the story that most people don't know about but it's been happening for about probably five or ten years in about two thousand. Two researchers decided to do was to look at what makes cancer cancer. So sometimes this is called the lumper splitter problem that is when you're grouping things together you can either lump them into a single category or you can split them into their own category so if you take mammals for example you can say okay. Well we have wales. We have humans and we have chimpanzees and you lump them all together as mammals. So that's great you can also split them and say well you know. Humans and chimpanzees were were hominids. And you know we're not. We don't swim so them into two categories so those are the splitters and they're not right or wrong but they do different things so lumper's when you lump everything into a single category. It emphasizes the similarities between the two that were greaves air as opposed to fish. And when you split them. You emphasize the differences between the two. That is you know we live on land of water and cancer had mostly been Sort of splitters. So they'd sweat breast cancer from colon cancer from stomach cancer from liver cancer and it was divided. According to the cell of words and in two thousand two researchers weinberg and hanrahan decided something very interesting. They would actually look at the similarities. As opposed to the differences between the two answers. They wrote a paper which went on to be sort of the most cited paper and oncology's crops the most important paper you know. Research paper in oncology and it was basically laying out the hallmarks of cancer. So what is that makes cancer cancer and what was different. Goethe of course they were lumper's rather than splitters where everybody else was a splitter. They were lumper so he put them all together and said what is it about cancer that makes it different than sell and they came up with eight hallmarks and they basically come down to certain things so one these sales they move around so move around so if you think about a lung cancer the long sal does not move might your lung sal does not happen to the blood and go down and hang out with your liver for a little while right. It stays where it's supposed to stay so it can't move around. The second thing is that it grows. It grows like crazy so long cells. They can't grow through the number of cells that die off or matched almost exactly by the number of cells. Like that's wire lung doesn't keep expanding until you know pushes everything out of the way but lung cancer cells do so. This is another big important. You know. Fundamental difference between cancer cells and normal cells. So they grow they move around. The third thing is that they're mortal now. The paper went into the sort of scientific language of it but understand it simply fells. Don't live forever. So if you have a sal in your body like the lung sal and you take it out of the lungs l. It will only be able to divide a certain number of times before too no longer. Divide so this is called the hey flick limit in it's controlled by the keelan years on the ends of the chromosomes and this was very popular a few years ago in the anti-ageing circles people talk about them years and stuff. But essentially you can't keep replicating forever like one cell will divide a certain number of times than it's dot and then the fourth thing is that it uses a very peculiar way of generating energy cult-like hall. Were normal cells. use a different sort of pathway. oxidative phosphorylation so. That was really important because now people started to focus on. What is it that makes cancer cancer. Which makes it easier to ask the question. What is cancer. And how does it differ from normal cells. They grow their mortal. They move around the use glycolysis. The next sort of big staff was sort of in the mid two thousand when people started to look around for answers so the genetic paradigm had run. Its course we were all in. We spent hundreds of millions of dollars trying to develop treatments for this sort of genetic paradigm. Came up with a handful but none short of recently what people needed to know was again that next level of understanding. So it's really the next y you know. The first paradigm was cancer. Cells are cells that grow too much. But why right and that was the answer. Genetics genetic mutations caused cells to grow too much and so the next question then to understand cancer is why. Why are these genes mutated in not mutating in grand ways. They're mutating in very specific ways. And these were the ways they were mutating. They're growing. they were immortal. They were moving around and they were using the glycolysis so the heston is higher. They doing and this is what led to the idea that people started to say. Well what we have to do is not look just that human genes. because that's too narrow. They brought in an astro biology actually sort of gifts some different thoughts. His first thought was that this disease goes way way back right. It goes back us the beginnings of humanity. So let's go back and really look at the differences between noon cellular cells multicellular cells. Were remember that our body is composed of small units called cells liver cells lung cells and so on but the very earliest organisms. Had a single cell say you have a game of say soccer and you have single thousands just like being a player right player. You're on your off that's it you don't have to interact with anybody. You don't have to do anything but you're very limited in what you can do because you have to do everything yourself right you have to score you have to golden. You have to do everything as life. On earth evolve groups of cells started to get together and this is sort of led to the next big jump which was a jump from unicef to multi. There's a huge advantage to multi. Larry which is that. You can develop specializations so you can have forwards you can have defense and you can have goalies an each sal. Each person can sort of focus. On what baidu bass leave something for something else shoes advantage but there is a fundamental change in the way that you have to be structured. If you're single sell your basic we competing with all other cells when you are part of a team of cells behalf to cooperate. There's a huge difference. So all the things up until that point of unicef cellular parity refocus on how to survive an employee that is other cells. Were basically the enemy because they were trying to get the same resources. You were debt all of a sudden when you move into multi celerity. You need to learn how to cooperate so just like a team so if you're an individual all the other players are opponents when you get into a team you have to completely switch your load of thinking you have to say now. How do i cooperate with these other players so that the team is going to be the best and when you move from unicef cellular life to multicellular life you can say okay. Let's look at these cells and how they are fundamentally different between unisex celerity in multicellular parity while one unicef cellular sal so unisel organisms. Like bacteria or fungi. For example they grow. they always grow. So if you have fungi on a slice of bread it will grow until there's no more iranian doesn't care about anybody else is not leaving anything for anybody else. It's just competing for food and it will grow. It will grow as long as it can. That's it nothing stops. The second thing is that these cells are immortal. That is if you take a bacteria you can continuously replicate it forever. That's not the case with normal multicellular life because a south for example you take it out put it in a dish. It will stop after a certain number things. Third major thing is that it moves around because again if you think about bacteria or fungi when they exhaust their futures they gotta get somewhere else so their natural state is to move around. Because you're always looking for a better source of food or whatever whereas multicellular organisms. They need ourselves to stick together in various the civic spot that is your liver has to be in a certain spot. Your lung has to be certain spot. Your heart has to be a spot for to work together. As opposed to that and then unicef cellular organisms ten mostly to us by costs so people said well look you know the way that cancer cells differ from normal sounds is exactly the way that sows in a multicellular organism differ from unicef elliott organisms. That could not have been simply a coincidence because the way that they interact is like the cells all of a sudden so you know. These cancer cells have suddenly turned into unisel their organisms. They're basically out for themselves riser. They used to be part of a team but now they've turned instead of being cooperative. They're sort of on. They're all looking out for themselves. This lung cancer cell is nothing like the long because it's basically asteroids wound. Survival that is they will kill other cells. it will do whatever it takes to survive. You will move around looking for better opportunities metastasized so it's no longer looking after the good of the individual and that's the reason why the thought is that cancer disease is actually is sort of evolutionary process but not forwards in evolutionary time backwards towards the unicef cellular state right and that's a very very interesting thought because it explains so much about why cancers look so similar you know just to finish that thought. Chances are so similar because we evolved from single celled organisms. That seed of that. Cancer lies every single one of ourselves and as we move backwards towards that sort of unicef cellular sort of destination. Everything looks saying that is to say if you're to say okay. Well you know you have fifty kids in room. Everybody has a painting of white. You know pink elephant. Is it more likely that all those kids just decided to paint a pink ellison's or did they simply open up. The box and pink elephant was already there and that's more likely so that sort of cancer subroutine short of exists reprogrammed in every one of us but as we move from unicef salutary to multicellular life that cancer subroutine was never sort of erase. He simply built programs on top of that adds in order to subvert those tendencies so that we became the sort of team but under certain types of stress as you remove all those controls that cancer subroutine than is allowed to sort of flourish and of course that cancer subroutine is not. It's not like something evil is it's simply survival subroutine right. It's the most basic survival techniques of our most basic evolutionary past. Which is the single cell organism in explains a lot. So this idea explains so much explains why cancers developed in the same way it explains why south when you look at them are primitive. That is they look like. They're not getting more complicated. They look like they're getting more primitive. When you look at south that's how they described them for the last fifty years in medical technology primitive sows or blast cells. They're sort of differentiated that as they're losing their specialization. They're going backwards in time. They're very early looking sows. And explains why almost every single cell in your body can become cancerous because it's not a matter of hitting one specific gene. It's the sort of most essential kernel of how that cell develops not in our lifetime but many many many lifetimes ago so every single sal can become cancerous not just in humans but indeed in all of the animal world explains why cancer is so common because that of cancerous subroutine is there sort of preprogrammed in all of us. But what's important when you start to look at things from an evolutionary standpoint is need you to one very important conclusion. Which is that the most important thing that leads to evolution this not that genetics. It's the environment that is it's the ecology that is the interaction between an individual and his environment is the most important determinate. Because if you look at you know. Cancer it's estimated that seventy eighty percent of cancer is environmental. That is smoking for example. That's something that's environmental. It's not genetic many of us so instead of just focusing purely on the jeans what we do by looking at it from an evolutionary ecological standpoint the start to look at it in terms of the genes in relationship to their environment because he can't control your genes but you can control your environment which means that this now gives us hope to go further and say what is it about our environment that we can change in order to lower our risk of cancer because we know that it's largely environmental disease. Now i'm gonna take a quick break from my childhood. Jason show to our show partner organic by the organic juice so provide you with all organic energy without the caffeine. It's rich in antioxidants and contain superfood ingredients to strengthen your immune system the ingredients include cortisol. Really siberian ginseng rishi mushroom. Asai beats four different berries in pomegranate. And if you're worried about making this a consistent part of your healthy routine no need to worry. All you do is mix the scoop of the ride juice powder with the glass of filtered water. Give it a shaker. Stir and you're ready to enjoy and as the listening to the show. You get twenty percents off your again if i purchase by going ultima health. Podcast dot com slash fai again. That's ultimately podcast dot com slash or by inorganic by spelled o. r. g. a. n. Ifi the red juice powder from organic. I will give you clean energy without the crash of caffeine now. I'm going to give a show other show partner blue blocks if you've been holding off on getting a pair of blue light glasses. Don't wait any longer. Blue blocks has a site-wide black friday sale. Going on right now. You have until the end of the month to save twenty five percent off everything. Blue blocks has to offer typically being a listener to the show you save fifteen percent off the order which is incredible but this is a significant discount on top of that. If you're new to blue light glasses. I recommend starting with the sleep. Plus glasses which eliminate one hundred percent of the blue and green light between four hundred and five hundred and fifty nanometers and this is the exact range has been shown in clinical trials to disrupt melatonin and negatively impact. Our sleep he just put them on two to three hours before bed. And you get optimal results after just one evenings use to take advantage of this incredible deal go to ultima held. Podcast dot com slash. Blue box. again earl is ultimately podcasts. Dot com slash blue blocks and blue blocks is spelled b. l. u. b. l. o. x. On top of that you get free shipping worldwide on orders over one hundred dollars. Start sleeping better by getting yourself. A pair of the block sleep plus glasses and wearing them nightly before bed. This is a great time to get a pair for everyone in the family. And now back to my chat with jason and this ties back to how i opened up paradigm three that stress in the environment has to be chronic and sub lethal. We mentioned smoking inherent and talked about that is being one of these carcinogens. Or stresses. what are some of the other common ones that were facing today. Certain tobacco smoke is sort of by far and away the biggest one the other ones that have been well identified or other chemical so asbestos. It's very common. Silicon is also very common viruses is another common one so certain viruses are Carcinogenic so human papillomavirus in Cervical cancer for example hepatitis. B virus hepatitis. C virus are carcinogenic because liver cancer and then in bacteria so he'll go back through pylori which is a bacteria that resides stomach causes stomach cancer and that was one of the reasons why we saw such a huge difference for example between asians who had a lot of stomach cancer because they had a lot of h. Laurie and north americans where the sanitation was better. The sort of there wasn't this overcrowding. People were sort of spread out so they didn't have a lot of h. I. lori and therefore the rate of stomach cancer were sort of like one tenth of the rate of say japan in the nineteen fifties then as soon as the japanese people would emigrate to america. The rates stomach cancers just plummeted because again you're not exposed to this coin stress so those were the things in from evolutionary standpoint. You have to say while there's two things that will lead to this evolutionary process when you're talking about evolution you talk about selection pressures and what is it in the environment that is selecting certain genes and giving them a survival advantage so in sort of the way darwin had discovered it was that he saw that on this island galapagos birds and some of them had these short each which were really good for eating nuts others. These long beaks were really good for eating food. They saw in the hearts of island. The hell out of fruit. You had a lot of long beaks. And when the part of the island had lots of nazi had short peaks. So it's not that long beak is better than sharpie. It all depends on where you are. What your food source is. It's the environment which selects the genes to develop so. That's why you know looking at it from an evolutionary standpoint. It's always environment that is critical. So what is it about smoking. What is it about as best as what is it about certain types of viruses that cause these genes to move from a sort of multicellular organisms state normal. Stay to the sales becoming a sort of survivalist. That is you activate the core of your survivalist programming. And the answer. Is that certain types of damage so has the chronic and has to be sub lethal and the reason i asked me sub lethal is because if you have a single sort of catastrophic event everything dies and when everything dies cancer doesn't survive so it has to be sort of sub lethal and has to chronic because that's what happens in evolution. Evolution is not a single one time thing that is if you have a single shock like you know a meteor falls and everything just dies if too overwhelming and too it simply is not there on a long enough basis to exert a selection pressure so any type of chronic sub lethal damage. In fact when you look at all any type of chronic sub people damage it can cause cancer so each it's look at say esophageal cancer stomach acid which hainan goes back into the asaf against which causes heartburn. It's actually well known to cause soft joke. Hanser why because you have a chronic sub lethal damage to those often you'll cells from the stomach acid stomach acid. The perfectly normal substance is just in the wrong place or if you looked at any of the any of the carcinogens they're all sub lethal toxins hepatitis. B hepatitis c. For example cause chronic low grade liver damage hepatitis a and hepatitis e on the other hand. 'cause a single acute episode of overwhelming liver damage and they don't cause cancer. You know almost anything that you look at. If you have a single event of high radiation like nuclear bombs they. They studied these survivors of the japanese hiroshima and nagasaki. And they're worried that they'd have a lot of cancer turns out. They didn't actually have a lot of cancer because it was a single. Large dose of radiation not a chronic low level dose of radiation and interestingly enough when you use chronic radiation as you do in radiation treatment to cure cancer you actually increase the risk of other cancers. So all the treatments of paradigm one. That is surgery radiation and chemotherapy. That is cutting burning and poisoning. Not only do they sure. A lot of cancer to treat are cancers girl also all well known carcinogens. So the thing that you're using to treat cancer also causes cancer and his most types of chemotherapy cause cancer. The good thing is that they treat the one cancer. You're doing i so that you'll survive hopefully to get your second catcher. But they're all carcinogens and that is the reason why that is the reason why the treatments are actually also a cause of a secondary. They're called secondary malignancies. That is the will cause it any. Chronic sub lethal damage is what sets up the environment that leads to this transformation tree sort of cancer state. It's the environment which allows these genes which allows the service revivalist kernel that is cancer to manifest in survi-. Let's talk about what happens at that moment. Nfl when that threshold is crossed and a cell goes from multicellular functioning. Normally to uni cellular in cancerous. It probably has happening all the time. Actually and this is why our body actually has a number of defenses against cancer. We actually have the innate protection against cancer so our immune system has something called immune surveillance where it will go around looking for cancer cells and important finding them will instantly destroy them so that is one of the reasons. Why if you have an immune suppressors state that is if you're taking immune. Suppressing medications like transplant patient. For example. you're a much higher risk of developing cancer. Because you're not able to get rid of these cancer cells that are developing so the way i like to think about it is that our body is sort of like a city right. We've got all these cells and they live harmoniously together. My you know a nice city so there are certain rules and there. There are certain rules that apply. That is you know. You can't just you have your apartment or condo. You can compress passing into someone else. You have to wear pants. You can't just walk around naked all day you know. There's certain rules have to follow to be an orderly society cancer cells because we're like thousand a multicellular organizations of people in the city have to follow certain rules. You line up at the grocery store you don't just barge in and shoves somebody else out of the way and that sort of environment also has people to enforce the rules. That is their policeman and so on their firefighters than for fires. There's all these people that are there to sort of maintain order what happens during the transformation to cancer is as if the law and order suddenly dissolves right and you see this when you have stay civil war. Nobody knows who's in charge and so on and all of a sudden you go from a well functioning society itself where there's rules there. No more rules in every sal is therefore itself right and that's the sort of environment that is going to favor the cancerous thing so just like in a city so you have a city. Civil war breaks out what happens. There's looting there's violence all of a sudden those rules that apply no longer apply and if you wanna survive. You need to do something about it. Even if you're not a loser you're not violent if you don't wind up trying to get some food or something you may just thought your family may just thought she wind up doing all these things i normally one do. You know it's like this. Sort of civil unrest and sorta like anarchy. And that's what's happening in the sorta tissue. Is that under the influence of this. Chronic damage like smoking like tobacco. Like there's this nor loss of order this loss of normal order and that's when cells have a higher tendency to become cancerous because they're faced between staying where they were doing what they're doing. But you're going to probably die if you do that or becoming this sort of anarchist. You know everybody for themselves. Locked the doors. Go grab some food even if it means looting the store that's what you have to do to survive and that's sort of change that's transformation that happens when you go from sort of normal sows to a chance from sell. It probably happens all the time. But then the sort of law and order people the police or the military or whatever if you will not analogy come in and they restore order so this probably happens all the time in our immune system forms. That function comes in sees that. There's a couple of sleeper cells of cancer cells of wipe them out before you even know it. It's interesting because again. It explains a few things that we've we've seen over the years that is there certain cases of cancer where people have survived twenty thirty years with this with the cancer and then all of a sudden it grows again. It's like how does the cell survived twenty or thirty years and it's like the properly survived in equilibrium. That is it was strong enough to survive but not strong announced to expand the anti-cancer forces and the cancer forces are equally match so that it stays small but anything that tips the balance against those anti-cancer forces allows cancer to grow so the biggest one is probably age so age. Immune system often starts to weaken and in those cases cancer cells. And of course you're getting more damage to those cancer cells may start to grow the interesting thing about this. Whole situation is the seltzer making the transformation based on survival and in the end when they transform you know going back to a more primitive form and cancer takes over the body. The person ends up dying in the end in the cancer doesn't survive in the end. Yeah it's interesting and that's often a question people vast like why would it. Cancer developed to be so lethal. Because it's gonna kill itself in the process that is if you have a very bad cancer that cancer will kill you and then the cancer itself will die. Why like that. The seemed to make sense but again it's just like those warlords and so on when they get into that state where they're sort of fighting for survival at some point is so maladaptive that they will just die but they don't care because they're not looking towards the future they're just looking to survive that instant in time and that's why they don't plan to go any further just like a bacteria and it's exactly like a a single celled organism so if you look at a bacteria you put it in a sort of nutrient broth or something like that or you grow it or if you have a yeast on a slice of brad it will continue to grow until everything is eaten up. There's none of this. Oh let's save some you know. Be smart if we don't grow and we just kind of go law. That would be the smart thing to do. Not when things are because there's no coordination right. It's every cell for himself. Everybody from south and that ultimately is destructive. When you're looking at it from a sort of a multi cellular point of view in the end asserted cancer actually kills itself. But you can understand. Why would do that by looking at it. More from a you know like this is a sort of almost a separate species right. Because i find this really interesting because you have to look at the cancer almost like a separate species. It's almost like a lung. Salary liver seller poland sell anymore. It's like branch and made its own species like bacteria because that's how the immune system actually sees that cancer. It actually sees it an identifier. Is it as foreign. It doesn't identify it as part of our own selves national identifier System looks at this cancer cells and says that's a foreign invader. Let's kill it. So that's what keeps it in check for a long time and explain why cancer actually has so much more in common with the way we treat infectious diseases that is infectious diseases. They continue to grow. They metastasized so when you're talking about metastatic disease may talk about cancer. Because these you know lung cancer can metastasized and go into the sort of lung can spot on the lung and you go into your brain for example the same with bacteria so we have infections in their metastatic is also an infection. In your heart valve will easily metastasized go into your brain whereas heart attack will never go anywhere like you. Don't get a heart attack in the matassa sizes if you get a cut on your leg. It doesn't suddenly become a cut on your face right. It doesn't do that but after almost treat the disease is almost like an infectious disease and tried to kill it. The same way we have Cocktails of regimens for certain bacteria. We have cocktails of chemotherapy for that. Because it's almost like a separate. New species has developed in our own body when you're talking about chemotherapy and treatment for cancer. This is one part of the book. I was really blown away by the cost of these drugs and treatments. And how they've gone up over the air so talk about where we're at right now with cost and what somebody would expect if they're diagnosed with cancer. Yeah it's sad. Part of the whole thing is that the cost of treatment have conway up in. You might say while these drugs are expensive but unfortunately that's only part of the story so the first drug of that sort of new genetic paradigm was an accident which was a great drug. They price it quite high for the time and what happened over the ensuing years was sort of unprecedented so the way that drugs had been in the past is that you'd price on and for about ten years you had coffee right protections nobody copy you but then generics would come in and they would lower the price if you look got. Say a blood pressure medication. It would start off being very expensive in about ten years later. Fifteen years later it would drop to lights. Five percent of the original cost rights of a drug cost. Ten bucks originally are twenty bucks for a month. Ten fifteen years later would cost like two dollars for a month of medications. That's the way most drugs had been cancer I think they decided that. Instead of dropping drugs they just kept raising the prices and it was because i think the market was willing to pay it because these were such great drives in this new paradigm treatment so the very same drug matt's in which in two thousand costs you know a few thousand dollars all of a sudden the price just went up and up and up and so for the very steam drought so no extra you know development cost nothing like that for the very same drug. It was three four times a cost and then other drug developer's looked at that and said okay so when they came time to shoot introducing this sort of generic medications. They didn't drop the price instead of saying okay. We're going to come in a price which is ten percent of the original cost came in and said we're going to introduce generic is gonna cost actually a little bit more than the original is like. Wow that's crazy but if everybody colludes like all the drug companies collude to keep the prices high then the prices they hide because you have no other twice years as a group of consumers we have no choice because we we need those medications so the companies instead of. It's like those you know baseball collusion talks. That used to happen right when all the owners would say. Okay while everybody. We're going to work together to drive down. The prices of their the drug companies sort of colluded to raise the prices and it only happened in the united states. Right other places. Prices have come down significantly in the united states. The crisis have just stayed sky high. And now you're talking about for course of treatment of most of these newer drugs in developing sort of in the hundred thousand dollars a year range and that's not even uncommon. That's who can even afford that kind of thing and it's sort of tragic and even the older drugs are priced so high that people simply can't afford it enforced. That's why you have shows like breaking bad where the entire premise is that. This guy had to sell drugs in order to ford his lung cancer treatment who was just The extent and that's why spread it. Is this sort of high prices of cancer. Droughts it's a real problem. I I don't know what the solution is unless there is Sort of government interaction. You know oversight perhaps but it is a real problem. There's just no no way. Americans can actually survive if the prices of treatment are going to be that high especially compared to other places in the world. And i know you mentioned in paradigm to when a couple of these drugs came out. In the beginning they worked really well but overall are the drugs for cancer. Success story like the current drugs on the market. That means big bucks for you know if they're willing to forego that money what's the success rate of using these treatments and that's the sad part. Is that the initial drugs. Were amazing but over the last sort of number of years. The treatment success rate has gone down so low that if you look at sort of how long they extend lines. The average was two point one months which is really very little to say that. If you look at you know this is not to pick on one drug but a number of drugs. Yes look at all the drugs that have been developed over the last say fifteen years and say what is the average increase in survival that you will get from taking one of these very very expensive drugs and it was two point. One months of your seventy five years old when you develop your cancer in you would survive to seventy six with you. Know the stream that caused a couple of hundred thousand survived a seventy six two months. Is that even worth it. Like not only. Are you going to bankrupt everything. Your quality of life may or may not be better with the treatment. And if you have to sell your house and cut off your kids from their inheritance. I'm not sure that anybody would really do that. The problem is that that paradigm of genetic treatments Just ran into a wall so that further developments just stock and this is where this third sort of paradigm we really hold a significant amount of promise because if you now understand that this cancer should be viewed as a sort of a separate species is really something that is foreign to us that vall from officer to speed away and it's caused by this crime damage while the the logical thing that is to say well west street at like an infection if boost the immune system ban. You're going to be able to treat these parasites than single cell parasites more effectively. That's led to the development of the sort of next huge area of cancer therapeutics which has been ongoing for about five years six years now again. This paradigm has been going on for a couple years. But it's basically immunotherapy and that's one of the things that is where people are looking at ways to uncover the cancer and expose it to our own immune system in thinking that bats. It'd be much more successful way to treat cancer in its first couple of treatments. We've had for indeed. This been sort of really incredible success. Maybe not as good as the first genetic treatments but the sort of pipelines come looks especially promising because now we can develop these treatments. We can look at things completely differently instead of going on about you know. Let's look at changing jacks. we can look at. Hey how are we going to change our points of new howard gonna boost our immune system and so there's been a few treatments for melanoma for example that has an extremely extremely successful hasn't really made a big difference but hopefully were just beginning of this paradigm shifts. I mean we're only a few years into a comparative seventies to twenty ten which was forty years. So we're only sort of like five or ten years into this new paradigm now. I'm gonna take another quick break from my chat with jason. Tv show to our show partner. Perfect kito the kito cookies from perf akita. You'll question how something healthy can taste so good. But they've figured it out they come in four flavors peanut butter double chocolate chocolate chip and snicker doodle. They're the perfect tree for your cookie. Cravings and have only four grams net carbs per serving which is to cookies. They're made with cleaning real ingredients and listen to the show. You get twenty percents off your perfect hito purchase by going podcast dot com slash perfect. Hito again that. You're elise ultimately podcasts. Dot com slash perfect. Kito get yourself some of the key cookies. They make the perfect breakfast dessert or on the go snack. Now give a shout out to other show partner. Peak t super charger. Fast and elevate your health with peak fasting tease. 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You save five percent on your peak purchase by going ultimate help podcasts dot com slash pt again they ultimately podcasts dot com slash peak t and peak is spelled p. i q. u. e. on top of that you get free shipping on orders over sixty dollars if you're into time restricted eating give pete fasting tease it. Try to help. Keep you from being angry. And now back to my chat with jason jason knowing what you know i know. There's so many different kinds of cancer. Everybody has their own situation and has to make their own decision. But with the extensive knowledge you have on cancer. If you or somebody in your family was diagnosed what path would you take when you get the cancer. There's really That's where the research has been very good. They've put a lot of money into trying to out the best regimens and you know she should take in this drug versus the struggling district so they've put a lot of effort and money into developing the best sort of benjamin's what we've gone from a treatment standpoint i would just go with whatever the holiday trip recommended and that's changing all. It's one where you can really start to make a difference in understanding is sort of looking at how cancer progresses and seeing if there's any way you can change it because you know transformation this cancerous transformation is only the first part of the process after that it's the has to develop that is You know even if you have cancer cell and needs to develop let one of the things that there's this sort of increasing understanding of what makes a cancer so row than another and that's again one of the sort of the the environment. What part of the environment is it. And that comes to the real question of sorta nutrition and cancer which is another huge fascinating talk. We've always known that nutrition plays a huge role in catching nineteen eighty one. The government should of asked a couple of very prominent cancer researchers who say what are the causes the known causes of cancer so we look at something called a population attribution faction tobacco. Smoking of the known causes cancer was the biggest about thirty five percents so smoking as a contributes to about thirty five percent of all cancers that we know about and the second one which is very close on the heels of tobacco smoke was diet and way above everything else like way above radiation way of chemicals way above the stop that we worry about like pesticides and all the stock which is like one percent or two percent diet. They estimated was vote thirty to forty percent of the attributable risk of cancer. So that's really interesting because the next question of course was well if the diet is such a huge part of how cancer or grass. Which car of the diet is it. That's important and that's where we spent decades trying to find the answer so the first thought was that it's fiber like we don't eat enough fiber and the thought was nineteen seventies. If you ain't fiber than you would should have have more and bigger bowel movements and that would sort of push out all the stuff. Clean out your colon. Maybe it's the infrequent bowel movements that are allowing sue to sort of ross in your cause cancer so they did all kinds of studies and in the two thousands what they found of course after three or four studies was that eating more fiber simply does not your risk of cancer. So that's sort of fell by the wayside. Then they said well maybe it's dietary fat because they fought. How's everything else. They thought it caused. Obesity costs heart. Disease turns out within really but that's what they thought never made any sense because americans on average had eating the same amount of fat is before but we didn't have any role in cancer certain populations like the initially eight lots of fat like whale blubber and seal blubber and Islanders a coconut all day. Long very very high in saturated fat and they were getting cancer in any particular knows. There's no reason to think that it did. But they thought while. Maybe it's the digest factors. It does everything else so they did a huge study all the women's health initiative where they randomized people to hide low fat diets and after like ten years but they found was no difference in main difference. If you ate a lot of fat little fat so dietary fiber was not the answer. Dietary fat was not the engine. Then they thought well maybe. It's some kind of vitamin deficiency. Because maybe you're just lacking something and if you replace it you can reduce your risk cancer. So they did a big study on beta carotene. Which is what you get in parents. The thing that makes it orange as a precursor to vitamin a which is why they say it's good for is because it's pressure to biden and they. They randomized people and vitamin as a beta. Carotene didn't make any difference. In fact that seems to make things worse then looked at vitamin d so full of acid might even be twelve. They did a couple huge randomized trials by this. I mean these are studies that take like ten years and thirty million dollars and five universities to complete their huge trials and they looked at vitamin b. And it didn't make any difference. Actually the people who took the vitamin b. Looked like they thought more cancer so the people took by look like dumber cancer. The people took vitamin d. Look pick on more cancer and then they looked at vitamin c. No difference vitamin d was the latest one so there is a few studies about eight or nine years ago. That said hey. Vitamin d will protect you from cancer. So they did. Another huge trial just came out a few years ago. Maybe last year the year. Before i take vitamin d doesn't protect you from cancer. Vitamin e either. Look that doesn't protect you from cancer omega threes. They look bad doesn't protect you from cancer. It's interesting because on the one hand we said well we know that diet is a huge plays a huge role in the causation of cancer. Almost on par like in the same neighborhood as smoking but it wasn't fiber. It wasn't fat and it wasn't a vitamin deficiency and literally that costs sort of like forty years of research to come up with those that sort of knowledge so what the heck was and the answer became clear sort of in the mid to thousands because as we had this obesity epidemic. What it turns out is that obesity plays a huge role in cancer. So there are now about. Thirteen cancers acknowledged by the world health organization that our bc related cancers including breast cancer and colorectal cancer. Most prominently something like lung cancer. Of course has no. there's really very little dietary role. It's about smoking deleo. Same thing but for other cancers we just don't know like you know certain cancers like cervical cancer it all depends on viral infection but breast cancer is not viral. Infection is not a talker. Turns out that obesity is a huge huge player. These so the key then is to say while if you are overweight than you should maintain weight and that's where proper nutrition really starts to play a role again. We saw this in breast cancer. For example in japan a japanese woman in japan is relatively low when they come to america when they immigrate to america their restored a triples within a couple of generations. You know the food has changed in. The rates of obesity have changed as well and it may very well be the obesity. Which is a hyper insulin. State which is what's leading to the cancer that is when eat a lot when you have a lot of nutrients your body wants to grow and tipping that sort of bodies mindset towards growth. Actually tips more towards allowing cancers to survive in progress. It doesn't necessarily make them transform into cancers which is who result of chronic somebody damage but if it does progress it's going to give it sort of hell. It's going to eat it along this journey. That's where sort of nutrition starts play a very very important role in not the transformation cancer transformation but the progression of cancer. So does the research show. How about Would have to be to really up their odds of continuing that cancer growth. It's interesting because it's probably a continuum that is the higher you are in terms of your weight the higher your bris the actual some of the data's quite striking even like with the first sort of five pounds which is sort my god that service scared but it's a continuum so the more you're overweight the higher risk you are and it's probably not just your body weight but it's probably the insulin levels so there's very close correlation between obesity too much insulin body. Insulin is not only metabolic hormone. But it's actually a very very potent growth hormone so that's why it allows cells to survive. That is if you look. At the difference. Between breast cells they have very little. Insulin receptors in breast cancer cells. They have locked in some sectors. So that's one of the big differences. So if you grow breast cancer cells in the lab and you take away the incident those cells actually just shrivel up and die. They basically can't survive without insulin. So therefore high levels of insulin especially persistently high levels. Insulin are going to allow the cancer cells to survive much. Better it's probably a continuum that is higher up on the risk jail. You go the more you are at risk of it and probably starts really with type of overweight too. Which is a little scary. But that's what some of the research shows that make sense important information and while we're talking about insulin. There's the insulin that spikes as we're consuming foods and then there's the insulin. That diabetics are injecting and that plays a role in cancer too. So talk about that. Yeah there was a few concerns because some of the large retrospective studies. Show that diabetic to take insulin. Because now you're exposing themselves sumare insulin. There's a lot of danger that that instance can promote cancer and there's a lot of these data that show that that's unfortunately looks like the case. Some of the data is inconsistent because other data show there's no increased risk of cancer. But the problem is of course. Cancer is a disease that develops over ten or fifteen or twenty years. It doesn't develop sort of right away. That is if you are overweight. Does a fifteen year old. You don't just immediately get breast cancer. You get breast cancer. Like age fifty. It's a lifetime of sort of increased risk which leads you to that it amongst a lot of other light aging and all that trying to stop so these sort of studies where people have said. Well we did. This randomized study where we gave people insulin. And they didn't get more cancer while you're doing it for like two years three years and it's really gonna be hard to say if it actually increases risks substantially over that period of time. So i would be very leery of at. I think that there is a very real risk there. But that's one of many things. If of course you do lose weight if you are type. Two diabetic not type one diabetic because remember type one diabetic have low insulin levels. So they're trying to replace a taking insulin to sort of replace their normal insulin levels whereas type two diabetics have exceedingly high levels of insulin in their body. In your giving more so. That's a bad thing that is you up to insulin. You shouldn't be taking more instant. Usually trying to take lessons learnt as opposed to type ones. Who have to middle and therefore taking a little bit of incentives normal so for type two or if you try to maintain a normal weight very often that diabetes will actually get significantly better off into the point where you don't have to take in and we have more options in terms of medications interesting good distinction there between type one and type two and earlier. We talked about metastases. So i wanna come back to this. This is where cancer is leaving from the primary tumor traveling through the body to a new site and setting up base in and growing a new tumor in a new location. So let's talk about win the happens because it doesn't happen in all cases so what gets cancer to that point where metastasis occurs. And why you know. I found this part of the most interesting. Because it's probably the most important because metastases is really what kills people. I think that for lot of years way that people thought of it is that metastasis is very late. Process saying you have a breast cancer. It has to be there for a number of years. it grows it grows. It grows and eventually gets big enough. That breaks off suze. After ten years of breaks often then goes to deliver so the question is. How does it do that because the environment in the liver is extremely different than the environment and the breast. So how can a cell that normally survives in the breast all of a sudden survive in the liver. It's almost impossible to do. It's like humans to mars and just walking out and you know it's like oh here we go. It's like you're gonna die so that was the sort of question as to why that happens. How it happens in again the evolutionary sort of teradyne sort of explains this process in a very interesting and much more consistent way with the data that is. It's not that the cancer grows and grows and grows and then suddenly breaks off ten fifteen years. It probably is breaking off all the time and what happens. Is that the body. Just wipes it out so breast cancer even from before you can detect it this shedding these cancer thousands of blood millions of these cancer cells into the blood but almost immediately they're getting wiped out and the new system kills them. The bloodstream is very fast and is a very different environment. Some of them mainland in the liver or the brain but can't survive there because it's simply to foreign an environment for this breast sow which lands in the brain. And it's like whoa. I'm used to the brass and all of a sudden it's like well. What is all this right orlands. In the long as what's offers air blowing in and out right this is crazy. So these cells don't survive and get wiped out almost immediately but they evolved in that says what's sort of really fascinating about the evolutionary teradyne is that it starts to explain how matanzas happens so the technology has evolved to the point that we can actually detect these low volume cancer cells in the blood. So they're called circulating tumor cells. And this is what some people call liquid biopsy that is. You could take actually some blood. And look for cancer cells airing very minute. Small quantities of these cancer cells. He 'cause they're actually getting destroyed. Needed we upon leaving breast tumor. So the estimates are they survived. Maybe an hour at the most before they're all dead so that's why they're so hard to detect. Were not able to detect early early metastatic cells before but now explains why how cancers develop in how metastasis developed because basically now. We have saying you take this breast cancer. Continuously shedding off cells while all of sudden one day this breast cancer has mutated and it just is able to survive a little bit longer in the blood the bloodstream for example. The dangerous that are in the from now acts as a selective pressure for evolutionary change. That is these sows which are now able to survive. Survive long enough to get back to the original breast cancer site. The breast tumor now their progeny are going to be just a little bit more likely to survive the bloodstream. So maybe instead of all million cells dying you have one cell that makes it. That runs out comes back and propagates itself so maybe the next time two or three cells are able to survive and that just keeps going so this process of metastasis is not a late stage thing. It's actually very early early early. Crow says which is what contributes to the evolution of this tumor as it goes year after year because remember these tumors often develop after many many years is that it keeps evolving keeps evolving keeps evolving. And by the time you sere. There's some clones of south so some had developed from the sort of early tumors had developed laters. So it's interesting because when you ask a biopsy of these cancers you can find multiple sub crumbs. It's not one single clone of cell and the metastatic site if you have a breast cancer and you take a biopsy metastasized delivery take a biopsy from liver. Those two sites are actually quite different from each other genetically different because had different evolutionary pressures in the liver that is as they were trying to survive they face different is a different environment in the liver compared to the breast so therefore it was facing different evolutionary selection pressures. And it's evolved a completely different way. So that metastatic site has evolved from the original site and that sort of Process explains a lot of what we see things like cancers with unknown primary why some people will will survive for twenty years with no cancer and then it will suddenly come back because all that time. It's been sort of evolving evolving evolving. So we thought that these cancers lay dormant but they don't they're actually continuously changing as they go and again. If you understand that there different ways that you can apply that knowledge to change treatments for example you may not need to apply what's known as maximally tolerated dose. That is the standard way to apply. Chemotherapy is to give as much chemotherapy as you can. Without killing the patient. That's basically maximum tolerated dose. And maybe you don't need that because what's gonna happen you give. Maximum does is. The dad is now going to act as a selection pressure for the development of resistance. So maybe you don't need that. Maybe you can give a smaller dose over longer time and just control it rather than erotica. So that's something called adaptive therapy which is one of these sort of new ways of treating cancer. Which would never have come across. If you're on that sort of older paradigms of genetic disease now with an evolutionary paradigm. We're like hey this makes sense because we have a whole branch of side hands evolutionary biology and we can apply these lessons which we've actually learned ready to the cancer problem and come up with all these innovative new treatments. Immune therapy adoptive therapy. You know there's so many other ways that you could go when cancers leaving the primary site in spreading through the body is it doing that to get better access to resources are wiser doing that. It's just way that it is because that's the way single celled organisms are. They showed they move around raid. I mean if you think about viruses and bacteria and stuff that constantly looking for better places to go and it doesn't matter so what they do. Of course you know you have the same bacteria or fungus or something it grows and grows and then it's very mobile right at likes to move around so therefore it just flies off. You know it moves all over. The place looks for better To exploit best just part of the way that yuna sally their organisms operate as opposed to cells in multicellular oriented. Like the normal liver cell. It has adhesion molecules that. Stick it to the liver. It cannot move. It's bound down really tight to that spa so that it can't move as opposed to single celled organisms which actually tried to get around as much as they can in the book. You talk about how intermittent fasting can be used as a therapy to help prevent cancer. Talk about how. I would work. And there's not a lot of data in this area but what we know is that obesity is a big risk factor for cancer and therefore if you can maintain a normal weight than you're presumably going to lower your risk of these obesity related cancers substantially intermittent. Fasting is one of the ways that people have used to maintain a normal weight which is very interesting. The other thing is the only other place in fasting in cancer you know. Some people use fasting during chemotherapy to lower the side effects which is also interesting because fasting. What it does is. It puts your body in a sort of a low growth mode so moves the body from sort of growth mode into sort of a repair regeneration mode and because chemotherapy is a poison that attacks rapidly growing south by china putting yourself into a more dormant state. You can actually try to lower the side effects that you're gonna get from chemotherapy. So that's been using several studies and has been reasonably effective at changing some people's response. So if you're able to tolerate the chemotherapy then of course you're going to be able to take the drug better which is going to hopefully lead to better anti-cancer fact you also talk about consuming. Green tea is that from a treatment. Perspective or from preventative as former preventative stamp wine. So this is something called chemo-prevention and There are not a lot of drugs that have been well studied for creating chemo-prevention the diabetes drug metformin has been used in the only other thing that sort of has a little bit of data. But not a lot is green tea and it's felt that some suddenly anti-oxidants and the cat that you get in green tea help prevent against cancer. So there's a lot of sort of data from japan where they do drink a lot of the screen t. In his shows that perhaps it may have an anti-cancer fact so as not a very strong effect but on the other hand green. Tea's relatively harmless. You don't really think that anybody has any you know bad effects from drinking green tea. It's traditional sort of Food that can be consumed in a very high Those and it's not very expensive so from that standpoint it's been us quite vance and so therefore its potential as a sort of Adjunct to sort of chemo-prevention all jason. I love the new book. The cancer code assist so comprehensive. I can tell you. Put your whole heart and soul into this book. And i wanna thank you for coming back on the show thank you. How can the listeners connect with you after the show Yeah so they can go to my website which is the fastest method dot com or they can follow me on twitter or social media. It's dr jason fungus d. r. jason. Von can find me there. It's all going to be linked up over in the show notes and jason any final thoughts before we part ways. I think the only other thing is that this is such an interesting topic. And i'm hoping that you know people who who are suffering from cancer are just interested actually gained a bit of perspective into the ways that the the field is changing. Because i don't see a lot of people talking about a lot of people sorta stuck in that old sort of thinking in his. We need to move to a new way of thinking if we're going to develop new treatments and sort of ways to help people more and i hope that this spurs development in that serve area is gonna be fascinating over the next five and ten years to see how cancer research continues tenfold and where treatments go. Yeah thanks again jason. Okay thank you so much such powerful and important information and like i said at the beginning if you know somebody in your life that could benefit from this. Please share the episode along. We'd love to connect with over instagram. You can tag. Dr jason fong. An ad ultimate health. Podcast you can take a screenshot of the players. You're listening takes your video clip yourself or a picture and we love to connect with the over there for full show notes. However ultimate help podcasts dot com slash three eighty. There's links everything we discussed today and so much more. Be sure and check those out and before lay go. Want to give some to my editor an engineer j sanderson podcast. Tech dot com danke jays. And this week's fun. Fact is that we've uploaded our first interview clips to our youtube channel. There's much more video content to come so be sure and over there watching subscribe. And you could do that. Over at ultimate podcasts dot com slash. Youtube have an awesome week. Talk to you soon wishing you ultimate health.