The Cancer Episode

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I'll see you there, friend. Welcome to Stuff You Should Know. A production of iHeart Radio. Hey and welcome to the podcast. I'm Josh and there's Chuck and Jerry's here too.

“This is a little fashion episode of Stuff You Should Know.”

I guess one that we hope helps people understand things better. Just the clumsy swag can put it. Yeah, it's pretty clumsy. Thanks. Niceest.

You did well then. Did you? Did you already know a lot about cancer? Before I was searching this. Yeah.

I mean, I feel like I knew most of this stuff. I really. Generally, like obviously, you know, that we're going to go over a lot of statistics and stuff early on. So I didn't wasn't super dialed in, but.

Uh, yeah. I mean, we got. We have cancer in our family on my mom's side. Uh, like my mom had breast cancer. My her sister had some kind of cancer.

I had one of her brothers had some kind of cancer. So it's sort of been around and I've lost a couple of friends to cancer. Yeah. So it's popped up here and there. Yeah, I would say that's more than your fair share based on some of these statistics.

Yeah. And, you know, I was. I mean, not to spoil anything, but. I did see that only five to ten percent of all cancer cases can be attributed to genetic defects. Yeah.

I saw something like that too. So that that made me feel better as far as, you know, knowing that I'm going to die of heart disease. Right.

“You know, I mean, that is all American though, isn't it?”

Oh, baby. It is. They, they, um, they give you a little American flag to hold in your casket when you die of heart disease. Yeah. But, uh, yeah.

I mean, those are the two leading causes, you know, especially if you're an American. So, you know, that's one of the two is probably going to take, uh, take me out. Well, that's the thing. It sucks to think about this kind of stuff. Yeah, you're going to, there's a hundred percent change.

You're going to go somehow some way. That's right.

Uh, and I think 40 percent of men and women in the United States will get a cancer diagnosis.

It's a point. That's a lot. Yeah. One, one in every two point five Americans. Yeah.

That's a sobering step. And I feel bad for that point five American because they already have it hard enough. Right. I need to find a way to get a little humor in here. Um, so let me, let me kind of tell you what I learned about cancer that I just did not understand.

Okay. Which is kind of like the overview of what cancer is. It's, it cancers not just one disease. Which I kind of knew, but I'd heard that had no idea what people are talking about. What they're talking about is it's actually nowadays an umbrella term for a collection of more than 200 different diseases.

And they all share two important things in common.

“One, they are, they come from genetic defects.”

Not just inherited genetic defects like you were talking about. And then two, um, the mechanism of the disease is uncontrolled cell growth. That's cancer. But the reason it's so insidious and difficult to treat and, you know, kill so many people is because it comes from your own body. It's not like a foreign invader. It's your body doing what it normally does, which is cells divide and they don't do it quite right sometimes and they can turn cancers.

And your body has ways to handle with it, handle that stuff and get rid of it. But if you, if your body starts to get overwhelmed or your immune system starts to get depleted as you age, then the cancer can take hold and then it goes from a normal byproduct of cell division to disease. It didn't really understand cancer in those terms until I researched this. Yeah. Well, that's good. I mean, that probably means you haven't faced it a lot in your immediate surroundings.

Yeah. You, brother, her older brother, Bobby, has ditched four cancer right now. He's been hanging in there for a really long time. He's been living his best life and everything, but, you know, it's, it's just the kind of this constant in our lives. Yeah. For sure. Yeah. So if five to 10% are attributed to genetic defects, then the other 90 to 95% are rooted in environment and lifestyle. Obviously, with lifestyle, we're talking about some obvious things like smoking and diet. Alcohol, the sun exposure, stuff like that. Stress is one that's kind of scared to think about obesity.

But then, you know, 15 to whatever 20% are due to stuff like environmental pollutants and just radiation. Like that you can experience maybe in your workplace where you live or something like that. That's all like super, super sad. It's all sad. But, you know, the stuff that you have no control over, but you live near a thing. That's just super scary. Yeah. Yeah. For sure. That UV radiation also can just come from being out in the sun.

“Yeah. For the course of your life, which I think is the reason why skin cancers are the most common type of cancer.”

Yeah. I think you're right. The name cancer is Latin for crab. So, you know, just like the zodiac sign. So, in the early days, doctors describing tumors that had like veins or extensions coming out of them said they were crab like. And the way they said that was they called them cancers. Yeah. So, there you go. That's the end of the episode. Should we go over some of these other stats?

Yeah. Um, with, this is largely American stats, but we tried to extend them where we could to the UK Australia, Canada. Yeah. Places where people listen to us. Exactly. So, I'm going to make sure everybody could share in this pressiveness.

No, I agree. At any point about 17 million Americans are living with cancer and about 5,800 new cases are diagnosed every day in the US, about 1100 in the UK, and just 450, and Australia.

Oh, so, 450 to 696, it's a range, I guess. No, no, that's Australia's 696 is Canada's. Oh, it's Canada, I'll tell you. Yeah. And every year, about 600,000 Americans die of cancer, which accounts for about 17% of all deaths in the United States with far and away with lung cancer being the leader there.

“Yeah. The UK has flipped December 5 in Australia, number 3 in Canada, but it's definitely up there, right?”

Yeah. And lung cancer, not just in the US, but worldwide, is the, as most responsible for deaths from cancer. It's really prevalent because smoking was really prevalent, and still is. And like you can chalk the vast majority of cancer deaths every year up to smoking, people who smoke, make up the vast majority of people who die from lung cancer. And in the US, it's like 130,000 people every year, and something like 100,000 of those people smoked.

So every decade, a million people die because they smoke cigarettes, and then every year about 7300 Americans die from secondhand smoke exposure, which is even worse.

Yeah. Collorectal cancer is number 2 at about 55,380 deaths expected this year in 2026, but sort of the sobering part of colorectal cancer is that it's really, really, I mean, you could even say skyrocketing in young adults.

So there's a lot of work, obviously, in the insurance world when it comes to covering things like this, because as you'll see getting ahead of the game and cancer is the name of the game with beating cancer.

“Yeah, for sure. And that is actually a reason why deaths from cancer in the West are on their way down and have declined precipitously in some cases.”

It depends on the type of cancer, but like cancer death rates for all cancers declined by almost 30% in the US over the past 20 years.

Amazing. Right. And the five-year survival rate, which as we'll see is pretty much for most cancers synonymous with cured, like you're cured of cancer, that's that past 70% in 2025.

So like the numbers are pretty good, and there's other kinds of cancers that have like eye poppingly positive survival rates. Yeah, breast cancer for sure is one. One of the highest at about 90.5% thyroid is really up there, 98% prostate, 96% testicular cancer at 95% in skin cancer at almost 94%. So those are really, really encouraging numbers. It's, you know, one of the scariest words I imagine you can hear from a doctor, but you know, if you look at the numbers, unless it's just sort of one of those rare worst case scenarios, where you get some kind of news, it's something is, you know, stage four and metastasized.

“And, you know, that just, that doesn't happen very often thankfully. No, typically pancreatic cancer is pointed to is kind of like the poster child for that.”

Yeah. And the reason why is because you don't show symptoms until it's metastasized, and that means you're, your diagnosis typically at stage four, which is last stage cancer, which means that I think it has a five-year survival rate of 11.5% in the United States.

Long cancers is only 22%. So yeah, I'm going to get screened hopefully this month because I just turned 50.

Okay. I'm now eligible for a lung CT because I smoked when I was younger and now I'm 50. So cross your fingers because I don't want cancer. I don't want you to have cancer either, buddy. Thanks, man. That's like maybe the nicest thing you've ever seen. Well, you know, especially when you've done the right thing and improved your health so much, and any time somebody works really hard to do something really, really hard like quitting smoking. You hope that there's a real great payoff for that, you know, Emily smoked for a long time too, so she's always just sort of worried and she has cancer in her family, so she has always getting tons of screenings for things.

It's smart. Yeah. So I think one out of every six deaths globally every year are from cancer, and the rates are really boosted by lower income countries because they don't have a lot of access like we do in the West to services, to screenings, even HPV vaccinations.

That's a huge preventative for a whole suite of cancers. Yeah. And in the United States, it's very prevalent and it can save your sexual partners life years down the road.

And like they don't necessarily have access to that. And by the way, HPV hepatitis other viruses that can cause cancer called oncavirus is like oncology.

“That's right. Should we talk about cells for a little while?”

I mean, I don't see how we can talk about cancer and not talk about cells. Yeah. So I think we would help if we talked a little bit about how cell division and like healthy cells are supposed to work, which is cells divide and reproduce, and they, you know, they do that when they should. Generally, and they do that where they need to do that generally, and they locate themselves in the body where they're supposed to go after they mature into a specialized cell. So a cell will divide and then once it matures, it gets an assignment basically to go perform a role.

And you know, it generally does that pretty well, and when it gets to the, and it's it's pretty miraculous when you think of just normal cell life, like how, how like kind of wonderful it is to look at like when they get to the end of their life, they know that. And they self-destruct and they say we've done our job, it's time for us to exit the scene. And with cancer, all of that almost just flip-flop. It is. And again, like cancer just cells in your body that have become damaged or you inherited them with damage and like they just happen, but your body has all sorts of defenses to get rid of them as like waste and it handles it, right?

Either they cells accumulate into a tumor that crowds out the healthy cells and keeps them from doing their thing. So if it's liver cancer, your liver can't filter enough stuff out anymore and that you die from organ or systemic failure, because the cancers cells have just crowded out the healthy cells.

“So like we said, it's a genetic mutation that's going on and some DNA changes are going to raise the levels of proteins to keep the cell growing. Others might lower levels of a protein that tells it when to stop growing.”

Sometimes it'll, you know, the ones that we talked about, it'll, it'll not have, and we'll talk about the specific protein, I guess, is why we can, why, why wait, it's p53.

What is going to be suspenseful first? I know p53 is the one that basically is like the switch that tells a cell like, hey, it's, we've done our job as time to go. So one DNA mutation might not tell that p53 gene to express itself, and they think, sign to think that more than one DNA change has to occur. Right. For a healthy cell to turn cancerous. So if you have an inherited genetic related change or something, you might need fewer additional changes to develop that cancer. Yeah, because it's not like when you develop a carcinoma skin cancer, like that's the first time you've ever developed cancer right there, or a potentially cancer itself, like, it's not like you were just touched by the sun once and all of a sudden you have cancer, it's just not how it works.

“Instead, you have those cells happening all the time, but they have built in mechanisms to to reprogram themselves to basically take care of the damaged genes and turn them off or on.”

If you're like you said the wrong genes are are offer on ones that have nothing to do with with a cell turn and cancerous, or again, if it does turn cancerous, the body's immune system can come take care of it, right, and that's why you, why you have to have more than one genetic mutation because it sells pretty good at repairing itself, and if it's not p53 comes up like a like a boxing manager and like, you know,

Max your face and wants to see if you if they need to throw in the towel.

Yeah, and if you have too many genetic mutations, it's going to throw in the towel for you and you're going to have to undergo a pop toasts. That's right, you know, we talked about tumors, we're going to be talking more about that obviously, but there's also something like leukemia. There are cancers of the blood where you don't form a tumor, but the blood cells, again, they just replicate such they crowd out the healthy ones.

“And it's all doing this because they express, how would you say that? Tell them a raise?”

Yeah. Okay, and that keeps the telomere's lengthen, the telomere is what allows the cell to divide, and they, you know, kind of dwindled out over time.

But if they're expressing that telomerase, it's lengthened and that wears out a little more slowly so that tumor can just keep dividing and growing basically.

One of the other reasons they're so quick to divide is that they don't stick around long enough, or they don't wait to divide long enough to mature. And like you said, healthy cells divide mature and then become specialized, they get their assignment. And tumor cells or cancer cells just don't, they just divide too quickly to ever mature. And so as they're doing that, they pick up all sorts of new genetic mutations. And so the cells of a tumor can have a bunch of different genetically different cells because it just starts getting so out of hand.

Like I guess at the very beginning of a tumor, the cells are probably still relatively similar, but by the time you have a big old tumor, it's just this big mass of a bunch of weirdo cells that kind of like multiplicity with Michael Keaton. Right. And this is, I mean, cancer can really be insidious when you think about what's going on. Cancer cells can also recruit normal cells near a tumor to develop new blood vessels and stuff to help keep the tumor alive and help it kind of thrive and help it grow.

It's like, hey, here's more oxygen and more nutrients because cancer cells are recruiting other cells and like turning them to the dark side. And there's one other thing that they found recently is not only can they recruit cells to create new blood vessels for them, they can recruit neurons nearby. And they send phony messages to the brain, which then in turn sends out this, I can't remember the name of it, but it's an immune cell whose job is to basically tell all the other immune cells like, hey, you can just relax everything's all clear.

That's what cancer cells do that's insane that like something can evolve in a depth that quickly because we're talking about doing this on the order of like months or a few years maybe.

Yeah. It's just crazy what cancer is. Yeah, for sure. All right, I think maybe we should take a break. Yeah, I'm starting to get worked up.

Yeah, that was a good table setting and we'll come back and talk about types of cancer right after this. You're not incurable, you're not broken, you're having a normal human experience and we have a solution for that. That solution is our show free therapy. I'm Ben and I'm Kevin and we think everyone could use a little bit of therapy including us.

“Absolutely, that's why each week we sit down with a different therapist to talk about the things we're all doing.”

If you're trying to get rid of anxiety, you're actually feeling more anxiety. We talked to some of the leading therapists in the country about all of life's headaches work family dynamics and of course dating in relationships. Everyone chooses a different set of problems challenges flaws. You have to figure out which set of problems you're willing to work with. So listen, a free therapy with Ben and Kevin on the iHeart Radio app, Apple podcast or wherever you get your podcast.

Because therapy is expensive, but our podcast is free! Hey, this is Robert Lam and this is Joe McCormack and we're the hosts of the stuff to blow your mind to podcasts. This week on the show, it's Star Trek. So we're going to be talking about the bore all week long. Are you ready to get some probes put in your flesh?

That's right, tune in, resistance is futile. We're going to talk science, the culture of the bore, various interpretations.

And we're going to talk about Star Trek first contact on Weird House cinema on Friday.

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“This season on my podcast, here's the thing I'm speaking with more artists,”

policymakers and performers, but actor Steven Root. I think for me to be any good or for any character, to be any good, you've got to put enough of yourself and your empathy for people in it. I'm a people watcher. You see that guy going down the jungle.

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“Listen to here's the thing on the iHeart Radio app, Apple podcast or wherever you get your podcasts.”

[Music] All right, so we're back to talk about types of cancer. Like you mentioned from the jump there are more than 200 types of cancer because they're more than 200 types of cells in the body. And that's no coincidence obviously.

They're basically classified according to where they start in the body.

But that also means that you can get cancer of almost anything anywhere in the body. Yeah, and again I said the most common one is a carcinoma. I think 85% of all cancers are carcinomas and those start with epithelial tissue or cells. Which are like the outside layer of your organs and make up tissue, the skin. And again it's just because all of us are exposed to the sun over the course of our lifetimes.

And eventually I guess it's just a game of odds that can you know, some of those cancer cells can just overwhelm the immune system as we get older because our immune system declines. Which is one of the joys of aging it turns out. That's right, lymphoma and it makes up about 5% of cases that starts obviously in the lymph glands. And the lymphatic system and the lymphatic system obviously runs throughout your entire body. So lymphoma can start almost anywhere.

Yeah. If you've ever heard of non-Hodgkin lymphoma, which is the most common or Hodgkin lymphoma, which is Hodgkin's disease. Those are the two major subtytes of lymphoma.

That's definitely a cruel one. There's also leukemia, which is cancer of white blood cells that begins in the bone marrow. And that's where white blood cells are formed along with red blood cells. And strangely no one has any idea why, but this is the most common type of cancer in children.

But adults can get it too, but if you are a child with cancer, it's most likely leukemia and they just don't understand what the problem is there.

Yeah, brain and spinal cord cancer is probably one of the scariest kinds when you just sort of hear those words like brain tumor. But you know, I have known people who have had brain tumors who are doing just fine.

“They are central nervous system cancers. And then at I think that's 3% of all cancers, right?”

Yeah. And then what do we have at one percent? Myeloma is another one that starts in the bone marrow. This is plasma cells, which make up the liquid part of your blood. But it's also a type of white blood cell, so it's created in the bone marrow.

And I was like, wait, that's two types of bone marrow cancers. And it turns out the bone marrow is called the metatastic, metatastic niche. Because it's a magnet for some types of cancer cells that go to the bone marrow and just set up shop there. This is like an embarrassment of riches for all the stuff the cancer can use to recruit and protect itself. Yeah.

And then also 1% we have sarcoma. That begins in the connected tissue or the supportive tissue, like maybe in your muscle and your blood vessels and your fat or cartilage or even bone. Chuck, because there's so many different kinds of cancers and they do all sorts of different stuff. I've read that essentially every case of cancer is totally unique because of the person's body is totally unique.

And so they stage them, they basically describe them in different terms.

And the two things that they base the descriptions on most are size and growth. And the whole thing starts with stage zero cancer. It goes from stage zero to stage four. In stage zero is like you technically don't have cancer. It can be pre-cancerous cells. You just have a spot that's acting a little weird. And it's mostly curable because the cancer has an undergone one of the things that makes cancer so hard to treat. It hasn't spread to the surrounding tissues.

So you can just go in, cut out the little growth and you just got all the cancer. You're not leaving anything behind.

“Yeah, here it's stuff you should know. We love stage zero cancer.”

It's our favorite kind of cancer. As far as cancers go, this is the one we're behind. We're not afraid to say it. It even looks pretty. It's got that nice round O in the middle. Yeah, but nothing in the center of that thing.

Of course, you have stage one next. They go stage one, two, three and four. Stage one is, you know, it's a little bit more cancer. It's smaller. Obviously not smaller than zero, but smaller than two.

To contain to one area has not spread to the lymph nodes or other areas, which is basically where you get to and stage two is the tumor is going to be larger.

And it may have spread to the lymph nodes at this point. Yeah, and it's almost certainly spread to the surrounding tissue too, but it's like it's kind of invisible. The tumor is quite obvious, but the spread around the tumor is not quite visible. So it makes it harder to get rid of through surgery. Stage three, it's grown even bigger and into deeper into the surrounding tissues.

And it also has probably spread to nearby lymph nodes. And then once it spreads, once it metastasizes what it's called, you have entered stage four. That's right. That means it's definitely spread outside its original place, probably to other organs or anywhere in your body really. And that is metastatic cancer. You may also hear a letter sometimes in a diagnoses like stage two A and the letter will describe an aggressiveness with A being the least aggressive all the way up to D being the most aggressive.

Right. And then words like remission and cure are also used.

“Remission is where the cancer is, it basically describes how the cancer is responding to the treatment, right?”

If the cancer is on its heels and it's shrinking and it's doing all, it's all the stuff you want it to do through treatment. It's in remission. That would be partial remission. Complete remission is where you've treated the cancer and it can no longer be detected in the body. But that doesn't mean that it's cured. That's like a whole different term.

Meaning there's no evidence of the disease. And even though there may be a risk of reoccurrence if you're cured.

Basically, like five years is what you said. If you're in complete remission for five years, you can kind of stamp that cure on your forehead.

Yeah. I think that doctors are kind of like I don't like to use that word. They're just nervous about it coming back, you know? Yeah. I mean, I don't know any doctors. Well, I do know some doctors actually, but I haven't asked them like how they feel about the language around it, you know?

“Yeah. Well, wait if you want to get in touch with them.”

No, but well, we'll hear from doctors. I'm sure. In patients, I'm looking forward to getting emails from all kinds of people on this.

For sure. So the history is, you know, we're not going to get to in the weeds because it's basically a situation where they thought black bile was what, you know,

cause death and disease for many hundreds of years, probably thousands. And then there was a Dutch scientist, the father of anatomy, Andreas. Visileus, who finally said, you know what? I've looked at a lot of dead bodies, they even stole some corpses to make it happen. And guess what, everyone? There's no black bile in the body. And everyone was like, why are they? Well, why are people dying? That took a little bit longer. I think in 1793, there was an anatomist in London, they Matthew Bailey. That's what I'm going to do with.

Yeah, who was like, all right, here's real proof, everyone, that cancer isn't black bile. It's, you know, we found out that tumors can grow in the body really fast. And for a long, long time, it was, let's, let's cut that stuff out of the body and see what happens.

Yeah, because surgeons were like, oh, it's a tumor we can get rid of that. And I think, at first, they thought this is around 1850 when it really kicked off.

They initially thought like, we can totally take care of cancer from now on. Yeah. But what they figured out over time, because some of their patients that they treated would come down with cancer again, like a year later, something like that, was that that cancer would spread kind of invisibly deeper into the tissue. And that just getting rid of the tumor wasn't enough, because it left too much of the cancerous cells to re-perliferate and grow again. Yeah. And, you know, very sadly, they were like, you know, because I think they were so thrilled by the advent of successful surgery,

“that they were a little scalpel-happy. And we're like, we'll just keep removing stuff then, because that's how you cure this thing.”

And that lifts, you know, some, disfiguration a lot of times when they just kept like getting rid of, you know, pieces of your body. Yeah. And it took a long time. It took decades before they finally figured out that it was a systemic thing. And finally understood what metastization is. And then they came up with better treatment, starting with the X-rays in 1895, right? That's where they were discovered. And as little as a year later, an American medical student named Emil Gruba, he was like, you know, trying to use those to treat cancer and he was successful. He treated successfully treated a patient with breast cancer using X-rays.

So now you got radiation, which can you can go in and cut the tumor out and then you can irradiate what's left. And now things are starting to cook. Yeah. Things are starting to cook a little bit. Kima Therapy didn't interest the scene. Thanks to kind of a weird story. But in the U.S. Army, doctors were conducting autopsies on soldiers who died from mustard gas exposure. And they're like, hey, this gas is attacking white blood cells. So they got a developed a derivative of mustard gas called Mechlorethamine.

“And that became the first chemo drug in the 1940s. And they still use that sometimes for some types of lymphoma, I think.”

Yeah, because it's a disease of your white blood cells, right? There's a guy who is basically synonymous with chemotherapy, his name's Sydney Farber. He the Dana Farber Cancer Institute is named after him and it is world renowned. And it's also I found a really great resource for info, really understandable, but detailed info on cancer. Yeah. He came up with a cancer drug for treating leukemia in children.

And I think it's what it was called. And that was back in 1947. So if you see photos of him after 1947, he usually has a little halo over his head. The thing is, and we're going to see this after we take a break, but chemotherapy is a very blunt instrument, right?

Yeah. Because it just goes in, wipes out so much stuff that you don't want to wipe out. It's just not very targeted. But again, as we'll see, it's gotten a lot better over time. Yeah. And a lot better to take things to some some great new nausea drugs because nausea and fatigue are two of the biggest rough parts of chemotherapy. Yeah. I've heard that for sure.

All right. Should we take our second break?

Yes, please. All right. We're going to come back and we're going to talk about treatment because there's a lot of great stuff going on you guys. We'll be right back. You're not incurable. You're not broken. You're having a normal human experience and we have a solution for that. And that solution is our show free therapy. I'm Ben, and I'm Kevin, and we think everyone could use a little bit of therapy, including us.

“Absolutely. That's why each week we sit down with a different therapist to talk about the things we're all doing.”

If you're trying to get rid of anxiety, you're actually feeling more anxiety. We talked to some of the leading therapists in the country about all of life's headaches. Work, family dynamics, and of course dating in relationships. Everyone chooses a different set of problems challenges flaws. You have to figure out which set of problems you're willing to work with.

So listen, a free therapy with Ben and Kevin on the iHeart Radio App, Apple Podcasts, or wherever you get your podcasts. Because therapy is expensive, but our podcast is free! Hey, this is Robert Lam, and this is Joe McCormack, and we're the hosts of the stuff to blow your mind to podcasts. This week on the show, it's Star Trek, so we're going to be talking about the bore all week long. Are you ready to get some probes put in your flesh?

That's right, tune in, resistance is futile, we're going to talk science, the culture of the bore, various interpretations,

and we're going to talk about Star Trek first contact on Weird House Cinema on Friday.

Listen to stuff to blow your mind on the iHeart Radio App, Apple Podcasts, or wherever you get your podcasts.

“Hi, it's Alex Baldwin, this season on my podcast, here's the thing I'm speaking with more artists, policymakers, and performers, but actor Stephen Root.”

I think for me to be any good or for any character, to be any good, you've got to put enough of yourself and your empathy for people in it. I'm a people watcher. You see that guy going down the drain though, yeah, I can use that. Open Igloo Co-founder, Alia Mohamed. I love staying on top of what is going on in our city, what is going on in city politics, what is on renter's minds, and taking all of that knowledge to build a platform that hopefully is going to make New York City better in the long run.

And actress and singer Melissa Erico. Partnership took on a whole other meaning when I started making my own work. It's like you with a great actress or actor, it was best to come out of your trailer full of life and just face another person who's full of life and don't talk.

“Listen to here's the thing, on the iHeart Radio App, Apple Podcasts, or wherever you get your podcasts.”

[Music] So check two things. The first one is I was wondering if cancer was actually a relatively recent thing, like maybe from the industrial revolution on. Right. Yeah, I used to wonder that too. Absolutely not. I mean, I think imhotep described it 4,700 years ago of breast cancer. So it's been around a really long time. The reason it's only kind of recently come under investigation and study is because we used to die from a bunch of other stuff, mostly communicable diseases.

Rather than cancer, it was pretty low on the list, and then as we started to take care of those other communicable diseases, then cancer suddenly became a much bigger problem than it had been before. Yeah, for sure. In the reason that we haven't, you know, developed like a complete just cure all for cancer is because that no two cancers are the same. They all develop in different ways.

And they're doing a lot of, you know, we'll talk about some of the like more breakthrough stuff they're doing,

but right now what the standard practice kind of still is, if you have a malignant tumor is to shrink that tumor with targeted radiation,

to eradicate what cancer is remaining in your body and to hopefully stay off metastasis. Yeah. And you'll do that round of chemotherapy, wait a little while, and then they'll test you and see what effects it had, and then if it's still there, you do another round and another round and test after each time until eventually they're like, we can't detect cancer anymore, and now you're in full remission. Hopefully forever. Yeah. If you don't have a tumor, like you said earlier, if it's like a cancer of the blood, chemotherapy is your main defense there,

and probably radiation as well. And also, you've probably heard of like a bone marrow transplant or stem cell transplant. Yeah. That's also used in cases like leukemia. I was looking into that, and it's apparently not nearly as bad as it's been made out to be. Everyone's like it's the most painful thing you can possibly do. And also, apparently only 10% of people who apply to be donors,

actually end up donating marrow, most of the others, and their plasma will do. Right.

So you end up basically donating blood.

Chemotherapy, like I mentioned before, the break is a lot better than it was, even like 10 or 15 years ago, because this serotonin antagonists, which is a new class of anti nausea drugs really can help block the nausea receptors in the brain. Right. And I know just from like family and stuff that was one of the worst parts, and I'm sure it's still no picnic, but those are really helped. Yeah. I mean, just what a horrible thing going into chemotherapy, knowing that you're going to get horribly nauseated for a while.

“It's kind of the dread has to be really serious, you know?”

Yeah. I mean, one of our friends, like you and me, have recently underwent cancer, the jaw surgery, and boy, the way he described just the pain of that surgery, and what he felt like the next day was brutal. I don't think I have the exact words here on my text.

I don't know if I'd read him anyway, but he basically was like, you felt like he'd gotten run over by a truck, and that was just like post-post-op.

I mean, that was just after the surgery, you say? Yeah, for sure. But he's doing great. Good, good. Yeah, I'm glad.

So yeah, surgery is a big part of it. If it's a tumor, obviously, if it's a cancer of the blood, and there's no tumor, they're not doing that, like you said. But you promise cutting edge stuff, right? And something that is still, you can kind of call it cutting edge, just because it's so gee-wiz. But it's starting to become much more prevalent and available throughout the west.

It's a form of immunotherapy, which is basically training your immune system to target cancer cells in the same way that it targets foreign invaders.

“Because again, cancer is not a foreign invader, and it's very, very clever at using the body's own immune system to prevent it from being attacked, right?”

I was thinking about this truck. Cancer is like one of those rogue agents in a movie that was trained by the very agency that now seeks to pull it. Yeah, he's good metaphor. Thanks, man. I've been working on it for a couple of weeks now.

So, yeah, you know, your body generally does a pretty good job of doing that kind of thing, but not in the case of cancer. So they're working on therapies that, like you said, can train your body to do that. And I guess the leading, or I guess one of the leading methods is called car T cell therapy. In this case, the car stands for chimeric antigen receptor, which is a targeted receptor for the type of cancer cells that invade your body. Right. So they basically just take some of your blood. They separate the T cells, your immune cells out of it.

And they use CRISPR. Did we do a whole episode on CRISPR, the gene editing technology I feel like we did? It was either a whole episode or it was came up pretty heavily in more than one back in the day. Okay, but it's a tool for basically use a virus that has the gene G1 in it and the virus is whatever diseases spreads is turned off. And you insert that into like a T cell. And now the T cell has the gene G1 and those genes get the T cell to express the same proteins that are in that kind of cancer.

“So now you put the T cells back in, you have to proliferate them for a while.”

And there's a bunch of T cells running around telling the rest of your immune system, look for this. Do you see this protein right here? This is what we're looking for. And in other cases, it can cause T cells to grow the kind of receptors that needs to attack and latch on to cancer just like it would any foreign invader.

Yeah, that's amazing. Some other gene therapy techniques that are, I guess, still in the testing stage, they, you know, we mentioned that P53 protein. That's the one that says like, hey, it's, we've done our job, it's time to self-destruct. And that's the one cancer cells don't have. So some gene therapy techniques include turning on that P53 protein and cancer cells.

Yeah, so they either self-destruct or at least stop dividing, right? It's amazing. Yeah, there's others that there's genes that basically turn the cells into magnets for immune cells.

“And then I saw another one where they can turn, they can make the cancer cell mature finally, right?”

And so they will have a job. Basically, and get this, they found that the vast majority of those cells basically pull the plug, they, they undergo a pop toast, as they self-destruct. So they'd rather die than have a job. The cancer cells would. In that crazy cancer cells are genetics in other words.

Wow, that's, that's incredible. I didn't know about that one. They also have on the horizon personalized cancer vaccines, right?

That's a new treatment designed to basically prime your immune system to target cancer cells, to reduce recurrence risk. And, you know, obviously, hopefully like kind of fewer side effects than something like chemotherapy. Yeah, and it's not good that they use the word vaccines because it suggests that you can go get the vaccine before you have cancer and no keep you from having cancer. And that's not the case.

“It's vaccine in the sense that it primes your immune system to fight cancer better, but it's personal lives, right?”

They take your cancer and examine it and then figure out what, what treatment will best defeat your specific cancer. And that's part of a larger kind of push that's going on now. It's called precision oncology, which is, you're studying the individual patient patients' cancer to defeat it. And now that we have genomic scans that you can really kind of go through the DNA of a cell pretty quickly and find the mutations and then figure out how to use those mutations against the cancer. I mean, this is, it's a really great frontier that we're on right now. It's very hopeful.

Yeah, for sure. You know, we do have done a lot of AI pooping on the show, but one of the great benefits of AI is that it's already kind of stepped up in cancer treatment. And in sort of cancer diagnoses, it seems like, like, maybe having, along with the human radiologists having AI looking at radiology scans to detect tumors that maybe a radiologist doesn't notice. Maybe also to help predict a risk. And there's an AI MIT model that's able to predict a person's risk of developing lung cancer six years in advance.

And that's amazing because, you know, as we've kind of hammered home already, like the whole trick to cancer is getting an early diagnosis and start going at it right away.

Yeah, and that's the, I mean, that's the big money part right there is detecting it early.

“And because of things like screening and other kinds of detection that we have in routinely used in the West, that's why cancer rates are going down, but like I said before, the developing world is pushing cancer rates up.”

And much so that the World Health Organization is expecting cancer diagnoses to increase 77% by 2050 over 2023. So in just over 25 years, almost almost 100% increase. I'm just going to say, 77% is close enough to 100% where we're talking about that level of increase of cancer diagnoses. Sure, you know, we talked a little bit about risk factors already. Things that you can control, like, you know, alcohol obesity, certainly tobacco and sun exposure, things like that. There is an interesting emerging field called psycho neuro immunology, which is a branch of Western medicine that acknowledges the effect of the brain or your mind really on the systems of the body.

You know, it's, I don't think it's like woo-woo stuff to say that a real, real, deep will to live can make a difference if you're, you know, up against cancer. And it can work the other way too, and I've seen this as well when someone is like, you know what, this isn't the life I want, and I'm, I'm done because it's just, it's time for me. And people go very quickly after someone has sort of made that decision. So, there's something to it for sure.

And then, yeah, like how to prime it in people is, it's definitely being investigated now, and it does seem to be a thing for sure.

Yeah, and, you know, on that sort of last note around the language when someone has, has chosen to not continue treatment.

“The way people talk about it is changing, I think, probably for the better, because, you know, you shouldn't say like someone has given up the fight, because it indicates that they're like quitting something or surrendering.”

And that, in fact, is like, one of the bravest things you can do, I think. Yeah, that's, yeah, I mean, it's definitely, because you're just saying, like, okay, I'm accepting my fate, and that is incredibly brave. Yeah, and not just saying, like, giving up the battle of cancer, just using framing cancer treatment and cancer disease in terms of fighting and battling implies things like that. You know, you don't have the guts to keep fighting, you know, or you're quitting or you're surrendering as another way to put it.

And for some people, yes, like battle fighting, it definitely inspires them. So no one's saying, like, don't use those terms anymore. Right.

It's just that for other people, they're like, I don't, like, this is making me feel bad.

Like, I'm responsible for my death. And those people, they're like, you know, call it your journey with cancer, living with cancer, treating your cancer, more neutral terms less fighting terms. And they're, they just say, the researchers say, follow the patients lead on which way, like, how you frame the terms of cancer, living with cancer and treating cancer. I mean, that's super valid.

“Sure. And if you know someone in your life that is accepted, that it's time for them, like, that's when they need, like, your, your support and love more than ever, I think.”

It's in, I mean, I would just recommend to not, not, like, be devastated in front of them at least. Right. And to try and try and support that decision, you know, because that's a, that's a brave thing to accept. That's going to be tough for a kid to understand and accept to, you know, yeah. There was a member that, uh, that episode of the pit that really dealt with that.

Oh, yeah. That was Lord. Got wrenching. I've got one quick soap box PSA. That's okay. Yeah.

Let's do it. So in the United States, mammograms are covered by insurance.

The problem is, is that you very often need to follow up because they're, like, this mammograms good enough, but not quite.

There's this thing in here. I want to see closer. Let's take a look. And it's probably nothing in the most cases. It is nothing. But they do that because they're like, we don't want to miss something that's really important. The follow up imaging is not covered by insurance. So there's a, you know, plenty of women out there who are like, I don't have the money to pay out a pocket for a CT scan.

So I'm just not going to go get the follow up imaging and cross my fingers. So there's bills floating around there, basically like insurance companies.

“You have to cover all follow up imaging as well.”

Like you can't just, just do the bare minimum. But it's just not going to work for people anymore, hopefully. Yeah. And it mammograms suck. Yeah. It's an awful process that's like already there's an incentive to avoid something like that. So insurance companies, or, you know, we've rented before, but they need to step it up in a lot of ways.

That's certainly one of them. And also as we mentioned before, with the increased rate of colorectal cancer and younger adults, make them available to be covered in your 30s. You know, there's probably not a lot of 30 year olds that have the gumption to be like, you know, I'm going to go ahead and get a colonoscopy at 35 years old. But if they want to, then it should well be covered.

You know, for sure. Uh, wow. That was a good one. Chuck, nicely done. We made it. I would say, do you have anything else about cancer, but I know you do. So we're just going to say this one's wrapped up.

That's right. Since we just wrapped this episode on cancer up, that means it's time for listener mail, of course. That's right. I'm going to finish with the very heartwarming story, which is a good way to end this one. Awesome.

Uh, this was from our phone books, short stuff, when we talked about sort of randomly calling the wrong person with the same name. Uh, hey, guys, when I was 15, I tried to call someone in our friend group. I looked up the last name. I found a long list of entries and put a small dot in pin next to each name of someone I thought lived in our school district.

And you'll see why. Uh, thankfully, two towns in our area had similar names, but went to different school districts. I didn't know that at the time.

So I called over a dozen numbers asking for my friend, who I never found.

“But one guy answered, and when I asked, can I please speak to name redacted?”

He answered, well, he isn't here, but this is that name. And I answered, well, this is Amanda, which is actually a fake name, guys, because the Boston Song Amanda was out at the time. And it was all I could think of on the spot. This story's getting good. We, I think you see her, it's edited.

We spoke for 30, 30 minutes on the phone about the met, too. It just won the World Series and hung up. I then called back that guy once a week for five months. And we eventually decided to meet under a street light on the corner. And dudes, we've been married for 33 years.

Awesome. Together for 39, and in December, our daughter is going to get married. He is my person, my soulmate, my everything. I'm a weirdo, and he gets me and always has all because of the phone book. That is so great, man.

To answer your question, yes, the other guy knows the story and that he is the reason that I found my husband.

I don't think he could believe it.

And I sort of still can't really believe it myself after all these years. Nowadays, it would be so unlikely to even pick up a call from an unknown number. So thank you again for consistently creating such polished, elite entertainment. Pollished? I know.

Elite? Wow. Not two words, we usually associate with ourselves.

“No, I think she's talking about the daily.”

I think so. But that is from Laura and Laura sent picks of her and her husband in 1987, 1993, and won from this year. And it is adorable. He had quite the mustache. I saw the subject line.

I haven't looked at the email yet, so I have to run over into that. But it's a great story, man. Yeah, I love it. That was Laura. That was Laura.

Thank you, Laura. That was, I don't know. It's a contender for number one. Yeah, maybe. That's right.

You and name redacted husband. Yeah. And so glad you're still together. Seriously, one of the best ever. So thank you for sending that email Laura.

“And if you want to take your shot at the number one email spot, we love that.”

You can send it off to [email protected]. Stuff you should know is a production of iHeartRadio. For more podcasts, my heart radio visit the iHeartRadio app. Apple podcasts are wherever you listen to your favorite shows. Hey, this is Robert Lam.

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