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David B. Agus M.D. · The David Rubenstein Show

0:02
Speaker 1: One of the most respected and best known oncologists in
0:05
Speaker 1: the world is doctor David Aegis. He leads the Ellison
0:08
Speaker 1: Medical Institute at the University of Southern California, where he's
0:11
Speaker 1: also a Professor of Medicine. I had a chance racing
0:14
Speaker 1: to sit down with him to talk about the high
0:16
Speaker 1: incidence of cancer now and how one treats cancer in
0:19
Speaker 1: modern life. Cancer has been around for thousands of years.
0:22
Speaker 1: How does one get cancer? Is it genetic? Is it
0:25
Speaker 1: a behavioral or environmental?
0:28
Speaker 2: Yes?
0:28
Speaker 3: Yes, and yes so there certainly are what we call
0:32
Speaker 3: genetic predispositions. There's a several dozen genes that if you
0:37
Speaker 3: inherit a faulty copy of it, your risk of cancer
0:39
Speaker 3: is dramatically higher than the average population.
0:42
Speaker 2: But cancer is a change in the genome. Sometimes behavior, sometimes.
0:46
Speaker 3: Things you smoke, things you do can cause or induce
0:51
Speaker 3: changes in DNA.
0:52
Speaker 2: So you don't get it from your parents.
0:53
Speaker 3: You can cause them through what you do. But there
0:56
Speaker 3: has to be a change in DNA to get cancer.
1:00
Speaker 2: Has it.
1:00
Speaker 1: Nixon said that we're going to have a war on
1:02
Speaker 1: cancer when he was president, and that was more than
1:05
Speaker 1: fifty years ago. Have we really made progress in combating
1:08
Speaker 1: cancer in the last fifty years.
1:10
Speaker 3: The answer is we've made tremendous progress, but it's not enough.
1:14
Speaker 3: So we now have immunetherapy right your own immune system
1:17
Speaker 3: can attack the cancer. We now have molecularly targeted therapy
1:21
Speaker 3: with every single patient in the country it's covered by Medicare,
1:24
Speaker 3: can have their cancer DNA sequenced and we can potentially
1:28
Speaker 3: use a pill to target a molecular alteration or an
1:31
Speaker 3: on switch in his cancer and turn it off. All
1:34
Speaker 3: of those by time, but we haven't cured the disease.
1:37
Speaker 1: Now. Some people say they get full body scans, and
1:40
Speaker 1: other people say that's not good for you because it's
1:42
Speaker 1: not cost effective and also you might get too much radiation.
1:47
Speaker 1: What do you think about full body scans as a
1:49
Speaker 1: way to take whether you have cancer or not.
1:51
Speaker 3: So there are MRIs now which don't have radiation to
1:54
Speaker 3: do full body scans, so certainly looking on a scan
1:57
Speaker 3: can be helpful. Many times one centimeter cancer is still
2:02
Speaker 3: many one hundred million cells. So it has yet to
2:06
Speaker 3: be proven that using anology like that with the exceptional
2:09
Speaker 3: lung cancer where it clearly works in smokers, So smokers
2:12
Speaker 3: every year should get a scan.
2:14
Speaker 2: You catch it early. You can cure the lung cancer, but.
2:17
Speaker 3: In other cancer really hasn't been shown to make a
2:20
Speaker 3: dramatic difference. Breast cancer it does, lung cancer it does,
2:24
Speaker 3: but many of the others it hasn't.
2:25
Speaker 2: Yet.
2:26
Speaker 3: We need better imaging technology, we need better blood tests,
2:30
Speaker 3: but most of our resources are spent on treating and
2:33
Speaker 3: figuring out new ways to understand the biology of cancer,
2:37
Speaker 3: very little on the diagnosis and the identifying early of cancer.
2:41
Speaker 1: Now, there are different types of cancer in terms of
2:43
Speaker 1: its potential fatality, and you measure cancer by how long
2:47
Speaker 1: one survives after five years? Is that more or less it?
2:50
Speaker 2: Yeah?
2:50
Speaker 1: I mean from diagnosis, cancer is categorized by having stage one,
2:54
Speaker 1: stage two, stage three, stage four. What does that really mean?
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Speaker 3: They're all a little bit different depending on the type
3:00
Speaker 3: of the cancer. Stage four means it's all over the body.
3:02
Speaker 3: It's metastasized to different parts of the body. Stage one
3:06
Speaker 3: means it's confined. Stage two normally means it's spread but
3:10
Speaker 3: in a local area, and stage three means it's spread
3:14
Speaker 3: a little bit more than local, but it's still in
3:16
Speaker 3: half of the body. And again the stage four is
3:18
Speaker 3: all over. So as you go up in stages survival goes.
3:22
Speaker 2: Down and outcome goes down.
3:24
Speaker 1: Now I've been told that the cancer that is the
3:26
Speaker 1: most survivable is breast cancer if detected in stage one
3:30
Speaker 1: I think a ninety eight percent survival rate or something
3:32
Speaker 1: like that, and we detect this by having mammograms. Right,
3:36
Speaker 1: So what should men get? Should men get a PSA
3:39
Speaker 1: every year which helps with prostate cancer detection?
3:43
Speaker 2: Why not?
3:43
Speaker 3: I mean, so there's an argument that you know, well,
3:46
Speaker 3: if you find a PSA test and PSA is high,
3:49
Speaker 3: we're doing over number, too many biopses, too many prostate surgeries,
3:53
Speaker 3: and too many reiation.
3:53
Speaker 2: And that's true.
3:55
Speaker 3: So finding a cancer doesn't necessarily mean you need to
3:58
Speaker 3: treat it, which I know which is a weird statement.
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Speaker 3: But there are many cancers, some indolent prostate cancer, indolent
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Speaker 3: thyroid cancer, some indolent breast cancer, so that don't necessarily
4:09
Speaker 3: need aggressive treatments but can be followed. So we call
4:13
Speaker 3: that active surveillance. So we need to develop better guidelines,
4:16
Speaker 3: better ways of framing or talking about them. I say, cancer,
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Speaker 3: you panic, I want treatment, But in many of them
4:24
Speaker 3: there's no benefit to doing treatment and lots of side effects.
4:27
Speaker 1: Now, some people say that the incidence of cancer, which
4:30
Speaker 1: is to say people getting it is higher than it
4:32
Speaker 1: was twenty or thirty or forty years ago. Is that
4:34
Speaker 1: because detection is better than it used to be.
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Speaker 3: All right, So the dirty secret is we have no idea.
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Speaker 3: We don't collect data well in the United States. What
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Speaker 3: we do know is that there's not a dramatic rise
4:45
Speaker 3: in cancer in the United States. But what we are
4:47
Speaker 3: seeing is a troubling trend is younger people are getting
4:50
Speaker 3: more cancers.
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Speaker 2: That's real.
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Speaker 3: We have no idea why, but we are seeing younger people,
4:56
Speaker 3: more colon cancer, more breast cancer, and other cancers in
5:00
Speaker 3: younger individuals twenty thirty forty year olds that we never
5:03
Speaker 3: used to see.
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Speaker 1: What do you think could possibly be the cause? I
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Speaker 1: assume pollution or the environment.
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Speaker 3: In some ways, we assume it's either something in the environment.
5:11
Speaker 3: We assume its diet, it's ultra process foods, it's microplastics,
5:16
Speaker 3: it changes in the microbiome. We really don't know until
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Speaker 3: we start to collect data we can, and we don't
5:23
Speaker 3: really have a data collection system unfortunately in the United States.
5:27
Speaker 1: So when younger people get cancer, what is their prognosis
5:31
Speaker 1: these days? And what can they really do to deal
5:33
Speaker 1: with cancer.
5:34
Speaker 3: So it's interesting all of the regimens we have surgery,
5:37
Speaker 3: chemotherapy were designed around people who were older with cancer.
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Speaker 3: I do think the biology of younger cancer is very different.
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Speaker 2: So first of all, we need to.
5:45
Speaker 3: Develop regimens meant for younger people. That being said, we
5:50
Speaker 3: also have to start screening younger people for cancer. The
5:53
Speaker 3: age of colon cancer screening dropped from fifty to forty
5:56
Speaker 3: five recently, and it probably should drop even further. So
6:01
Speaker 3: if you have any family history of cancer, we probably
6:04
Speaker 3: should start screening earlier.
6:06
Speaker 1: So the best way somebody can prevent cancer is eat well, exercise,
6:15
Speaker 1: get an annual check up, and what else can you
6:18
Speaker 1: do well?
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Speaker 2: I think there's a cadre of blood tests. You should
6:20
Speaker 2: get an irregular cadence.
6:22
Speaker 3: I think that you need to talk to your doctor
6:24
Speaker 3: about potential medicines that can lower risk. Things like aspirins,
6:28
Speaker 3: statins and other things can lower cancer risk in the
6:32
Speaker 3: right individuals. If you have a family history or others,
6:35
Speaker 3: and it's know your family history, figure out what Aunt
6:38
Speaker 3: Marge died from and really understand because many of those
6:41
Speaker 3: family histories carry down from person to person. Important to
6:44
Speaker 3: know in today's world. I can sequence your genome literally
6:47
Speaker 3: overnight and know if you would inherited the gene that
6:50
Speaker 3: gave you higher risk for those diseases, and then we
6:53
Speaker 3: get a target of prevention based on that gene that
6:56
Speaker 3: you have.
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Speaker 1: Well, should everybody get their geneme tested or because is
7:01
Speaker 1: it expensive to do that?
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Speaker 3: You can look at all the cancer risk genes for
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Speaker 3: about one hundred dollars in today's world, and I think
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Speaker 3: it's important.
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Speaker 2: Knowledge is power.
7:09
Speaker 3: Okay, Remember the generation before us, if they had cancer
7:13
Speaker 3: was considered a sign of weakness, and many never talked
7:15
Speaker 3: about it. So getting a real accurate family history sometimes
7:18
Speaker 3: is really hard.
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Speaker 1: I've been told that if a man lives long enough,
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Speaker 1: he will get prostaate cancer. Now, if you're eighty or older,
7:25
Speaker 1: you're going to die of something else, probably, But is
7:27
Speaker 1: that true that every man, probably, if he lives long enough,
7:30
Speaker 1: will get prostaate cancer.
7:31
Speaker 3: So there's no question that the indulin prostate cancers are
7:35
Speaker 3: very common. If I walk through the streets of New
7:37
Speaker 3: York City and bib seed everybody over sixty, I'd find,
7:41
Speaker 3: you know, thirty five or so prostate cancers.
7:44
Speaker 2: But again, most of them won't cause a problem.
7:47
Speaker 3: What we know is we can grade the aggressivity of
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Speaker 3: the cancer and know which are the ones that are
7:51
Speaker 3: going to cause a problem. We have a blood test
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Speaker 3: called PSA that is very good based on the slope
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Speaker 3: of the curve, the change in the number, it's starting
8:00
Speaker 3: to identify which are the more aggressive ones. Doing a
8:03
Speaker 3: biopsy is not a horrible procedure, and under the microscope
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Speaker 3: we can say, hey, this is going to be bad
8:10
Speaker 3: or don't worry about this one. So we're getting a
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Speaker 3: lot better about dealing with them now.
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Speaker 1: At Johns Hopkins, where you trained, a famous procedure was
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Speaker 1: developed for prostate cancer. They kind of minimize some of
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Speaker 1: the adverse effects of a prostate surgery. Is that a
8:26
Speaker 1: good thing to do? If you're going to prostate surgery?
8:29
Speaker 1: Have this kind of procedure. It's done by a computer
8:32
Speaker 1: and it's a robot. I guess i'd should say that
8:34
Speaker 1: does the actual surgery.
8:35
Speaker 2: Patrick Walsh was a rock star.
8:38
Speaker 3: Patrick Walls was a young urologist at Hopkins who at
8:41
Speaker 3: the time people took out the whole prostant and the
8:43
Speaker 3: problem is the nerve looked like the prostate tissue. So
8:47
Speaker 3: they were taking out the nerve and they had continence problems.
8:50
Speaker 2: Impotency problem and all the men.
8:52
Speaker 3: So Patrick looked in kids who had basically died during childbirth,
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Speaker 3: young kids and was able in those kids to know
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Speaker 3: where the nerve was and develop what's called the nerve
9:04
Speaker 3: sparing prostatectomy and started to pioneer that approach. Now with
9:08
Speaker 3: a robot, we can go on through a small incision,
9:12
Speaker 3: blow up the abdomen so there's a high pressure so
9:14
Speaker 3: there's almost no bleeding. And instead of looking down a
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Speaker 3: cave where the prostate is deep in the abdomen, you
9:19
Speaker 3: blow it up on a.
9:20
Speaker 2: Big sony screen, great visualization.
9:23
Speaker 3: You could take out that prostate and have better outcomes
9:26
Speaker 3: in terms of side effects, and the patient literally can
9:29
Speaker 3: go home the same day.
9:30
Speaker 1: So I know you do things other than on college
9:33
Speaker 1: sheep and tell us what does the Ellison Institute do.
9:36
Speaker 3: We are at Technology Application Institute, so we develop drugs.
9:40
Speaker 3: We now have a large AI group that can design
9:43
Speaker 3: molecules targeting areas of cancer. So we're designing a molecule
9:49
Speaker 3: that hits part of the prostate cancer signaling cascade to
9:53
Speaker 3: block it. That'll go into the clinic next year. We
9:56
Speaker 3: have a breast cancer molecule that we're made with AI.
9:58
Speaker 3: So with AI, we can actually use AI to what
10:02
Speaker 3: is the structure of the target and then what is
10:04
Speaker 3: the structure of the molecule, And what would have taken
10:07
Speaker 3: many years, we literally can do it in months is
10:10
Speaker 3: design a molecule to go into the clinic. So that's
10:13
Speaker 3: been a tremendous advance for us and enable us to
10:17
Speaker 3: have a whole pipeline of drugs to treat cancer.
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Speaker 1: Now I am now seventy five years old, and when
10:22
Speaker 1: you get to be seventy five, you worry about your
10:24
Speaker 1: body collapsing and not working. You also worry about your
10:27
Speaker 1: mind not working so much so on Alzheimer's, what's the
10:31
Speaker 1: best way for me to prevent myself from getting Alzheimer's
10:34
Speaker 1: or some kind of dementia.
10:36
Speaker 3: So one of the largest studies ever done in Europe,
10:38
Speaker 3: what they showed is every year you delay retirement, you
10:41
Speaker 3: reduce the incidents of Alzheimer's by three percent.
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Speaker 2: So it's the old adage you don't use it, you
10:46
Speaker 2: lose it.
10:47
Speaker 3: So keeping your brain engaged making yourself uncomfortable, which you
10:51
Speaker 3: are good at doing with your myriad of activities, is
10:54
Speaker 3: fantastic And I love that.
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Speaker 1: Now you've had a lot of very famous patients, like
10:59
Speaker 1: Steve Jobs. Our famous patients are more difficult to deal
11:03
Speaker 1: with than the average person because they have big egos,
11:05
Speaker 1: or they're easier to deal with because they just say,
11:07
Speaker 1: take care of this problem and I'll trust you.
11:09
Speaker 3: They're all different. I mean, you know, there are people
11:12
Speaker 3: I take care of who are amazing. You know, Jack
11:14
Speaker 3: Kemp was a remarkable individual.
11:16
Speaker 2: And when I first started care of him, he goes,
11:19
Speaker 2: you need to do me a favor and I want
11:20
Speaker 2: you to come to my house.
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Speaker 3: And I go, okay, thinking we're going to discuss his
11:25
Speaker 3: case and what's going on. And what he did was
11:27
Speaker 3: he had his whole family sitting in a long table
11:30
Speaker 3: and he had his church come and serve them dinner.
11:33
Speaker 3: He wanted me to see who he was and he said, listen,
11:36
Speaker 3: you make all the decisions. I trust you, but I
11:39
Speaker 3: want you to understand my value system. And it really
11:42
Speaker 3: was a beautiful way of approaching things. And it's a
11:45
Speaker 3: privilege to take care of anybody that they put their
11:47
Speaker 3: health their future into my hands.
11:49
Speaker 1: Let's talk about your own background. So where were you born?
11:52
Speaker 2: Baltimore, Maryland?
11:54
Speaker 1: Balmer as they call were okay, And was your father
11:57
Speaker 1: at Hopkins.
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Speaker 3: My father went to Hopkins Undergraduate and University of Maryland
12:01
Speaker 3: Medical School.
12:02
Speaker 1: Where did you go to school in Baltimore or somewhere else?
12:06
Speaker 3: I went to school in Philadelphia. My father had moved
12:10
Speaker 3: as a professor. He was initially drafted from Baltimore.
12:12
Speaker 2: To the Air Force.
12:13
Speaker 3: We went to San Antonio, Texas, and I went to
12:16
Speaker 3: Saint Mary's Hall. I was the first one of the
12:18
Speaker 3: first two boys that went into a school that went
12:20
Speaker 3: from nursery all the way through college. And you know,
12:23
Speaker 3: I still remember first grade. I was one of two
12:25
Speaker 3: boys in the school. Then we went to Philadelphia, and
12:29
Speaker 3: then I went undergraduate to Princeton and med school at
12:32
Speaker 3: University of Pennsylvania, and then internship in residency at Johns Hopkins,
12:37
Speaker 3: fellowship at Sloan Kettering, and then to the NIH for
12:39
Speaker 3: a few years.
12:40
Speaker 1: And so did you know from the beginning you wanted
12:42
Speaker 1: to be an oncologist or a medical researcher? When did
12:45
Speaker 1: you realize what you wanted to do?
12:47
Speaker 2: Well? I was a geek as a kid. You know.
12:49
Speaker 3: It was about ten years after Sputnik and I did
12:51
Speaker 3: this little competition where you had to do this test,
12:55
Speaker 3: and we were one of four kids chosen and we
12:57
Speaker 3: went lab to lab across the country where we kind of,
13:00
Speaker 3: you know, got to tinker in the labs. And I
13:02
Speaker 3: loved being in the lab, and so as I got older,
13:05
Speaker 3: I kind of realized that I wanted to apply the
13:08
Speaker 3: lab to patients.
13:09
Speaker 2: I couldn't just be in the lab. Oncology.
13:11
Speaker 3: Cancer was an amazing place because something in the lab
13:14
Speaker 3: could be translated right away to patients. Patients were willing
13:17
Speaker 3: to take the risk. I was willing to take the risk.
13:20
Speaker 3: So that got me into cancer.
13:22
Speaker 1: So today, how many people work at the institute.
13:24
Speaker 2: Now about two hundred and fifty.
13:26
Speaker 1: And so you're teaching at the medical school and also
13:30
Speaker 1: running the institute, and you also do clinical work for patients. Yeah,
13:35
Speaker 1: so how do you take care of your own health?
13:37
Speaker 2: You know, you have to set priorities and you have
13:39
Speaker 2: to learn to say no. So I'd be at home
13:42
Speaker 2: every day of the week for dinner.
13:43
Speaker 3: I don't go out. I say no to a lot
13:45
Speaker 3: of things my business. It's easy to say no, Oh,
13:49
Speaker 3: I have a patient emergency, I can't go to this,
13:50
Speaker 3: I can't go to that. It makes it very easy
13:52
Speaker 3: to say no. I really try to make my schedule regular.
13:57
Speaker 3: You know, it turns out if you snack in between
13:59
Speaker 3: a meal the next day, your body expects that snack
14:02
Speaker 3: and insulin corts. All the stress hormones go up, You
14:06
Speaker 3: lose productivity, your metabolism goes down, you gain weight. It's
14:10
Speaker 3: really tough on the body. So I'm very regular with
14:13
Speaker 3: when I get up, when I eat, when I go
14:15
Speaker 3: to bed, and that makes an enormous impact on your
14:18
Speaker 3: overall health.
14:19
Speaker 1: Well, you have two children. Were you able to convince
14:22
Speaker 1: them to go to medical school?
14:23
Speaker 3: One of them went to medical school, the youngest I
14:26
Speaker 3: didn't convince him.
14:28
Speaker 2: You know, he wasn't going to go. He was, you know,
14:30
Speaker 2: went to MIT. Was a total.
14:32
Speaker 3: Techie, totally into programming, AI and data. And then COVID
14:37
Speaker 3: happened and he was privileged to work for a group
14:40
Speaker 3: analyzing data on COVID and trying to help with some
14:42
Speaker 3: of the COVID software for some of the clinical trials,
14:45
Speaker 3: and he kind of learned, you know, I want to
14:47
Speaker 3: do things to help people.
14:49
Speaker 2: I want to do things that matter.
14:50
Speaker 1: So what about some free medical advice? What about a statin?
14:53
Speaker 1: Shouldn't everybody take a statin? There for a certain age, they.
14:56
Speaker 3: Are remarkable drugs lowering LDL, which is a surrogate many
15:01
Speaker 3: camps for inflammation in the body. Lowering that LDL has
15:04
Speaker 3: a benefit in heart disease, and there is a risk
15:07
Speaker 3: reduction in cancer. And so I certainly am a believer
15:11
Speaker 3: if you have a family history of heart disease or cancer,
15:14
Speaker 3: that you want an LDL in the more acceptable range
15:17
Speaker 3: or the lower risk range.
15:18
Speaker 2: And it makes sense.
15:19
Speaker 1: What about red meat. I don't eat red meat, but
15:21
Speaker 1: I don't know why that's going to make me live
15:22
Speaker 1: longer or not. Is red meat healthy for you?
15:25
Speaker 3: Well, in a large study in Europe, they show that
15:27
Speaker 3: three servings a week.
15:28
Speaker 2: Had no health detriment.
15:30
Speaker 3: There is a health benefit in several studies with grass
15:33
Speaker 3: fed beef.
15:33
Speaker 2: So it's the key is moderation. Don't eat process meat.
15:36
Speaker 2: People who had processed meat every.
15:39
Speaker 3: Day for twenty years had about a twenty percent increase
15:42
Speaker 3: in colon cancer. So yeah, if you have a hot
15:45
Speaker 3: dog a day for twenty years, it can increase colon cancer.
15:48
Speaker 3: So I probably wouldn't do that, but a moderation it's fine.
15:52
Speaker 1: I don't drink alcohol either. Is that going to make
15:54
Speaker 1: me live longer?
15:55
Speaker 2: Not necessarily.
15:55
Speaker 3: Again, the warnings on alcohol, So there's an association small
15:59
Speaker 3: with alcohol and cancer, particularly women and breast cancer. There's
16:03
Speaker 3: also an association of things like toast and coffee with cancer.
16:07
Speaker 3: When you burn the coffee bean or toast, that brownness
16:10
Speaker 3: is a krylamide which has carcinogenic properties just like alcohol does.
16:16
Speaker 3: But it's a very, very minor contributor. Despite all the
16:19
Speaker 3: hullabaloo that was made over the last couple of months.
16:22
Speaker 1: So today, if I wanted to live another ten or
16:25
Speaker 1: fifteen or twenty years in a healthy way, your recommendations
16:28
Speaker 1: to me, if I can summarize it, is, maybe take
16:31
Speaker 1: a baby aspirin, maybe take a statin, exercise a little
16:35
Speaker 1: bit every day, don't eat too much red meat, don't
16:39
Speaker 1: drink too much alcohol, and pray a little.
16:43
Speaker 2: Bit, and consider heart imaging. Okay, figure out where we are,
16:47
Speaker 2: where we're starting from.
16:49
Speaker 3: Look at all you be up to date with all
16:51
Speaker 3: your vaccines, which is critical. Make sure that regular blood
16:55
Speaker 3: values are on good order, and then consider genetic testing
16:59
Speaker 3: if you have a family history of anything.
17:01
Speaker 1: One thing I've often wondered about, and maybe you, based
17:04
Speaker 1: on your experience, you can tell me what age do
17:07
Speaker 1: people really begin to think about dying. In other words,
17:10
Speaker 1: what age they really go to their lawyer and say,
17:12
Speaker 1: all right, I really want to worry about my will,
17:14
Speaker 1: or I really go to the doctor and say I
17:16
Speaker 1: want to live longer. Is that at age sixty, sixty five, seventy,
17:19
Speaker 1: Where do you see it? Based on your pages that
17:21
Speaker 1: are really beginning to think about death for the first time.
17:23
Speaker 2: So it's interesting.
17:24
Speaker 3: A study came out earlier last year or later at
17:26
Speaker 3: the end of last year that was looked at biologic
17:29
Speaker 3: age and said the biggest change in health happened.
17:32
Speaker 2: At age forty three in age sixty, so.
17:35
Speaker 3: That's when you know medical issues change the most forty
17:38
Speaker 3: three and sixty and both of those time points when
17:42
Speaker 3: things happen is when you start to kind of realize
17:45
Speaker 3: that you're not immortal. And so I see that very
17:48
Speaker 3: commonly in patients. You know, most of my patients. You know,
17:52
Speaker 3: the first thing I have is listen, you have a cancer.
17:54
Speaker 3: I'm gonna be able to control it. I don't think
17:55
Speaker 3: you'll die from it, but I would recommend getting your
17:58
Speaker 3: affairs in order.
17:59
Speaker 2: There's nothing wrong with being prepared.
18:01
Speaker 3: You know, hope for the best, but plan for the
18:03
Speaker 3: worst is a very reasonable thing. I've seen too many,
18:06
Speaker 3: and I'm sure you have too people who weren't prepared
18:09
Speaker 3: and horrible fights within family because they weren't prepared, and
18:12
Speaker 3: that's not a good thing.
18:14
Speaker 1: So I guess the most dangerous words in English language
18:16
Speaker 1: are maybe, get your affairs in order.
18:18
Speaker 2: No, I think it's a reasonable thing. I think it's
18:20
Speaker 2: an important thing.
18:22
Speaker 3: There's nothing wrong with it, And I'm not saying it
18:25
Speaker 3: is an alarmist thing.
18:26
Speaker 2: I just believe in it.
18:27
Speaker 1: People live to one hundred, but they're really have a
18:29
Speaker 1: lot of physical and mental problems. But you think we
18:31
Speaker 1: can ever get to people living to one hundred and
18:34
Speaker 1: actually have the physical and mental abilities of somebody who's
18:37
Speaker 1: eighty or seventy.
18:38
Speaker 2: One hundred percent. We can, and I think we will.
18:40
Speaker 3: I can't see a reason why all of us can't
18:43
Speaker 3: live in a healthy, quality way till that point. You know,
18:46
Speaker 3: the early nineteen sixties was the last time in the
18:48
Speaker 3: United States you can die with the cause of death
18:50
Speaker 3: being old age on a death certificate. Now you need
18:53
Speaker 3: a death Alzheimer's, heart disease, cancer. I want to go
18:56
Speaker 3: back to people dying of old age.
18:58
Speaker 1: Can you go to a cocktail party with out people
19:00
Speaker 1: are saying I got this pain here, I got this
19:02
Speaker 1: pain here. What should I do about you? Ever get that?
19:05
Speaker 2: I get that constantly and again?
19:07
Speaker 1: What do you tell people?
19:08
Speaker 2: I consider it a privilege to talk to them.
19:10
Speaker 3: It doesn't bother me. It bothers my wife, believe me,
19:13
Speaker 3: but it doesn't bother me. And I'm happy to try
19:16
Speaker 3: to help them. I mean the ability to help someone,
19:19
Speaker 3: you know, I look at it is that it takes
19:21
Speaker 3: two seconds of my brain time to help them, and
19:24
Speaker 3: the benefit to.
19:25
Speaker 2: Them can be very signifant.
19:26
Speaker 3: So there's an asymmetric part of the relationship here.
19:29
Speaker 1: For new kinds of treatments like stem cell treatments and
19:32
Speaker 1: things like this. Are these the kind of things that
19:35
Speaker 1: medicine's working on in ten years from today? What do
19:38
Speaker 1: you think we will be able to do that we
19:39
Speaker 1: can't do today?
19:40
Speaker 3: So, first of all, when you go to any mall now,
19:44
Speaker 3: you know, and you go to a mini mall in
19:46
Speaker 3: California or a mall here, you see a stem cell center,
19:49
Speaker 3: you know, a nutritional center of selling nad and vitamins
19:54
Speaker 3: and supplements, all of them promising you the fountain of youth.
19:58
Speaker 3: Every single one of them is of fraud. And I
20:01
Speaker 3: think the important to say that there is no data
20:03
Speaker 3: behind them, and so it's difficult because they have great marketing.
20:08
Speaker 3: It makes intuitive sense. Well, stem cell. I read in
20:11
Speaker 3: the New York Times stem cells were good. This says
20:13
Speaker 3: stem cells, therefore I want them. And that's the reductionist
20:18
Speaker 3: approach many people take when they see these buzzwords. So
20:21
Speaker 3: these are the future, but they're not here today, is
20:24
Speaker 3: the important message. There's no question we will at some
20:28
Speaker 3: point get to them. There now are ways of turning
20:30
Speaker 3: the stem cells back on, and so there are clinical
20:33
Speaker 3: trials now doing things to turn them on back in
20:36
Speaker 3: the hip and elderly people who broke their hip after repair,
20:39
Speaker 3: in the heart, in the eye, in the hair, other places,
20:43
Speaker 3: and it's going to be very exciting. It's still early
20:46
Speaker 3: days and we have to perfect that science, but this
20:49
Speaker 3: is something in the future to turn on. The regenerative
20:52
Speaker 3: capacity of our body is something that will enable us
20:55
Speaker 3: to have you alluded to it before is quality years
20:59
Speaker 3: in our eighties, nine, nine, and one hundred. With stem
21:02
Speaker 3: cell technologies, we're going to be able to reverse that.
21:04
Speaker 1: Well, what do you most enjoy about the profession you have.
21:06
Speaker 1: It's helping other people solving these problems that are help
21:09
Speaker 1: people you may not know, but people around the world.
21:12
Speaker 3: When people come to see me, I mean most of
21:14
Speaker 3: the time, they have advanced cancers, so they failed conventional treatment.
21:18
Speaker 3: So I get to think out of the box, look
21:19
Speaker 3: at all of the data, and come up before AI
21:23
Speaker 3: with something that I think can work for them and
21:25
Speaker 3: try it. I get to watch evolution happen. When I
21:28
Speaker 3: give a drug to a patient that cancer evolves. I'm
21:32
Speaker 3: watching evolution happen in weeks to months in my patient
21:36
Speaker 3: and learning the biology of cancer from perturbing it. Believe
21:39
Speaker 3: it or not, I'm a weird species and that I
21:42
Speaker 3: work in the lab and I see patients.
21:44
Speaker 2: There aren't many of us left in.
21:46
Speaker 3: The world, and to be able to do both, I
21:49
Speaker 3: do autopsies on my patients who pass away. So I
21:53
Speaker 3: see what I missed, where I was right, where I
21:56
Speaker 3: was wrong, and I learned to get better.
21:58
Speaker 1: Have you ever thought, if you were in college today,
22:01
Speaker 1: whether you would go in today's environment go to medical
22:03
Speaker 1: school or would you go to Silicon Valley.
22:06
Speaker 3: Well, first of all, I would never get into medical
22:07
Speaker 3: school today. I look at what they do in the
22:09
Speaker 3: tests and whatever it is hard. Back when I did
22:12
Speaker 3: it it seemed easier. I probably would still going to medicine.
22:17
Speaker 2: I love it. I pinched myself every day I get
22:20
Speaker 2: to do what I do.
22:23
Speaker 1: Thanks for listening to hear more of my interviews. You
22:25
Speaker 1: can subscribe and download my podcast on Spotify, Apple, or
22:29
Speaker 1: wherever you listen