Latest / Stuff You Should Know / The Cancer Episode

Transcript

The Cancer Episode · Stuff You Should Know

• 0:01
  Speaker 1: Welcome to Stuff You Should Know, a production of iHeartRadio.
• 0:11
  Speaker 2: Hey, and welcome to the podcast. I'm Josh, and there's Chuck,
• 0:13
  Speaker 2: and Jerry's here, too. And this is a good old-fashioned
• 0:16
  Speaker 2: episode of Stuff You Should Know. I guess one that
• 0:20
  Speaker 2: we hope helps people understand things better is the clumsiest
• 0:26
  Speaker 2: way I can put it.
• 0:26
  Speaker 1: Yeah, it's pretty clumsy.
• 0:29
  Speaker 2: Thanks.
• 0:30
  Speaker 1: Nice as... You did well then.
• 0:32
  Speaker 2: Did you already know a lot about cancer before researching this? Yeah.
• 0:38
  Speaker 1: I mean, I feel like I knew most of this stuff.
• 0:42
  Speaker 2: Oh, really?
• 0:42
  Speaker 1: Generally. Like, obviously, you know, that we're going to go
• 0:45
  Speaker 1: over a lot of statistics and stuff early on. So
• 0:47
  Speaker 1: I wasn't super dialed in.
• 0:49
  Speaker 2: But, yeah.
• 0:51
  Speaker 1: I mean, we have cancer in our family on my
• 0:56
  Speaker 1: mom's side. Like, my mom had breast cancer. Her sister
• 1:02
  Speaker 1: had some kind of cancer. My one of her brothers
• 1:05
  Speaker 1: had some kind of cancer. So it's sort of been
• 1:08
  Speaker 1: around and I've lost a couple of friends to cancer.
• 1:10
  Speaker 2: Yeah.
• 1:11
  Speaker 1: So it's popped up here and there.
• 1:15
  Speaker 2: Yeah, I would say that's more than your fair share
• 1:16
  Speaker 2: based on some of these statistics. Yeah.
• 1:19
  Speaker 1: And, you know, I was. I mean, not to spoil anything, but.
• 1:25
  Speaker 1: I did see that only 5% to 10% of all
• 1:28
  Speaker 1: cancer cases could be attributed to genetic defects.
• 1:32
  Speaker 2: Yeah, I saw something like that, too.
• 1:34
  Speaker 1: So that made me feel better as far as, you know,
• 1:37
  Speaker 1: knowing that I'm going to die of heart disease.
• 1:40
  Speaker 2: Right. You know? I mean, that is all American, though,
• 1:44
  Speaker 2: isn't it?
• 1:45
  Speaker 1: Oh, baby, it is.
• 1:47
  Speaker 2: They give you a little American flag to hold in
• 1:51
  Speaker 2: your casket when you die of heart disease.
• 1:53
  Speaker 1: Yeah. But, you know, I mean, those are the two
• 1:56
  Speaker 1: leading causes, you know, especially if you're an American. So,
• 1:59
  Speaker 1: you know, that's one of the two is probably going
• 2:01
  Speaker 1: to take take me out.
• 2:04
  Speaker 2: Well, that's the thing. It sucks to think about this
• 2:07
  Speaker 2: kind of stuff, but you're going to there's 100 percent
• 2:10
  Speaker 2: chance you're going to go somehow some way.
• 2:12
  Speaker 1: That's right. And I think 40 percent of men and
• 2:17
  Speaker 1: women in the United States will get a cancer diagnosis
• 2:20
  Speaker 1: at some point.
• 2:21
  Speaker 2: That's a lot. Yeah, one in every 2.5 Americans.
• 2:26
  Speaker 1: Yeah, that's a sobering stat.
• 2:28
  Speaker 2: And I feel bad for that 0.5 American because they
• 2:30
  Speaker 2: already have it hard enough.
• 2:32
  Speaker 1: Right. I knew you'd find a way to get a
• 2:35
  Speaker 1: little humor in here.
• 2:37
  Speaker 2: So let me kind of tell you what I learned
• 2:41
  Speaker 2: about cancer that I just did not understand.
• 2:43
  Speaker 1: Okay.
• 2:44
  Speaker 2: Which is kind of like the overview of what cancer is.
• 2:48
  Speaker 2: Cancer is not just one disease, which I kind of knew,
• 2:50
  Speaker 2: but I'd heard that I had no idea what people
• 2:52
  Speaker 2: are talking about. What they're talking about is it's actually
• 2:56
  Speaker 2: nowadays an umbrella term for a collection of more than
• 3:00
  Speaker 2: 200 different diseases. Yeah. And they all share two important
• 3:05
  Speaker 2: things in common. One, they come from genetic defects, not
• 3:10
  Speaker 2: just inherited genetic defects like you were talking about. And
• 3:13
  Speaker 2: then two, the mechanism of the disease is uncontrolled cell growth.
• 3:20
  Speaker 2: That's cancer. But the reason it's so insidious and difficult
• 3:24
  Speaker 2: to treat and, you know, kills so many people is
• 3:27
  Speaker 2: because it comes from your own body. It's not like
• 3:30
  Speaker 2: a foreign invader. It's your body doing what it normally does,
• 3:34
  Speaker 2: which is cells divide and they don't do it quite
• 3:37
  Speaker 2: right sometimes and they can turn cancerous. And your body
• 3:40
  Speaker 2: has ways to handle that stuff and get rid of it.
• 3:44
  Speaker 2: But if your body starts to get overwhelmed or your
• 3:48
  Speaker 2: immune system starts to get depleted as you age, then
• 3:50
  Speaker 2: the cancer can take hold and then it goes from
• 3:53
  Speaker 2: a normal byproduct of cell division to disease. I didn't
• 3:57
  Speaker 2: really understand cancer in those terms until I researched this. Yeah.
• 4:01
  Speaker 1: Well, that's good. I mean, that probably means you haven't
• 4:04
  Speaker 1: faced it a lot in your immediate surroundings.
• 4:07
  Speaker 2: Yeah, Yubi's brother, her older brother Bobby, has stage 4
• 4:11
  Speaker 2: cancer right now. And he's been hanging in there for
• 4:13
  Speaker 2: a really long time. He's living his best life and everything. But,
• 4:16
  Speaker 2: you know, it's just kind of this constant in our lives.
• 4:21
  Speaker 1: Yeah, for sure. Yeah, so if 5% to 10% are
• 4:25
  Speaker 1: attributed to genetic defects, then the other 90% to 95%
• 4:28
  Speaker 1: are rooted in environment and lifestyle issues. Obviously, with lifestyle,
• 4:35
  Speaker 1: we're talking about some obvious things like smoking and diet, alcohol,
• 4:40
  Speaker 1: the sun exposure, stuff like that. Stress is one that's
• 4:44
  Speaker 1: kind of scary to think about.
• 4:46
  Speaker 2: Yeah.
• 4:47
  Speaker 1: Obesity. But then, you know, 15 to whatever, 20 percent
• 4:53
  Speaker 1: are due to stuff like, you know, environmental pollutants and
• 4:59
  Speaker 1: just radiation like. that you can experience maybe in your
• 5:03
  Speaker 1: workplace or your, uh, where you live or something like that.
• 5:06
  Speaker 1: And that's all like super, super sad. It's all sad,
• 5:09
  Speaker 1: but you know, the stuff that like you have no
• 5:11
  Speaker 1: control over, but you live near a thing that's just
• 5:15
  Speaker 1: super scary.
• 5:16
  Speaker 2: Yeah. Yeah, for sure. Um, that, that UV radiation also
• 5:19
  Speaker 2: can just come from being out in the sun over
• 5:22
  Speaker 2: the course of your life, which, um, I think is
• 5:25
  Speaker 2: the reason why, uh, skin cancers are the most common
• 5:29
  Speaker 2: type of cancer.
• 5:31
  Speaker 1: Yeah, I think you're right. The name cancer is Latin
• 5:34
  Speaker 1: for crab. So, you know, just like the Zodiac sign.
• 5:37
  Speaker 1: So in the early days, doctors describing tumors that had
• 5:41
  Speaker 1: like veins or extensions coming out of them said they
• 5:45
  Speaker 1: were crab like. And the way they said that was
• 5:48
  Speaker 1: they called them cancerous.
• 5:50
  Speaker 2: Yeah. So there you go. That's the end of the episode.
• 5:53
  Speaker 1: Should we go over some of these other stats?
• 5:56
  Speaker 2: Yeah. This is largely American stats, but we tried to
• 6:00
  Speaker 2: extend them where we could to the U.K., Australia, Canada.
• 6:04
  Speaker 1: Yeah, places where people listen to us.
• 6:06
  Speaker 2: Exactly. Just wanted to make sure everybody could share in
• 6:09
  Speaker 2: this depressiveness.
• 6:11
  Speaker 1: No, I agree. At any point, about 17 million Americans
• 6:15
  Speaker 1: are living with cancer, and about 5,800 new cases are
• 6:18
  Speaker 1: diagnosed every day in the U.S., about 1,100 in the U.K.,
• 6:20
  Speaker 1: and just 450 in Australia. 696 in Canada.
• 6:27
  Speaker 2: I saw, too, later.
• 6:29
  Speaker 1: Oh, so 450 to 696? It's a range, I guess?
• 6:32
  Speaker 2: No, no, that's Australia. 696 is Canada's.
• 6:35
  Speaker 1: Oh, it's Canada. I thought you said Australia.
• 6:37
  Speaker 2: Yeah. No, uh-uh.
• 6:39
  Speaker 1: And every year, about 600,000 Americans die of cancer, which
• 6:44
  Speaker 1: accounts for about 17% of all deaths in the United States,
• 6:49
  Speaker 1: far and away with lung cancer being the leader there.
• 6:52
  Speaker 2: Yeah.
• 6:53
  Speaker 1: Yeah.
• 6:53
  Speaker 2: The UK is flipped. It's number five in Australia, number
• 6:56
  Speaker 2: three in Canada. But it's definitely up there, right? Yeah.
• 7:00
  Speaker 2: And lung cancer, not just in the US, but worldwide,
• 7:04
  Speaker 2: is most responsible for deaths from cancer. It's really prevalent
• 7:10
  Speaker 2: because smoking was really prevalent and still is. And you
• 7:14
  Speaker 2: can chalk the vast majority of cancer deaths every year
• 7:18
  Speaker 2: up to smoking, people who smoked. make up the vast
• 7:22
  Speaker 2: majority of people who die from lung cancer. And, um,
• 7:25
  Speaker 2: in the U S it's like 130,000 people every year
• 7:28
  Speaker 2: and something like a hundred thousand of those people smoked.
• 7:33
  Speaker 2: So every decade, a million people die because they smoke cigarettes.
• 7:38
  Speaker 2: And then every year, about 7,300 Americans die from secondhand
• 7:43
  Speaker 2: smoke exposure, which is even worse. Yeah.
• 7:47
  Speaker 1: Um, colorectal cancer is number two, uh, at about 55,380 deaths, uh,
• 7:52
  Speaker 1: expected this year in 2026. But, um, sort of the,
• 7:57
  Speaker 1: the sobering part of colorectal cancer is that it's really, really, um,
• 8:02
  Speaker 1: I mean, you could even say skyrocketing in young adults. Uh,
• 8:06
  Speaker 1: it's up 51% since 1994 and people between 20 and 49,
• 8:08
  Speaker 1: and they don't, um, I mean, you should go get
• 8:15
  Speaker 1: colonoscopies in your 40s and I would even say by
• 8:19
  Speaker 1: the age 40, but your insurance may not cover it.
• 8:21
  Speaker 1: So there's a lot of work, obviously, in the insurance
• 8:25
  Speaker 1: world when it comes to covering things like this, because
• 8:29
  Speaker 1: as you'll see, getting ahead of the game and cancer
• 8:32
  Speaker 1: is the name of the game with beating cancer.
• 8:35
  Speaker 2: Yeah, for sure. And that is actually a reason why
• 8:39
  Speaker 2: deaths from cancer in the West are on their way
• 8:43
  Speaker 2: down and have declined precipitously in some cases. It depends
• 8:46
  Speaker 2: on the type of cancer. But like cancer death rates
• 8:49
  Speaker 2: for all cancers declined by almost 30 percent in the U.S.
• 8:54
  Speaker 2: over the past 20 years.
• 8:55
  Speaker 1: That's amazing.
• 8:56
  Speaker 2: Right. And the five year survival rate, which, as we'll see,
• 8:59
  Speaker 2: is pretty much for most cancers synonymous with cured, like
• 9:03
  Speaker 2: you're cured of cancer. That's that past 70 percent in 2025.
• 9:06
  Speaker 2: So Like the numbers are pretty good. And there's other
• 9:11
  Speaker 2: kinds of cancers that have like eye-poppingly positive survival rates.
• 9:16
  Speaker 1: Yeah, breast cancer for sure is one. One of the
• 9:19
  Speaker 1: highest at about 90.5%. Thyroid is really up there, 98%. Prostate, 96%.
• 9:21
  Speaker 1: Testicular cancer at 95%. And skin cancer at almost 94%.
• 9:23
  Speaker 1: So those are really, really encouraging numbers. It's one of
• 9:26
  Speaker 1: the scariest words I imagine you can hear. from a doctor. But,
• 9:42
  Speaker 1: you know, if you look at the numbers, unless it's
• 9:45
  Speaker 1: just sort of one of those rare worst case scenarios
• 9:49
  Speaker 1: where you get some kind of news that something is,
• 9:51
  Speaker 1: you know, stage four and metastasized.
• 9:53
  Speaker 2: Right.
• 9:54
  Speaker 1: And, you know, that just that doesn't happen very often, thankfully.
• 9:58
  Speaker 2: No, typically pancreatic cancer is pointed to as kind of
• 10:02
  Speaker 2: like the poster child for that. Yeah. And the reason
• 10:05
  Speaker 2: why is because you don't show symptoms until it's metastasized.
• 10:10
  Speaker 2: And that means you're diagnosed typically at stage four, which
• 10:13
  Speaker 2: is last stage cancer, which means that I think it
• 10:16
  Speaker 2: has a Five-year survival rate of 11.5% in the United States.
• 10:21
  Speaker 2: Lung cancers is only 22%. So I'm going to get
• 10:25
  Speaker 2: screened hopefully this month because I just turned 50. Oh, good.
• 10:29
  Speaker 2: Which means I'm now eligible for a lung CT because
• 10:33
  Speaker 2: I smoked when I was younger and now I'm 50.
• 10:35
  Speaker 2: So cross your fingers because I don't want cancer.
• 10:39
  Speaker 1: I don't want you to have cancer either, buddy.
• 10:41
  Speaker 2: Thanks, man. That's like maybe the nicest thing you've ever
• 10:44
  Speaker 2: said to me.
• 10:47
  Speaker 1: Well, you know, especially when you've done the right thing
• 10:49
  Speaker 1: and improved your health so much. And anytime somebody works
• 10:52
  Speaker 1: really hard to do something really, really hard, like quitting smoking,
• 10:56
  Speaker 1: you hope that there's a real great payoff for that.
• 10:58
  Speaker 1: You know, Emily smoked for a long time, too. So
• 11:00
  Speaker 1: she's she's always just sort of worried and she has
• 11:03
  Speaker 1: cancer in her family. So she has always getting tons
• 11:08
  Speaker 1: of screenings for things.
• 11:09
  Speaker 2: Good. It's smart. Yeah. So I think. One out of
• 11:14
  Speaker 2: every six deaths globally every year are from cancer. And
• 11:19
  Speaker 2: the rates are really boosted by lower income countries because
• 11:23
  Speaker 2: they don't have a lot of access like we do
• 11:26
  Speaker 2: in the West to services, to screenings, even HPV vaccinations. Yeah.
• 11:33
  Speaker 2: That's a huge preventative for a whole suite of cancers. Yeah.
• 11:37
  Speaker 2: And in the United States, it's very prevalent and it
• 11:40
  Speaker 2: can save your sexual partner's life. years down the road.
• 11:46
  Speaker 2: And they don't necessarily have access to that. And by
• 11:50
  Speaker 2: the way, HPV, hepatitis, other viruses that can cause cancer
• 11:54
  Speaker 2: are called oncoviruses, like oncology.
• 11:57
  Speaker 1: That's right. Should we talk about cells for a little while?
• 12:01
  Speaker 2: I mean, I don't see how we can talk about
• 12:03
  Speaker 2: cancer and not talk about cells. Yeah.
• 12:05
  Speaker 1: So I think it would help if we talked a
• 12:07
  Speaker 1: little bit about how cell division and healthy cells are
• 12:11
  Speaker 1: supposed to work, which is Cells divide and reproduce and they,
• 12:17
  Speaker 1: you know, they do that when they should generally and
• 12:20
  Speaker 1: they do that where they need to do that generally.
• 12:23
  Speaker 1: And they locate themselves in the body where they're supposed
• 12:25
  Speaker 1: to go after they mature into a specialized cell. So
• 12:29
  Speaker 1: a cell will divide and then once it matures, it
• 12:31
  Speaker 1: gets an assignment basically to go perform a role. And,
• 12:36
  Speaker 1: you know, it generally does that pretty well. And when
• 12:39
  Speaker 1: it gets to the end, it's pretty miraculous when you
• 12:41
  Speaker 1: think of just normal cells. cell life, like how kind
• 12:46
  Speaker 1: of wonderful it is to look at. Like when they
• 12:48
  Speaker 1: get to the end of their life, they know that
• 12:51
  Speaker 1: and they self-destruct and they say, we've done our job.
• 12:53
  Speaker 1: It's time for us to exit the scene. And with cancer,
• 12:57
  Speaker 1: all of that almost is flip-flopped.
• 12:59
  Speaker 2: It is. And again, like cancer are just cells in
• 13:03
  Speaker 2: your body that have become damaged or you inherited them
• 13:06
  Speaker 2: with damage and And like they just happen, but your
• 13:10
  Speaker 2: body has all sorts of defenses to get rid of
• 13:12
  Speaker 2: them as like waste and it handles it. Right. So
• 13:16
  Speaker 2: this isn't just like tumors we're talking about. This actually
• 13:18
  Speaker 2: applies to any kind of cancer cell. They never stop dividing,
• 13:23
  Speaker 2: which is one of the things we said at the beginning.
• 13:26
  Speaker 2: Uncontrolled cell division and growth is essentially how you die
• 13:29
  Speaker 2: from cancer. Right. Either. the cells accumulate into a tumor
• 13:34
  Speaker 2: that crowds out the healthy cells and keeps them from
• 13:37
  Speaker 2: doing their thing. So if it's liver cancer, your liver
• 13:40
  Speaker 2: can't filter enough stuff out anymore and that you die
• 13:44
  Speaker 2: from organ or systemic failure because the cancer cells have
• 13:47
  Speaker 2: just crowded out the healthy cells.
• 13:50
  Speaker 1: Yeah. So like we said, it's a genetic mutation that's
• 13:53
  Speaker 1: going on and some DNA changes are going to like
• 13:57
  Speaker 1: raise the levels of proteins to keep the cell growing.
• 14:00
  Speaker 1: Others might lower levels of a protein that tells it
• 14:04
  Speaker 1: when to stop growing. Sometimes it'll, you know, the ones
• 14:09
  Speaker 1: that we talked about, it'll not have, and we'll talk
• 14:12
  Speaker 1: about the specific protein, I guess, is why we can,
• 14:16
  Speaker 1: why wait? It's p53.
• 14:18
  Speaker 2: That was going to be suspenseful for a second.
• 14:20
  Speaker 1: I know. P53 is the one that basically is like
• 14:23
  Speaker 1: the switch that tells a cell like, hey, we've done
• 14:26
  Speaker 1: our job. It's time to go. So one DNA mutation
• 14:29
  Speaker 1: might not tell that P53 gene to express itself. And
• 14:35
  Speaker 1: they think, scientists think that more than one DNA change
• 14:39
  Speaker 1: has to occur for a healthy cell to turn cancerous.
• 14:42
  Speaker 1: So if you have an inherited genetic related change or something,
• 14:49
  Speaker 1: you might need fewer additional changes to develop that cancer.
• 14:52
  Speaker 2: Yeah, because it's not like when you develop a carcinoma,
• 14:56
  Speaker 2: a skin cancer, like that's the first time you've ever
• 14:59
  Speaker 2: developed cancer right there or a potentially cancerous cell. Like,
• 15:04
  Speaker 2: It's not like you were just touched by the sun
• 15:06
  Speaker 2: once and all of a sudden you have cancer. It's
• 15:07
  Speaker 2: just not how it works. Instead, you have those cells
• 15:11
  Speaker 2: happening all the time, but they have built-in mechanisms to
• 15:15
  Speaker 2: reprogram themselves to basically take care of the damaged genes
• 15:20
  Speaker 2: and turn them off or on. Or like you said,
• 15:22
  Speaker 2: the wrong genes are off or on, ones that have
• 15:26
  Speaker 2: nothing to do with a cell turning cancerous. Or again,
• 15:30
  Speaker 2: if it does turn cancerous, the body's immune system can
• 15:32
  Speaker 2: come take care of it. Right. And that's why you
• 15:35
  Speaker 2: why you have to have more than one genetic mutation,
• 15:39
  Speaker 2: because it sells pretty good at repairing itself. And if
• 15:42
  Speaker 2: it's not P53 comes up like a like a boxing
• 15:47
  Speaker 2: manager and like, you know, smacks your face and wants
• 15:50
  Speaker 2: to see if you if they need to throw in
• 15:52
  Speaker 2: the towel.
• 15:53
  Speaker 1: Yeah.
• 15:53
  Speaker 2: And if you have too many genetic mutations, it's going
• 15:56
  Speaker 2: to throw in the towel for you, and you're going
• 15:58
  Speaker 2: to have to undergo apoptosis.
• 16:02
  Speaker 1: That's right. You know, we talked about tumors. We're going
• 16:04
  Speaker 1: to be talking more about that, obviously. But there's also
• 16:07
  Speaker 1: something like leukemia. There are cancers of the blood where
• 16:10
  Speaker 1: you don't form a tumor. But the blood cells, again,
• 16:14
  Speaker 1: they just replicate such that they crowd out the healthy ones.
• 16:18
  Speaker 1: And it's all doing this because they express– How would
• 16:22
  Speaker 1: you say that? Telomerase?
• 16:25
  Speaker 2: Yeah.
• 16:26
  Speaker 1: Okay. And that keeps the telomeres lengthened. The telomere is
• 16:30
  Speaker 1: what allows the cell to divide, and they kind of
• 16:33
  Speaker 1: dwindle down over time. But if they're expressing that telomerase,
• 16:38
  Speaker 1: it's lengthened and it wears out a little more slowly
• 16:40
  Speaker 1: so that tumor can just keep dividing and growing, basically.
• 16:44
  Speaker 2: Yeah. One of the other reasons they're so quick to
• 16:47
  Speaker 2: divide is that they don't stick around long enough or
• 16:50
  Speaker 2: they don't wait to divide. long enough to mature. And
• 16:53
  Speaker 2: like you said, healthy cells divide, mature, and then become specialized.
• 16:59
  Speaker 2: They get their assignment. And tumor cells or cancer cells
• 17:02
  Speaker 2: just don't, they just divide too quickly to ever mature.
• 17:06
  Speaker 2: And so as they're doing that, they pick up all
• 17:08
  Speaker 2: sorts of new genetic mutations. So the cells of a
• 17:14
  Speaker 2: tumor can have a bunch of different, genetically different cells
• 17:18
  Speaker 2: because it just starts getting so out of hand. Like
• 17:20
  Speaker 2: I guess- At the very beginning of a tumor, the
• 17:23
  Speaker 2: cells are probably still relatively similar. But by the time
• 17:27
  Speaker 2: you have a big old tumor, it's just this big
• 17:30
  Speaker 2: mass of a bunch of weirdo cells that kind of
• 17:33
  Speaker 2: like multiplicity with Michael Keaton.
• 17:36
  Speaker 1: Right. That's right. And this is I mean, cancer can
• 17:40
  Speaker 1: really be insidious when you think about what's going on.
• 17:44
  Speaker 1: Cancer cells can also recruit normal normal cells near a tumor.
• 17:48
  Speaker 1: to like develop new blood vessels and stuff to help
• 17:51
  Speaker 1: keep the tumor alive and like help it kind of
• 17:55
  Speaker 1: thrive and help it grow. It's like, hey, here's more
• 17:57
  Speaker 1: oxygen and more nutrients because cancer cells are recruiting other
• 18:02
  Speaker 1: cells and like turning them to the dark side.
• 18:04
  Speaker 2: Yeah, and there's one other thing that they found recently
• 18:06
  Speaker 2: is not only can they recruit cells to create new
• 18:10
  Speaker 2: blood vessels for them, they can recruit neurons nearby and
• 18:14
  Speaker 2: they send phony messages to the brain which then in
• 18:19
  Speaker 2: turn sends out this, I can't remember the name of it,
• 18:21
  Speaker 2: but it's an immune cell whose job is to basically
• 18:25
  Speaker 2: tell all the other immune cells like, hey, you can
• 18:27
  Speaker 2: just relax. Everything's all clear. So the brain sends those
• 18:31
  Speaker 2: to where the tumor is and the tumor recruits them
• 18:34
  Speaker 2: and surrounds itself with a bunch of immune cells that
• 18:36
  Speaker 2: tell the body nothing to see here. Keep moving on.
• 18:40
  Speaker 2: That's what cancer cells do. That's insane that like something
• 18:44
  Speaker 2: can evolve and adapt that quickly because we're talking about
• 18:47
  Speaker 2: it doing this on the order of like months or
• 18:50
  Speaker 2: a few years, maybe. It's just crazy what cancer is.
• 18:54
  Speaker 1: Yeah, for sure. All right. I think maybe we should
• 18:58
  Speaker 1: take a break.
• 18:58
  Speaker 2: Yeah, I'm starting to get worked up.
• 19:00
  Speaker 1: Yeah, that was a good table setting. And we'll come
• 19:02
  Speaker 1: back and talk about types of cancer right after this.
• 19:32
  Speaker 1: All right, so we're back to talk about types of cancer.
• 19:36
  Speaker 1: Like you mentioned from the jump, there are more than
• 19:39
  Speaker 1: 200 types of cancer because there are more than 200
• 19:43
  Speaker 1: types of cells in the body, and that's no coincidence, obviously.
• 19:48
  Speaker 1: They're basically classified according to where they start in the body.
• 19:52
  Speaker 1: But that also means that, you know, you can get
• 19:55
  Speaker 1: cancer of almost anything anywhere in the body.
• 19:58
  Speaker 2: Yeah. And again, I said the most common one is
• 20:01
  Speaker 2: a carcinoma. I think 85% of all cancers are carcinomas,
• 20:04
  Speaker 2: and those start with epithelial tissue or cells, which or
• 20:09
  Speaker 2: like the outside layer of your organs, they make up tissue,
• 20:11
  Speaker 2: the skin. And again, it's just because all of us
• 20:14
  Speaker 2: are exposed to the sun over the course of our lifetimes.
• 20:17
  Speaker 2: And eventually, I guess it's just a game of odds
• 20:20
  Speaker 2: that can, you know, some of those cancer cells can
• 20:24
  Speaker 2: just overwhelm the immune system as we get older because
• 20:27
  Speaker 2: our immune system declines, which is one of the joys
• 20:30
  Speaker 2: of aging, it turns out.
• 20:31
  Speaker 1: That's right. Lymphoma makes up about 5% of cases. That starts, obviously,
• 20:36
  Speaker 1: in the lymph glands. uh, in the lymphatic system and
• 20:39
  Speaker 1: the lymphatic system obviously runs throughout your entire body. So
• 20:43
  Speaker 1: a lymphoma can start almost anywhere. Um, if you've ever
• 20:47
  Speaker 1: heard of a non Hodgkin lymphoma, which is the most
• 20:50
  Speaker 1: common or Hodgkin lymphoma, which is Hodgkin's disease. Uh, those
• 20:55
  Speaker 1: are the two major subtypes of lymphoma. And, um, you know,
• 21:00
  Speaker 1: there is some irony here for sure, because the lymph systems, um,
• 21:04
  Speaker 1: clears out cancerous cells from your body as waste. So, uh,
• 21:07
  Speaker 1: That's definitely a cruel one.
• 21:11
  Speaker 2: There's also leukemia, which is cancer of white blood cells
• 21:16
  Speaker 2: that begins in the bone marrow. And that's where white
• 21:21
  Speaker 2: blood cells are formed along with red blood cells. And strangely,
• 21:25
  Speaker 2: no one has any idea why, but this is the
• 21:27
  Speaker 2: most common type of cancer in children. Adults can get
• 21:30
  Speaker 2: it too. But if you are a child with cancer,
• 21:34
  Speaker 2: it's most likely leukemia, and they just don't understand what
• 21:37
  Speaker 2: the problem is there.
• 21:40
  Speaker 1: Yeah. Brain and spinal cord cancer is probably one of
• 21:44
  Speaker 1: the scariest kinds when you just sort of hear those words,
• 21:48
  Speaker 1: like brain tumor. But, you know, I have known people
• 21:51
  Speaker 1: who have had brain tumors who are doing just fine.
• 21:54
  Speaker 2: Yeah.
• 21:55
  Speaker 1: They are central nervous system cancers. And then at, I
• 21:59
  Speaker 1: think that's 3% of all cancers, right?
• 22:02
  Speaker 2: Yeah.
• 22:02
  Speaker 1: And then what do we have at 1%?
• 22:04
  Speaker 2: Myeloma is another one that starts in the bone marrow.
• 22:08
  Speaker 2: This is plasma cells, which make up the liquid part
• 22:10
  Speaker 2: of your blood. But it's also a type of white
• 22:13
  Speaker 2: blood cell. So it's created in the bone marrow. And
• 22:17
  Speaker 2: I was like, wait, that's two types of bone marrow cancers.
• 22:20
  Speaker 2: And it turns out the bone marrow is called a
• 22:23
  Speaker 2: metastatic niche cancer. Because it's a magnet for some types
• 22:28
  Speaker 2: of cancer cells that go to the bone marrow and
• 22:30
  Speaker 2: just set up shop there. This is like an embarrassment
• 22:33
  Speaker 2: of riches for all the stuff the cancer can use
• 22:35
  Speaker 2: to recruit and protect itself.
• 22:38
  Speaker 1: Yeah. And then also 1%, we have sarcoma. That begins
• 22:42
  Speaker 1: in the connective tissue or the supportive tissue, like maybe
• 22:46
  Speaker 1: in your muscle and your blood vessels and your fat
• 22:48
  Speaker 1: or cartilage or even bone.
• 22:50
  Speaker 2: Yeah. Chuck, because there's so many different kinds of cancers
• 22:54
  Speaker 2: and they do all sorts of different stuff, I've read
• 22:57
  Speaker 2: that essentially every case of cancer is totally unique because
• 23:01
  Speaker 2: every person's body is totally unique. And so they stage them.
• 23:06
  Speaker 2: They basically describe them in different terms. And the two
• 23:09
  Speaker 2: things that they base the descriptions on most are size
• 23:12
  Speaker 2: and growth. And the whole thing starts with stage zero cancer.
• 23:16
  Speaker 2: It goes from stage zero to stage four. And stage
• 23:19
  Speaker 2: zero is like you technically don't have cancer. It can
• 23:22
  Speaker 2: be precancerous cells. You just have a spot that's acting
• 23:25
  Speaker 2: a little weird. And it's mostly curable because the cancer
• 23:31
  Speaker 2: hasn't undergone one of the things that makes cancer so
• 23:34
  Speaker 2: hard to treat. It hasn't spread to the surrounding tissues.
• 23:38
  Speaker 2: So you can just go in, cut out the little growth,
• 23:41
  Speaker 2: and you just got all the cancer. You're not leaving
• 23:43
  Speaker 2: anything behind. Yeah.
• 23:45
  Speaker 1: Here at Stuff You Should Know, we love stage zero cancer.
• 23:50
  Speaker 2: It's our favorite kind of cancer.
• 23:52
  Speaker 1: As far as cancers go, this is the one we're behind.
• 23:54
  Speaker 2: For sure.
• 23:55
  Speaker 1: We're not afraid to say it.
• 23:56
  Speaker 2: For sure. It even looks pretty. It's got that nice
• 23:58
  Speaker 2: round O in the middle.
• 24:00
  Speaker 1: Yeah, but nothing in the center of that thing. Right.
• 24:03
  Speaker 1: Of course, you have stage one next. They go stage one, two, three,
• 24:06
  Speaker 1: and four. Stage one is, you know, it's a little
• 24:10
  Speaker 1: bit more cancer. It's smaller, obviously not smaller than zero,
• 24:14
  Speaker 1: but smaller than two. It's contained to one area, has
• 24:17
  Speaker 1: not spread to the lymph nodes or other areas. which
• 24:21
  Speaker 1: is basically where you get to in stage two is
• 24:25
  Speaker 1: the tumor is going to be larger and it may
• 24:28
  Speaker 1: have spread to the lymph nodes at this point.
• 24:30
  Speaker 2: Yeah, and it's almost certainly spread to the surrounding tissue too,
• 24:33
  Speaker 2: but it's kind of invisible. The tumor is quite obvious,
• 24:38
  Speaker 2: but the spread around the tumor is not quite visible.
• 24:41
  Speaker 2: So it makes it harder to get rid of through surgery.
• 24:45
  Speaker 2: Stage three, it's grown larger. even bigger and into deeper
• 24:50
  Speaker 2: into the surrounding tissues. And it also has probably spread
• 24:54
  Speaker 2: to nearby lymph nodes. And then once it spreads, once
• 24:58
  Speaker 2: it metastasizes, what it's called, you have entered stage four.
• 25:04
  Speaker 1: That's right. That means it's definitely spread outside its original place,
• 25:09
  Speaker 1: probably to other organs or anywhere in your body, really.
• 25:12
  Speaker 1: And that is metastatic cancer. You may also hear a
• 25:15
  Speaker 1: letter sometimes in a diagnosis like stage 2A, and the
• 25:19
  Speaker 1: letter will describe an aggressiveness with A being the least
• 25:22
  Speaker 1: aggressive all the way up to D being the most aggressive.
• 25:26
  Speaker 2: Right. And then words like remission and cure are also used.
• 25:32
  Speaker 2: Remission is where the cancer is. It basically describes how
• 25:36
  Speaker 2: the cancer is responding to the treatment, right? if the
• 25:39
  Speaker 2: cancer is on its heels and it's shrinking and it's
• 25:42
  Speaker 2: doing all the stuff you want it to do through treatment,
• 25:45
  Speaker 2: it's in remission. That would be partial remission. Complete remission
• 25:50
  Speaker 2: is where you've treated the cancer and it can no
• 25:53
  Speaker 2: longer be detected in the body. But that doesn't mean
• 25:57
  Speaker 2: that it's cured. That's like a whole different term. Yeah.
• 26:01
  Speaker 1: I mean, cure is a sort of a dicey word
• 26:03
  Speaker 1: when it comes to cancer. Um, That's basically complete remission,
• 26:07
  Speaker 1: meaning there's no evidence of the disease. And even though
• 26:11
  Speaker 1: there may be a risk of reoccurrence if you're cured,
• 26:16
  Speaker 1: basically like five years is what you said. If you're
• 26:18
  Speaker 1: in complete remission for five years, you can kind of
• 26:22
  Speaker 1: stamp that cure on your forehead proudly.
• 26:25
  Speaker 2: I think that doctors are kind of like, I don't
• 26:30
  Speaker 2: like to use that word. They're just nervous about it
• 26:32
  Speaker 2: coming back, you know? Yeah.
• 26:34
  Speaker 1: I mean, I don't know any doctors. Well, I do
• 26:37
  Speaker 1: know some doctors actually, but I haven't asked them like
• 26:41
  Speaker 1: how they feel about the language around it, you know?
• 26:43
  Speaker 2: Yeah. We'll wait if you want to get in touch
• 26:45
  Speaker 2: with them.
• 26:46
  Speaker 1: No, but we'll hear from doctors, I'm sure.
• 26:49
  Speaker 2: Yeah, I hope so.
• 26:51
  Speaker 1: And patients. I'm looking forward to getting emails from all
• 26:54
  Speaker 1: kinds of people on this.
• 26:55
  Speaker 2: For sure.
• 26:56
  Speaker 1: So the history is, you know, we're not going to
• 26:58
  Speaker 1: get too in the weeds because it's basically a situation
• 27:02
  Speaker 1: where They thought black bile was what, you know, caused
• 27:07
  Speaker 1: death and disease for many hundreds of years, probably thousands.
• 27:11
  Speaker 1: And then there was a Dutch scientist, the father of anatomy,
• 27:14
  Speaker 1: Andreas Vesalius, who finally said, you know what? I've looked
• 27:20
  Speaker 1: at a lot of dead bodies. I even stole some
• 27:22
  Speaker 1: corpses to make it happen. And guess what, everyone? There's
• 27:25
  Speaker 1: no black bile in the body. And everyone was like, well,
• 27:28
  Speaker 1: why are people dying? That took a little bit longer,
• 27:32
  Speaker 1: I think. In 1793, there was an anatomist in London
• 27:37
  Speaker 1: named Matthew Bailey.
• 27:39
  Speaker 2: That's what I'm going with.
• 27:40
  Speaker 1: Yeah, who was like, all right, here's real proof, everyone,
• 27:43
  Speaker 1: that cancer isn't black bile. It's, you know, we found
• 27:48
  Speaker 1: out that tumors can grow in the body really fast.
• 27:51
  Speaker 1: And for a long, long time, it was let's let's
• 27:54
  Speaker 1: cut that stuff out of the body and see what happens.
• 27:57
  Speaker 2: Yeah, because surgeons were like, oh, it's a tumor. We
• 27:59
  Speaker 2: can get rid of that. And I think at first
• 28:02
  Speaker 2: they thought this is around 1850 when it really kicked off.
• 28:06
  Speaker 2: They initially thought, like, we can totally take care of
• 28:09
  Speaker 2: cancer from now on. But what they figured out over time,
• 28:13
  Speaker 2: because some of their patients that they treated would come
• 28:16
  Speaker 2: down with cancer again, like a year later or something
• 28:18
  Speaker 2: like that, was that that cancer would spread kind of
• 28:22
  Speaker 2: invisibly deeper into the tissue later. And that just getting
• 28:25
  Speaker 2: rid of the tumor wasn't enough because it left too
• 28:28
  Speaker 2: much of the cancerous cells to reproliferate and grow again.
• 28:32
  Speaker 1: Yeah. And, you know, very sadly, they were like, you know,
• 28:36
  Speaker 1: because I think they were so thrilled by the advent
• 28:39
  Speaker 1: of successful surgery that they were a little scalpel happy
• 28:43
  Speaker 1: and were like, we'll just keep removing stuff then because
• 28:46
  Speaker 1: that's how you cure this thing. And that left, you know,
• 28:50
  Speaker 1: some disfiguration a lot of times when they just kept
• 28:54
  Speaker 1: getting rid of pieces of your body. And it took
• 28:58
  Speaker 1: a long time. It took decades before they finally figured
• 29:00
  Speaker 1: out that it was a systemic thing and finally understood
• 29:04
  Speaker 1: what metastasization is. And then they came up with better treatments,
• 29:10
  Speaker 1: starting with x-rays in 1895, right? Mm-hmm.
• 29:15
  Speaker 2: That's where they were discovered. And as little as a
• 29:18
  Speaker 2: year later, an American medical student named Emil Gruber he
• 29:24
  Speaker 2: was like, I'm going to try to use those to
• 29:26
  Speaker 2: treat cancer. And he was successful. He successfully treated a
• 29:30
  Speaker 2: patient with breast cancer using x-rays. So now you've got radiation,
• 29:33
  Speaker 2: which you can go in and cut the tumor out,
• 29:36
  Speaker 2: and then you can irradiate what's left. And now things
• 29:39
  Speaker 2: are starting to cook.
• 29:41
  Speaker 1: Yeah, things are starting to cook a little bit. Chemotherapy
• 29:44
  Speaker 1: enters the scene, thanks to kind of a weird story.
• 29:47
  Speaker 1: But in the U.S. Army, doctors were conducting autopsies on
• 29:52
  Speaker 1: soldiers who died from mustard gas exposure And they're like, hey,
• 29:56
  Speaker 1: this gas is attacking white blood cells. So they developed
• 30:01
  Speaker 1: a derivative of mustard gas called mechlorethamine. And that became
• 30:05
  Speaker 1: the first chemo drug in the 1940s. And they still
• 30:09
  Speaker 1: use that sometimes for some types of lymphoma, I think.
• 30:12
  Speaker 2: Yeah, because it's a disease of your white blood cells, right?
• 30:15
  Speaker 1: Yeah.
• 30:16
  Speaker 2: There's a guy who is basically synonymous with chemotherapy. His
• 30:20
  Speaker 2: name is Sidney Farber. The Dana-Farber Cancer Institute is named
• 30:25
  Speaker 2: after him, and it is world-renowned. And it's also, I found,
• 30:29
  Speaker 2: a really great resource for info, really understandable but detailed
• 30:33
  Speaker 2: info on cancer. Yeah. He came up with a cancer
• 30:37
  Speaker 2: drug for treating leukemia in children, aminopterin, I think is
• 30:41
  Speaker 2: what it was called. And that was back in 1947.
• 30:44
  Speaker 2: So if you see photos of him after 1947, he
• 30:49
  Speaker 2: usually has a little halo over his head.
• 30:51
  Speaker 1: Mm-hmm.
• 30:52
  Speaker 2: The thing is, and we're going to see this after
• 30:55
  Speaker 2: we take a break, but chemotherapy is a very blunt instrument, right?
• 31:02
  Speaker 2: I've heard a kind of an oncological gallows humor before
• 31:07
  Speaker 2: that basically says, with chemotherapy, you're trying to kill the
• 31:11
  Speaker 2: tumor before you kill the patient. Yeah. Because it just
• 31:14
  Speaker 2: goes in and it wipes out so much stuff that
• 31:18
  Speaker 2: you don't want to wipe out. It's just not very targeted. Yeah.
• 31:23
  Speaker 2: But again, as we'll see, it's gotten a lot better
• 31:26
  Speaker 2: over time.
• 31:27
  Speaker 1: Yeah, and a lot better to take thanks to some
• 31:31
  Speaker 1: great new nausea drugs because nausea and fatigue are two
• 31:35
  Speaker 1: of the biggest rough parts of chemotherapy.
• 31:38
  Speaker 2: Yeah, I've heard that for sure.
• 31:41
  Speaker 1: All right, should we take our second break?
• 31:43
  Speaker 2: Yes, please.
• 31:44
  Speaker 1: All right, we're going to come back and we're going
• 31:45
  Speaker 1: to talk about treatment because there's a lot of great
• 31:48
  Speaker 1: stuff going on, you guys. We'll be right back.
• 32:17
  Speaker 2: So, Chuck, two things. The first one is I've always
• 32:21
  Speaker 2: wondered if cancer was actually a relatively recent thing, like
• 32:24
  Speaker 2: maybe from... the industrial revolution on.
• 32:27
  Speaker 1: Right. Yeah. I used to wonder that too.
• 32:29
  Speaker 2: Absolutely not. I mean, I think Imhotep described it 4,700
• 32:33
  Speaker 2: years ago, breast cancer. So it's been around a really
• 32:37
  Speaker 2: long time. The reason it's only kind of recently come
• 32:41
  Speaker 2: under investigation and study is because we used to die
• 32:45
  Speaker 2: from a bunch of other stuff, mostly communicable diseases and
• 32:49
  Speaker 2: rather than cancer. It was pretty low on the list.
• 32:52
  Speaker 2: And then as we started to take care of those
• 32:54
  Speaker 2: other communicable diseases, then cancer suddenly became a much bigger
• 32:59
  Speaker 2: problem than it had been before.
• 33:01
  Speaker 1: Yeah, for sure. And the reason that we haven't, you know,
• 33:05
  Speaker 1: developed like a complete just cure-all for cancer is because
• 33:09
  Speaker 1: that no two cancers are the same. They all develop
• 33:13
  Speaker 1: in different ways. And they're doing a lot of research
• 33:17
  Speaker 1: You know, we'll talk about some of the like more
• 33:19
  Speaker 1: breakthrough stuff they're doing. But right now, what the standard
• 33:22
  Speaker 1: practice kind of still is, if you have a malignant tumor,
• 33:26
  Speaker 1: is to shrink that tumor with targeted radiation and then
• 33:30
  Speaker 1: remove that tumor and then prescribe a course of chemotherapy,
• 33:35
  Speaker 1: which is probably like more than one chemotherapy drug to
• 33:39
  Speaker 1: eradicate what cancer is remaining in your body and to
• 33:43
  Speaker 1: hopefully stave off metastasis. Yeah.
• 33:47
  Speaker 2: And you'll do that round of chemotherapy, wait a little while,
• 33:52
  Speaker 2: and then they'll test you and see what effects it had.
• 33:54
  Speaker 2: And then if it's still there, you do another round,
• 33:56
  Speaker 2: another round and test after each time until eventually they're like,
• 34:00
  Speaker 2: we can't detect cancer anymore. And now you're in full remission,
• 34:04
  Speaker 2: hopefully forever.
• 34:05
  Speaker 1: Yeah. If you don't have a tumor, like you said earlier,
• 34:09
  Speaker 1: if it's like a cancer of the blood, chemotherapy is
• 34:12
  Speaker 1: your main defense there. and probably radiation as well. And also,
• 34:19
  Speaker 1: you've probably heard of like a bone marrow transplant or
• 34:21
  Speaker 1: stem cell transplant.
• 34:22
  Speaker 2: Yeah.
• 34:23
  Speaker 1: That's also used in cases like leukemia.
• 34:26
  Speaker 2: I was looking into that, and it's apparently not nearly
• 34:28
  Speaker 2: as bad as it's been made out to be. Everyone's like,
• 34:31
  Speaker 2: it's the most painful thing you could possibly do. And also,
• 34:34
  Speaker 2: apparently only 10% of people who apply to be donors
• 34:37
  Speaker 2: actually end up donating marrow. Most of the others, their
• 34:40
  Speaker 2: plasma will do instead. So you end up basically donating blood.
• 34:46
  Speaker 1: Uh, chemotherapy, like I mentioned before the break is, um,
• 34:50
  Speaker 1: a lot better than it was even like 10 or
• 34:52
  Speaker 1: 15 years ago because this, uh, serotonin antagonist, which is
• 34:56
  Speaker 1: a new class of anti-nausea drugs really can help block, uh,
• 35:00
  Speaker 1: block the nausea receptors in the brain.
• 35:01
  Speaker 2: Right.
• 35:02
  Speaker 1: And I know, you know, just from like family and
• 35:04
  Speaker 1: stuff that that's, That was one of the worst parts.
• 35:08
  Speaker 1: And I'm sure it's still no picnic, but those have
• 35:10
  Speaker 1: really helped.
• 35:11
  Speaker 2: Yeah. I mean, just what a horrible thing going in
• 35:14
  Speaker 2: to get chemotherapy, knowing that you're going to get horribly
• 35:17
  Speaker 2: nauseated for a while. The dread has to be really serious,
• 35:22
  Speaker 2: you know? Yeah.
• 35:23
  Speaker 1: I mean, one of our friends of you and me
• 35:28
  Speaker 1: have recently underwent cancer, the jaw surgery. And Boy, the
• 35:34
  Speaker 1: way he described just the pain of that surgery and
• 35:38
  Speaker 1: what he felt like the next day was was brutal.
• 35:43
  Speaker 1: I don't think I have the exact words here on
• 35:44
  Speaker 1: my on my text. I don't know if I'd read
• 35:46
  Speaker 1: him anyway, but he basically was like he felt like
• 35:49
  Speaker 1: he'd gotten run over by a truck. And that was
• 35:51
  Speaker 1: just like post post-op.
• 35:53
  Speaker 2: I mean, geez, that was just after the surgery, you say?
• 35:56
  Speaker 1: Yeah, for sure. But he's doing great.
• 35:59
  Speaker 2: Good.
• 36:00
  Speaker 1: Good.
• 36:00
  Speaker 2: I'm glad. So, yeah, surgery is a big part of it.
• 36:05
  Speaker 2: If it's a tumor, obviously, if it's a cancer of
• 36:09
  Speaker 2: the blood and there's no tumor, they're not doing that,
• 36:10
  Speaker 2: like you said. But you promised cutting edge stuff, right?
• 36:16
  Speaker 2: And something that is still, you can kind of call
• 36:18
  Speaker 2: it cutting edge just because it's so gee whiz, but
• 36:21
  Speaker 2: it's starting to become much more prevalent and available throughout
• 36:25
  Speaker 2: the West. It's a form of immunotherapy, right? which is
• 36:29
  Speaker 2: basically training your immune system to target cancer cells in
• 36:34
  Speaker 2: the same way that it targets foreign invaders. Because again,
• 36:38
  Speaker 2: cancer is not a foreign invader, and it's very, very
• 36:41
  Speaker 2: clever at using the body's own immune system to prevent
• 36:46
  Speaker 2: it from being attacked, right? I was thinking about this, Chuck.
• 36:50
  Speaker 2: Cancer is like one of those rogue agents in a
• 36:53
  Speaker 2: movie that was trained by the very agency that now.
• 36:57
  Speaker 1: Seeks to kill it. Yeah, it's a good metaphor.
• 37:01
  Speaker 2: Thanks, man. I've been working on it for a couple
• 37:03
  Speaker 2: of weeks now.
• 37:05
  Speaker 1: So, yeah, you know, your body generally does a pretty
• 37:08
  Speaker 1: good job of doing that kind of thing, but not
• 37:10
  Speaker 1: in the case of cancer. So they're working on therapies that,
• 37:12
  Speaker 1: like you said, can train your body to do that.
• 37:16
  Speaker 1: And I guess the leading or I guess one of
• 37:18
  Speaker 1: the leading methods is called CAR T-cell therapy. In this case,
• 37:22
  Speaker 1: the CAR stands for chimeric antigen receptor, which is a
• 37:27
  Speaker 1: targeted receptor for for the type of cancer cells that
• 37:30
  Speaker 1: invade your body.
• 37:32
  Speaker 2: Right. So they basically just take some of your blood,
• 37:34
  Speaker 2: they separate the T cells, your immune cells, out of it,
• 37:38
  Speaker 2: and they use CRISPR. Did we do a whole episode
• 37:41
  Speaker 2: on CRISPR, the gene editing technology? I feel like we did.
• 37:44
  Speaker 1: It was either a whole episode or it came up
• 37:46
  Speaker 1: pretty heavily in more than one back in the day.
• 37:49
  Speaker 2: Okay. But it's a tool for basically you use a
• 37:53
  Speaker 2: virus that has the genes you want in it, and
• 37:55
  Speaker 2: the virus is... whatever disease it spreads is turned off.
• 37:59
  Speaker 2: And you insert that into like a T cell. And
• 38:02
  Speaker 2: now the T cell has the genes you want. And
• 38:05
  Speaker 2: those genes get the T cell to express the same
• 38:09
  Speaker 2: proteins that are in that kind of cancer So now
• 38:12
  Speaker 2: you put the T cells back in you after you
• 38:14
  Speaker 2: proliferate them for a while. And there's a bunch of
• 38:17
  Speaker 2: T cells running around telling the rest of your immune system,
• 38:19
  Speaker 2: look for this. Do you see this protein right here?
• 38:22
  Speaker 2: This is what we're looking for. And in other cases,
• 38:25
  Speaker 2: it can cause T cells to grow the kind of
• 38:27
  Speaker 2: receptors that it needs to attack and latch on to cancer,
• 38:32
  Speaker 2: just like it would any foreign invader. So I have
• 38:35
  Speaker 2: a neighbor friend who underwent CAR T cell therapy.
• 38:39
  Speaker 1: Yeah, that's amazing. Some other gene therapy techniques that are,
• 38:44
  Speaker 1: I guess, still in the testing stage, we mentioned that
• 38:47
  Speaker 1: p53 protein. That's the one that says, like, hey, we've
• 38:51
  Speaker 1: done our job. It's time to self-destruct. And that's the
• 38:54
  Speaker 1: one cancer cells don't have. So some gene therapy techniques
• 38:58
  Speaker 1: include turning on that p53 protein in cancer cells so
• 39:02
  Speaker 1: they either self-destruct or at least stop dividing.
• 39:06
  Speaker 2: Right.
• 39:06
  Speaker 1: It's amazing.
• 39:07
  Speaker 2: Yeah, there's others that there's genes that basically turn the
• 39:10
  Speaker 2: cells into magnets for immune cells. And then I saw
• 39:14
  Speaker 2: another one where they can turn the they can make
• 39:18
  Speaker 2: the cancer cell mature finally. Right. And so they.
• 39:23
  Speaker 1: Will have a job basically.
• 39:26
  Speaker 2: And get this. They found that the vast majority of
• 39:29
  Speaker 2: those cells. basically pull the plug. They undergo apoptosis, they self-destruct.
• 39:36
  Speaker 2: So they'd rather die than have a job, the cancer
• 39:39
  Speaker 2: cells would. Isn't that crazy?
• 39:42
  Speaker 1: Cancer cells are Gen X, in other words.
• 39:44
  Speaker 2: Pretty much.
• 39:46
  Speaker 1: Wow, that's that's incredible. I didn't know about that one.
• 39:49
  Speaker 1: They also have on the horizon personalized cancer vaccines. Right.
• 39:54
  Speaker 1: That's a new treatment designed to basically prime your immune
• 39:58
  Speaker 1: system to target cancer cells to reduce recurrence risk. And,
• 40:04
  Speaker 1: you know, obviously, hopefully like kind of fewer side effects
• 40:06
  Speaker 1: than something like chemotherapy.
• 40:08
  Speaker 2: Yeah. And it's not good that they use the word
• 40:10
  Speaker 2: vaccines because it suggests that you can go get the
• 40:12
  Speaker 2: vaccine before you have cancer and they'll keep you from
• 40:14
  Speaker 2: having cancer. And that's not the case. It's vaccine in
• 40:17
  Speaker 2: the sense that it primes your immune system to fight
• 40:19
  Speaker 2: cancer better, but it's personalized, right? So they take your
• 40:24
  Speaker 2: cancer and examine it and then figure out what treatment
• 40:30
  Speaker 2: will best defeat your specific cancer. And that's part of
• 40:34
  Speaker 2: a larger kind of push that's going on now. It's
• 40:36
  Speaker 2: called precision oncology, which is you're studying the individual patient's
• 40:42
  Speaker 2: cancer to defeat it. Now that we have genomic... scans
• 40:48
  Speaker 2: that you can really kind of go through the DNA
• 40:50
  Speaker 2: of a cell pretty quickly and find the mutations and
• 40:53
  Speaker 2: then figure out how to use those mutations against the cancer. That's,
• 40:57
  Speaker 2: I mean, this is, it's a really great frontier that
• 41:00
  Speaker 2: we're on right now. It's very hopeful.
• 41:03
  Speaker 1: Yeah, for sure. You know, we do have done a
• 41:05
  Speaker 1: lot of AI poo-pooing on the show, but one of
• 41:08
  Speaker 1: the great benefits of AI is that it's already kind
• 41:11
  Speaker 1: of stepped up in cancer treatment and And sort of
• 41:16
  Speaker 1: cancer diagnoses, it seems like, like maybe having, along with
• 41:20
  Speaker 1: a human radiologist, having AI looking at radiology scans to
• 41:25
  Speaker 1: detect tumors that maybe a radiologist doesn't notice. Maybe also
• 41:30
  Speaker 1: to help predict risk. I know there's an AI MIT
• 41:33
  Speaker 1: model that's able to predict a person's risk of developing
• 41:37
  Speaker 1: lung cancer six years in advance. And that's amazing because,
• 41:41
  Speaker 1: you know, as we've kind of hammered home already, Like
• 41:44
  Speaker 1: the whole trick to cancer is getting an early diagnosis
• 41:48
  Speaker 1: and start going at it right away.
• 41:50
  Speaker 2: Yeah, and that's the big money part right there is
• 41:54
  Speaker 2: detecting it early. And because of things like screening and
• 41:59
  Speaker 2: other kinds of detection that we have and routinely use
• 42:03
  Speaker 2: in the West, that's why cancer rates are going down.
• 42:06
  Speaker 2: But like I said before, the developing world is pushing
• 42:10
  Speaker 2: cancer rates up So much so that the World Health
• 42:13
  Speaker 2: Organization is expecting cancer diagnoses to increase 77% by 2050
• 42:18
  Speaker 2: over 2023. So in just over 25 years, almost 100% increase.
• 42:27
  Speaker 2: I'm just going to say it. 77% is close enough
• 42:30
  Speaker 2: to 100% when we're talking about that level of increase
• 42:33
  Speaker 2: of cancer diagnoses.
• 42:35
  Speaker 1: Yeah, for sure. You know, we talked a little bit
• 42:38
  Speaker 1: about risk factors already. things that you can control like alcohol, obesity,
• 42:44
  Speaker 1: certainly tobacco and sun exposure, things like that. There is
• 42:48
  Speaker 1: an interesting emerging field called psychoneuroimmunology, which is a branch
• 42:54
  Speaker 1: of Western medicine that acknowledges the effect of the brain
• 42:58
  Speaker 1: or your mind really on the systems of the body.
• 43:01
  Speaker 1: And I don't think it's like a woo-woo stuff to
• 43:07
  Speaker 1: say that a real person real deep will to live
• 43:12
  Speaker 1: can make a difference if you're, you know, up against cancer.
• 43:18
  Speaker 1: And it can work the other way too. And I've
• 43:19
  Speaker 1: seen this as well when someone is like, you know what,
• 43:23
  Speaker 1: this isn't the life I want and I'm done because
• 43:26
  Speaker 1: it's just, it's time for me. And I've seen people
• 43:29
  Speaker 1: go very quickly after someone has sort of made that decision.
• 43:32
  Speaker 1: So there's something to it for sure.
• 43:34
  Speaker 2: Yeah, they definitely started to research that more and more.
• 43:37
  Speaker 2: It seems... kind of thin, the amount of it that's
• 43:41
  Speaker 2: out now. But this investigation into what the will to
• 43:43
  Speaker 2: live is and then, yeah, like how to prime it
• 43:46
  Speaker 2: in people is it's definitely being investigated now. And it
• 43:50
  Speaker 2: does seem to be a thing for sure. Yeah.
• 43:53
  Speaker 1: And, you know, on that sort of last note around
• 43:57
  Speaker 1: the language, when someone has chosen to not continue treatment,
• 44:02
  Speaker 1: the way people talk about it is changing, I think,
• 44:04
  Speaker 1: probably for the better, because You know, you shouldn't say
• 44:08
  Speaker 1: like someone has given up the fight because it indicates
• 44:13
  Speaker 1: that they're like quitting something or surrendering. And that, in fact,
• 44:18
  Speaker 1: is like one of the bravest things you can do,
• 44:21
  Speaker 1: I think.
• 44:22
  Speaker 2: Yeah, that's yeah. I mean, it's definitely because you're just
• 44:26
  Speaker 2: saying like, OK, I'm accepting my fate. And that is
• 44:29
  Speaker 2: incredibly brave. Um, yeah. And not just saying like giving
• 44:34
  Speaker 2: up the battle with cancer, just using framing, cancer treatment
• 44:38
  Speaker 2: and cancer disease in terms of fighting and battling implies
• 44:43
  Speaker 2: things like that, that, you know, you don't have the
• 44:45
  Speaker 2: guts to keep fighting, you know, or you're, you're quitting
• 44:49
  Speaker 2: or you're surrendering is another way to put it. Um,
• 44:52
  Speaker 2: and for some people, yes, like battle fighting, it definitely
• 44:56
  Speaker 2: inspires them. So no one's saying like, don't use those
• 44:59
  Speaker 2: terms anymore. It's just that for other people, they're like,
• 45:03
  Speaker 2: I don't like this is making me feel bad. Like
• 45:05
  Speaker 2: I'm responsible for my own death. Those people, they're like,
• 45:10
  Speaker 2: you know, call it your journey with cancer, living with cancer,
• 45:14
  Speaker 2: treating your cancer, more neutral terms, less fighty terms. And
• 45:19
  Speaker 2: they just say, researchers say, follow the patient's lead on
• 45:24
  Speaker 2: which way, like how you frame the terms of cancer,
• 45:28
  Speaker 2: living with cancer and treating cancer. And I mean, that's
• 45:31
  Speaker 2: super valid. For sure.
• 45:33
  Speaker 1: And, and if you know someone in your life that is, is, uh,
• 45:37
  Speaker 1: accepted that it's, it's time for them, like that's when
• 45:41
  Speaker 1: they need like your, your support and love more than ever.
• 45:44
  Speaker 1: I think it's in, um, I mean, I would just
• 45:48
  Speaker 1: recommend to not, uh, Not like be devastated in front
• 45:52
  Speaker 1: of them, at least.
• 45:53
  Speaker 2: Right.
• 45:54
  Speaker 1: And to try and try and support that decision, you know,
• 45:56
  Speaker 1: because that's a that's a brave thing to accept.
• 45:59
  Speaker 2: That's got to be tough for a kid to understand
• 46:02
  Speaker 2: and accept, too, you know?
• 46:03
  Speaker 1: Yeah.
• 46:04
  Speaker 2: There was a member that that episode of The Pit
• 46:08
  Speaker 2: that really dealt with that.
• 46:10
  Speaker 1: Oh, yeah. That was Lord gut wrenching.
• 46:14
  Speaker 2: I've got one quick soapbox PSA. That's OK.
• 46:17
  Speaker 1: Yeah, let's do it.
• 46:18
  Speaker 2: So in the United States, mammograms are covered by insurance.
• 46:24
  Speaker 2: The problem is, is that you very often need a
• 46:28
  Speaker 2: follow-up because they're like, this mammogram's good enough, but not quite.
• 46:33
  Speaker 2: There's this thing in here I want to see closer.
• 46:35
  Speaker 2: Let's take a look. And it's probably nothing. In most cases,
• 46:38
  Speaker 2: it is nothing. But they do that because they're like,
• 46:41
  Speaker 2: we don't want to miss something that's really important. The
• 46:44
  Speaker 2: follow-up is, imaging is not covered by insurance. So there's
• 46:49
  Speaker 2: plenty of women out there who are like, I don't
• 46:51
  Speaker 2: have the money to pay out of pocket for a
• 46:54
  Speaker 2: CT scan. So I'm just not going to go get
• 46:57
  Speaker 2: the follow-up imaging and cross my fingers. So there's bills
• 47:00
  Speaker 2: floating around there, basically like insurance companies, you have to
• 47:03
  Speaker 2: cover all follow-up imaging as well. Like you can't just
• 47:08
  Speaker 2: do the bare minimum. It's just not going to work
• 47:10
  Speaker 2: for people anymore, hopefully.
• 47:13
  Speaker 1: Yeah. And mammograms suck. It's an awful process that's like
• 47:18
  Speaker 1: already there's an incentive to avoid something like that. So
• 47:24
  Speaker 1: insurance companies, we've ranted before, but they need to step
• 47:27
  Speaker 1: it up in a lot of ways. That's certainly one
• 47:29
  Speaker 1: of them. And also, as we mentioned before, with the
• 47:32
  Speaker 1: increased rate of colorectal cancer in younger adults, make them
• 47:37
  Speaker 1: available to be covered in your 30s. There's probably not
• 47:41
  Speaker 1: a lot of 30-year-olds that have the gumption to be like,
• 47:43
  Speaker 1: you know what, I'm going to go ahead and get
• 47:45
  Speaker 1: a colonoscopy at 35 years old. But if they want to,
• 47:50
  Speaker 1: then it should well be covered.
• 47:51
  Speaker 2: Totally. For sure. Wow. That was a good one, Chuck.
• 47:57
  Speaker 2: Nicely done. We made it. I would say, do you
• 48:00
  Speaker 2: have anything else about cancer? But I know you do.
• 48:02
  Speaker 2: So we're just going to say this one's wrapped up.
• 48:05
  Speaker 1: That's right.
• 48:06
  Speaker 2: Since we just wrapped this episode on cancer up, that
• 48:09
  Speaker 2: means it's time for listener mail, of course.
• 48:13
  Speaker 1: That's right. I'm going to finish with a very heartwarming story,
• 48:16
  Speaker 1: which is a good way to end this one.
• 48:18
  Speaker 2: Awesome.
• 48:19
  Speaker 1: This was from our phone books short stuff when we
• 48:23
  Speaker 1: talked about sort of randomly calling the wrong person with
• 48:25
  Speaker 1: the same name. Hey, guys, when I was 15, I
• 48:28
  Speaker 1: tried to call someone in our friend group. I looked
• 48:29
  Speaker 1: up the last name, found a long list of entries
• 48:32
  Speaker 1: and put a small dot and pin next to each
• 48:34
  Speaker 1: name of someone I thought lived in our school district.
• 48:37
  Speaker 1: I still have that phone book with the markings and
• 48:39
  Speaker 1: you'll see why. Thankfully, two towns in our area had
• 48:42
  Speaker 1: similar names, but went to different school districts. I didn't
• 48:44
  Speaker 1: know that at the time, so I called over a
• 48:46
  Speaker 1: dozen numbers asking for my friend, who I never found.
• 48:50
  Speaker 1: But one guy answered. And when I asked, can I
• 48:52
  Speaker 1: please speak to name redacted? He answered, well, he isn't here,
• 48:56
  Speaker 1: but this is that name. And I answered, well, this
• 48:59
  Speaker 1: is Amanda, which is actually a fake name, guys, because
• 49:02
  Speaker 1: the Boston song Amanda was out at the time. And
• 49:05
  Speaker 1: it was all I could think of on the spot.
• 49:07
  Speaker 1: The story's getting good. I think you see where it's headed.
• 49:10
  Speaker 1: We spoke for 30 minutes on the phone about the
• 49:13
  Speaker 1: Mets who had just won the World Series and hung up.
• 49:15
  Speaker 1: I then called back that guy once a week for
• 49:17
  Speaker 1: five months and we eventually decided to meet under a
• 49:21
  Speaker 1: streetlight on the corner. And dudes, we've been married for
• 49:26
  Speaker 1: 33 years.
• 49:27
  Speaker 2: Awesome.
• 49:28
  Speaker 1: Together for 39. And in December, our daughter is going
• 49:32
  Speaker 1: to get married. He is my person, my soulmate, my everything.
• 49:36
  Speaker 1: I'm a weirdo and he gets me and always has.
• 49:38
  Speaker 1: All because of a phone book.
• 49:40
  Speaker 2: That is so great, man.
• 49:42
  Speaker 1: To answer your question, yes, the other guy knows the
• 49:44
  Speaker 1: story and that he is the reason that I found
• 49:45
  Speaker 1: my husband. I don't think he could believe it. And
• 49:47
  Speaker 1: I sort of still can't really believe it myself after
• 49:50
  Speaker 1: all these years. Nowadays, it would be so unlikely to
• 49:52
  Speaker 1: even pick up a call from an unknown number. So
• 49:54
  Speaker 1: thank you again for consistently creating such polished elite entertainment. Polished?
• 49:59
  Speaker 2: I know.
• 50:00
  Speaker 1: Elite?
• 50:01
  Speaker 2: Wow.
• 50:01
  Speaker 1: Not two words we usually associate with ourselves.
• 50:04
  Speaker 2: No, I think she's talking about the daily.
• 50:07
  Speaker 1: I think so. But that is from Laura, and Laura
• 50:08
  Speaker 1: sent pics of her and her huds in 1987, 1993,
• 50:13
  Speaker 1: and one from this year. And it is adorable. He
• 50:16
  Speaker 1: had quite the mustache.
• 50:18
  Speaker 2: I saw that subject line. I haven't looked at the
• 50:20
  Speaker 2: email yet, so I have to run over and do that.
• 50:23
  Speaker 2: What a great story, man.
• 50:25
  Speaker 1: Yeah, I love it.
• 50:26
  Speaker 2: That was Laura?
• 50:27
  Speaker 1: That was Laura.
• 50:28
  Speaker 2: Thank you, Laura. That was... I don't know. That's a
• 50:31
  Speaker 2: contender for number one, maybe.
• 50:33
  Speaker 1: That's right. You and name-redacted husband. I'm so glad you're
• 50:37
  Speaker 1: still together.
• 50:38
  Speaker 2: Seriously, one of the best ever. So thank you for
• 50:40
  Speaker 2: sending that email, Laura. And if you want to take
• 50:43
  Speaker 2: your shot at the number one email spot, we love that.
• 50:47
  Speaker 2: You can send it off to stuffpodcasts at iheartradio.com.
• 50:54
  Speaker 1: Stuff You Should Know is a production of iHeartRadio. For
• 50:57
  Speaker 1: more podcasts from iHeartRadio, visit the iHeartRadio app. Apple Podcasts,
• 51:01
  Speaker 1: or wherever you listen to your favorite shows.