The Alarming New Risks of Cancer Everyone Needs to Hear

I'm joined by world-renowned. oncologist Dr. Siddhartha Mukherjee. So, we're seeing younger and younger people. diagnosed with cancer. >> So, you're getting a spike in cases and. you're getting a. >> Spike in deaths. >> Spike in deaths. So, that is real. [music] You cannot really you you can't. turn your eyes away from that. That is a. real number. >> Joining us now is actress Olivia Munn. You learned you had breast cancer at. what age? >> 42. >> 42. >> I was then diagnosed with multifocal,

multi-quadrant, bilateral breast [music]. cancer. >> When Chadwick Boseman died after colon. cancer, the world was stunned. >> Yeah, Chad was 38 [music]. when he was diagnosed with stage 3 colon. cancer. >> He was at an age where normally he. wouldn't have even been getting a. colonoscopy. You can live a healthy lifestyle. You. can eat well. You can exercise. What is. going on? >> That it turns out there are lots and. lots [music] of sleeper cancer cells in. everyone's body. The new theory, or one.

new theory, is that they need to be. woken up. And the sleeping beauty wake-up potion. is, at least one [music] of them is. chronic inflammation. This is very new. research. >> Hi everybody. It's great to be with you. here on the Oprah podcast and I am. really glad that you joined us for this. episode because. we're talking about a health issue that. I know has impacted every single family.

in the United States in some way or. another. And all over the world. It's the word. that makes your blood run cold if you. ever hear a doctor say it to you or to. anyone you love. It's the big C. It's. cancer. And now doctors and researchers. are seeing an alarming rise in the rates. of cancer in younger adults in their. 20s, in their in their 30s, in their. 40s, and I have experienced that within.

my own family and circle of loved ones. The question is why? Why is this. happening? And what does this mean now. for how we live? And at what age should. people start paying attention? So, I'm. joined by world-renowned. oncologist. He's world-famous. and author of the seminal Pulitzer. Prize-winning book on cancer, The. Emperor of All Maladies, Dr. Siddhartha. Mukherjee. And I just welcome you and so.

really, really, really excited that you. would be willing to sit with us and talk. about it. >> It's my pleasure. >> Yeah, I first want to talk about your. book because, as we were just talking. before, it's an astonishing work. And. The Emperor of All Maladies, you all, as. I just said, won the Pulitzer Prize. It. spans 4,000. years through the history of cancer. And. in the author's note, you say, "This is. a chronicle of an ancient disease, once. a clandestine whispered-about illness. that has metamorphosed into a lethal,

shape-shifting entity imbued with such. penetrating metaphorical, medical, scientific, and political potency that. cancer is often described as the. defining plague of our generation." So, that's what you say in the author's. notes. But it helped me, and if you have. read it or or will read it, it will help. you understand cancer, and particularly. if you have somebody who's going through. it, help you understand it not just as a. disease, but as a story, one that is.

deeply human, deeply complex, and still. unfolding. So, the idea for this book came from one of. your patients. >> It came from one of my patients. Cancer. is my Moby Dick. >> Mhm. >> I will. I've hunted it for 20 years. I will. spend my last breath. hunting it. >> Mhm. >> I. have spent every waking moment of my. life thinking about cancer and thinking.

about cancer patients. What this book. boils down comes down, as sometimes say, Moby Dick began with a journey and a. question and this book begins with a. journey and a question and the question. was a very simple one. I was a fellow, you know, in the hierarchy of. cancer doctors, a fellow is pretty low. down on the list. I was a fellow tending. my patients and I had a patient that I. had developed a very warm relationship. with. Um, a woman who was dying, who, you know, gone from trial to trial to.

trial, extended out her life possibly by. three or four years and then she turned. to me one day and she knew and I knew. that the end had come. And she turned to me and I and she said. to me, "Where did all of this come from and. where am I going?". Very simple question. And to my astonishment, I realized that. there was no book. or a show or a podcast or anything in.

the on the planet that would tell the. full story. What What did this come. from? Yeah. Where did it come from? Where Where Where How How How old is. this disease? Where am I going and why. am I here? Um, and it would seem to me this book is. almost a kind of so dedicated to her. because she sort of set me off on this. journey and the question. >> That's right. And she, you know, that's. how cancer became my Moby Dick. >> But you devoted the book to this that. the little 3-year-old boy, Robert.

Sandler. Yes. Tell us why, who died of. leukemia in 1948. >> Stories don't live in abstractions. Stories live in real lives. They live in. real people and books on medical books, medical textbooks tend to be, you know, very abstract. They take away names of. people. They They remove all of human. qualities of of a book. So, I was looking for a human being, a. real person to begin the book with, to. pin the book down on. And I knew that there was there must. have been the a first child who received.

chemotherapy for in this case uh. leukemia, children's leukemia. And I. kept searching for that child. I kept. looking for that child. Ultimately, after a very long and tur-. you know, circuitous journey, uh which. took me actually from. the Dana-Farber Cancer Institute in. Boston back to India, back again, I. ultimately found the name of this child. The name was buried in a newspaper. clipping which was in microfiche. You. know, there's not searchable. You. couldn't have found it anyway.

So, I found the name of this child and. then, you know, I went to the home of. this child. I I I learned about the. child's family and his name was Robert. Sandler. And that's how the book came about. >> Wow. So, last year you released a new. edition with four new chapters titled. The Emperor's New Journey. And you wrote. that it felt urgent to update this book. Why? >> Well, lots of things have happened since. the book first came out in 2010. And so, 15 [clears throat] years had passed. And it seemed to me that it it needed an.

update. Now, it's a funny thing, as you. know, people don't tend to evergreen. their books. You know, you don't go back. and write your book again. But what's it What do you What was. interesting is, you know, cancer you. couldn't do that because things were. history was being made as we live. So, this is a lived history. And so, I had. to update it in order to capture what. had happened since 2010. And so much had. happened in prevention, in detection, and in treatment that I had to write. almost write an addendum or a new set of. chapters. >> Even in chemotherapies, cuz I'm going.

through this with a family member now. And one of the things I've learned is. that that what chemotherapy used to be. compared to what it is now is so much. more improved. Yeah. >> It's vastly different. People, you know, take you know, people have a visceral. reaction to that word or to that word. You know, I'll be caught in the wards. I'll be throwing up. I'll have a you. know, a. a vomit basin next to me. My my lose my. hair. My body will shrink. That's not. true today. I mean, of course, there are. still some chemotherapies that we still.

use that are sort of chemotherapies of. olden days. >> Yes. >> But, there are lots more new therapies. where you don't have all these side. effects. You still have some, but you. don't have these severe side effects. There's there's a whole new world of. therapy that has emerged even in the. last 15 years. >> So, one of the things that I really. appreciated about the Emperor of. Maladies is that as I was saying to you. before is that it tells the story of. cancer. But, even in the very beginning, what it clarified for me that cancer. isn't just one thing. It's many diseases.

and it really is an abhorrent cell. The. cell's gone awry. So, can you in it just. give us the most basic definition of. what cancer is? Because when we hear the. word, everybody just goes, you know, fearful. >> it's a disease in which the disease. typically is a disease of a single cell. that's that is no longer able to respond. to signals that tell it to stop growing. So, just to give you an example, you cut. your hand and you have a wound. The.

wound cells, you know, start growing. back into the wound and then they stop. growing. That's normal. In cancer, it is. as if those wound cells never begin. never have the signal to stop growing. >> Why? >> Genetic mutations in the cancer cells, mutations in genes. tell the cells normally tell cells when. to start and stop growing. Genes make. proteins. Those proteins act as signals. Those signals tell a cell, now you're. done. You should stop growing and go. back to being a you know, being a. non-growing cell.

In a cancer cell's genetic mutations. make proteins that are no longer able to. respond to these stop growth. Therefore, the cancer cell is unable to. stop growing and it keeps growing and. ultimately keeps making a large and. larger masses. It can take over your. bones, take over your blood, take over. other parts of your body, and even. metastasize. It migrates and starts. growing in places where normal that. where it should norm- normally not be. growing. I mean, why should a breast. cell be growing a breast cancer cell be. growing in the bone? It's because it's.

co-opted it it's co-opted it's um its. environment and made it an environment. where it can actually start growing. again in in the the case of a breast. cancer cell inside bone. >> So, it's a cell gone awry. >> It's a cell gone awry in multiple. different ways, not just awry in the in. the in the basic way that I said, well, you know, it can't stop growing. It's. also gone awry because it's hijacked. other parts of other signals from the. cell which enable it to move, to. metastasize,

to colonize other organs, to live in. other places. It's all of that. A cell. that's gone awry with this massive. hijacking. >> Okay. So, we're seeing younger and. younger people diagnosed with cancer. The American Cancer Society found that I. think I read that cancer incidence rates. in women under 50 are now 82% higher. than males and you've said that the. incidence of colorectal cancer in young. men and women in the United States is. nearly double since 1995. What is going. on? >> So, it's very important you ask you're.

asking a very important question. This. is very particular to young men and. women. So, I'll give you three examples. and they're all three concrete examples. >> Okay. >> The first one is colorectal cancer, cancer of the colon and rectum. Uh so, basically in the the lower bowels. >> Yeah. >> Colorectal cancer incidence has. increased dramatically in young men and. women and it's colorectal cancer. mortality, which is a statistic that. never lies. Uh colorectal cancer mortality in young. men and women has increased dramatically.

as well. I'll come to the why in a. second, but that's a clear signal that. that's not just early diagnosis or early. detection. >> Okay. >> It because early diagnosis. >> going to be my question. Is it that. we're just getting diagnosed and. detecting it sooner? And that's not. true. >> So, that's not true because if you if if. it was just early detection or early. diagnosis, then you wouldn't have that. you wouldn't have the fact usually in. statistical terms you wouldn't have an. increase in actual mortality. So, it's a it's a it's a statistical you.

know, when you have an early detection. you can get a spike in in in cases, but. you don't like necessarily get a spike. in mortality. >> Yeah. >> But in this case you're getting so for. colorectal cancer you're getting a spike. in cases and you're getting a spike in. deaths spike in deaths. So, that is. real. You cannot really you can't turn. your eyes away from that. That is a real. number. I'll give you a second example, breast. cancer in young women. So, breast cancer. uh mortality in young women was slowly.

coming down year after year after year, but for the past few years it's being. plateauing. >> Hm. >> Which means that something is happening. such that the kinds of breast cancer. that we're getting in these young women. is um is either causing more mortality. or is generally more aggressive and we. know both of these are true. And once. again, it's not because of early. detection number one cuz most of these. women are being are not being caught by. mammography. >> They're not. >> No, they're detecting it often.

themselves. And number two, as I said, statistics don't lie. >> Yeah, they're not being caught by. mammography cuz they haven't even. started the mammograms. >> That's right. They haven't even started. the mammograms. So, they are detecting. by themselves often coming to their. doctors because of of having detected. it. And secondly, as I said, statistics. don't lie. And that it is in it's being. reflected by this lowered curve or. slowing down of the gains that we've had. in the past decades. I'll give you one. last example. um and that's also relevant, and that is. endometrial cancer. So, endometrial.

cancer, also in young in women and. particularly young women, has been. rising in cases. Endometrial cancer, we don't usually. have a detection for. We don't have any. test for. It's usually, you know, when. people come with bleeding or pain. >> Yeah. >> That has been rising, so that's not an. early detection problem. And thus far, usually endometrial cancer, you know, early stages is quite curable. So, it's. not been re- flected in increase in. mortality, but it may soon be reflected. at some point of time in increase in. mortality. So, you have three different.

cancers with three different patterns. Colorectal cancer, increase in the. incidence, increase in mortality. Breast. cancer, increase in the incidence. particularly of the aggressive kinds, and a plateauing or slowing down of. gains in mortality. And endometrial cancer, increase in. incidence and. no increase in mortality yet, but we'll. see. >> So, you can live a healthy lifestyle. You can eat well. You can exercise. You. can get enough sleep. You can do all the. things. I know people who have done.

this. They don't smoke and they don't. drink excessively. And then it feels. like, you know, you're 38 and it comes. out of nowhere. So, how much of this. early onset is driven by what is. inherited or. by something in the environment? Or do. we know? >> So, the the sad story is that we don't. know, but we're getting to know. >> Okay. >> Um so, virtually all cancers have some. component in which, as I said, they're. all genetic diseases ultimately. But.

many cancers have a component of of the. environment in it. So, it's a genes plus. environment phenomenon. >> Mhm. >> Um so, the problem is when we talk about. the environment, we talk relatively. poorly about the environment. So, you. just said what you eat, what you do, what exercise, and other things. But your real. environment is much more complex. It is. the things that you're exposed to um as. a child. It is things that are in your. gut, the so-called microbiome that's in. your gut. It is um things that you eat,

but you may not know that you are being. exposed to because, you know, you may be. thinking that you're eating a very. healthy diet, but some aspect of your. diet might be might be the problem. Um. and finally, all the things that you're. exposed to, the so-called exposome. Um. so again, there is that the external. environment, there is your genes, and. there's one piece that that is. critically missing here. And that is. your internal environment, the the. environment which actually bathes your. cells, your body with whatever it bathes.

it in. And one very major part of that. that we've discovered is the. inflammation in the internal. environment. >> Oh, that's what I was going to ask. There's growing conversation around. chronic inflammation as a root of many. diseases. What does that mean actually. when you have inflammation? So and how. does it connect to cancer? >> So inflammation is a sort of a bucket. word. Um it's it means many things. It. means different things to different. people. You come and say, "Oh my god, my. left cheek is inflamed because it's.

burning." Other people might say, "I. have chronic inflammation." In fact, that's the. >> If you have chronic inflammation, do you. even know you have chronic inflammation? >> No, often you don't know that you don't. have chronic inflammation. So just a. great example of that is as best as. workers, I'll give you a historical. example. Yeah. As best as workers um. were exposed to little particles of as. best as and they started having. inflammation in their lung. It wasn't. until much later when they started. having cough and, you know, all these. other symptoms that uh lung symptoms. that they realized that they had chronic.

inflammation in the lungs. >> Right. >> The point that I'm trying to make is. that there are many different kinds of. inflammation. Just like there are many. different kinds of cancer, inflammation. means it's it's a chronic or or acute. activation of the immune system. >> Okay. >> And the immune system gets chronically. or acutely activated and it starts. sending sending signals. Some people do. describe it as it's as if your immune. system is saying your body's on fire. There's a kind of inflammation which we. which is brought on by certain kinds of. immune cells. Not every immune cell is. the same. There's another kind of.

inflammation that's brought on by other. kinds of immune cells. And so far Yeah. So far, we've been able to track down. cancer risk to one kind of inflammation. Not all kinds of inflammation, to one. kind of inflammation. That's a very big. advance because. we could now ask the question if we if I. can track that inflammation in your. body, if I can make a test for that. particular kind of inflammation in your. in your body, can I make a potential. test for future cancer?

>> Mhm. You're right. Research suggests that. healthy people may have a cadre of. potentially cancerous clones, sleeping. assassins. So, I'm asking, is there a. possibility that that part of. what we're seeing is simply that cancer, because it's rooted in our own cells, is. going to always find a new way to show. itself? >> So, this was another surprise from from. work done by many people, but really. recent work. The surprise was people.

thought, oh, you know, cancer cell grew. up, uh got the mutations that acquired, you. know, hijacked or commandeered the uh. its its uh its genes, and off it went. >> Yeah. >> It turns out that the it's it's a little. bit more complicated than that and a. little more chilling than that. >> Yeah. >> Which is that it turns out there are. lots and lots of sleeper cancer cells in. everyone's body. I want to repeat that. There are lots and lots of sleeper. cancer cells in everyone's body. And. they're just asleep. They're just.

dormant. >> Okay. So, by the time the cancer shows. up, it's it's been sleeping there for. how long? >> We don't know, but it's been sleeping. there for a while. But it it we think. that it needs something to wake up. >> Wow. >> And inflammation, chronic inflammation, we're realizing more and more is one of. those. sleeping beauty signals. >> So, say that again. We all are carrying. the sleeper cells. >> We're all carrying sleeper cells in. various organs, but they're dormant, they're asleep, they probably do nothing. to you for the rest of your life. The. new theory, or one new theory, is that.

they need to be woken up. And the the sleeping beauty wake up. potion. is at least one of them is chronic. inflammation. This is very new research. It has to be validated over and over. again, but it really changes the. paradigm. It says, you know, it's not as if you had a, you know, one. morning you woke up, I'm sorry, not you, one someone woke up, I hope it's no one. here, but one someone woke up and a. cancer cell started having genetic. mutations and off it went and became the. the tumor that the nasty tumor became.

That would be one theory. Another theory is actually the morning. that that night that we were asleep, there were thousands of dormant cancer. cells sitting in your body. And something happened, in this case. this what I call the sleeping beauty. kiss, something happened that woke them up. And in this case, we're realizing that. that one something is chronic. inflammation. >> That's big. >> It is very big. It is a new theory, has. to be tested, but it really changes the. way we think about about cancer. That's.

why I had to write a whole new chapter. on it. >> Yeah. >> Because this theory was, yeah, because it really switches around the. way we think about cancer or how I. thought about cancer. As I said, new. theory, lots to be tested in it, but it. is a powerful theory. >> That that inflammation is the kiss that. wakes it up. >> Yes. >> And that's why now there's so many. people talking about. reducing your inflammation. >> That is why. And if we could test the. particular kind of inflammation,

>> Cuz there are all kinds of inflammation. >> kinds of inflammation, but if we could. test that particular kind of. inflammation, we would have a biomarker, we would have a marker for future cancer. and potentially even prevent it. Potentially by stopping that. inflammation. >> think we will find a prevention in your. lifetime? >> I think we will find a prevention my. lifetime. Yes, it may not work 100%. >> Yeah. >> As I said, it is my Moby Dick and I will. hunt it. >> going to say you going. You and Moby are going to be out there. >> Me and Moby are going to be out there. >> Out there. So, breast cancer as many of. you know is one of the most common.

cancers in women across the world. It's. now rising faster in women under 50 than. in older women and younger patients are. being diagnosed with more aggressive. forms of as we've been talking about. So, joining us now is actress and. activist wife and mother of two Olivia. Munn. Uh welcome Olivia. Great great to have. you here and thank you for zooming in. You learn you had breast cancer at what. age? >> Uh. uh 42. >> 42. What happened? >> So, I had um been doing everything I was.

supposed to do. The mammograms, the. ultrasounds. I have dense breasts. Um. and also I think it's important for. people to understand what dense breasts. means because we hear these terms a lot. and um don't really connect with it. So, dense breasts is when you like. it's like when you look at the sky and. you see clouds and you see blue sky. Well, when you do a mammogram you have. dense breasts, your tissue and your. tumor is all look like clouds. But when. you have dense breasts, you get an MRI. or an ultrasound it it's a blue sky and. then there's like one cloud and then.

that's your tumor. So, I was getting my mammograms done and. my ultrasounds and um I was cleared and. I had genetic testing done as well just. to be proactive and. my doctor said there's something called. the lifetime risk assessment test and it. gives you uh a score that tells you how. likely you are to have breast cancer in. your lifetime and anything above 20% is. considered high risk and it's like a few. minutes. It's online. It's free and I. came back at 37.3%. so I went to get an MRI and.

after that MRI I was off to the races. I. was then diagnosed with multifocal, multi-quadrant, bilateral breast cancer. >> Yeah. Truly touching story. >> Wow. And you've had multiple surgeries. Tell us about that and how you're doing. today. >> So, along with the the stuff that you do. before double mastectomy, like a lymph. node dissection and nipple delay, I had. a double mastectomy and I also had my. ovaries and my fallopian tubes and my. uterus removed as well. Um.

there's this um when you have a hormone. positive breast cancer, like my and mine. is ER positive, uh PR positive, >> So, why would you have ovaries removed? Cuz that didn't have anything to do with. your breasts. >> Exactly. So, there's a medication called. Lupron that I had to take and that. medication suppresses the estrogen. production in my ovaries and it was. debilitating. It was a shot every month. and I had my son had just turned one. when I was diagnosed and I couldn't get. out of bed. It was actually.

debilitating. I would get up, I would go. get something to drink, and I would just. come right back to bed. I was probably. out of bed maybe a total of 45 minutes. for an entire day and this went on for. months and I just had to figure out a. solution. So, I I said, "Can I just get. an oophorectomy and have them removed?". And then when I was doing that I said, "You know what? I don't want to have to. worry about cancer coming into other. places. Can we just go ahead and take. out my fallopian tubes and my uterus?". So, we did that all just to be. preventative and to help me get off of. this medication, but there's also this.

other medication that I have to be on. called an aromatase inhibitor and that. suppresses the testosterone in my body. that turns into an estrogen that could. feed my cancer. Um and you asked how I'm. doing today and. I've always really maintained a positive. outlook when I was talking about this. I. think it was so important for me when I. was talking about it publicly to come. with a lot of hope. Also, be very. realistic and honest about the tough. times, but um there's so much hope in in.

this journey because people are doing. all this research and and I have the. ability to fight. I've been given the. chance to fight where so many. women in my position were told to get. their affairs in order. So, I wanted to. be really hopeful. >> In the middle of all of this, you. stopped the cancer treatment to do in. vitro fertilization and egg retrieval? >> So, I had frozen my eggs in my 30s and. um we were we wanted to have another. child, and so it was. I was diagnosed with breast cancer, and. the next day we had already planned to.

turn those eggs into embryos. And my. husband was like, "What do What do we. do? What do we do?" And I said, "I don't. know what's going to happen to me, so. just go I don't even know if cuz when. you freeze your eggs, you don't know. until they're turned into embryos if any. of them uh work out. So, I said, "Just. go and and like just just try to make. the embryos, and we'll deal with it. later." And um we were able to get um. able to get a small amount of embryos, but in order to ensure that we could. have another baby, um I said I I think I.

need to go and do more. do another round and get more eggs out. And so, I spoke with my fertility. doctor, and he said, "We're going to put. you on to a breast cancer protocol, and. um that means that's a lot less. hormones." And I was putting myself at. risk, um and my fertility doctor, he's. like, "You know, we're just going to get. you. like just a couple more, and then we're. calling it." And it was just a it was a. calculated risk that I just felt I I had. to take, and my baby girl Maymay is 19. months, and she's in the world because.

of that risk I took, and and I would do. it all over again just to to have her. >> What do you want other women to know? Because. 42's. scary. >> I want other women to know first and. foremost that the lifetime risk. assessment test is something that is. free, and it's online, and it saved my. life. And I think that every woman. should know what it is. It's something. that every doctor takes for their their. patients that when you go in they ask. for your blood pressure and your family. history, but they don't ask what your. lifetime risk assessment score is. So,

we're working on legislation that will. help make the standard of care for every. doctor to also know that information. >> I think you've already done such a great. job. They saw uh increase in people. taking that test after you told your. story. And I'm sure it's going to go up even. more now. that you're sharing your story. >> Thank you for for helping to to get out. this message because that's the. I mean, as you know more than anyone, it's just like continuing the. conversation over and over. The. awareness that just has to keep going, which is why we want the onus to come.

off of women some to to know about this. test and put it on to doctors to to be. there in those offices and and educate. the patients about it. >> Yeah. So, you sharing your story has. already done so much for women. I thank. you for that. >> Thank you. >> Thank you. Take good care. >> Thank you, Olivia. >> Yeah. >> Good luck. >> So, more and more women, 30s, 40s, are. experiencing much of what she talked. about. >> Absolutely. And as you can imagine, I. mean, these are often, you know, young.

women with families. They have children. to think about. They have future. fertility to think about as Ms. Munn. did. And so, the the decision becomes not just, you. know, about yourself. It becomes about. your family. >> So, what are the current recommendations. for breast cancer? I've been taking a. mammogram now since I was 40 doing. screenings, but if women in their 30s. are being I I also have a family member. who at 36, you know, developed breast.

cancer and wasn't even wasn't even. through a mammogram, just just through. doing her own breast test. So, what should be happening? Should we be. screening earlier? >> Well, so the problem with mammograms is. that the yield to discover real cancer. is very low, especially in young women. Um and that's complicated, of course, by. women who have young breasts. By yield, I mean. there's a number, uh, which is how many. mammograms you need to need to take in. order to save one breast cancer life.

>> And you said complicated by women who. have. >> dense breasts. >> Dense breasts, okay. >> Olivia talked a little bit about that. Um, but leaving aside the question of. dense breasts, which is, uh, uh, particularly the case with young women, the yield of a mammogram is is very low, especially in that in that group. And. so, doing mammograms early, uh, or doing. more mammograms, will inevitably yield. lots and lots of false positive, lots. more biopsies, lots more anxiety, and.

you know, it'll obviously yield a few, um, a few real cases of breast cancer. So, what I've been recommending is is. very much on the lines of, uh, of what. Olivia did, which is to say, if you're a. first of all, if you're a young woman, and if you have any history of breast. cancer, of, uh, ovarian cancer, of. pancreatic cancer, you should go and see. a physician to potentially look at to do. some genetic counseling to see if you're. at a genetic risk for breast cancer. >> Wow.

>> And those are people who have, you know, will pick up people with so-called. BRCA1, BRCA1, BRCA2 mutations, among. other things. Number two. is that there is actually a genetic. test. If you have a family history of. breast cancer, or any of these cancers, there's a genetic test that even if you. are not BRCA1 or BRCA2 positive, it will. give you a score of the risk that you. have genetic risk for breast cancer. It's a score. It's called a polygenic. risk score. Again, it's not perfect, but.

if women who do have a polygenic risk. scores, I'm if they do have one, and. certainly if they have BRCA1, BRCA2, and. some of these other breast cancer genes, I'm recommending them to enroll in in. with intensive screening. There are many. around. Some of them use a combination. of MRI and mammograms sort of. alternatively. Some of them are MRI. only. What I'm really hoping for is that. there's a test that will come along. which won't be as invasive and will. which will not have as as many false. positive as a mammogram that we can use.

that as a potential way to screen these. younger women. >> Okay. >> So, when Chadwick Boseman, the actor who. played the Black Panther, died after a. private battle with colon cancer, the world was stunned. Chadwick was just. 43 and his wife, Simone Boseman, was by. his side until the end. Simone, thank. you for joining us. We were all so stunned and you all. were able to manage to keep that. private. I read that his symptoms began.

just weeks before his diagnosis in 2016. What was going on? >> Yeah, um well, first, thank you for. having me. >> Thank you. >> Chad was 38 when he was diagnosed and he. was diagnosed at stage three. So, just before that, he had already. been to the doctor a few times before I. even found out about it. And. essentially, he was just he was having. trouble going to the bathroom. >> Mhm. >> First, the frequency changed and then it. really slowed down altogether and.

stopped altogether, which just impacted. his ability to. move and operate and and eat. He was on a really strict exercise. regimen. Um so, it was affecting him. quite a bit. And. there were maybe. three or four weeks in between our first. visit to the doctor together and him. being diagnosed with stage three colon. cancer. >> And so, once you both found out, did did.

he go into chemotherapy? What was the. procedure for. helping him? >> Yeah, there was there was chemo, there. were surgeries, um. uh a few different rounds of chemo and a. few different types of chemotherapy to, you know, see what worked on his. particular type of colon cancer. >> Mhm. >> And he also, you know, there was also. Eastern medicine that we involved. We. were doing all the research we could and. trying all of the avenues that we could.

to get his immune system to fight his. cancer and fight the um. fight the effects of the chemo as well. >> By the time you're stage three, though, what does that actually mean? Dr. Mukerjee. >> So, it means that the cancer has spread. beyond certainly spread beyond the. original local site. It's gone through. the the bowel wall, um and um. in many cases, uh depending on what kind. of cancer has started invading the lymph. nodes. So, it's it's it's it's called.

advanced uh cancer in the case of. colorectal cancer. >> Mhm. >> Now, astonishingly, I mean, I'm so sorry. that you had to go through all of this. um and and the world is very sorry for. it, I think. Astonishingly, um. immunological therapy still works in. stage three um in some cases. I'm sorry. it didn't work in this particular case, but it really works. I mean, this is an. incredibly important conversation we're. having because you know, cases like this. remind us that we have got to do better.

We have just got to do better and if we. don't do better in this in diagnosis and. in treatment, um then, you know, shame on us. >> Yeah. >> So. >> And and and he was at an age where. normally he wouldn't have even been been. getting a colonoscopy. >> I have a friend who's 42 who's going. through this, also stage three, and also. had to. make up a story about it being in his. family in order to even allow them to.

test him. They weren't going to test. him. The doctor said, "You know, you're. too young. You know, it's probably just. stomach ache or whatever.". >> Big misconception, by the way. >> Big Big What is a big misconception? >> Misconception is that, you know, we're. seeing we know the rise of colorectal. cancer. incidence and death in young men. So, no. doctor when if you come with abdominal. lower abdominal pain or abdominal pain. should be saying to you, "Oh, it's just. you know, something you ate." Yeah, that's not That's not the standard. anymore. >> I know that caretaking is one of the.

most demanding jobs, and you were there. by his side till the end. What is your. advice to those who are supporting loved. ones with cancer, Simone? >> Just love your way through it. It's. going to be stressful. It's going to be. overwhelming. Um. but let the good times be good. And do as much research as you can. Try. as many things as you can. Really leave. no stone unturned because the. the the the guilt of grief.

is almost an impossible thing to deal. with even when you do try all of the. things. If you have even an inkling that. something might have any kind of effect. on your loved one's situation, you. should try it, and you should push them. to try things as well. >> That was interesting you were talking. about the guilt of grief. Are you still. carrying that? Are you still thinking. there's with that there there was. something else you could have done or. should have done or might have done? >> I think I will always wonder if there. were things we could have should have.

done. Um. I think that's a Yeah, that's a reality. of of losing someone. You'll always. wonder whether it's from from cancer or. from anything else. Could I have talked. to them? Could I have. you know, kept them in the house for 5. more minutes and they didn't get in that. car accident. Anything is is going to. come into your mind. And um I think it's. also survivor's guilt. I think for. the first several years, I could not. make sense of why I was still here and. he was not. >> Mhm.

>> When he was just such an incredible. extraordinary spirit and person. >> Yeah. >> And it is the edges are less sharp. Now. But they are still here. >> Yeah, and you know what? I was just. thinking too. and I know no four people in my. immediate family and friends who are. going through one form or another of. cancer right now and. we know about it. We the family know. about it, other people know about it. I. think it's even doubly hard when you.

have to keep it a secret or you have to. not let other people know. So that that. adds to the stress because he was. working and. and correctly so if everybody knew he. had cancer there would have been a. completely different reaction on set and. all the other things. And so how. absolutely courageous of him and of you. to go through that when you're. getting cancer treatment. It's just. unimaginable. >> I just wanted to add them. incredibly brave of you and to share. this journey. Um.

you know, I I I think about the guilt of. grief a lot. Um it really rests. the guilt of grief is something that. resonates with many many families and I. always return to the very famous uh uh. quartet of things that patients patients. want to do when they when they're facing. death which is. to say to someone that they love them to. be told that they're loved to say to. someone that they forgive them and to be. told that they're forgiven. And I can.

tell you for sure the way you took care. of him Simone, I'm sure that you. received all four. Um so I hope that. helps with you with with the guilt of. grief. >> Thank you. Thank you. >> And you say he was your greatest. spiritual teacher. Tell us why. >> Oh man, he he was. Um you know, credit. to my my mother, she gave me my. foundation for for my own spirituality, but Chad. he was. someone who did not just believe in.

spirituality, but he really lived it. And he showed me. discernment. And he showed me what the. feeling of truth was, what it means, how. to understand when I know something that. is right or good, and when I know that. it is not good, and when I know that I. don't know, and then how to go to God. and ask for guidance, and. most importantly, to be able to listen. and wait for God to answer.

>> Mhm. >> And those are. principles that I learned from him that. I'll I'll carry with me for the rest of. my life. >> Well, it sounds like he was truly the. Black Panther. >> He truly truly truly was. >> Sounds like he was truly the Black. Panther. Really. Thank you. Thank you so. much. Thank you. >> Thank you. >> So, what can people do? Is there. anything. First of all, what you just said, if you are under 50. years old and you go to your doctor.

complaining of stomach pain, rectal. pain, and the doctor says it's just a. stomach ache, you should fight like hell. to get the test. >> a different doctor. >> You should get a different different. doctor. You should get a different. doctor. >> Yes. >> Yeah. So, because you're you just said doctors. know that this is happening. >> This is a well-known phenomenon. It is. published in national statistics. everywhere around the United States. >> That you don't have to wait till you're. 50 anymore. >> There's no reason to wait if you have. symptoms. If you have symptoms. >> Yes. >> there's absolutely no. it doesn't make sense. It's like saying,

"My car is broken. I'm I'm going to wait. until next 10 years to fix your car.". Yeah. This doesn't make any sense. So, yes. >> So, uterine cancer, I understand, is the. most common cancer for female. reproductive organs. And one young woman. named Eve was recently diagnosed and. shared her story on social media. Watch. this. >> My name's Eve. I'm 28 years old and in. October of 2025, I was diagnosed with. stage 4 endometrial adenocarcinoma that. has metastasized to other parts of my. body. And the reason for this video is because.

I am starting a series. um to kind of talk about the symptoms. that I had leading into this diagnosis. I've had tons and tons of women reach. out to me via social media asking. "How did you know? What did you do to. find out? What are you doing now? I'm so. scared." And. the last thing that I want is for. this circumstance that I'm walking. through to cause fear and anxiety in.

other people. I remember before this. diagnosis came out to light. the anxiety and the fear that I had. um just leading up to this moment was. absolutely crippling and I I would never. wish that upon anybody. >> And Eve is joining us now from Texas. Hi, Eve. >> Hi. >> Hi, how are you? >> How are you? How are you? >> I'm good. Thank you.

>> I heard you were dealing with symptoms. for years, but you were dismissed by. doctors. And what were those symptoms? >> Those symptoms were. uh prolonged uterine bleeding. So, I was. having bleeding at that point for about. 3 years now. >> Wow. >> Um I also was having urinary. incontinence um and then the other one. was extreme pelvic pain, which all of. these when I did present them to my. gynecologist at the time. was dismissed and labeled as just PCOS,

which is what I was diagnosed with over. 10 years ago. >> The first one I apologize. >> Your doctor should have known. >> Your doctor should have known. >> Your doctor should have known. >> You know, it's interesting that that. three cases that I picked were. colorectal cancer, breast cancer, and. endometrial cancer because this is. known. This is established. It's known. And so. a a young woman particularly with PCOS, the syndrome that she has, who comes in. with. vaginal bleeding, pelvic pain, etc. needs to have a. >> know PCOS stands for what?

>> Polycystic ovarian syndrome. Um well, you can tell us more about it than I. can, but um. this is well known. And you know, the. sad sad story about all of this is that. if you catch endometrial cancer early in. its first stages, it is highly curable. It is very very very curable. And so um. the idea is that as soon as someone. comes in, particularly with this kind of. history, >> Yeah. >> with pelvic pain, with etc. etc. they. need to be assessed to see if they have.

endometrial cancer. >> Yeah. >> Um I would say that the only piece of. good news is that these cancers have. become over time more and more We've. We've gotten more and more better and. better therapies, chemotherapy, some of. them. I can tell that you're probably on. one of those chemotherapies already. Um. but also there's second line and third. line therapies. So there's a lot of. progress in treatment, but this this is. a case that should not have happened. >> Eve, so what are the doctor saying is. your prognosis right now? >> Right now, my prognosis is less than 2.

years, and that changed over a span of. I want to say 4 months. Over initially. when we first found out about the. cancer, um I was given about 5 years. And the reason why there was such a long. delay was because. um insurance companies weren't wanting. to cover for treatment. Um so that. played a big role, and by that time the. cancer, which was already stage four, grade three, it had already metastasized. even more. Um and we actually found out.

about this after 4 years of infertility. So that was really hard to hear. Um but. the prognosis as, um, I've been. praying over myself is not a promise. And so, even though I'm given less than. 2 years, I'm going to live and believe. that God still has more for me, and that. if I'm here right now, it's for a. reason. >> Absolutely. And one of those reasons is. you wanted to share with other young. women what you wanted them to know. And. what is it you want them to know?

>> I want them to know that it is. extremely, extremely important to truly. advocate for yourself. And like, like we. just said, if one doctor is not. listening to you, you have to push and. find another one. Even if you go through. 10 doctors, you have to find one until. they finally sit down and hear what you. have to say because. I didn't do that, and I do feel like had. I spoke up earlier, before I even knew. that I had cancer, I wouldn't be in this. situation today. >> So, so tell me this, Eve. Every time.

you were told that it wasn't the, you. know, that you shouldn't be that. concerned about it, was a part of you. relieved? Because I think a lot of. people, when their doctors say, "Let's. keep an eye on it." or "Let's watch it.". which which I don't believe in let's. keep an eye on it. I believe in let's. look at it right now. But, when your. doctors say that, there's a sort of a. sense of relief that maybe it's not as. bad as I thought, and therefore you you. buy into that. Is that what Is that what. you did? >> It was actually not relieving for me at.

all because I I always kind of knew in. my subconscious that something was. wrong. Um, I actually worked in women's. health for a little over 8 years, and so. I I talked to women who had the same. symptoms. And every time I would bring. them up, my doctor actually said, "You. know, if you were a few years older, then I'd be concerned for cancer." But, because you at the time I was 24, 25. years old, it it didn't cause any alarm. And so, I do feel like, um, and it was. always per ACOG guidelines, per ACOG.

guidelines. And I really would like for. ACOG guidelines to be updated at.

>> mean, your body was telling you it it. was not your body was not telling you. something. Your your body was screaming. from the rooftops. So, >> Yeah. >> I'm sorry. As I said, it's hard for me to put.

myself in every physician's shoes, but. but these are known facts. These are. just. you know, there there's there's. something very well known about all of. this. >> Eve, thank you so much for being. courageous enough to share your journey. with us. Thank you. >> Thank you. >> You know what? Someone is watching or. listening right now who has had one or. more of those symptoms, who's looked the. other way, and because of you today, they won't. They will follow through. I believe that. is true. Thank you so much. Thank you so much.

>> Thank you. >> Thank you for sharing. So, you talk in. the book about all the various kinds of. cancers. Is there one cancer when you. hear that cancer that all doctors go on. the alert? >> Well, the typical answer to that. question is pancreatic cancer. >> Yes. >> Um and and doctors go on the alert. But. as you know, as as of very recently, for. the first time in human history, there. was one medicine that changed the that.

in a randomized controlled trial, so in. other words, in a in a fair, statistically clean way showed that. there was it would increase the lifespan. of patients with advanced pancreatic. cancer. Now, the increase was from 6 months to 13. months, and you could say, "Who cares?". But that's not the way to think about. it. The way I think about cancer, all. cancer, is it's like climbing a mountain. And the first crampon you put into the. mountain is very crucial. Cuz it's going. to hold it up the whole journey upwards.

And in this case, the first crampon has. been planted. From here on, we'll know, you know, how does it become resistant? Can we make another medicine? Can we. combine it with a third medicine? And so. forth. So, that's that. And then a cure. Of course, my personal nemesis has been. acute myeloid leukemia, AML, which I've. treated for many years, and still. Tatiana Schlossberg wrote this very. moving piece, and she died of AML, that. same disease, few months ago. >> You write this on page 473, about the.

time you met with your book editor. You. said, "I sat in the editor's waiting. room, high above 6th Avenue, looking. outside. It was one of those magical New York. afternoons, when the balminess in the. air becomes intoxicating, and crowds had. gathered on the streets. But I was a. trainee in oncology in Boston, and all I. could see was a landscape of future. grief. and anxiety. The woman laughing breezily by the. bakery might be diagnosed with cancer, ovarian or breast. In a few years, I. imagined the man smoking a cigarette.

with evident pleasure in a hospital gown. as he went for a lung CT scan. The lenses with which I saw the world. had forever been changed, you wrote. So, my question is, how do you personally. cope with, you know, the immersing. of yourself with people fighting every. day for their lives and you don't know. if you can save them. How have you How. have you managed to do that? >> Well, people say that the way to manage.

to do that is by. moving yourself away, to distance. yourself from the fight. I think it's. just just complete nonsense. Um I think the way you survive. being an oncologist, the way you survive. many of these intense professions that. make deep demands of you is to lean in. instead of leaning out. Um and by leaning in, I mean you make. that person's grief your grief. Uh you make that person's fight your.

fight. Um you make every fight your fight and. eventually if that explodes, it. explodes, but you can't you can't. survive by leaning out because that will. always come back to haunt you. >> Yeah. >> The only way you can survive is by. leaning in. >> Well, what you described feels to me is. the difference between having a good. doctor. and having a great doctor. >> Yeah. >> Yeah. And you know, having people in my. family going through it now, I mean, I. see the difference between people who. are really leaning in and the people who.

you're just another patient. >> Yeah. >> Yeah. Yeah. So, what is what what is the future? It's like with that woman who started. this whole book uh for you, what is the. future? What do you see for where we're. headed with cancer in the future? Will it be eradicated or is that just a. pipe dream we're all having for. ourselves? >> Well, I can tell you what I'm doing. I. You know, in some ways I think of myself. in the in my own. um.

journey or fight against cancer as an as. an opportunist. In other words, if new. technology comes along and I can push it. to use in cancer, I'll make I'll bring. it along and make it useful for cancer. >> Has AI been helpful? >> AI is the single most revolutionary. technology of our generation. And if. we're not using it for cancer, we're. losing the plot. So, in other words, people have all. sorts of paranoia and fears about AI. They're worried about, you know, job. loss and. >> Mhm. >> um you know, fake fake news and so. forth. >> But I think the one thing everybody. agrees on is that.

>> I'm an AI optimist. And I think if there. is one use case of AI that is. optimistic, it's medicine. >> Medicine, yeah. >> I started a new effort company called. Manifold AI. Manifold comes from the. Sanskrit word for brain or mind. So, the. idea is to turn the mind of AI to make. new cancer medicines. Cheaply, better, more efficiently, and. and and superior medicines. And the way we do that is by is you. know, you can't go into Claude or you. know, Gemini and say find me a medicine.

for breast cancer and out pops an. answer. What you have to do is you have to go. and teach it the basic rules of. medicinal chemistry, physics, and to. some extent biology, but basic rules of. medicinal chemistry to teach it how to. build a medicine, just like humans build. medicines. Humans don't build medicines. by going into Claude code and writing a. code for medicines. They make it. molecule by molecule. They figure out. what the what the what the targets are. They validate those targets, and then. they build a medicine by stitching.

together, literally stitching together a. molecule in in space that can either, you know, jam a a lock and a key in in. in a cancer relevant target. So, that's what we're doing at Manifold. We have We have We have taught the. algorithm. The algorithm actually knows. more medicinal chemistry than I do. >> Mhm. >> Um and it it speaks to us. It speaks. back to us by by producing, this is the. funny thing about it, it speaks the. language of medicinal chemistry. So, if. you give it a potential target or a.

query, it will start generating not one, not. two, not three, but series of medicines. that it's been built. using the laws of chemistry and physics, these constraints. And then of course we have to test them. in real life and then feed that. information back to AI and say yes, you're wrong there, you're right there, you're wrong there. And that's called. reinforcement learning. You you learn. >> Mhm. >> And I think that is the capacity to. really change the game. We used to build. medicines one at a time using human.

medicinal chemists. That's not good. enough. We need to do better. So we're. making medicines many at a time using AI. medicinal chemistry. >> One one of one of our guests today spoke. of, you know, leaning in and also. keeping a positive attitude. Uh I think Olivia was talking about. that. Keeping in a a positive attitude. through the whole process. Have you. found that the way a patient approaches. uh their cancer diagnosis.

affects the outcome or not? >> Not in the simple way you think. I mean, I think the the problem with uh I mean, I applaud people who have. incredibly positive attitudes to their. cancers. I think it's wonderful, but it. also unfortunately creates a a kind of. prison cell. of optimism for patients who don't have. a positive attitude. You may be. suffering from terrible grief because. you know, you're you're worried about. leaving your children behind. And and. should you be blamed for that? No. You. should be you know, the.

I do think that attitude makes a. difference in terms of your capacity to. cope with, you know, with with cancer. You know, it it's it's it's something. that brings you to the hospital day. after day, night after night. I talk. about Carla in my book and I at one. point I wonder, you know, what I was in. traffic. I was going to her home one day. and I said, what is it that brought her. night after day after day, night after. night to the hospital in this boiling. traffic, you know, sitting.

So so a positive attitude, I think, you. know, can become its own stigma. You. have to have a positive attitude, you. know. You've got to be you've got to. think positive. You've got to think. better. I think that can become its own stigma. Some people are are, you know, drenched. with grief. But to them, I generally say, I. understand. I understand you're you have. full right to be drenched with grief. I. would be, too. Who would not be? But on the other hand, let me make sure. that that. that you being immersed in sorrow and. grief and anxiety does not prevent you.

from getting the medical care that you. need. >> Right. >> That's the difference in the question. about positive attitude. >> there anything we should be doing or, you know, adapting the way we live and. eat and move and exercise to improve. the, you know, inevitability of those sleeper. cells being awakened? >> Well, there there small ways. I I I. think I I I I wish I could give you big. ways. >> Yeah. >> But the small ways that are certainly, you know, I think that.

uh I'll give you a couple of. associations that I thought I think are. alarming. I think there is a growing. relationship between forever plastics. and inflammation that I find alarming. So, um I don't it's not been proven out. yet, but it there's enough there's a. there's a beginning of a smoking gun. there. Um obviously, uh obesity has been. now connected with many kinds of cancer, um including most importantly, um. endometrial cancer is a a cancer related. to obesity. So, so you know, >> Forever plastics.

>> Uh so, yeah, forever plastics, you know, the the standard things is past. >> Yes. >> inflammatory pathway. Uh obesity and. diet. Uh appropriate risk assessment. So, in other words, really think about. think through. If you are at high risk, you need to be seeing a different kind. of doctor uh in terms of your risk for. cancer. And um you know, in in terms of. diet, we've now known forever that um. diets that are that diets that are. diverse and that actually are rich in.

fiber. >> Yeah. >> Um the Mediterranean diet. >> Um, are much, much lower risk of of uh. colorectal cancer. So, I you know, generally speaking, uh I always advise. for all of this. Um, on the end of. there's some cancer that are caused by. viruses. Uh, human papillomavirus, for. instance, causes cervical cancer. The. The incidence of cervical cancer in. patients who get the HPV vaccine, women. who get the HPV vaccine, is zero. So, in other words, it completely.

eliminates. There should be no cervical. cancer cancer left in the world. So, get. the vaccines that are relevant. Um, and. those are the you know, those are the. very broad recommendations. I think as. we explore the sole issue of chronic. inflammation, we'll find more things. that potentially cause chronic. inflammation. We'll find things that are. that are markers of chronic. inflammation. That would be a big day. Cuz that will mean that we can start. It's just It'll be It'll be like finding. a cholesterol for cancer.

As in cholesterol for heart disease and. chronic inflammation or cancer. It would. be It'll be That would be a big day. because we will then be able to say, I. think that you have a heightened risk. for cancer because there's chronic. inflammation going on in their body. Let. me try to see how I can help and figure. out, you know, how to balance that, how. to decrease that, and potentially look. for cancers. >> So, all these things we see on the. market for anti-inflammatory. causing and none of that means anything. >> No. They usually not even attacking the. right kind of inflammation. Um,

you know, the the anti-inflammatory. >> That's just commercial marketing. That's That's the low fat of this era. >> That is the low fat of this era. >> Yeah. Low fat of this era. >> Yeah. >> So, what keeps you up at night? >> What keeps me up at night is hope. Um, I'm an I'm an I'm a born optimist. Um, I live I eat off I I my my. my morning breakfast is optimism. My. evening dinner is optimism. I'm an. optimist. I think that we will make a.

difference and we will make a difference. in this disease before I die. >> Thank you. >> Thank you. >> Thank you. >> Thank you, Dr. Mukherjee. The book is. The Emperor of All Maladies. It's a. biography of cancer and the new edition. is available everywhere books are sold. Thank you, Olivia Munn. Simone, thank you. Simone Boseman for. sharing and Eve for sharing your stories. with us. And thank you all for listening and. watching. Take good care of yourself. >> Thank you. >> Dear listeners, it is with sadness that. I share with you that my guest on this.

episode, the young woman named Eve who. was fighting stage four endometrial. cancer, passed away just a few weeks. after our conversation. It was an honor to have Eve on the Oprah. podcast. She told us it was deeply. important to her to share her story. because she wanted to help other women. facing similar medical challenges. We extend our sincerest condolences to. Eve's husband, family, and friends. May her life continue to be a blessing. to all who loved her.

Dr. Mukherjee says we're on the cutting. edge of AI advances and research for. cancer. To read more about this work, >> [music]. >> check out his New York Times article, Can We Make AI Belong? The link is right. there on your screen. If you want to dive deeper into the. history and also the future of cancer. [music] treatment, the QR code for Dr. Siddhartha Mukherjee's updated Pulitzer. Prize-winning book, The [music] Emperor. of All Maladies, is right there on your screen. It offers.

a deeply researched look into a disease. that has touched nearly [music] every. person. on Earth in some way over the last 5,000. years. >> [music]. >> To order the book, just scan the QR. code. It's that easy. Right now, our. listeners tell us that the podcast. [music] is resonating with you and is. serving as a bright spot in your day, that means a lot [music] to me. So, here's the thing. I would really. appreciate it if you like and subscribe. to the Oprah podcast on YouTube or.

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