The Cancer Episode | STUFF YOU SHOULD KNOW

[music]. Welcome to Stuff You Should Know, a. production of iHeart Radio. [music]. Hey, and welcome to the podcast. I'm. Josh and there's Chuck and Jerry's here, too. And this is a good oldfashioned. episode of Stuff You Should Know. Uh, I. guess one that we hope helps people. [music] understand things better is the. clumsiest way I can put it. >> Oh, that's pretty clumsy. Thanks.

>> Nice. You did well then. >> Did you were did you already know a lot. about cancer before researching this? >> Yeah, I mean I feel like I knew most of. this stuff. >> Oh, really? >> Generally, like obviously, you know, that we're going to go over a lot of. statistics and stuff early on, so I. didn't wasn't super dialed in, but. >> uh yeah, I mean, we got. we have cancer in our family on my mom's. side. >> Mhm. uh like my mom had breast cancer, my uh.

her sister had some kind of cancer, my. one of her brothers had some kind of. cancer. So, it's sort of been around and. I've lost a couple of friends to cancer. >> Yeah. >> So, it it's popped up here and there. >> Yeah. I would say that's more than your. fair share based on some of these. statistics, you know. >> Yeah. And you know, I was uh I mean, not. to spoil anything, but uh I did see that. only 5 to 10% of all cancer cases could. be attributed to genetic defects.

>> Yeah, I saw something like that, too. >> So, that that made me feel better as far. as, you know, knowing that I'm going to. die of heart disease, >> right? >> You know, >> I mean, that is all American though, isn't it? >> Oh, baby. It is. [clears throat] They. they um they give you a little American. flag to hold in your casket when you die. of heart disease. >> Yeah. But uh yeah, I mean those are the. two leading causes as you know, especially if you're an American. So, you know, that that's one of the two is.

probably going to take uh take me out. >> Well, that's the thing. It sucks to. think about this kind of stuff, but. you're gonna there's a 100% chance. you're going to go somehow someway. >> That's right. Uh, and I think 40% of men. and women in the United States will get. a cancer diagnosis at some point. That's. a lot. >> Yeah. One one in every 2.5 Americans. >> Yeah. That's a sobering stat. >> And I feel bad for that.5 American.

because they already have it hard. enough. [laughter]. >> I knew you'd find a way to get a little. humor in here. Um, so let me let me kind. of tell you what I learned about cancer. that I just did not understand. Okay. Okay. Which is kind of like the overview. of what cancer is. It's it cancer is not. just one disease, which I kind of knew, but I'd heard that. I had no idea what. people are talking about. >> What they're talking about is it's. actually nowadays an umbrella term for a. collection of more than 200 different.

diseases. >> Yeah. >> And they all share two important things. in common. one they are they come from. genetic defects not just inherited. genetic defects like you were talking. about. >> and then two um they the mechanism of. the disease is uncontrolled cell growth. that's cancer but the reason it's so. insidious and difficult to treat and and. you know kills so many people is because. it comes from your own body. It's not.

like a foreign invader. It's your body. doing what it normally does, which is. cells divide and they don't do it quite. right sometimes and they can turn. cancerous. And your body has ways to. handle with it, handle that stuff and. get rid of it. But if you if your body. starts to get overwhelmed or your immune. system starts to get depleted as you. age, then the cancer can take hold and. then it goes from a normal byproduct of. cell division to disease. I didn't. really understand cancer in those terms. until I researched this. Yeah. Well,

that's good. I mean, that probably means. you haven't faced it a lot in your. immediate surroundings. >> Yeah. Um, Yumi's brother, her older. brother, Bobby, has stage four cancer. right now. And, um, he's been hanging in. there for a really long time. He's. living his best life and everything, but, you know, it's. >> it's uh, it's just kind of this constant. in our lives. >> Yeah, for sure. Uh, yeah. So if 5 to 10%. are uh attributed to genetic defects, then the other 90 to 95% are rooted in.

environment and lifestyle. Um obviously. with lifestyle we're talking about uh. some obvious things like smoking and. diet um alcohol, the sun exposure, stuff. like that. Um stress is one that's kind. of scary to think about. >> Yeah. >> Uh obesity. Um but then you know 15 to. whatever 20% are due to stuff like um. you know environmental pollutants and. just radiation like that you can.

experience maybe in your workplace or. your uh where you live or something like. that. That's all like super super sad. It's all sad but you know the stuff that. like you have no control over but you. live near a thing that's just super. scary. >> Yeah. Yeah. For sure. um that that UV. radiation also can just come from being. out in the sun over the course of your. life, which um I think is the reason why. uh skin cancers are the most common type. of cancer.

>> Yeah, I think you're right. Um the name. cancer is Latin for crab. So, you know, just like the zodiac sign. So, uh in the. early days, doctors describing tumors. that had like veins or extensions coming. out of them, uh said they were crablike. Uh, and the way they said that was they. called them cancerous. >> Yeah. So, there you go. That's the end. of the episode. >> Should we go over some of these other. stats? >> Yeah. Um, with this is largely American. stats, but we tried to extend them where.

we could to the UK, Australia, Canada. So, >> places where people listen to us. [laughter]. >> Exactly. Just wanted to make sure. everybody could share in this. depressiveness. >> No, I agree. uh at any point about 17. million Americans are living with cancer. and about 5,800 new cases are diagnosed. every day in the US about 1,00 in the UK. and uh just 450 in Australia. >> 696 in Canada I saw too later. >> Oh, so 450 to 696. It's a range I guess.

>> No, no, that's Australia. 696 is. Canada's. >> Oh, it's Canada. I thought you said. Australia. >> Yeah. No. Uhuh. Uh, and every year about. 600,000 Americans die of cancer, which. accounts for about 17% of all deaths in. the United States with um, far and away. with lung cancer being the the leader. there. >> Yeah. The UK has flipped. It's number. five in Australia, number three in. Canada, but it's definitely up there, right?

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

like a 100,000 of those people smoked. So every decade a million people die. because they smoke cigarettes and then. every year about 7,300 Americans die. from secondhand smoke smoke exposure. which is even worse. >> Yeah. Um colctile cancer is number two. uh at about 55,380. deaths uh expected this year in 2026. But um sort of the the sobering part of. colorectile cancer is that it's really.

really um I mean you could even say. skyrocketing in young adults. Uh it's up. 51% since 1994 in people between 20 and. 49 and they don't um I mean you you. should go get colonoscopies in your 40s. and I would even say by the age 40 but. your insurance may not cover it. So, uh, there's a lot of work, uh, obviously in. the insurance world. >> when it comes to covering things like. this because, as you'll see, getting.

ahead of the game in cancer is the name. of the game with beating cancer. >> Yeah, for sure. Um, and that is actually. a reason why deaths from cancer in the. west are are on their way down and have. declined precipitously in some cases. is. it depends on the type of cancer, but o. like cancer death rates for all cancers. declined by almost 30% in the US over. the past 20 years. >> That's amazing, >> right? And the 5year survival rate, which as we'll see is pretty much for.

most cancers synonymous with cured, like. you're cured of cancer. >> That's that passed 70% in 2025. So like. the numbers are are pretty good. And. there's other kinds of cancers that have. like eyepoppingly positive survival. rates. >> Yeah, breast cancer for sure is one. Um, one of the highest at about 90.5%. Uh, thyroid is really up there 98%, prostate 96%. Uh, testicular cancer at 95% and skin.

cancer at almost 94%. So. >> those are really, really encouraging. numbers. Uh it's, you know, one of the. scariest words I imagine you can hear, um from a doctor, but um. >> yeah, >> you know, if you look at the numbers, uh. unless it's just sort of a one of those. rare worst case scenarios, uh where you. get some kind of news that something is, you know, stage 4 and metastasized, >> right? >> Uh and you know, that just that doesn't. happen very often, thankfully. >> No. Uh typically pancreatic cancer is.

pointed to you as kind of like the. poster child for that. >> Yeah. And the reason why is because you. don't show symptoms uh until it's. metastasized. And that means you're. you're diagnosed typically at stage. four, which is last stage cancer, which. means that I think it has a 5year. survival rate of 11.5% in the United. States. >> Lung cancers is only 22%. So, >> yeah, >> I'm going to get screened um hopefully. this month because I just turned 50, >> which means I'm now eligible for a lung.

CT because I smoked when I was younger. and now I'm 50. So, cross your fingers. cuz I don't want cancer. >> I don't want you to have cancer either, buddy. >> Thanks, man. That's like maybe the. nicest thing you've ever said to. [laughter] me. Well, you know, especially when you've. done done the right thing and improved. your health so much and uh anytime. somebody works really hard to do. something really really hard like. quitting smoking, uh you hope that. there's a real great payoff for that. You know, Emily smoked for a long time,

too. So, she's she's always just sort of. worried and she has cancer in her. family, so uh she has always getting. >> tons of screenings for things. >> Good. It's smart. >> Yeah. So uh I think one out of every six. deaths globally every year are from. cancer and it's the rates are really. boosted by lower income countries. because they don't have a lot of access. like we do in the west to services to. screenings. Um even HPV vaccinations.

>> Yeah. >> That's a huge preventative for a whole. suite of cancers. >> Yeah. Um, and in the United States it's. very prevalent and it can save your. sexual partner's life years down the. road. Um, and like they don't. necessarily have access to that. And by. the way, HPV, hepatitis, other viruses. that can cause cancer called ankco. viruses like oncology. >> That's right. Uh, should we talk about.

cells for a little while? >> I mean, I don't see how we can talk. about cancer and not talk about cells. >> Yeah. So I think we it would help if we. talked a little bit about how um cell. division and uh like healthy cells are. supposed to work which is uh cells. divide and reproduce and they you know. they do that when they should uh. generally and they do that where they. need to do that generally and they. locate themselves in the body where. they're supposed to go uh after they. mature. >> into a specialized cell. So a cell will.

divide and then once it matures it gets. an assignment basically uh to go perform. a role and you know it generally does. that pretty well. Uh and when it gets to. the end it's it's pretty miraculous when. you think of just normal. >> cell life like how how like kind of. wonderful it is to look at like. >> uh when they get to the end of their. life they know that uh and they. self-destruct and they say we've done. our job. It's time for us to to exit the. scene. Uh, and with cancer, all of that. almost is flip-flopped. >> It is, uh, and again, like cancer are.

just cells in your body that have become. damaged or you inherited them with. damage and like they just happen, but. your body has all sorts of defenses to. get rid of them as like waste and it. handles it, right? Um, so this isn't. just like tumors we're talking about. This actually applies to any kind of. cancer cell. Um, they never stop. dividing, which is one of the things we. said at the beginning. uncontrolled cell. division and growth is essentially how. you die from cancer, right? Either these.

cells accumulate into a tumor that. crowds out the healthy cells and keeps. them from doing their thing. So, if it's. liver cancer, uh your liver can't um. filter enough stuff out anymore and that. you die from organ or systemic failure. because the cancer cells have just. crowded out the the healthy cells. >> Yeah. So, you know, like we said, it's a. genetic mutation that's going on. And. some DNA changes are going to like raise. the levels of proteins to keep the cell. growing. Uh, others might lower levels.

of a protein that tells it when to stop. growing. >> Uh, sometimes, uh, it'll, you know, the. ones that we talked about, it'll it'll. not have uh, and we'll talk about the. specific u protein, I guess, is why we. can why why wait? It's p-53. That was. going to be suspenseful for a second. >> I know. Uh p-53 is the one that. basically is like the switch that tells. a cell like, "Hey, it's we've done our. job. It's time to go.". >> Yeah. >> So, one DNA mutation might um not tell.

that uh p-53 gene to express itself. >> And they think uh scientists think that. more than one DNA change has to occur, >> right, >> for a healthy cell to turn cancerous. So. if you have an inherited genetic uh. related change or something, you might. need fewer additional changes to develop. that cancer. >> Yeah. Because it's not like when you. develop a carcinoma, a skin cancer. Like. that's the first time you've ever. developed cancer right there or a a.

potentially cancerous cell. Like it's. not like you were just touched by the. sun once and all of a sudden you have. cancer. It's just not how it works. Yeah. Instead, um, you have those cells. happening all the time, but they have. built-in mechanisms to to reprogram. themselves to basically take care of the. damaged genes and turn them off or on. Or, like you said, the wrong genes are. are are off or on, ones that have. nothing to do with with a cell turning. cancerous. >> Um, or again, if it does turn cancerous,

the body's immune system can come take. care of it, right? And that's why you. why you have to have more than one um. genetic mutation because it's the cell. is pretty good at repairing itself. And. if it's not p-53 comes up like a like a. boxing manager and like you know smacks. your face and wants to see if you if. they need to throw in the towel. >> Yeah. >> And if you have too many genetic uh. mutations, it's going to throw in the. towel for you and you're going to have. to undergo apoptosis.

>> That's right. uh you know we talked. about tumors we're going to be talking. more about that obviously but there's. also uh something like leukemia uh there. are cancers of the blood where you don't. form a tumor uh but the blood cells uh. again they just replicate such they. crowd out the healthy ones. >> uh and it's all doing this because they. express uh how would you say that. telomerays. >> uh yeah. >> okay uh and that keeps the telomeres. lengthened the telomeir is what allows.

the cell to divide uh and they they you. know kind of dwindle down over time but. um if they're expressing that telomease. it's lengthened and it wears out a. little more slowly so that tumor can. just keep dividing and growing. basically. >> Yeah. One of the other reasons they're. so um quick to divide is that they don't. stick around long enough or they don't. wait to divide long enough to mature and. like you said healthy cells divide. mature and then become specialized. they. get their assignment and tumor cells or.

cancer cells just don't they just divide. too quickly to ever mature and so as. they're doing that they pick up all. sorts of new genetic um mutations. >> So the cells of a tumor can have a bunch. of different genetically different cells. because it just starts getting so out of. hand. Like I guess at the very beginning. of a tumor, the cells are probably still. relatively similar, but by the time you. have a big old tumor, it's just this big.

mass of a bunch of weirdo cells that. kind of like multiplicity with Michael. Keaton, >> right? That's right. Uh and this is I. mean cancer can really be insidious when. you think about what's going on. [snorts] Um, cancer cells can also. recruit normal normal cells near a tumor. to like uh develop new blood vessels and. stuff to help keep the tumor alive and. like help it uh kind of thrive and help. it grow. It like it's like, "Hey, here's. more oxygen and more nutrients because. cancer cells are recruiting.

>> uh other cells and like turning them to. the dark side.". >> Yeah. And there's one other thing that. they found recently is not only can they. recruit um cells to to create new blood. vessels for them, they can recruit. neurons nearby and they send phony. messages to the brain which then in turn. sends out this I can't remember the name. of it, but it's an immune cell whose job. is to basically tell all the other. immune cells like hey you can just. relax. Everything's all clear. So the.

brain sends those to where the tumor is. and the tumor recruits them and. surrounds itself with a bunch of immune. cells that tell the body, "Nothing to. see here. Keep moving on." That's what. cancer cells do. That's insane that like. something can evolve and adapt that. quickly because we're talking about it. doing this on the order of like months. or a few years maybe. >> Yeah. >> It's just crazy what cancer is. >> Yeah, for sure. Um all right, I think. maybe we should take a break. Yeah, I'm. starting to get worked up.

>> Yeah, that was that was good table. setting. And we'll come back and talk. about types of cancer right after this. [music]. [music]. [music]. >> [music].

>> All right. So, uh, we're back to talk. about types of cancer. Uh, like you. mentioned from the jump, there are more. than 200 types of cancer. Uh, because. there are more than 200 types of cells. in the body, and that's no coincidence, obviously. Uh, they're basically. classified according to where they start. in the body. Um but that also means that. you know you can get cancer of almost. anything anywhere in the body. >> Yeah. And again I said the um most.

common one is a carcinoma. I think 85%. of all cancers are carcinomomas and. those start with epithelial tissue or. cells which are like the outside layer. of your organs. They make up tissue the. skin. And again it's just because all of. us are exposed to the sun over the. course of our lifetimes. And eventually, I guess it's just a game of odds that. can, you know, some of those cancer. cells can just overwhelm the immune. system as we get older because our. immune system declines, which is one of. the joys of aging, it turns out.

>> That's right. Uh, lymphoma makes up. about 5% of cases. That starts obviously. in the lymph glands, uh, in the. lymphatic system, and the lymphatic. system obviously runs throughout your. entire body. So, a lymphoma can start. almost anywhere. >> Yeah. Um, if you've ever heard of uh. non-hodkin lymphoma, which is the most. common, or hodkin lymphoma, which is. Hodgkins disease, uh, those are the two. major subtypes of lymphoma. And, um, you.

know, there is some irony here for sure. because the lymph system is, um, clears. out cancerous cells from your body as. waste. So, uh, that's a definitely a. cruel u a cruel one. Um there's also. leukemia which is a cancer of white. blood cells that begins in the bone. marrow. Um and it's that's where white. blood cells are formed along with red. blood cells. And strangely no one has. any idea why, but this is the most. common type of cancer in children.

Adults can get it too, but if you are a. child with cancer, it's most likely. leukemia, and they don't they just don't. understand what the what the problem is. there. Yeah. Um uh brain and spinal cord. cancer is probably one of the scariest. uh kinds when you just sort of hear. those words like brain tumor. Uh but you. know I have known people who have had. brain tumors who are doing just fine. >> Yeah. >> Um they are central nervous system. cancers. >> Uh and then at I think that's 3% of all.

cancers. Right. >> Yeah. >> And then what what do we have at 1%. >> Uh myeloma is [clears throat] another. one that starts in the bone marrow. This. is plasma cells which make up the liquid. part of your blood. >> Uh but it's also a type of white blood. cell. So it's created in the bone. marrow. And I was like wait that's two. types of bone marrow cancers. And it. turns out the bone marrow is called a. metatastic meta yeah metatastic niche. >> because it's a magnet for some types of. cancer cells that go to the bone marrow.

and just set up shop there. This is like. an embarrassment of riches for all the. stuff the cancer can use to recruit and. protect itself. Yeah. Uh and then also. 1% we have saroma. Uh that begins in the. um connective tissue or the supportive. tissue like maybe in your muscle and. your blood vessels and your fat or. cartilage or even bone. >> Um Chuck, because there's so many. different kinds of cancers and they do. all sorts of different stuff. I've read. that essentially every case of cancer is. totally unique because every person's.

body is totally unique. >> Um and so they they stage them. They. basically describe them in different. terms. And the the two things that they. base the descriptions on most are size. and growth. >> Mhm. >> And the whole thing starts with stage. zero cancer. It goes from stage zero to. stage four. And stage zero is like you. technically don't have cancer. It can be. precancerous cells. You just have a spot. that's acting a little weird. And um. it's mostly curable because uh the.

cancer hasn't undergone one of the. things that makes cancer so hard to. treat. It hasn't spread to the to the. surrounding tissues. So, you can just go. in, cut out the little growth, and you. just got all the cancer. You're not. leaving anything behind. >> Yeah. Here at Stuff You Should Know, we. love stage zero cancer. >> It's our favorite kind of cancer. >> As far as cancers go, this is the one. we're behind. And we're not afraid to. say it. >> For sure. It even looks pretty. It's got. that nice round O in the middle.

>> Yeah. Well, nothing in the center of. that thing, >> right? Uh, of course you have stage one. next. Uh, they go stage one, two, three, and four. Stage one is, [snorts and clears throat] uh, you know, it's a little bit more cancer. Um, it's. smaller. Um, obviously not smaller than. zero, but smaller than two. It's. contained to one area, has not spread to. the lymph nodes, uh, or other areas. Uh, which is basically where you get to in. stage two is the tumor is going to be. larger, and it may have spread to the. lymph nodes at this point.

>> Yeah. Yeah. And it's almost certainly. spread to the surrounding tissue, too, but it's not like it's kind of. invisible. The tumor is quite obvious, but the the spread around the tumor is. not quite visible. So, it makes it. harder to get rid of through surgery. Uh, stage three, it's grown even bigger. and into deeper into the surrounding. tissues and it also has probably spread. to nearby lymph nodes. And then once it. spreads, once it metastasizes is what.

it's called, you have entered stage. four. >> That's right. Uh that means it's. definitely spread outside its original. place uh probably to other organs uh or. anywhere in your body really. And that. is metastatic cancer. Uh you may also. hear a letter sometimes in a diagnosis. like stage 2 A. And the letter will. describe an aggressiveness uh with A. being the least aggressive all the way. up to uh D being the most aggressive. Right. Uh and then words like remission. and cure are also used. Um remission is.

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

>> Yeah. I mean, cure is a sort of a dicey. word when it comes to cancer. Um that's. basically complete remission. Uh meaning. there's no evidence of the disease. Uh. and uh even though there may be a risk. of reoccurrence, if you're if you're. cured, uh basically like five years is. what you said. If you're in complete. remission for 5 years, you can kind of. stamp that cure on your forehead. proudly. >> I think that um doctors are kind of like. I I don't like to use that word. They're.

just nervous about it coming back, you. know. >> Yeah. I mean, I don't know any doctors p. Well, I do know some doctors actually, but uh I haven't asked them like how. they feel about the language around it, you know. >> Yeah. We we'll wait if you want to get. in touch with them. No, but we'll uh. we'll hear from doctors, I'm sure, and. and patients. >> I'm looking forward to to getting emails. from all kinds of people on this. >> for sure. >> So, the history is, you know, we're not. going to get too in the weeds because.

it's basically a situation where uh they. thought black bile was what, you know, caused death and disease for many. hundreds of years, probably thousands. Uh, and then there was a Dutch. scientist, the father of anatomy, uh, Andreas, uh, Vzileas, who finally said, uh, you know what? I've looked at a lot. of dead bodies. They even stole some. corpses to make it happen. >> And guess what, everyone? There's no. black bile in the body. And Evan was. like, all right, well, why are people. dying? Uh, that took a little bit.

longer. Uh, I think in 1793, there was. an anatomist in London named Matthew uh, Bailey. That's what I'm going with. >> Yeah. Who was like, "All right, here's. real proof, everyone, that uh cancer. isn't black bile. Uh it's, you know, we. found out that tumors can grow in the. body really fast." And for a long long. time, it was let's let's cut that stuff. out of the body and see what happens. >> Yeah. Because surgeons were like, "Oh, it's a tumor. We can get rid of that.".

And and I think at first they thought. this is around 1850 when it really. kicked off. Um they initially thought. like we can totally take care of cancer. from now on. >> But what they figured out over time. because some of their patients that they. treated would come down with cancer. again like a year later or something. like that was that there that cancer. would spread kind of invisibly deeper. into the tissue and that just getting. rid of the tumor wasn't enough because. it left too much of the cancerous cells.

to repoliferate and grow again. >> Yeah. And you know very sadly they were. like uh you know because I think they. were so thrilled by the advent of. successful surgery. >> that they were a little scalpel happy. and were like we'll just keep removing. stuff then because that's how you cure. this thing. Uh and that left you know. some disfiguration a lot of times when. they uh just kept like getting rid of. you know pieces of your body. >> Yeah. >> Uh and it took a long time. It took. decades before they finally figured out.

that it was a systemic thing and finally. understood what uh metastasization is. and uh then they came up with better. treatments starting with the X-rays in. 1895. Right. >> Mhm. That's where that's where they were. discovered. And as little as a year. later, an American medical student named. Emil Gruba um he was like, I'm going to. try to use those to treat cancer. and he. was successful. He treated uh. successfully treated a patient with.

breast cancer using X-rays. So now you. got radiation which can you can go in. and cut the tumor out and then you can. irdiate what's left. And now things are. starting to cook. >> Yeah, things are starting to cook a. little bit. Uh chemotherapy then enters. the scene. uh thanks to kind of a weird. story, but uh in the US Army uh doctors. were conducting autopsies on soldiers. who died from mustard gas exposure and. they're like, "Hey, this gas is. attacking white blood cells.". >> So they got a developed a derivative of.

mustard gas called uh meccamine and that. became. >> the first chemo drug in the 1940s and. they still use that sometimes for some. types of lymphoma I think. >> Yeah. because it's a disease of your. white blood cells, right? >> Yeah. >> Um there's a guy who is basically. synonymous with chemotherapy. His name. is Sydney Farber. Uh he the Dana Farber. Cancer Institute is named after him and. it is worldrenowned. Uh and it's also I. found a really great resource for info.

really understandable but detailed info. on cancer. >> Yeah. >> Um he came up with a cancer drug for. treating leukemia in children. uh. Amanopterin I think is what it was. called and that was back in 1947. >> So if you see um photos of him. >> after 1947 he usually has a little halo. over his head. >> Mhm. The thing is, and we're going to see. this after we take a break, but. chemotherapy is a very blunt instrument,

right? It I' I've heard a kind of a. oncological gallows humor um before that. basically says um with chemotherapy, you're trying to kill the tumor before. you kill the patient. >> Yeah. >> Because it just goes in and it wipes out. so much stuff that is you don't want to. wipe out. It's just not very targeted. But, uh, again, as we'll see, it's. gotten a lot better over time. >> Yeah. And a lot better to to take, um,

thanks to some some great new, uh, nausea drugs because nausea and fatigue. are two of the biggest rough parts of. chemotherapy. >> Yeah, I've I've heard that for sure. >> Uh, all right. Should we take our second. break? >> Yes, please. >> All right. We're going to come back and. we're going to talk about treatment. because there's a lot of great stuff. going on, you guys. We'll be right back. >> [music]. [music].

[music]. [music]. >> Uh so Chuck, two things. Uh the first. one is I've always wondered if cancer. was actually a relatively recent thing. like maybe from the industrial. revolution on. >> Right. Yeah. I used to wonder that too. >> Absolutely not. I mean I think immoteep.

uh described it 4700 years ago of breast. cancer. >> So it's been around a really long time. The reason it's only kind of recently. come under investigation and study is. because we used to die from a bunch of. other stuff mostly communicable diseases. um rather than cancer. It was pretty low. on the list and then as we started to. take care of those other communicable. diseases then cancer suddenly became a. much bigger problem than it had been.

before. >> Yeah, for sure. Uh and the reason that. we haven't, you know, developed like a. complete just cure all for cancer is. because that no two cancers are the. same. >> Uh they all develop in in different. ways. >> And they're they're doing a lot of um. you know, we'll talk about some of the. like more breakthrough stuff they're. doing, but um right now what the. standard practice kind of still is uh if. you have a malignant tumor is to shrink. that tumor uh with targeted radiation.

Yeah. and then remove that tumor and. then prescribe a course of chemotherapy. uh which is probably like more than one. chemotherapy drug to eradicate what. cancer is remaining in your body and to. hopefully save off uh metastasis. >> Yeah. Um and you'll do that round of. chemotherapy, wait a little while, and. then they'll test you and see what. effects it had. And then if it's still. there, you do another round and another. round and test after each time until. eventually they're like, "We can't.

detect cancer anymore." And now you're. in full remission, hopefully forever. >> Yeah. Uh if you don't have a tumor, like. you said, uh earlier if it's like a. cancer of the blood, >> uh chemotherapy is is your main um. defense there. And probably radiation as. well. And also uh you've probably heard. of like a bone marrow transplant or stem. cell transplant. >> Yeah. Uh that's also used in in cases. like leukemia. >> I was looking into that and it's. apparently not nearly as bad as it's. been made out to be. Everyone's like.

it's the most painful thing you could. possibly do. And also apparently only. 10% of people who apply to be donors. actually end up donating marrow. Most of. the others their plasma will do. >> instead. So you end up basically. donating blood. Uh chemotherapy, like I mentioned before. the break, is um a lot better than it. was even like 10 or 15 years ago because. these uh serotonin antagonists, which is. a new class of anti-nausea drugs, really. can help block uh block the nausea.

receptors in the brain, >> right? >> And I know, you know, just from like. family and stuff, that that's uh that's. that was one of the worst parts. And I'm. I'm sure it's still no picnic, but those. have really helped. >> Yeah. I mean, just what a what a. horrible thing going in to get. chemotherapy knowing that you're going. to get horribly nauseated for a while. It's gota the dread has to be really. serious, you know. >> Yeah. I mean one of uh one of our. friends uh like that of you and me have. um recently underwent uh cancer the jaw.

surgery and boy the way he described. just the pain of that surgery. >> and what he felt like the next day was. um was brutal. I uh I don't think I have. the exact words here on my on my text. I. don't know if I'd read them anyway, but. um he basically was like he felt like. he'd gotten run over by a truck and that. was just like post post op. I mean, geez. And that was just after the. surgery, you say? >> Yeah, for sure. Um, but he's. [clears throat] doing great. >> Good. Good. I'm glad.

>> Um, so yeah, surgery is a big part of. it. Uh, if it's a tumor, obviously, if. it's a um a cancer of the blood and. there's no tumor, they're not doing that. like you said. But, um, you promise. cutting edge stuff, right? and something. that is still you can kind of call it. cutting edge just because it's so g-. whiz um but it's starting to become much. more prevalent uh and and available. throughout the the west. It's a form of. amunotherapy which is basically training.

your immune system to target cancer. cells in the same way that it targets. foreign invaders because again cancer is. not a foreign invader and it's very very. clever at um using the body's own immune. system to prevent it from being. attacked. Right. I was thinking about. this, Chuck. Cancer is like one of those. rogue agents in a movie that was trained. by the very agency that now seeks to. kill it. >> Yeah,

>> it's a good metaphor. >> Yeah, thanks man. I I've been working on. it for a couple of weeks now. >> So, uh yeah, you know, your body. generally does a pretty good job of. doing that kind of thing, but not in the. case of cancer. So, they're working on. therapies that, like you said, um can. can train your body to do that. And I. guess the leading or I guess one of the. leading methods is called CAR TE-C cell. therapy. >> Uh in this case the CAR stands for. chimeriic antigen receptor which is a. targeted receptor um for the type of. cancer cells that invade your body.

>> Right? So they basically just take some. of your blood they separate the tea. cells your immune cells out of it um and. they use crisper. Did we do a whole. episode on crisper the gene editing. technology? I feel like we did. It was. either a whole episode or it was came up. pretty heavily in more than one back in. the day. >> Okay. But it's a tool for basically. using you you use a virus that has the. genes you want in it and the viruses um. whatever disease it spreads is turned. off and you insert that into like a TE-C.

cell and now the T- cell has the genes. you want and those genes get the TE-C. cell to express um the same proteins. that are in that kind of cancer. So now. you put the tea cells back in you after. you proliferate them for a while and. there's a bunch of tea cells running. around telling the rest of your immune. system look for this. Do you see this. protein right here? This is what we're. looking for. And in other cases it can. cause tea cells to grow the kind of. receptors that need that it needs to.

attack and latch on to cancer just like. it would any foreign invader. So I have. a a a neighbor friend who underwent. cartis cell therapy. >> Yeah, that's amazing. um some other gene. therapy techniques uh that are I guess. still in the testing stage. Um they you. know we mentioned that p-53 protein. that's the one that says like hey it's. it's we've done our job it's time to. self-destruct. >> and that's the one cancer cells don't. have. So some gene therapy techniques uh. include turning on that p-53 protein in.

cancer cells. Yeah. >> So they either self-destruct or at least. stop dividing. >> Right. >> It's amazing. >> Yeah. There's others that um there's. genes that basically turn the cells into. magnets for immune cells. And then I saw. another one where they can turn the they. can make the cancer cell mature finally, right? And so it will um. >> have a job. >> basically. And get this, they found that. the vast majority of those cells.

um uh basically pull the plug. They they. undergo apoptosis. They self-destruct. So, they'd rather die than have a job. The cancer cells would. >> Isn't [laughter] that crazy? >> Cancer cells are Gen X, in other words. >> Pretty much. >> Wow. That's that's incredible. Uh I. didn't know about that one. Um they also. have uh on the horizon personalized. cancer vaccines, >> right? Uh that's a new uh treatment. designed to uh basically prime your. immune system to target cancer cells to.

reduce uh recurrence risk and um you. know obviously [clears throat] hopefully. like kind of fewer side effects than. something like chemotherapy. >> Yeah. And they it's not good that they. use the word vaccines because it. suggests that you can go get the vaccine. before you have cancer and it'll keep. you from having cancer. And that's not. the case. It's vaccine in the sense that. it primes your immune system to fight. cancer better. But the but it's. personalized, right? So they take your. cancer and examine it and then figure. out how like what what um treatment will.

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

now. It's very hopeful. >> Yeah, for sure. Um, you know, we do have. done a lot of AI poo pooing on this. show, but uh, one of the great benefits. of AI is that it's already kind of. stepped up um, in in cancer treatment. and uh, and sort of cancer diagnoses. It. seems like like maybe having uh, along. with the human radiologist having AI. looking at uh, radiology scans to detect. tumors that maybe a radiologist doesn't. notice. Um, maybe also to help predict.

uh, risk. Right. >> I know there's an AI MIT model that's. able to predict a person's risk of. developing lung cancer six years in. advance. >> And that's amazing because, you know, as. we've kind of hammered home already, like the whole trick to cancer is is. getting an early diagnosis and start. going at it right away. >> Yeah. And that's the I mean, that's the. big money part right there is detecting. it early. Um and because of things like. screening and other kinds of detection.

that we have and routinely use in the. west, that's why cancer rates are going. down. But like I said before, the. developing world is pushing cancer rates. up. So much so that the World Health. Organization is expecting cancer. diagnosis to increase 77%. >> by 2050 over 2023. So, in just over 25. years, almost well almost 100% increase. I'm just going to say 77% is close.

enough to 100% where we're talking about. that level of increase of cancer. diagnosis. >> Yeah, for sure. Um, you know, we talked. a little bit about risk factors already, things that you can control like, you. know, alcohol, obesity, uh, to certainly. tobacco and sun exposure, things like. that. Uh there is an interesting emerging. field called psychonuroimmunology. which is a a branch of western medicine. that acknowledges the effect of the the. brain. >> right. >> uh or your mind really on the systems of.

the body and you know uh it's I don't. think it's like a woowoo stuff to say. that a real real deep will to live uh. can make a difference um if if you're. you know up against cancer. Um, and it. can work the other way, too. And I I've. seen this as well when someone is like, you know what, >> this isn't the life I want and I'm I'm. I'm I'm done cuz it's just uh it's time. for me. And I've seen people go very.

quickly after someone has sort of made. that decision. So, >> there there's something to it for sure. >> Yeah, they they definitely started to. research that more and more. It seems uh. kind of thin the amount of it that's out. now, but the this investigation into. what the will to live is and then Yeah. like how to prime it in people uh is is. it's definitely being investigated now. and it does seem to be a thing for sure. >> Yeah. And you know on that um sort of. last note around the language when. someone has has chosen to to not.

continue treatment. Um the way people. talk about it is changing I think. probably for the better because uh you. know you shouldn't say like someone has. given up the fight uh because it it. indicates that they're um like quitting. something or surrendering. >> and that in fact is like. one of the bravest things you can do I. think. >> Yeah. Uh that's yeah I mean it's. definitely it because you're just saying. like okay I'm accepting my fate and that. is incredibly brave.

>> Um yeah and not just saying like giving. up the battle with cancer just using. framing cancer treatment and cancer um. disease in terms of fighting and. battling implies things like that that. you know you don't have the guts to to. keep fighting you know or you're you're. quitting or you're surrendering is. another way to put it. Um, and for some. people, yes, like battle, fighting, it. definitely inspires them. So, no one's. saying like, don't use those terms.

anymore, >> right? >> It's just that for other people, they're. like, I don't like this is making me. feel bad. Like, I'm responsible for my. own death. >> Um, those people, they're like, you. know, call it your journey with cancer, living with cancer, um, treating your. cancer, more neutral terms, less fighty. terms. And they're they're they just say. researchers say follow the patient's. lead on which way like how you frame the. terms of of cancer, living with cancer. and treating cancer. And I mean that's.

super valid. >> for sure. And and if you know someone in. your life that has is uh accepted that. it's it's time for them like that's when. they need like your your support and. love more than ever. I think it's and um. >> I mean I would just recommend to not uh. >> not like be devastated in front of them. at least, >> right? >> And to try and try and support that. decision, you know, cuz that's a that's. a brave thing to accept. >> That's got to be tough for a kid to.

understand and accept too, you know. >> Yeah. >> There was a remember that uh that. episode of the pit that really dealt. with that. >> Oh yeah, >> that was Lord gut-wrenching. Um, I've got one quick soapbox PSA if. that's okay. >> Yeah, let's do it. >> So, in the United States, mammograms are. covered by insurance. >> The problem is is that you very often uh. need a followup because they're like,

"This mammogram's good enough, but not. quite. There's this thing in here I want. to see closer. Let's take a look." And. it's probably nothing. In most cases, it. is nothing. But they do that because. they're like, "We don't want to miss. something that's really important." The. follow-up imaging is not covered by. insurance. So, there's, you know, plenty. of women out there who are like, "I. don't have the money to pay out of. pocket for a CT scan, so I'm just not. going to go get the follow-up imaging. and cross my fingers." So, there's bills.

floating around there. Basically, like. insurance companies, you have to cover. all followup imaging as well. Like, you. can't just just do the bare minimum. It's just not going to work for people. anymore hopefully. >> Yeah. And mammograms suck. >> Yeah. >> It's an awful process that's like. already uh there's an incentive to avoid. something like that. So, uh insurance. companies are, you know, we've ranted. before, but they need to step it up in a. lot of ways. That's certainly one of. them. And also as we mentioned before uh.

with the increased rate of colorectile. cancer in younger adults um make them. available to be covered in your 30s uh. you know there's probably not a lot of. 30-year-olds that have the gumption to. be like you know what I'm going to go. ahead and get a colonoscopy at 35 years. old but if they want to uh then it. should well be covered you know. >> for sure. Uh, wow. That was a good one, Chuck. Nicely done. >> Uh, we made it. >> I would say, do you have anything else.

about cancer? But I know you do. So, we're just gonna say this one's wrapped. up. >> That's right. >> Uh, since we just wrapped this episode. on [music] cancer up, that means it's. time for listener mail, of course. >> That's right. I'm going to finish with a. very heartwarming story, which is, uh, good way to end this one. >> Awesome. Uh, this was from our phone. books short stuff when we talked about. sort of randomly calling the wrong. person with the same name. >> Uh, hey guys. When I was 15, I tried to. call someone in our friend group. I. looked up the last name, found a long.

list of entries, and put a small dot and. pin next to each name of someone I. thought lived in our school district. I. still have that phone book with the. markings, and you'll see why. Uh, thankfully, two towns in our area had. similar names, but went to different. school districts. I didn't know that at. the time. So, I called over a dozen. numbers asking for my friend who I never. found. But one guy answered and when I. asked, "Can I please speak to name. redacted?" He answered, "Well, he isn't. here, but this is that name." And I. answered, "Well, this is Amanda." Uh,

which was actually a fake name, guys, because the Boston song Amanda was out. at the time. And it was all I could. think of on the spot. The story's. getting good. [laughter]. We I think you see where it's headed. We. spoke for 30 uh 30 minutes on the phone. about the Mets who had just won the. World Series and hung up. I then called. back that guy once a week for 5 months. and uh we eventually decided to meet. under a street light on the corner and. dudes we've been married for 33 years. >> Awesome. >> Uh together for 39 and in December our.

daughter is going to get married. Uh he. is my person, my soulmate, my. everything. I'm a weirdo and he gets me. and always has all because of a phone. book. >> That is so great, man. >> Uh to answer your question, yes, the. other guy knows the story and that he is. the reason that I found my husband. I. don't think he could believe it and I. sort of still can't really believe it. myself after all these years. Nowadays, it would be so unlikely to even pick up. a call from an unknown number. So, thank. you again for consistently creating such. polished elite entertainment. >> Polished. >> I know. Elite.

>> Wow. >> Not two words we usually associate with. ourselves. [laughter]. No, I think she's talking about the. daily. >> I think so. Uh, but that is from Laura. and Laura sent pics of her and her husb. uh in 1987, 1993 and one from this year. and it is adorable. He had quite the. mustache. >> I saw that subject line. I haven't. looked at the email yet, so I have to. run over and do that. That's what a. great story, man. >> Yeah, I love it. >> That was Laura. >> That was Laura. >> Thank you, Laura. That was I don't know.

That's a contender for number one, maybe. That's right. You You and Name. redacted husband. I'm so glad you're. still together. >> Seriously, one of the best ever. So, thank you for sending that email, Laura. And if you [music] want to take your. shot at the number one email spot, we. love that. You can send it off to. Stuffpodcast@ iheartradio.com. Stuff You Should Know is a production of. iHeart Radio. For more podcasts, iHeart. Radio, visit the iHeart Radio app, Apple.

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