267 ‒ The latest in cancer therapeutics, diagnostics, and early detection | Keith Flaherty, M.D.

[@PeterAttiaMD]

In this episode, we discuss: 0:00:40 - Keith’s interest and expertise in cancer 0:04:55 - Cancer deaths by decade of life, and how cancer compares to other top causes of death 0:10:33 - The relationship between hormones and cancer 0:18:42 - The link between obesity and cancer 0:23:40 - Current state of treatments for metastatic cancer and reasons for the lack of progress over the decades 0:35:19 - The interplay between the immune system and cancer cells 0:44:29 - Different ways cancer can suppress the immune response, and how immunotherapy can combat cancer’s evasive tactics 0:59:30 - Elimination of a substantial portion of cancers through immune cell engineering faces challenges of specificity, cost, and scalability 1:10:15 - Why TIL therapy isn’t always effective, and the necessity for multimodal therapy to address various aspects of the cancer microenvironment 1:31:49 - The challenge of treating metastatic cancer underscores the importance of early detection to improve survivability 1:38:36 - Liquid biopsies for early detection of cancer and determining the possible tissue of origin 1:49:21 - Commercially available cancer screening tests 1:57:21 - How to address the disparity in cancer care, and the exciting pace of progress for cancer detection and treatment

[@mugflub]

Peter Attia is a modern-day superhero. His superpower is a combination of intense passion, incredible intelligence, and an unstoppable drive. He is a force of nature in the world of medicine and is doing so much good. I'm reading his book now and it's phenomenal. He really gives me hope for the future of health care. Medicine 3.0 is on the way!

[@andynicoll8566]

On my way to my yearly cystoscopy. Six years clear since bladder cancer treatment! Yea, fingers crossed.

[@gwendawnseto2284]

Hope good news again 😊

[@tomdehen]

Congratulations! I am 23 years clear of bladder cancer. My warning to everyone is: blood in urine with no pus or pain equals cancer. My doctor wasted time treating me for an infection because he couldn't wrap his head around the idea of bladder cancer in a patient 48 years old. He was a good doctor though. It's hard to be a urologist and have to deliver bad news to patients all day long. I had a customer who procrastinated while peeing out lots of blood clots and ended up losing his bladder.

[@sadiqzaman4406]

Speaking as a clinical Hematopathologist practicing at a national laboratory, this was a great interview that highlighted the importance of further developing and focusing on diagnostics at this juncture in the saga of cancer therapeutics. Having incorporated next-generation sequencing (DNA and more recently RNA) into our diagnostic hematopathology reports over the last 5+ years has done a great deal to allow us to not only more specifically diagnose leukemia or myeloid/ lymphoid neoplasms, but also to provide prognostic information in those patients on whom neither leukemia nor a myeloid/ lymphoid neoplasm has arisen yet. I am excited to see how we can further incorporate advancements in this field to even better prognosticate (and accordingly, prescribe guidance on the frequency/ closeness of follow-up) for those patients in whom leukemia/ lymphoma or its precursors have not yet arisen. Great interview.

[@gidave]

As a current waldenstrom survivor, I anxiously await new strides in the treatment of my disease. I continue to read journals regarding treatment and recovery methods. To date I rely on a very healthy diet, nearly carnivore, and very intense weight lifting and aerobics 6 days a week. Lots of water and sleep are essential. And distance yourself from crowds. Be careful with vaccinations. Talk to you hematologist or oncologist. This would be my advice.

[@yolandaphillips7511]

Ah! Thank you!! I thoroughly enjoy your podcasts. I find myself going from re-reading a chapter in your book Longevity to rewatching an episode. Absolutely insightful and inspiring ❤

[@lindaandnathan6103]

Hi Peter I found you on Andrew and Tim’s channel. Absolutely love your knowledge and how you explain things. Thank you for sharing so much valuable information to general people who don’t otherwise have access to these resources

[@dianalipton6444]

Explains why cancer has flourished after the COVID shots - immune suppression.

[@petercoderch589]

"Men have the highest rate of prostate cancer when their testosterone and DHT levels are at their lowest, in old age." - Yeah, but you're not taking into consideration that the old man had decades of his prostate cells being under oncogenic stimulation from those same hormones, while the young man has only a decade or so of that. HUGE difference. I don't understand why it's so difficult for people to understand the concept of damage accumulating over long spans of time, that you cannot establish a cause-and-effect link between things without taking into consideration time elapsed. It's like when people say that telomere shortening is the cause of ageing because young people have long telomeres and old people short telomeres, when they forget that young people have been around for a lot less long time so they have accumulated a loss less DNA damage, a lot less misfolded proteins, and have undergone a lot less epigenetic drift from having to constantly repair DNA damage(and telomerase actually accelerates the methylation clock). Correlation and causality are two different things. This is logic 101, but who even studies the branch of philosophy and mathematics known as logic nowadays?

[@LayneSadler]

Delfi was the most interesting thing I saw at AACR this year

[@dialectic5012]

What about the Differential Stress Resistance Hypothesis and cancer treatment?

[@trishmarck7798]

Why is there never mention about prevention. If early screening is so go why are the deaths so high ?? Screening = profits

[@chazlon5061]

because in a huge percent of cancer cases, the patients have no risk factors

[@threadfix]

How many are living healthily? Whole Foods, sleep, movement, social and physical environment etc etc drinking? obese? Stressed? Unhappy? And I acknowledge that “healthy” people get cancer What is going wrong?

[@WilliamChan]

So basically every time the US Presidential Primaries are starting to come into view, I'll be looking out for another one of these updates. lol Thank you guys for sharing!

[@doprisi]

Is there a modern version of the book "The transformed cell" by Rosenberg and Barry?

[@danielevans5864]

Does moderate to heavy alcohol consumption contribute as an independent risk factor in cancer?

[@skmrgoo5717]

Yes, Ethanol is considered a probable carcinogen. While light drinking might not significantly increase the risk for development of various cancers, heavy and possibly moderate drinking can increase said risk.

[@alexolbrych4443]

I'm new here, just wondering, is chemotherapy ever used as a preventative treatment in healthy patients? Would an every 5 year regiment of chemo starting at age 50 help weed out some of these microscopic-metastatic cases that are currently very difficult to detect? Worst case scenario here would be a patient who would hypothetically never get cancer in their life. Would this hypothetical treatment shorten their life and shorten their life enjoyment? if so by how much? would it be worth it?

[@alexolbrych4443]

listening further along here and it sounds like a robust immune system may do a good job already at preventing cancer... and chemo would hurt that system... so may hurt the overall goal of preventing cancer.

[@stephp7778]

Chemo is poisonous...we sign a waiver should chemo give us a new cancer....all the side effects from chemo are early stages of bone cancer, brain cancer, lung cancer etc... these are new cancers because the chemo destroys all your good cells. My oncologist didn't explain what I learnt after chemo...they gloss over it. Chemo is a catch 22.

[@gidave]

Chemo and other drugs are designed to target cancer cells. They also destroy healthy cells. I had 12 doses for my waldenstrom. It took me two years to recover weight and strength. No, you don't prevent cancer this way. Eat healthy and exercise. Don't smoke, drink, and stay away from refined foods.

[@luciususiholo6956]

X cures as a platform can scale expertise

[@cindianderson9443]

You talk about using standard chemo drugs when cells are still at the microscopic level. But is there any evidence this would work? Chemo only works on fast growing cells. Are they fast-enough growing at the microscopic level? And chemo doesn't kill cancer stem cells, so is there even a benefit to killing the daughter cells if you aren't treating the stem cells? It makes me crazy that there are numerous papers and conferences on how what is needed is a way to kill the cancer stem cells, yet you doctors never talk about them. Ever.

[@Mau365PP]

Just give us a protocol please 😢 Long covid is going to escalate cancer in the next decade dramatically

[@bellelacroix5938]

Long civid aged me. Weight gain. Muscle wasting. Lung weakness. Serious fatigue. Exercise a 'no way'. Price gouging delivery charges. Depression. Lonliness. No medical care. Gov't agencies shutdown. Check dont come. Id theft. Records tampering. Familial breaķown. Trans agenda escalating endangerment and harassment. Street mobbings. Home insurance tripled. Can't get affordable help cuz no one wants to work. Hustlers like carpetbaggers everywhere. Racism and sexism back in vogue. Dumbed down kids. Everyone is scared.

[@filipvuletic3445]

You mean vaccines?

[@Thomas-wz2nu]

Not long covid - long vaccine!

[@mugflub]

Sit down@@Thomas-wz2nu

[@MichaelMerritt]

“Why not both?”

[@007nige]

Listening to Flaherty was like listening and watching Michael J Fox. He was all over the place with what he had to say and was so animated, I could hardly follow him. His hands were waving, he talked as if he had drunk 40 cups of coffee, thus, unfortunately a lot of what he had to say was lost. He was very difficult to understand.

[@McGregoryO]

blah blah.. reductionist blither blather. nothing useful said here unfortunately.

[@qijingfan5656]

please find an expert speak a full sentence without pause of Uh, like, or break a sentence into 10 phrases

[@billytheweasel]

Thanks docs. Grateful. Can someone help? Three oncologists denied that the Warburg Effect is happening in my wife’s breast cancer. Is there a new study?

[@markleblanc451]

Have you listened to Thomas Seyfried talks on metabolic therapies? I don’t understand why more doctors don’t talk about it. Oh yeah! There’s no money in it

[@les0nick]

Have I heard correctly that immune therapy overall didn't pay the investment and now metabolic paths are in the focus? Even idea of pulse therapy was mentioned? That sound more what Dr Seyfried is saying for years...

[@threadfix]

The people who have followed Dr Seyfried and colleagues research need to be listened to! Results are visible and give better quality of life and in a lot of cases, longevity! Not Early death!

[@seanthundercock6770]

What about incurable cancer like mutiple myeloma mantle cell lymphoma .

[@gidave]

I have waldenstrom. Very similar, rare, and incurable. I eat a carnivore diet, exercise 7 days a week, and drink lots of water. I get a blood test monthly. Had chemo, blood transfusion, bone marrow transfusion. So far so good.

[@WhiteRussianBC]

Great discussion

[@vansicklejacquie]

Are mammograms very effective in early detection? I’ve heard about a better machine for detection.

[@jennyretief4978]

Ultrasound, for dense breast tissue

[@loris7964]

I found your speaker very wishy washy and not specific

[@bhylton86]

I don't think you appreciate what medicine is then.

[@loris7964]

@@bhylton86 I have cancer and it is stage 4 do not give me your wasted comment

[@parabolicpete2926]

If you will

[@ursuladre9650]

Great lecture on the basics of immunotherapy - thanks for having Dr Flaherty on. I find few podcasts which really get into the path/phys of cancer - thank you!

[@aryangod2003]

I have been very interested in training as an oncologist since high school, but my friend in medical school dissuaded me saying it is very depressing and has very low job sanctification. Is this true?

[@threadfix]

How much time has been spent looking for a cure? While the cancer death rates go up? Go figure