Starving cancer cells without starving YOU - With Dr. Siddhartha Mukherjee

nice thing about using targeted and nutritive therapies is that the cancers can no longer attract the shell and what happens over time is that their capacity to build this cell around themselves becomes less and less possible and that's because they don't secrete the factors that throw out the cells that form the shell so what you do then is come back with some kind of immune therapy as either maintenance or as down the road there so there is a path forward that has to be rational logical and sequence welcome to Target cancer podcast my name is Dr sanjanaja I'm a hematologist and medical oncologist also known as the ant talk on social media we try to educate and do a bunch of stuff today is super special because I have basically one of the biggest reasons I actually went into oncology and believe it or not City may not know this is also like I get a little style when I see your picture sometime I'm like oh I kind of like that I think you have a shirt just like this so we have the Pulitzer Prize winner best-selling author the person that really Bridges kind of academics of oncology with philosophical you know just ideas of how everything is uh interplayed Dr Siddhartha Mukherjee who is here to talk about hopefully a couple of things but the thing that I find really interesting which is one of the questions I get most on all my Social Media stuff is diet diet what can I do for diet you know to prevent cancer but especially I get a lot of questions when people have cancer and it's super frustrating because a lot of times the medical oncologist the answer is well you want to do this and that but nothing concrete so Dr thank you so much for being here and we're excited to have you my pleasure thank you for having me one of the things and you know I think anyone that that kind of follows my educational handle stuff knows about your book Emperor vomalities it's always the one that I kind of you know recommend when people are kind of faced with a cancer diagnosis one of the biggest things about cancer as you know and it's kind of the reason for the book I'm trying to write which is it's time to cancel the term a cure for cancer because it's very deceptive right you're basically trying to take something that arguably was almost celestially orchestrated or divinely orchestrated to have so many fail stops that is the human body through Evolution cells what if this doesn't work what if that doesn't work you tend to take all that like over hundreds and thousands of years the mechanics and algorithms and you're trying to basically now have to fight it when those same mechanisms are in place but all of a sudden it's going rogue and it makes it interesting but also again deceptive because it's hard to find a cure there's all kinds of mechanisms in place one of the things outside of targeted therapy that we talk about in Precision medicine and saying okay this is the on switch that makes it grow and this is the thing that's making it Escape immunity so stop that you're just you're frantically trying to you know keep everything up to speed with as quickly as the cancer which I kind of relate to viruses grows but you're looking at also what are the tools it uses outside of like necessarily you know the targets that we use and the immunity and you're looking at basically amino acids or the fuel or the gas potentially if that's not too kind of rudimentary on are there some cancer types and pancreatic is one of them which you always say why is it so stubborn it makes you know it recruits your own cells it uses fiberglass to repel other people micro environment stuff but you're like let's look and to see like really are there some tools that it's using that does make it unique and is that where you started with talking about these amino acids and pancreatic cancer yes but let's maybe we should take a step back yeah the step back it goes back to the 2000s and the early 2000s now cancer is of course a genetic disease even if it's caused occasionally by viruses like human papilloma virus or Epstein-Barr virus but it's essentially these viruses or genes themselves are mutated and ultimately cancer is a genetic disease genes are mutated those genes turn the normal processes of growth abnormal those cells now grow abnormally the we I liken it to saying it's like a car where the accelerators are jammed the acceler is being excited the growth or the bricks are snapped so that the cell can no longer have its normal ways of dividing right and the key is when you say genetic and that was one of our podcasts is we don't mean necessarily that was an inherited genetics right so people I think often mistake that to mean like oh but I don't have it in my family that we mean things that 85 percent of the time there used to be 95 now we're saying okay maybe we've learned about some more 80 percent time it's something that was errors in these genes with replication of billions of times in your lifetime in your lifetime that causes these errors that's correct so so there are two kinds of or the three kinds of errors that can be caused right one is we talk already about viruses uh viruses can come in tamper with your genes make yourself behave abnormally the second kind of error is that you unfortunately inherit something from your family which gives you a higher risk of getting cancer that would be genes like bracha 1 p53 and other syndromes and those patients have higher risks of cancer it's a little bit hard to quantify that number because that number keeps changing we used to think that they were single genes they're single genes that are very strong in their effect but now we know that there are other patients who have multiple genes tens 12s 15s maybe even hundreds that they inherit from their parents which raise their risk of cancer by 5 4 10 4 7 40. and then they're finally genes which are probably the most important set of genes that are mutated that change because when cells divide they make copying errors like a photocopier makes an error in making photocopies when Excel divide it's a photocopier it makes a change and that change happens to be in a gene that controls cell growth and that contributes to cancer so very broadly speaking those are the categories now going back to the 2000s we and as a community I'd say we had this idea that since cancer is a genetic disease then it must be the case that if we could find ways to block the products made by these genius proteins we would be very successful and many drugs came out of that a drug is called like Gleevec drugs like parasiva came out of the genetic sequencing and the genetic understanding of cancer and they were very successful some of them like Vivek are extraordinarily successful and then in the 2010s we began to feel that we're a little bit stuck that was a very humbling moment for everyone because we thought that we had solved the basic pathway not the not the answer but the basic pathway by which we would move forward in cancer research but we began to get stuck and the stuckness had to do with the idea that these genes many of these cancer genes cancer-causing genes just one great targets for drugs I'll give you an example you know I treat leukemia and when I treat leukemia I know exactly which genes are mutated I can tell you their names they're not relevant Tech to dnmt3a who knows you can call them various names and when we try to see if they could be targeted by either drugs or any other molecules we never found really good ways to Target them that was problem number one problem number two is that even and this is really really important even when we did find ways to Target them especially really the ones that were strong drivers of cancer what happened is that the cancer cancer cells because they're evolving all the time found ways to go around that Target it's a little bit like you know we would put we would find their killings here of cancer and we'd be very we'd be very happy and congratulate ourselves and we would drive an arrow into the Achilles heel of cancer and the cancer being growing so fast and evolving would just take the arrow out and throw it away yes and and to that exact point you know that's where the way that I help I think people understand is the same way was like with covet I thought we vaccinated against I think it's over the same way that viruses kind of like grow and then they get these variants right they they look different well why do I need another booster that's more comprehensive what does that mean well if that protein that you're attacking that M Spike or that M protein uh on the initial if like they just get smarter it's like the selection pressure of a viral Illness but in this in this case with therapy then all of a sudden in their desperation they're like okay I can you know undergo Calamity and basically try to find any escape to where this thing isn't needed anymore the same way when we walk hormone cancer it's often a misconception that the cancer is evolving as we give the therapy that's not the case the cancers and the viruses because they're mutating all the time and they have what's happening really is that there's already and I have to emphasize this there's already a variant that is resistant correct and all you're doing is killing off everything else and selecting that variant exactly um this was a big realization actually cancer doesn't have a brain and viruses don't have brains either but they do have mechanisms by which they mutate and if you have a billion of them then there's a chance that one of them has already even before you start the therapy has already developed a mutation that will cause it to resist your therapy so then the term I'm happy you said that because the term you know we had Dr Keith Flaherty talking about you know in some sense like the immune system play and everything like that but we use this term Escape mechanisms but to your point and it's a very good one is when people say well oh chemo you know they actually are not carrying the cancer on purpose right that's one of the things I get on social media and it's like it's hard to explain why after nine months to 14 you know 18 months especially like you said egfr it's aggresso and all these things it's hard to explain to somebody short of testicular where you can cure it with chemo why how you can't see anything but but it still always comes back and and there's this you know you learn from kind of opinion because I think it's better to just like accept where it's coming from then fight it and the thought is well then why is it coming back how come if it all went away comes back into your point and even that term Escape mechanism which they always talk about in colorectal with like oh well now they're not using this pathway what you're saying is it wasn't an escape it was it turned out to be an escape like in retrospect because it already underwent something that was not going to be this basically vulnerable to what the initial chemo and the initial tumor burden was that's what all the science shows thus far that makes so much more sense that the mechanism by which a cancer stops responding to your therapy even if it started your therapy is not because it has a brain and we figured out that you know this is the way I'm going to escape it it is because it already possessed a mutation that allowed would have allowed it in any case to escape the toxicity of the of the drug this has many many many consequences we can come to that in a second it has many consequences for how we think about therapy how we build therapy but we can come come to all of that in a second all right now in the 2000s we thought that if we found enough drugs that would kill the cancer cells targeted drugs especially we would Conquer Cancer and some of them were very successful we talked about we talked about really that being really the best example for a cancer called chronic biologinus leukemia or CML Gleevec really takes that cancer and puts it into one of the most profound remissions that has ever existed we were so excited and we thought that all cancers behave like this and you know we'll find these Achilles heels for all cancers pancreatic colon Etc and that's how things are going to go ahead and then reality things it hits slowly and slowly and now it's hit really hard and by heart I mean that we've tried now we've found in two problems problem number one is that cancers some genetic mutations that are in cancers we don't even have drugs for and we can't even seem to find them problem number two is that when we do find them they have that same they undergo resistance the most striking of these is after Decades of work we found a drug a group led by Kevin showcat and others found a drug that was exquisitely specific to block a pathway that was that is considered one of the central mechanisms of many many cancers and when they use the drug the extension of life was like 11 months or 10 months the cancer is resistant and all the patients died similarly work done by Lou Cantley who supports my collaborator will talk about all of that found drugs against another very prominent Gene that's mutated in cancer called B10 same story when they you know when it was applied the extension of life was a few months but to your previous point do we call it resistance then or is it that it just satisfied the initial like you know tumor biology and molecular sequencing of what we biopsied and really just were already behind the new one that was going to be P10 resistant or previous one you mentioned it's you know you don't mean like the semantics then because you really like injected this interesting thought to me about how is it escapes is it resistance or is it just sheer Serendipity of sorts like fortunate for the cancer where it's already ahead of you like you've already had this very that exists all right yes so let me say a few things about that Bert robot scene who's probably one of the smartest cancer researchers on the planet always says that there are three zeros between one billion and one billion if you have one billion cancer cells in your body that's one billion opportunities that the cancer cell has to have a mechanism by which it can resist a drug if you have 1 million cancer cells in your body it's three log or three times zero a thousand times less likely to create resistance against the drug right so keep that in the back of your mind because numbers matter but let's go back to the story that I'm trying to tell you we then began to realize that maybe it's not the cancer cell that we should be attacking only we can still attack the cancer cell but really what the cancer cell has built around itself the home the nest and that Nest has many components cancer cells need nutrients they need blood vessels they need to build a tissue environment around around themselves almost like an organ and maybe we should be instead of killing cancer cells only we should be focusing our attention on these metabolic pathways nutrient Pathways the the nests that the cancer is building on themselves the blood vessels that they draw the immune system that can or cannot look at them etc etc etc so by the mid-2000s a new idea is and was being born around cancer and that is that let's not attack just the cancer cell let's attack these homes these nutrients these metabolic pathways that cancers build around themselves and that's where I come in that's where I grew up because I like many other people was disappointed but also excited about the idea that maybe the problem is not just the cancer cell but this home this environment micro environment nutrient environment metabolic environment immune environment vascular blood vessel environment that the cancer builds around itself the advantage of these environments is that unlike the cancer they don't mutate there aren't billions of them they are relatively static and that's where I began to think that oh gosh maybe my work should be not around sequencing cancer cells and finding drugs that kill the cancer cell but rather thinking about what the cancer cell builds around itself metabolically vascularly blood vessel wise you know it's home etc etc I'm so sorry to interrupt you but the one thing that I thought think about again with these kind of allegories to just like human life as a whole is the same strategy they use in medieval times right if you had a castle and you had a whole bunch of people in there and you knew you couldn't really overtake the castle it was a strategy to basically say well heck we're just not gonna let you bring food and water and just starve the people inside and they build even in modern like War yeah right you would learn the fields around the castle and starve the people right without having to attack those Gladiators they just they starve like you're you're and they do it for war even Advanced like oh let's not let them get their weapons across this way so it's like you know they're powerful but you just want to dismantle the things that would be and that's the strategy that I thought would be very interesting that's wild and so when I launched my cancer career it was all around that strategy it was all around I don't sequence cancers I mean I sequence cancers meditate but that's not what I do as my sort of intellectual living what I do is I think about Cancers and I think about what homes they build if you think about again your analogy like who's bringing in the food into the castle what food is it and can I block the food can I block the blood vessels and that's how fire started if I had started with this idea that it's great that you know you can find drugs against the cancer but let's also block the mechanisms by which the cancers are metabolizing eating growing etc etc etc and that's the really the basis for fired as a kind of an intellectually uh the intellectual business with the company and that's interesting and because you're leveraging what we know people sometimes think of cancers like this enigmatic nebulous you know foreign thing but it's not it's it it was once a normal cell of sorts the one that started it all and it has a bunch of the tools that we know about normal cells so you're like let's extrapolate that like just knowing what the biology of cells are like and seeing if we it's almost a back door because now you're not trying to do the things that make it it's like any of those shows movies the thing that makes it so scary like this thing will never be defeated like Venom or whoever and instead of backdoor you're not trying to fight the things that make them so malignant but instead say dude I'm not gonna unless you have the tools to be able to like carry out your you know that malignant effect which is just it just so novel and then the question though would be that I think a lot of people would you know higher level and think okay but then wouldn't that starvation cause a starvation you know for your own intrinsic cells and my answer my guess would be no because they're not as hungry are not on the sixth year in that in that car very important question so there is a relatively narrow window by which in which we can find these metabolic Achilles heels so it turns out that cancers because they're growing so quickly and because they're dependent so acutely on nutrients are different from normal cells now this was known for a long time German scientists named Otto Warburg knew about this in the 1900s early 1900s if cancer is metabolize sugar differently than normal cells lots of scientists have known since that time that cancers metabolize amino acids to make proteins differently from normal cells look Handley and I showed that cancer is metabolize sugar especially when they're given stress with a drug differently than normal cells so there are in fact Achilles heels for cancers which will not affect normal cells but will affect cancer cells because the cancer cells are very very acutely dependent on these amino acids for their growth now you may have some side effects but they're nowhere near what you would expect from people it's kind of like the same concept of cytotoxic chemo somebody might say well well if it's cancer cells are normal and you're giving a poison from the yew tree taxol whatever like when they poison your regular cells yes but the reason that it's so effective and the reason for the earliest phase one and phase two is give it enough for the stuff that replicates fast and gets the damage and the ones that are slower the hair ones the GI ones may suffer a little bit more it's literally taking that concept but backwards it's like saying you know you need gas and and a change of oil at a certain frequency but if you're in sixth gear in an M5 you're going to need it something different than being in third gear at a lower speed and having a much you know less aggressive engine it's the same ish strategy of being able to like distinguish the two in the cytotoxic realm but instead in the provision realm which is like what you're providing for it to be able to execute so that's that's so interesting and then of course I think it's a wonderful questions it's not just a hypothesis it turns out that the genes that are mutated in cancer cells don't just mutate the growth of the cell or change they actually find mechanisms by which they can use these amino acids and use them in quicker in quicker ways in faster ways so it's it's like once the brakes and the accelerators have been jammed and broken in your car analogy it's as if that the entire engine begins to say I can use corn oil corn uh how they're trying to get fuel and gas with the corn products I can eat that I used to be able to use yes and that's something that no one knew but over time we and others have found that you know this is what the genes do they figure out different ways to use the gas and use the gas faster and the faster that they use the gas the more dependent the more addicted they become to the pathway by which they're using the dance in totally what happens is that they they find a mechanism and our job is to prevent them from finding that mechanism and in fact prevent them from even using that mechanism to fuel their growth often people say oh you know cancers eat sugar so you don't don't eat sugar because you'll just you know fuel your cancer stuff that's not right cancers are more sophisticated than that it's not like they're eating sugar they're metabolizing sugar and metabolizing and eating is a different thing right metabolizing means that converting chemically converting things into other substances that allow them to fuel their growth eating means obviously ingesting something so it's not like you you aren't feeding the cancer in the sense that you understand like in in the common common places what you're doing is you're you're targeting very particular metabolic pathways chemical Pathways in the cancer such that that addiction that the cancer cell has to whatever it might be amino acids certain amino acids certain kinds of sugar etc etc is disrupted so when you go to your doctor it's not like you're gonna go to your doctor and say I'm going to stop eating sugar what you're gonna have to do if fire is successful is you're going to have to find very specific and we've found them already very specific ways in which you interrupt or disrupt the metabolic pathways internal digestive system of cancer cells such that they can no longer grow that's a huge statement the internal metabolism I hope people heard that it's not your body but the cell yeah it's not your body it's the internal digestive system of that cancer cell yes yeah that's a huge point yeah so you you you cannot starve your cancer as far as we know all those people be crying this for a while you can't starve the cancer by starving yourself you could but you would die in the process that's what I that's what I kind of say I'm like it's a it's a technically correct statement yes you can solve your cancer cells but your own cells will die well before that so like it's that concept is there's no way that you can just completely block everything it's not binary one thing feed one thing not all of the ways that they process and everything are you know you just you can't without without literally killing a person in the process exactly so instead what you do is you find a particular internal digestive system of a cancer cell find the molecules that are part of the internal digestive system of the cancer cell that make it vulnerable to particular nutrients and you block that internal digestive system without causing you know you your whole body to starve and there's a there's a line or a window by which you can do that after a certain point of time if you kept doing that your whole body would start starving so somewhere in that window there's a sweet spot there's a sweet spot and bias and we and all our scientists have found such sweet spots there's not one there are many there are amino acids they're kind of sugars etc etc etc but it's not like you know you can say to yourself I'm not going to eat any protein and my cancer is going to go away it's not going to happen you have to find as I said the internal metabolism of the cancer and we have Target those and make sure that that doesn't affect the rest of the body but slows down the growth that makes sense that makes perfect sense and I think the next question that if anyone listened to previous podcasts is I had one where I really wanted to delineate you know the kind of almost rudimentary way we thought of histopathology as like oh this is how the Cancer's gonna behave it's like oh it's it's I don't know of the lung or you know whatever and and you know these episodes help people appreciate how dude it's so much more than that it's not just the histopath it's like okay proteanomics is it hurt too positive or not and then okay now we're talking molecular so the same way all that stuff is complicated and then you know if you can use your bracket pathway or not we've we've dissected all these things my next question I think some of the viewers would say is okay Dr Mukherjee is this a carbon copyable observation or is it something that you need to take your own like somatic tissue of that cancer cell don't put it in formalin take it and actually study that kind of like particular fingerprint and blueprint of that cancer cell or does everything look like it's actually you know applies in some correlation to either a molecular profile or just even the histopath I suppose for that quote-unquote pancreatic or whatever that tumor may be so it's an incredibly important question how personalized does this have to get um and the answer is that so far it seems as if these mechanisms are relatively General I'll use the word relatively because it has a little bit of a dependence on what genes are mutated because some genes are particularly good at as I said hijacking the fuel and those of course are the cancers that we want to send Achilles arrows right some genes that are particularly good but those but it's they're not like weirdly uncommon Gene these are common genes that are commonly mutated in cancers so it's not like you have to do an incredibly complicated histopath right or it can be complicated genetic pathology on the cancer and then come back and say oh you know I'm going to only make a particular diet for you that's specific for you it's much more that I would say that your cancer like 15 others or 20 others or 100 others or 500 others has a gene that has a particular capacity to use this fuel we know this because of experimental data so the diet that we're going to prescribe for you is X or Y right so you've observed that like you've like and that's that's the that's the answer right in in real scientific models yes right this is not this is not a hypothesis right this is like and that's that's the answer there is is when somebody says well Sanji you always talk about like Precision this is because that is remember the the closest thing to a fingerprint without taking the cell is just doing the sequencing If You observe that hey if it has x x z double zero it seems to like use these amino acids XC double zero ooh Let's test it oh yep sure enough they all be in the same way I mean that's how you that's that that isn't a very basic way how we treat hormone positive breast cancer if it has R2 you use it if you don't don't doesn't mean like eventually down the line maybe the not working this and that but we know that works and that's why a lot of people see it disappear up front so that's super cool and interesting now and I'm sure you were getting to this I'm just going to swipe it a little bit sooner but we've said many times and I've said and Keith Flaherty says that most expensive freedom I know you do because I already know the answer to this so forgive me but but that the way we're gonna like control cancer for a long time if not cure all cancers but at least control is going to be a multi-modality thing right so you talk about immune therapy and your podcast with Peter and Tia and how phenomenal it was you're re-enabling something that's always been doing what it's doing and got tricked for a moment you took off that you know invisible cloak from Harry Potter and all of a sudden it gets exploited and it gets attacked so you talk about immune therapy we talk about this cytotoxics when that's appropriate for the replication we talk about targeted therapies can this be done can I attack it from both ends can I attack that driver that that Thor hammer that the cancer is trying to use and I hopefully can Target it or I have to use cytotoxic just because it's so fast chemo but can I also then like Rob them if it's you know calories and hydrate and get them into an Aki basically by starving is it possible to attack it from both ends or even triple end if we can incorporate them into every one day of course it matters on the cancer type but surely you can if this could be used concurrently with with standard care Target therapies and cytotoxic I mean that's just that just feels good yeah combination that's amazing there's absolutely no reason that we aren't using most of these therapies and economies and that's why I said it's important to think about numbers I love numbers I'm sure you love numbers um there's a difference between 1 billion one trillion and one million so what do we do a one rational way and there may be many rational companies but one rational way to do all of this would be when you have a big tumor and you have a big tumor burden you use cytotoxics to kill most of your cells so you do a one billion to one million reduction now why does that help it helps for many reasons but the main reason it helps is it gives the cancer 1000 less chances of the communities oh see I don't think to highlight that that's so true it's the Rapid Way of just trying to reduce the chance of these like variants that get smarter ah that gives an interesting point to using immunotherapy alone for a high pd-1 versus like you know and against extrapolation versus Triple agent because yeah you might say oh this could respond well but we know immune therapy takes a while versus like if it's high burden lung like you know arguably so interesting why wouldn't you want to knock it downside reductively and incorporate that immunotherapy that's such a huge point that it's never been brought up on these shows I'm so happy you said that so the first thing that you would do rationally speaking is cytorejaptive therapy and it's cytoductive for several reasons of course it relieves some symptoms but more importantly it reduces the number of chances that the cancer has to create a resistant mutation and if it's a high disease break if you've got the cancer super early you don't need cyroductive therapy because you're already not at one billion cells but at one million cells all right now you reduce the cancer burden and now you use multiple angles of Attack One angle of attack is to use nutritive therapy so that you can starve the cancer the second angle of attack is that while you're starving the cancer you use targeted therapy and the third angle is that we've now learned over and over again that immune therapies don't work for many Cancers and we started figuring out why that's because cancers invent a kind of shell around themselves a shell of other cells a nest a home a citadel a port whatever you want to call it and immune cells can't get in there the nice thing about using targeted and nutritive Therapies is that the cancers can no longer attract the shell and what happens over time is that their capacity to build this cell around themselves becomes less and less possible and that's because they don't secrete the factors that draw out the cells that form the shell so what you do then is come back with some kind of immune therapy as either maintenance or as down the road so there is a path forward but it has to be rational logical and sequenced so you do cycle reduction to reduce mutational burden that's the immediate threat that's the day-to-day threat of having this recurrence right resistance you use cyroductive therapy and then you slowly begin to joke and paralyze the cancer and as you choke and paralyze the cancer imagine going back to your analogy of the Citadel right The Citadel if you burn the fields around the Citadel if you burn the fields around the fort people in the fort can't come out anymore and start planting new Fields so what that happened was that enables it to happen is that the immune cells can start going in and potentially restarting an immune reaction and we have other companies and other programs I have and others have other programs to do exactly that is that once you've burnt the field once you've burnt out the supply chain as it were for the cancer cell you then come back with immune therapies of various sorts so that now they can enter the fort and start killing the cells themselves so it's all it has to be done sequentially and thoughtfully and there's there are many blockades we can talk in another program about what the blockades are there's farmer companies that won't collaborate there are some that will collaborate blah blah blah but there is a road forward and the road forward is not just absurd it's not nonsense it's it's very logical right he says that they're like you build one on top of the other right it's not like you're just like oh I think one day like no it's like we're we're finding the different ways to really you know beat that thing or not even that I hate to use singular terms but but like you said the sequence and that's the point we haven't hit well is very important I'll do one more on top of that I don't know how you feel about it but I actually have a podcast coming up and I'm a buddy of mine he's a PhD uh he went to Juilliard in person anyway he said someday the reason people aren't talking about this because it's not sexy it's not talking to therapy but what they're looking at is basically to putting like high intense like triple levels of chemotherapy intra-tumly with an injection to do what's called antigen presenting cells antigen presenters same story and then you do that immune system to hopefully give it even more targets to hone on exactly the same story you think that you know you do high doses of therapy into a tumor to kill the tumor that's not the reason you're doing the high doses no you're doing it get it out the immune system so that it can now go to other tumors and there's a fancy name for it it's called the abscopal effect it's me it means that a tumor in your left arm if it gets an appropriate immune response all of a sudden those immune cells can go to the tumor in your right arm because they've been educated exactly and they know how to kill the cells in your left arm so they now know how to kill the cells in your right arm or whatever but that said there's a logical way to move forward and we are in the middle of that logical way and and the only way that we can do that and this is going to be my last Vlog is to restore what was broken by covet which was The Temper trial system we have got to restore the clinical trial system because the clinical trial system was desperately broken by covert nurses left coordinators left positions left Emergency Room Physicians left so we need to restore it so that all of this knowledge that we're collecting including the knowledge that we're collecting in fire can now become converted into clinical reactants that's huge that's one of my big pushes lately because when people say well why we haven't found Doug cure again singular but why didn't this have any other it's because you need the data to show and now I explain how phase one and phase two there's a reason people say well trials or guinea pigs this and that because back in the day back back it's like you drip enough poison to see if it kills the human subject or not that was science season and Mad Hatter stuff we are light years away from what that was right like that was that was available inside of toxic in the face who doesn't work now it's like a lot of what we're doing is stuff that we already know works with cell allergy or with targeted even you know things in other tumor types it's more like that splitting hairs and then splitting the Keratin cells and stuff to really be able to say these are the constituents and like you said the sequence I'm so glad you said that because I keep saying multi-modality but we mean multi-modality in sequence that is going to help just dismantle it's kind of death by a thousand paper cuts it's like if you can't beat the person and also the sequence is scientific yeah scientific it's not like right spaghetti on the wall it's one by one by one and the read and there's a reason behind it right because we know the science um normal cells and family we've studied we're taking where you use this term at some point on the shoulders of those you know before us we're literally taking what we've learned in observation stuff even if it didn't directly relate to pancakes taking those Concepts which is why can't which is what science is and attacking essentially something that is again a normal cell but we're doing it based on completely you know observational understood Concepts and that's huge now on that note I'm going to use this analogy and you're probably going to want to just throw up and or never talk to me again but but tell me if this kind of makes sense for our viewers like little 30 60 second clips about really like Salient points that you're making and to your point about sugar and sugar metabolism and starving it and not starving it and how you're saying it's not just a matter of like if you have it but it's what you do with it what came to mind oh my God I'm so embarrassed like hero is gonna I'm gonna say this if you get into a doggy hot dog eating contest and you didn't know how that hot dog eating contest worked and somebody said you're going to eat as much as you can this has some big guy that's just the dude I can put down some hot dogs he will unequivocally lose right he's just gonna try eating hot dogs and imagine a world where you only had hot dogs for for that matter the reason he loses is not because he can't eat or eat fast it's because when you see a competition you notice the way they're using it they like put in the bread first put in the water make it like much easier to swallow so they don't struggle and then like chop up the There's an actual complete it's the same stuff a hot dog and Devon and the water but they use it in a manner that completely if you took away the water that person that's the best in the world cannot win like you just cannot win if you made them do the water at the end or just the beginning he cannot win so you've taken the arguably what's his name or whatever you haven't changed the person which is the cancer cell you haven't changed the tools which is the the bun the the wiener or whatever the PC term is and water but you've done something about it to where you've dismantled that guy from winning any competition just because of what like of how it's used and again that's a very rudimentary example but I hope that can help people appreciate it's like oh it's not a simple thing of just take all the hot dogs like obviously then nobody can eat but there is some ways to use like with limitations you can only use this much water versus an amateur use it more and more um that you just came to me I mean based on your description but but I think it's pretty accurate it's exactly right which is that it's not that we're removing sugar or nutrients from the environment it's the way that we are removing the mechanisms or the internal what I call the internal digestion of a cancer cell that allows the cancer cell to succeed over a normal cell that's right that's the difference that champion is still like like he's still the fastest whatever under those circumstances but he's robbed and you didn't do anything to him you didn't change his mouth his tongue his taste nothing you just you just monopolize the way that he was able to like put himself ahead of the rest that's why amateur will never win this is amazing it's a great way a very surprising way to end with you know something so amazing with hot dogs it's America for you Dr Mukherjee this was a true honor true pleasure I'm I just can't wait to start funneling and helping people that are really you know the one thing about covet is it made people very curious and feel more ownership and responsibility and wanting to have some empowerment and control over their medical decisions and especially when it relates to cancers I think that is some you know the positive where we can capitalize this is going to help we're gonna funnel people there because people care about diets and care about these things and I'm just so excited and the only thing the last message is enrolled in clinical trials because if you don't or if one doesn't uh nothing will advance 100 thank you so much this is amazing [Music]

Channel: Target Cancer

Views: 128,627

Keywords: target cancer, target cancer podcast, sanjay juneja, sanjay juneja tiktok, cancer podcast, the onc doc, the onc doc tiktok, cancer therapy, how does cancer work, what is cancer, pancreatic cancer, pancreatic cancer treatment, pancreatic cancer cure, life saving diet

Id: wvgzHPXaD10

Length: 44min 47sec (2687 seconds)

Published: Wed Nov 09 2022