<p><a href="https://peterattiamd.com/keithflaherty2/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230821-pod-keithflaherty2&utm_content=230821-pod-keithflaherty2-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230821-pod-keithflaherty2&utm_content=230821-pod-keithflaherty2-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230821-pod-keithflaherty2&utm_content=230821-pod-keithflaherty2-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>Keith Flaherty is the director of clinical research at the Massachusetts General Hospital Cancer Center and a previous guest on The Drive. In this episode, Keith first delves into the statistics on cancer's prevalence as we age, underscoring the significance of finding effective treatments and early detection methodologies. He touches on the history of cancer therapeutics and illuminates the notable enhancements in cancer therapy within the last decade that are setting the stage for a promising future. He goes into detail on the potential of immunotherapy and therapies that can combat cancer's evasive tactics while explaining some of the existing challenges around specificity, cost, and scalability. Additionally, Keith highlights the significant leap in early detection methodologies, namely liquid biopsies, which have the potential not only to determine if a cancer is present in an early stage, but also identify the possible tissue of origin.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Keith's interest and expertise in cancer [3:15];</li> <li>Cancer deaths by decade of life, and how cancer compares to other top causes of death [7:00];</li> <li>The relationship between hormones and cancer [12:00];</li> <li>The link between obesity and cancer [18:45];</li> <li>Current state of treatments for metastatic cancer and reasons for the lack of progress over the decades [22:30];</li> <li>The interplay between the immune system and cancer cells [32:00];</li> <li>Different ways cancer can suppress the immune response, and how immunotherapy can combat cancer's evasive tactics [39:30];</li> <li>Elimination of a substantial portion of cancers through immune cell engineering faces challenges of specificity, cost, and scalability [52:15];</li> <li>Why TIL therapy isn't always effective, and the necessity for multimodal therapy to address various aspects of the cancer microenvironment [1:01:00];</li> <li>Potential developments in cancer therapy over the next five years: T-cell activation, metabolic interventions, targeting tumor microenvironments, and more [1:06:30];</li> <li>The challenge of treating metastatic cancer underscores the importance of early detection to improve survivability [1:19:15];</li> <li>Liquid biopsies for early detection of cancer and determining the possible tissue of origin [1:24:45];</li> <li>Commercially available cancer screening tests [1:33:45];</li> <li>How to address the disparity in cancer care, and the exciting pace of progress for cancer detection and treatment [1:40:15]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights
1. Manage Obesity to Reduce Cancer Risk
Recognize obesity as a significant carcinogen, comparable to UV radiation and smoking, due to its systemic effects like inflammation and altered metabolic signaling (e.g., high insulin, IGF-1 levels) that drive cancer. Actively manage obesity to reduce your cancer risk.
2. Utilize Current Cancer Screening
Regularly engage in established cancer screening protocols such as mammography and colonoscopy to detect cancers earlier, acknowledging that while not perfect, these methods can significantly reduce the risk of cancer death, especially when combined with other diagnostic tools.
3. Secure Expert Guidance for Liquid Biopsy
If you opt for advanced blood-based cancer screening, ensure you have access to a medical professional or a network of specialists who can expertly manage a positive test result, as the medical community is still developing standardized protocols for follow-up and diagnosis in these early detection scenarios.
4. Seek Expert Navigation for Cancer Care
When facing a cancer diagnosis, actively seek expert opinions and leverage specialized resources (e.g., N of One, Xcures, or similar platforms) to navigate complex cases, understand all available treatment options, and identify promising clinical trials, as access to specialized knowledge significantly impacts care quality.
5. Explore Advanced Blood-Based Cancer Screening
Consider advanced blood-based cancer screening tests (e.g., from Grail, Exact, Delphi) if you are an early adopter and understand the current limitations. These tests aim to find cancers at earlier, microscopic stages, but their adoption requires careful consideration.
6. Maintain Immune Surveillance Against Cancer
Understand that a healthy immune system plays a critical role in identifying and eliminating pre-cancerous cells. Support your immune system through general health practices, recognizing that profound immunosuppression can increase cancer risk.
Familiarize yourself with the varying prevalence of different cancer types across age groups (e.g., certain aggressive cancers in younger individuals, smoking-related and hormone-driven cancers in older populations) to better understand personal and population-level risks.
8. Embrace Multimodality Cancer Therapy
For future cancer treatment, be aware that the most effective strategies will likely involve a combination of therapies, targeting different aspects of cancer biology (e.g., cancer cell mechanisms, metabolic environment, immune cells, microenvironment) in a personalized approach, rather than relying on single-drug regimens.
Recognize that new therapies are being developed to target cancer’s unique metabolic dysregulation, specifically focusing on regulators outside the mitochondria and mitochondrial biogenesis. These approaches aim to potentiate existing treatments and overcome resistance, offering significant promise for improved long-term survival.
10. Understand Mutation-Inducing Therapies
Be aware that some conventional chemotherapies (e.g., platinum-based, alkylating agents) can be strategically used to induce more mutations in cancer cells. This can push them past a survival threshold and enhance their recognition by the immune system, potentially making them more susceptible to immunotherapy.
11. Subscribe for Advanced Longevity Knowledge
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