← The Peter Attia Drive

#32 - Siddhartha Mukherjee, M.D., Ph.D.: new frontiers in cancer therapy, medicine, and the writing process

Dec 10, 2018 1h 5m 13 insights
<p>In this episode, Siddhartha Mukherjee, oncologist, researcher, and author of the Pulitzer Prize-winning book "The Emperor of All Maladies: A Biography of Cancer," discusses his writing process, his thoughts about medicine, cancer, immunotherapy, and his recent collaboration on a study combining a ketogenic diet with a drug in mice that provided remarkable and encouraging results.</p> <p>We discuss:</p> <ul> <li>Sid's background [<a href="">5:00</a>];</li> <li>How Sid and Peter met [<a href="">6:00</a>];</li> <li>Sid's Pulitzer Prize-winning book: The Emperor of All Maladies [<a href="">8:00</a>];</li> <li>Sid's writing process: the tenets of writing [<a href="">12:30</a>];</li> <li>Our struggle to find preventable, human, chemical carcinogens of substantial impact [<a href="">23:30</a>];</li> <li>The three laws of medicine — Law #1: A strong intuition is much more powerful than a weak test [26:30];</li> <li>Law #2 of medicine: "Normals" teach us rules; "outliers" teach us laws [32:00];</li> <li>Law #3 of medicine: For every perfect medical experiment, there is a perfect human bias [35:00];</li> <li>The excitement around immunotherapy [38:15];</li> <li>The story of Gleevec [46:00];</li> <li>How does the body's metabolic state affect cancer? [49:30];</li> <li>Can a nutritional state be exploited and/or a drug sensitivity be exploited through a nutritional intervention? [52:00];</li> <li>How does Sid balance his family, writing, research, laboratory, and patients? [1:00:30]; and</li> <li>More.</li> </ul> <p> <span> Learn more at <a href="http://www.peterattiamd.com/"><span><u>www.PeterAttiaMD.com</u></span></a></span></p> <p> <span>Connect with Peter on <a href=""> <span> <u>Facebook</u></span></a> | <a href=""> <span> <u>Twitter</u></span></a> | <a href=""> <span> <u>Instagram</u></span></a>.</span></p>
Actionable Insights

1. Identify and Challenge Biases

Actively seek out and identify the inherent biases that may be influencing every claim or idea, as recognizing these biases is crucial for skeptical and scientific thinking in all aspects of life.

2. Apply Bayesian Thinking

Interpret new information or test results by considering past performance and prior probabilities, as the past is a strong guide for understanding the future in many aspects of life and decision-making.

3. Learn from Outliers

While generally applying Bayesian thinking, pay close attention to rare exceptions or ‘outliers’ because they can reveal fundamental laws and deeper understandings not apparent from normal cases.

4. Start and Persist on Projects

To achieve ambitious goals, initiate by ’throwing something at the world’ (e.g., the first line, experiment, or idea) and then persistently iterate and refine it, continuously asking questions.

5. Let Your Work Speak Back

Cultivate an openness in creative or scientific pursuits to allow your work or experiments to ‘speak back’ to you, engaging in a skeptical conversation with the emerging results to guide your next steps.

6. Ground Complex Information in Humanity

When communicating complex scientific or technical information, ensure a human element is present every few pages to make the content relatable and clarify its real-world payoff.

7. Craft Content for Broad Appeal

Design content for universal readability and multiple layers of interpretation, enabling diverse audiences to find it engaging and relevant from their unique perspectives.

8. Focus on Applied Research Impact

When evaluating or discussing scientific research, prioritize findings that have a clear manifestation in human medicine, such as new drugs, treatments, or fundamental reconceptions of disease management.

9. Address Obesity as Cancer Risk

Take the link between obesity and certain cancers seriously, as it is becoming a significant preventable risk factor, though the underlying mechanisms (endocrine, inflammatory, metabolic) are still being understood.

10. Ketogenic Diet: Specific Cancer Context

Do not self-prescribe a ketogenic diet for cancer prevention or treatment, as current animal studies show it is effective only in specific contexts (e.g., combined with PI3 kinase inhibitors) and can even accelerate some cancers when used alone.

11. Utilize Podcast Show Notes

Review the podcast’s meticulously prepared show notes, especially for challenging or technical content, as they contain comprehensive information and links to enhance your understanding.

12. Join the Podcast Email List

Sign up for the podcast’s weekly email list to receive valuable content, including interesting papers and observations, shared every Sunday morning.

13. Provide Podcast Feedback

Leave a constructive review (positive or negative) on Apple Podcast Reviews if you enjoy the podcast, to provide feedback and support the show’s continued improvement.