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Cancer, it's a word that if I say it to somebody you have cancer this is like hitting you on
the head with a club. It's a life-changing event no matter how you look at it. My goal
is not to be aggressive as possible and kill everything, my job is to make cancer a livable
manageable condition so that you live with cancer rather than dying with cancer. And
this really is or are the lucky years with regard to cancer. I want to talk about two
kinds of fundamental shifts that are happening now. The first is what we call immunotherapy.
When cancer cells happen they have a don't eat me signal on the surface. Well, we now
have the ability, and there are drugs that are approved that block that don't eat meat
signal and allow the immune system to come in and basically eat the cancer.
We've seen this work with a remarkable 90+ year individual named Jimmy Carter, our former
president. And we've seen it work with many other patients. So cancers like skin cancer
melanoma, like kidney cancer, some types of lung cancer and others have had some pretty
dramatic results with this immunotherapy and it's only getting better. We're learning how
to harness the power of our own immune system to attack cancer literally more on a daily
basis. Number two is what we call precision or personalized medicine. And they mean the
same thing. And there's a lot of confusion out there some call it precision medicine
or personalize, they're the same thing. And what it means is that I can now, for example
if you have cancer, I can take a piece of your cancer and sequence the DNA and look
at what genes are turned on and what genes are turned off and hopefully develop a way
to turn off the driving genes. And it works. And it works in many of the patients, not
all. In many of the patients we don't yet know the drivers. We don't have drugs to turn
off every gene, but I can sequence the DNA of the cancer and develop a personalized therapy
of that patient. So there may be a drug that was FDA approved for breast cancer, that gene
is driving lung cancer and I can use it in that patient.
You know, in the 1800s in Europe they started to classify cancer by body part. You have
breast cancer, you have prostate cancer or lung cancer. The next generation of students
of doctors are going to classify cancer by what are the on switches and the off switches
and it doesn't matter what body part it originated. At the same time, there's another way of thinking
about cancer. Because historically we would say we have got to target that cancer cell
and kill it. Well, to me cancer is a verb and not a noun. You're canering, something
the body does and not that the body gets. And so that philosophy needs a very different
way of approaching disease and it means changing the system in addition to trying to target
the cancer. So, for example, there was a trial done about a decade ago where they took women
with premenopausal breast cancer and normally we treat them and then wait for the cancer
to reoccur and we treat again. In this group of women after treatment we divided them into
two. Half got a drug that builds bone that was meant for osteoporosis and half got a
placebo. And the cancer recurrence was reduced by about 40 percent. Why? Because breast cancer
metastasizes to bone. So if I change the soil the seed doesn't grow.
So one of the most remarkable advances in cancer was from a drug that didn't even touch
the cancer. Just this week we announced a trial where patients with advanced prostate
cancer who are on aspirin do better because aspirin blocks inflammation. There is data
out of there that across the board with every cancer people who are on a statin, as the
Lipitor/Crestor's of the world, that those patients do better than patients who were
not. Why? Again, because those drugs block inflammation and inflammation allows cancers
to change more over time. So if we can block that change we can get a better outcome no
matter what cancer no matter what treatment. So we're learning a lot, new ways to target
the cancer and treat it, immunotherapy, molecular targeted therapy, and at the same time looking
to change that system so the cancer doesn't want to grow. Because remember, if you drop
a match after it rains, nothing happens. If you drop a match in Los Angeles it goes up
in flames. I want you, as an individual, to be much more like after it rains than to be
like that sunny Southern California.