one in three of us will be diagnosed
with cancer in our lifetimes one in
three is a big number so look to your
left and look to your right if it’s not
you it will be the person on your left
or on your right and if it’s not you or
your neighbor it will be a brother or
sister or it will be a parent or child
cancer is an insidious disease it robs
patients of their appetite their energy
their strength their stamina it robs
them of their independence and in many
cases their happiness it’s an unfair
disease and it is no respecter of
persons so one in three is a big enough
number that we ought to just plan on it
in fact better yet let’s start thinking
about how we can help our friends
families and neighbors when that
diagnosis comes what can we do what will
we do to help them how can we help
ourselves well I think a clue comes from
our furry mammalian friend the house
mouse and you may be wondering what in
the world does the house Mouse have to
do with how we’re going to attack cancer
well it turns out that we share about
95% of our DNA in common with mice
that’s another big number 95% I think
there’s a couple of things to learn
there the first is apparently it doesn’t
take much additional DNA to learn speech
or how to walk uprightly more
importantly and and and maybe more
seriously it means there’s probably
something that we can learn from mice
and there is recently a scientific
publication looked at two groups of mice
and these mice develop cancer and in the
first group mice that developed cancer
were placed off to the side alone by
themselves separate from the rest of
mice in the second group when a mouse
developed cancer it was placed in a
group of mice and it became the mouse in
the middle of that
would you like to guess which mice lived
longer and were stronger and did better
yeah absolutely it was the mouse in the
middle was the mouse that was left in
the group those mice lived longer and
we’re stronger and did better when mice
are engaged and have social interaction
they do a lot better and we who are 95%
identical to mice are no different so
that’s our first clue in in asking what
can we do when that diagnosis comes well
let’s make our friends family and
neighbors the mouse in the middle
think of the power of that statement the
mouse in the middle let’s surround them
with the social network that they need
let’s empower them let’s lift them up
and strengthen them if sick place the
mouse in the middle if sick place the
friend family member or neighbor in the
middle I’ve seen this in action one of
the great joys of my life is the
precious opportunity I have to take care
of cancer patients I love it I get to
meet people when they become the
one-in-three sometimes we have an
opportunity to cure and that can be
exhilarating and sometimes we don’t have
the opportunity to care and that’s
really hard I spend time counseling and
hugging and laughing and grieving and I
love all of that I’ve learned that
there’s a lot that happens during that
time I’ve learned that the relationship
between a cancer patient and their
doctor is like nothing else in medicine
and I think maybe like nothing else in
life so it is through that lens that I
have watched patients I have seen those
who are the mouse in the middle I get to
sit on the other side of that exam room
door in the clinic and I see patient
after patient come in and it’s amazing
those who are the mouse in the middle
it’s easy to spot they come and they’re
always accompanied by someone and
usually it’s the same person at every
single visit it’s a spouse or a devoted
child it’s a parent or a sibling or a
neighbor and often they come in groups
and when they come it they look like
they’re coming for a day-long event they
come carrying bags and magazines and
drinks and treats and snacks and they’ve
got their
iPads and they’re ready to go and
they’re wearing matching t-shirts and
they’ve got wristbands and headbands and
and it’s inspiring the point is they
come in support they come with their
arms around that person ready to support
them and those who come and support are
there to help listen to the plan they’re
there to help think through what’s
happening they’re there to share in the
good news and they’re there for the bad
news they’re there to help think through
decisions and sometimes they’re there to
help lighten the mood when that’s needed
in contrast I have seen patients come
who are not the mouse in the middle and
they have little or no support and
that’s tough that strength in numbers is
missing that Mouse in the midle
phenomenon is absent and it’s really
apparent now if you or someone you know
is that person that doesn’t have support
or for whatever reason has not wanted to
allow that support into your lives I
invite you to reach out and find a
friend we live in a world that where
it’s increasingly easy to become
isolated we interact through social
media and on digital devices we can have
a thousand friends at our fingertips but
we need one who will physically hold our
hand we can have hundreds of friends
online but whom would we call if we
needed a bowl of soup so I invite you to
reach out and find that friend I am
certain that there are people waiting
for the opportunity to experience this
with you I know that there is a friend
waiting for the privilege of standing
shoulder to shoulder with you when you
become the mouse in the middle you you
harness the power of an amazing social
network now the next step after that
after we have embedded ourselves and
surrounded ourselves with community
friends family and become this mouse in
the middle is that we want to get in the
middle of our medical care as well there
are several recent advances happening in
cancer care right now that are
absolutely transforming the way we treat
patients it’s like nothing we’ve ever
seen where
a confluence of science technology and
medical care that is allowing us to not
only surround people but target that
Mouse in the middle with precision and
let me just illustrate this point five
years ago if someone had been diagnosed
with lung cancer they would expect to
have a workup that in would include CT
scans and biopsies and pathology reports
and meeting with doctors and nurses and
then ultimately they would receive
chemotherapy and radiation well in many
cases that would work in some cases it
wouldn’t in the cases where it wouldn’t
the options after that become quite
limited today however five years later
there’s a much different scenario that
same patient diagnosed with lung cancer
would expect to have quite a different
workup now they would still have the
same CT scans and biopsies and meeting
with doctors and nurses but they would
also expect to have a really
comprehensive genomic analysis and
that’s a big word but it’s really cool
they can expect to have DNA pulled from
their tumor and looked at to find the
specific genes that were changed in
their tumor that caused just their tumor
to grow in a very individualized way in
addition they would expect to have a
whole protein analysis so now they have
genomic analyses proteomic analyses in
addition to all of these other things
and this new approach has a name it’s
called precision medicine and precision
medicine includes all of these things as
mentioned the CT scans health history
medications and now these new approaches
including looking at your DNA
immunotherapies and others this forms an
additional ring outside of that social
network now we have precise medical care
in addition to the social support and
the results are are terrific that lung
cancer patient that I mentioned
diagnosed five years ago would expect to
have a survival measured in months
that’s that’s tough to swallow today
that same on cancer patient if they have
certain genes or certain protein changes
they could expect to have a survival
measured in years or long
pretty terrific changes and there’s more
in addition to these targeted treatments
and DNA analyses there are new immune
treatments immune therapies we actually
recently have developed the ability to
awaken a patient’s own immune system to
recognize cancer and attack it as if it
were foreign but that’s pretty cool my
favorite example of this actually is a
drug that has recently been approved and
is available it’s given by IV and it’s
an antibody because it’s an antibody
it’s just like the antibodies that our
bodies make normally so it has very few
if any side effects and the way it works
is that cancer cells unfortunately are
pretty smart they have figured out how
to evade our natural immune systems and
they do this by putting proteins on
their surface so these immune cells have
these excuse me these cancer cells have
these little proteins on their surface
and when an immune cell comes in contact
that protein says everything here is
fine go away and that’s what happens and
then the tumors free to grow when we
give these immune therapies or
immunotherapies these antibodies come
and stick on those proteins and mask
them so that now an immune cell comes in
contact it doesn’t get that signal that
everything’s okay it actually recognizes
the cancer cell as foreign it attacks it
and eliminates it like it’s supposed to
do the results can be breathtaking we’re
seeing responses that we’ve never seen
before it’s it’s totally exciting now it
doesn’t work for everyone and there’s
lots left to do the point is precision
medicine immunotherapy this whole social
approach the cancer care is not your
father’s cancer medicine this is this is
a new era in every way and it’s totally
exciting now
the next step after being in the middle
of our social network and being
surrounded by precision medicine and
remembering a precision medicine really
is defined by medicine that is genomic
in nature takes into account our
molecular and personal information to
inform personalized health treatment
plans that that
the essence but it really is is reactive
and and that’s okay but as we engage
that precision medicine and social
network we see something very
interesting that happens which is this
target phenomenon and at the bullseye of
that target is the mouse in the middle
in other words we surround that mouse in
the middle of that patient with all of
the social support they need all of this
sophisticated healthcare and it’s all
focused on that single individual and
that’s exactly what we want that’s how
we get the best outcomes the only thing
that is better than treating cancer in
that way would be to prevent cancer and
that’s the next concept the next layer
which is precision health
let’s go beyond precision medicine which
is reactive and let’s pursue precision
health which is preventive and precision
health is really defined similarly to
precision medicine it’s the application
of precision medicine principles these
same genomic molecular personal health
discoveries but applied now to
populations with the with the goal that
we are going to keep people healthy as
long as possible we are going to help
patients live the healthiest lives
possible in the past precision health
has meant let’s do things like get our
cancer screenings and honestly that’s
the best thing that we can do when we
found when our friend or neighbor is
diagnosed
let’s not only surround them with social
support but let’s make sure that we
ourselves are getting the screenings we
need so that we don’t have now two
people with cancer right the only thing
worse than having one person that we
he’ll have to try to get through this
very difficult thing is to have two
people or three people so when we follow
precision health we do things like get
our mammograms when we’re 40 and get
colonoscopies when we turn 50 and wear
sunscreen and all of these practical
approaches increasingly we are seeing
that precision health also means getting
DNA testing imagine if we could draw
blood from everyone here tonight today
and then we could look and see if you
inherited genes from your parents that
would place you at risk for too
helping a cancer in your lifetime it
turns out 10% of all human cancers are
inherited they arise because they came
from a gene that you got from one of
your parents 10% that’s another big
number so imagine if we could prevent
all of those cancers that’s tens of
thousands it’s actually hundreds of
thousands of cancers a year in this
country alone that we could prevent and
that’s what’s coming is the opportunity
to add to our traditional screenings
this layer of molecular and DNA
screenings looking for people who have
inherited cancers well my my hope and my
belief is is that precision medicine and
precision health along with surrounding
the mouse in the middle with the social
network is the answer to how we treat
cancer I started by talking about the
one in three and one in three of us will
be diagnosed with cancer in our lifetime
when that diagnosis comes it can be
overwhelming our heads can spin and we
can be uncertain of what to do my hope
is that if that happens and when it
happens you’ll you’ll remember this
philosophy you’ll share what you know
with others you’ll place that Mouse in
the middle of this great Network make it
the bullseye
my hope is that you will make yourselves
the mouse in the middle of your own
social care your own precision health
care and your own preventive health care
thank you [Music]