[Music]
[Applause]
everything is a child of one’s own time
change the customs change customs
even the bathroom ones
change the technology change the
objects that we use and change
also diseases in the third photograph
and see the clinical picture of smallpox
as a disease that in the first decades of
nine hundred caused hundreds of
thousands of millions excused of dead in
all of Europe and that today has been
virtually eradicated thanks to a vaccine
this is the result more generally the
our evolution evolution that thanks
to technology has enabled us to
defeat many diseases and
in parallel, he helped to create them
others the evolution that, however, analyzed
both from the technological point of view and
from a purely biological point of view
can not avoid a thing the fact that
we must die but look if you have
paid the ticket to hear you say from
someone you must die
yet so are the main ones
causes of death today in the world
Western are diseases
cardiovascular and only malignant tumors
Today I speak to you about malignant tumors
because my field of clinical activity
and research activities and why the
tumor diagnosis a moment
particularly difficult in the economy
of a single person and family
that is around him behind every person
there is a family there is a story
more or less long is a problem of which yes
He speaks little and this is intuitive by one
side also understandable because we
we are tending towards the
beauty and we do not like talking about things
ugly but on the other side it’s something
that we should all know because i
numbers unfortunately speak clearly the
risk of getting cancer during
life is one in three is at risk of
dying of cancer is 1 in 5
and these are data that unfortunately too much
often they are discovered at the point in the moment
of the diagnosis that the critical moment
especially in the medical interaction
patient
when the questions arise
fabrizio come forward
hello maurizio hello hello curtain
what happened to you fabrizio and I am
one in three explain better last year
giuseppe diagnosed me with cancer
in the pancreas and we found ourselves in his
study to understand what to do fabrizio
you feel you smoked not very little to be true
absolutely no because the greater the
My leads to a lifestyle
particularly unregulated
especially how are you now I am
well
the cancer made me beautiful lost 30
chili I did not run and I want to run there
marathon between can not more than two three
months
fabrizio because because it is really you not
I know I came here on purpose to
ask for it and this is what I do
I will try to explain you in a few minutes
I will try to explain what cancer is and
I will try to explain to you why in cancer
cancer is born derives from alterations
of the replication mechanism of the
cells are cells that are bricks
make up our fabrics and yes
replicate at a variable speed in
relation to the type of fabric the
cell replication takes place
according to a preordained mechanism that yes
calls cell cycle during the phase
of a real division of the cycle
cellular our genetic material
there is the DNA is evenly distributed
in the two daughter cells it is a bit
difficult to explain how it replicates the
dna imagine a zipper a zipper
which opens two branches of the zipper
they constitute the filaments sons who
they are filled by a second
entrusting according to a principle of
biochemical complementarity of the
Repeating molecules is a mechanism a bit
difficult to understand but it happens is one
wonderful thing that has been discovered
in the fifties and that allows
precisely to generate two daughter cells
from a mother cell
this mechanism however as everything in the
world however is not perfect and a lot
often much more often than us
we can think of going to meet gods
errors these errors are repaired
because we have special mechanisms
error repair, however, when
these errors occur repeatedly
in the particular portions of the genome
who are deputies to the control precisely
of the cell cycle may arise
problems and cells of a given tissue
they can acquire the ability to
replicate uncontrollably a
finalistica acquiring over time the
ability to invade the fabric of
origin of the surrounding tissues and of
go even in the distant order
this is cancer because in cancer
cancer comes therefore because yes
check at the time of division
of the cells of the so-called mutations
that the technical term for the heroes
of which I mentioned before then the
cancer comes because it is verified of the
mutations because they make mutations
like a bit like in astronomy to go
always further in the explanation of
a dinner phenomenon get to the concept of
big band because the universe is born is a
but the question we ask ourselves is why
there is no cancer mutations can
occur for three specific factors
the first is the perturbation of the
replication of the cell due to a
external factor that we will call factor
of risk
the second mechanism is a mechanism e
it seems to you that the mutation is called for
from the mother to the pope the third mechanism
it is a random accumulation of mutations
genetic is the factor that weighs more
in this process the hereditary factor
it’s the one that weighs less
the other two are the most interesting and
I will try to drive them briefly for
understand which of the two weighs the most is
important this concept because today
all the information we very stressed out
on the prevention of tumors on the
control of the so-called factors of
risk are those I spoke to before
that of environmental factors that can
in some way interfere with
genome issues more risk factors
therefore the feeding is more common
incorrect especially for the tumors of the
gastro intestinal tract smoking
cigarette and the pollution there are
many others a little less known to
the first is the dust of the gods
chimneys was the first factor
environmental that allowed us to
correlate the environmental factors themselves
with cancer in particular cancer
of the testis in the 18th century to asbestos
some fungal toxins light the light
of the sun ultraviolet rays and the
papillomavirus for which a vaccine exists
we all think cancer is in
some way caused by these
factors
in reality it is not really like that because the
concept of cause rather consequences
difficult to prove in this
sector is more instead it is pregnant
to argue that a prolonged exposure
to these risk factors may
increase the incidence in some way
of tumors
and then which is where the true cause lies
what is the true primum movens of this
phenomenon is the factor c is therefore the
factor is random
and this rather disturbing his
we have researched for a hundred years
causes of cancer and we are coming to
conception that cancer caused by
case this is a 2015 publication
on science that is a bit upset the
scientific world is a model
complex mathematical that does not tend that
I do not explain that substantially
demonstrates in a very elegant way that
about 75 percent of the cancers are
fruit of pure chance
in particular the risk of developing
a tumor during life would be
proportion to the number of divisions of the
stem cells that are cells
progenitors and normal cells in
each and every fabric this model was
also criticized as it happens in all
new discoveries because it does not hold in
particular consideration precisely i
environmental factors that are those then
editable through the styles of
life in 2017 the same authors one
Italian tomasetti work in america
johns hopkins have expanded the
model also including the factors
environmental
I’m not going to explain this to you
slide I explain only the concept is
the concept is quite impressive
takes the lung tumor that the
tumor that is most easily managed
correlate with an environmental factor that
cigarette smoke only 50 per
one hundred to the lung tumors is
preventable through abstention from
risk factor for cancer of
pancreas that the tumor I study
in my in my business
this phenomenon even more disturbing
because around 70 80 percent of the cases
it arises by pure chance
actually the model as far as I can
be elegant mathematically robust
explains why the incidence of tumors
is very variable in relation
to the geographical area but this is a
argument that probably will come and
polished in the next few years, therefore the
message which is a message
destructive there is nothing that we
we can do because everything is deputed to
case
how can we do to prevent
the onset of cancer and all this
prevention of which doctors speak to you is
actually a bluff absolutely no the
message does not want to be a abandonment
of the concept of both primary prevention
that is, the elimination of causes
possible prevention of cancer or lacking
secondary therefore of early diagnosis
and this is an example we must undergo
to the screening programs that are but of
internationally that I am
all the territory is available because
however they do their part even if i
Unfortunately, screening programs are
present for a small number of tumors
because the biology of most
of the oplà xi and is very complex today
yes, the frontiers of research are
trying to find in the blood of the
substances that can be associated with
tumors in the very early stage but I repeat
this is a very difficult process
because the signal transduction pathways
of liberation the molecules in the blood e
the early disease stages are a lot
various still are not well understood too
if in recent years they have been made
giant steps thanks to machines like
these are called sequencers
sequencers are machines that
breaking the DNA in a thousand fragments
they manage to decode them as one
printer that writes a book is that we
we can read this way we are
been able to decode the genome
of all neoplasms through a
consortium an international consortium of
where the center in which work is part for
the minute lasi and pancreatiche and this
it is also a fundamental step
towards therapeutic approaches
new that can be customized
based on genetic alterations
of the individual patient
this still is not possible on a basis
routinary is not yet possible to
current practice but the future is that
that which will happen in who knows how many years
maybe 10 maybe 20 maybe 30 but it will come
this is the answer to the question that I
I have placed myself for you and I hope to have you
given information at least useful
but there is an idea to share
and I would like to take advantage of the model of
carcinogenesis to enlarge a little
the horizon to the broader concept
of science and research
scientific
science is guided by a vector of
forces I like to say unidirectional that
it always brings us forward this vector
pushed from behind forward by
knowledge that we have and that there
let’s put it behind you
accumulates more and more by projecting us
physically
how many on the other side calls us back
always forward the emptiness of what we
we do not know
this implies two fundamental concepts
the fact that knowledge is necessary
you can not generate hypotheses are not
they can generate theories if not a
knowledge
on the other hand, one must be aware of
be ignorant and this is it
particularly sad in the field in which
I work because in my tumors
pancreatic are more the questions than the
often answers the need to
information that people have
a series of questions that we do not
we know how to answer is a kind of
claim of care that is always stronger
but often this is what it is
that we can tell you what we are not
what we do not want to use
Wonderful montale is a process of
very long evolution starts from one
icarus presumption that he wants to fly falls
however, studies are done over time
of the systematic studies of this leonardo
da vinci to these studies even after a long time
time bring results first
flight of cars that carry around
600 people in the center of the world
all this process remains always and
anyway
the man the man of vitruvio di leonardo is
a tribute that Leonard himself wanted
to make classic thought to the canons but
at the same time it is a self-celebration
of the scientific nature of one’s own art
the human figure proportions
mathematically harmoniously inscribed
in the perfect figures of the circle and the
square the circle that represents the
heaven the divine the square that
represents the earth the man suspended between
heaven and earth and reaching out to the unknown e
for this reason that thought
humanistic and scientific thought
integrated into the research are the only and
the only tool we have today
to make ours better ourselves
children our grandchildren and the life of the
world that will come
abc
[Applause]
everything is a child of one’s own time
change the customs change customs
even the bathroom ones
change the technology change the
objects that we use and change
also diseases in the third photograph
and see the clinical picture of smallpox
as a disease that in the first decades of
nine hundred caused hundreds of
thousands of millions excused of dead in
all of Europe and that today has been
virtually eradicated thanks to a vaccine
this is the result more generally the
our evolution evolution that thanks
to technology has enabled us to
defeat many diseases and
in parallel, he helped to create them
others the evolution that, however, analyzed
both from the technological point of view and
from a purely biological point of view
can not avoid a thing the fact that
we must die but look if you have
paid the ticket to hear you say from
someone you must die
yet so are the main ones
causes of death today in the world
Western are diseases
cardiovascular and only malignant tumors
Today I speak to you about malignant tumors
because my field of clinical activity
and research activities and why the
tumor diagnosis a moment
particularly difficult in the economy
of a single person and family
that is around him behind every person
there is a family there is a story
more or less long is a problem of which yes
He speaks little and this is intuitive by one
side also understandable because we
we are tending towards the
beauty and we do not like talking about things
ugly but on the other side it’s something
that we should all know because i
numbers unfortunately speak clearly the
risk of getting cancer during
life is one in three is at risk of
dying of cancer is 1 in 5
and these are data that unfortunately too much
often they are discovered at the point in the moment
of the diagnosis that the critical moment
especially in the medical interaction
patient
when the questions arise
fabrizio come forward
hello maurizio hello hello curtain
what happened to you fabrizio and I am
one in three explain better last year
giuseppe diagnosed me with cancer
in the pancreas and we found ourselves in his
study to understand what to do fabrizio
you feel you smoked not very little to be true
absolutely no because the greater the
My leads to a lifestyle
particularly unregulated
especially how are you now I am
well
the cancer made me beautiful lost 30
chili I did not run and I want to run there
marathon between can not more than two three
months
fabrizio because because it is really you not
I know I came here on purpose to
ask for it and this is what I do
I will try to explain you in a few minutes
I will try to explain what cancer is and
I will try to explain to you why in cancer
cancer is born derives from alterations
of the replication mechanism of the
cells are cells that are bricks
make up our fabrics and yes
replicate at a variable speed in
relation to the type of fabric the
cell replication takes place
according to a preordained mechanism that yes
calls cell cycle during the phase
of a real division of the cycle
cellular our genetic material
there is the DNA is evenly distributed
in the two daughter cells it is a bit
difficult to explain how it replicates the
dna imagine a zipper a zipper
which opens two branches of the zipper
they constitute the filaments sons who
they are filled by a second
entrusting according to a principle of
biochemical complementarity of the
Repeating molecules is a mechanism a bit
difficult to understand but it happens is one
wonderful thing that has been discovered
in the fifties and that allows
precisely to generate two daughter cells
from a mother cell
this mechanism however as everything in the
world however is not perfect and a lot
often much more often than us
we can think of going to meet gods
errors these errors are repaired
because we have special mechanisms
error repair, however, when
these errors occur repeatedly
in the particular portions of the genome
who are deputies to the control precisely
of the cell cycle may arise
problems and cells of a given tissue
they can acquire the ability to
replicate uncontrollably a
finalistica acquiring over time the
ability to invade the fabric of
origin of the surrounding tissues and of
go even in the distant order
this is cancer because in cancer
cancer comes therefore because yes
check at the time of division
of the cells of the so-called mutations
that the technical term for the heroes
of which I mentioned before then the
cancer comes because it is verified of the
mutations because they make mutations
like a bit like in astronomy to go
always further in the explanation of
a dinner phenomenon get to the concept of
big band because the universe is born is a
but the question we ask ourselves is why
there is no cancer mutations can
occur for three specific factors
the first is the perturbation of the
replication of the cell due to a
external factor that we will call factor
of risk
the second mechanism is a mechanism e
it seems to you that the mutation is called for
from the mother to the pope the third mechanism
it is a random accumulation of mutations
genetic is the factor that weighs more
in this process the hereditary factor
it’s the one that weighs less
the other two are the most interesting and
I will try to drive them briefly for
understand which of the two weighs the most is
important this concept because today
all the information we very stressed out
on the prevention of tumors on the
control of the so-called factors of
risk are those I spoke to before
that of environmental factors that can
in some way interfere with
genome issues more risk factors
therefore the feeding is more common
incorrect especially for the tumors of the
gastro intestinal tract smoking
cigarette and the pollution there are
many others a little less known to
the first is the dust of the gods
chimneys was the first factor
environmental that allowed us to
correlate the environmental factors themselves
with cancer in particular cancer
of the testis in the 18th century to asbestos
some fungal toxins light the light
of the sun ultraviolet rays and the
papillomavirus for which a vaccine exists
we all think cancer is in
some way caused by these
factors
in reality it is not really like that because the
concept of cause rather consequences
difficult to prove in this
sector is more instead it is pregnant
to argue that a prolonged exposure
to these risk factors may
increase the incidence in some way
of tumors
and then which is where the true cause lies
what is the true primum movens of this
phenomenon is the factor c is therefore the
factor is random
and this rather disturbing his
we have researched for a hundred years
causes of cancer and we are coming to
conception that cancer caused by
case this is a 2015 publication
on science that is a bit upset the
scientific world is a model
complex mathematical that does not tend that
I do not explain that substantially
demonstrates in a very elegant way that
about 75 percent of the cancers are
fruit of pure chance
in particular the risk of developing
a tumor during life would be
proportion to the number of divisions of the
stem cells that are cells
progenitors and normal cells in
each and every fabric this model was
also criticized as it happens in all
new discoveries because it does not hold in
particular consideration precisely i
environmental factors that are those then
editable through the styles of
life in 2017 the same authors one
Italian tomasetti work in america
johns hopkins have expanded the
model also including the factors
environmental
I’m not going to explain this to you
slide I explain only the concept is
the concept is quite impressive
takes the lung tumor that the
tumor that is most easily managed
correlate with an environmental factor that
cigarette smoke only 50 per
one hundred to the lung tumors is
preventable through abstention from
risk factor for cancer of
pancreas that the tumor I study
in my in my business
this phenomenon even more disturbing
because around 70 80 percent of the cases
it arises by pure chance
actually the model as far as I can
be elegant mathematically robust
explains why the incidence of tumors
is very variable in relation
to the geographical area but this is a
argument that probably will come and
polished in the next few years, therefore the
message which is a message
destructive there is nothing that we
we can do because everything is deputed to
case
how can we do to prevent
the onset of cancer and all this
prevention of which doctors speak to you is
actually a bluff absolutely no the
message does not want to be a abandonment
of the concept of both primary prevention
that is, the elimination of causes
possible prevention of cancer or lacking
secondary therefore of early diagnosis
and this is an example we must undergo
to the screening programs that are but of
internationally that I am
all the territory is available because
however they do their part even if i
Unfortunately, screening programs are
present for a small number of tumors
because the biology of most
of the oplà xi and is very complex today
yes, the frontiers of research are
trying to find in the blood of the
substances that can be associated with
tumors in the very early stage but I repeat
this is a very difficult process
because the signal transduction pathways
of liberation the molecules in the blood e
the early disease stages are a lot
various still are not well understood too
if in recent years they have been made
giant steps thanks to machines like
these are called sequencers
sequencers are machines that
breaking the DNA in a thousand fragments
they manage to decode them as one
printer that writes a book is that we
we can read this way we are
been able to decode the genome
of all neoplasms through a
consortium an international consortium of
where the center in which work is part for
the minute lasi and pancreatiche and this
it is also a fundamental step
towards therapeutic approaches
new that can be customized
based on genetic alterations
of the individual patient
this still is not possible on a basis
routinary is not yet possible to
current practice but the future is that
that which will happen in who knows how many years
maybe 10 maybe 20 maybe 30 but it will come
this is the answer to the question that I
I have placed myself for you and I hope to have you
given information at least useful
but there is an idea to share
and I would like to take advantage of the model of
carcinogenesis to enlarge a little
the horizon to the broader concept
of science and research
scientific
science is guided by a vector of
forces I like to say unidirectional that
it always brings us forward this vector
pushed from behind forward by
knowledge that we have and that there
let’s put it behind you
accumulates more and more by projecting us
physically
how many on the other side calls us back
always forward the emptiness of what we
we do not know
this implies two fundamental concepts
the fact that knowledge is necessary
you can not generate hypotheses are not
they can generate theories if not a
knowledge
on the other hand, one must be aware of
be ignorant and this is it
particularly sad in the field in which
I work because in my tumors
pancreatic are more the questions than the
often answers the need to
information that people have
a series of questions that we do not
we know how to answer is a kind of
claim of care that is always stronger
but often this is what it is
that we can tell you what we are not
what we do not want to use
Wonderful montale is a process of
very long evolution starts from one
icarus presumption that he wants to fly falls
however, studies are done over time
of the systematic studies of this leonardo
da vinci to these studies even after a long time
time bring results first
flight of cars that carry around
600 people in the center of the world
all this process remains always and
anyway
the man the man of vitruvio di leonardo is
a tribute that Leonard himself wanted
to make classic thought to the canons but
at the same time it is a self-celebration
of the scientific nature of one’s own art
the human figure proportions
mathematically harmoniously inscribed
in the perfect figures of the circle and the
square the circle that represents the
heaven the divine the square that
represents the earth the man suspended between
heaven and earth and reaching out to the unknown e
for this reason that thought
humanistic and scientific thought
integrated into the research are the only and
the only tool we have today
to make ours better ourselves
children our grandchildren and the life of the
world that will come
abc
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