Andd stage on straw city where e have to be constantly chasing it down. Slashsh, poison, burn. We spent 150 billion each year treating cancer, yet t a patient with cancer is as likely too die of it today, with a few exceptions, as one would 50 years ago. Today we spend the hour with renowned cancer doctor dr. Azra raza, author of the new book the first cell and the human costs of pursuing cancer to the last. All that and more, coming up. Welcome to democracy now , democracynow. Org, the war and peace report. Im amy goodman. The pentagon has released new emails revealing how the White House Budget Office ordered the pentagon to halt all military minuteskraine only 91 after president trumps july 25 telephone call with the ukraine president zelensky. The heavily redacted emails shows Michael Duffey telling pentagon officialsls trump h had become personally interested in aid and had ordered the hold. The emails were released after the center for Public Integrity filed a freedom of information act request. Over the weekend, democratic lawmakers renewed demands for witnesses, including Michael Duffey, to testify at Trumps Senate impeachment trial. This is Senate Minority leader senator chuck schumer. If there was ever an argument that we mean need mr. Duduffy to testify, this is that information stop this email is explosive. A Trump Administration official, when we requested, is saying stop the aid, 91 minutes after trump called zelensky, and said keep it hush hush. What more do you need to request a witness . Amy in immigration news, the trumpet administration is considering a controversial plan to deport mexican asylumseekers to guatemala. The proposal comes after the u. S. Has already begun to deport hondurans and salvadorans who have arrived at the u. S. Border seeking asylum in the United States to guatemala under a Safe Third Country Agreement brokered without guatemalan president jimmy morales. They say deporting them to guatemala is dangerous, particularly for female and lgbtq asylumseekers. Guatemala has one of the high list highest rates of homicide, the murder of women,n, and the world. The Washington Post has revealed a secret played by steve or miller sought to use the u. S. Refugee agency to expand trumps mass deportation efforts. The plan would have included embedding immigration agents inside the Program Responsible for caring for unaccompanied children. Part of the plan was rejected by dedepartment of health and Human Services officials, but the department of health and Human Services is allowing eyes, immigration and Customs Enforcement agents, to collect fingerprints from adults seeking to claim custody of Migrant Children at government shelters. Ice can use thiss to target the adults for deportation. Meaning undocumented immigrants will be far less likely to claim custody of Migrant Children and therefore prolong the detention of children and the separation of families. Saudi arabia has sentenced five people to death for the killing of prominent journalist and washington popost columnist jamal khashoggi. Three additional people were sentenced to prison over the brutal murder carried out inside the saudi consulate in istanbul, turkey, which sparked international outrage. Saudi arabia has not announced who has been sentenced to death or imprisonment. The cia has concluded saudii Crown Prince Mohammed Bin Salman ordered khashoggis assassination, but the prince remains a close ally to the u. S. Government. The International Criminal court has taken a major step toward investigating israel for war crimesgagainst palalesnianans. On friday, the iccs prososecutr asked judges to outline the territorial jurisdictction of te investigation. While israel is t t a partto the international crimal cot, a an dictment could bject israeli i officials to International Arrest warrants. Israeli Prime MinisterBenjamin Netanyahu slammed the investigation as antisemitic, while palestinian prpresident mamahmoud abbas welcomed the ne. Today is a great day for us becaususe we accomplisished allt we need because from todaday, Te International crime court will start to accept all of the issues. Amy in india, widespread protests are continuing against the controversial new citizenship law, which many say is a major step toward the official marginalization of indias 200 million muslims. The law provides a path to citizenship for immigrants from afghanistan, bangladesh, and pakistan unless they are muslim. On sunday, indian Prime MinisterNarendra Modi tried to quell the protests by claiming the law is not aimed at marginalizing muslims already living in india. The muslims were born on indian soil or whose ancestors are chilildren of momother indi, brothers and sisters, they have nothing to do with the citizenship law or the National Register of citizens. The muslims are not being sent to any detention centers, nor are there any detention centers. Amy india has launched a crackdown against the protests. At least 25 people have been killed so far and over 1500 people arrested. Many of the demonstrators say the law goes against indias secular constitution. Tomomorrow theyre going to change something else. This is a fight for democracy. This is a fight for india. This is a fight for democracy. Amy Indias Supreme Court has agreed to hear constitututional challenges to the law in late january. In iraq, thousands of protesters poured into the streets of cities across southern iraq sunday demanding the appointment of an independent Prime Minister after the former Prime MinisterAdel Abdul Mahdi was forced to resign amid massive antigovernment protests. Security forces and militias have killed over 500 protesters and injured nearly 20,000 people since the protests erupted in october. They are also reports that prominent iraqi human rights activists have been disappeared. Reuters reports the death toll from irans brutal crackdown on antigovernment proteststs in november was significantly higher than previously reported, with as many as 1500 People Killed during the twoweeks of demonstrtrationsns. The figure was p provided by Iranian Interior Ministry officialals. It says the victims included at least t 400 wowomen and more tha dodozen teenagerers. Reuters also says the orders for the e crackdown cacame directlym irans Supreme Leader ayatollah ali khamenei, who reportedly toldld a gathering of highlevel officicials the Islamic Republic is in danger. Do whatever it takes to end it. You have my order. The pentagon says a u. S. Soldier was killed in afghanistan today, and a second u. S. Soldier was injured. The taliban claimed responsibility for the killing in kunduz province. The soldiers death comes as afghan officials released longawaited preliminary results from septembers election, which show presidedent ashraf ghani wn just over half the vote. His challengnger, abdullah abdullah, is contesting the election, which he says was marred by fraud. Voter turnout is low and some residents of the capital kabul said they supported neither candidate. Both ashraf ghani and abdullah have not done anything press in the past five years. They just deceived people and we dont want them anymore. They both committed fraud and the court must try them. Amy french president emmanuel macrcron is asking unions for a Christmas Truce as the massive strike against macrons proposed pension plan heads into its third week. Andtrikes are justifiable protected by the constitution, but i think there are moments in the nations like when it is good to observe a truce out of respect for r families and famiy lilife. So im calling on everyone to have the sense of responsibility. Amy president macron has also said he will give up his own president ial pension as a concession to demonstrators who have launched nationwide strikes over macrons effort to overhaul the french Pension System and effectively raise the retirement age for younger workers. The unions have ruled out a christmas t truce and are insted demandg g macron scrcrape the pensioion overhaul. In california, newly released body camera video shows a Sonoma County sheriff deputy fatally slamming a mans head into his own car. The sheriff Deputy Charlie blount and his partner, deputy jason little, apparently thought the driver, david glen ward, had stolen the car but it was, and fact, his own car. The two officers pulled him over and then Deputy Blount reached through the window and pulled ward by the hair and slammed his head into the cars frame. Deputy little tased him and then Deputy Blount put him in a restraint until he became unconscious. Ward was declared dead shortly afterwards. Deputy blount has been fired. And in texas, a grand jury has indicted former Fort Worth Police officer aaron dean for murdering Atatiana Jefferson in a case that sparked widespread outrage over Police Killings of African American women. Officer dean, who o is white, ws responding to a nonemergency call by a neighbor for wellness check. The neighbors saw jeffersons front door was open on a warm night in october. The 28yearold graduate student was in her bedroom, babysitting her eightyearold nephew. Soon after the officers arrived, dean shouted through jeffersons bedroom window to put her hands up and then n immediately opened fifire, killing her. He never identified himself as a police officer. On friday, atatianas mother celebrated the murder indictment. Atatianas father died in november of f a heart attack at the age of 58, less than one month after his daughters murder. And those are some of the headlines. This is democracy now , democracynow. Org, the war and peace report. Im amy goodman. Nermeen and im nermeen shaikh. Welcome to all of our r listenes and viewers from around the country and around the world. Why has there been so little progress in the were on cancer . According to the director of the National Institutes of health, Francis Collins americans are living longer, healthier lives. Life expectancy for a baby born in the u. S. Has risen from 47 years in 1900 to more than 78 years today. Among the advances that have helped to make this possible are a 70 decline in the u. S. Death rate from cardiovascular disease over the past 50 years, and a drop of more than 1 annually in the cancer death rate over the past couple of decades. A drop of just only 1 . For the trillions of dollars that has been poured into Cancer Research, a drop of just only 1 . Today we spend the hour with an oncologist who says we should be treating the disease differently. Amy in her new book the first cell and the human costs of pursuing cancer to the last, our guest for the hour dr. Azra raza nodes we spend 150 billion each year treating cancer, yet a patient with cancer is as likely to die of it today, with few exceptions, as one was 50 years ago. She argues experiments and the funding for eradicating cancer look at the disease when it is in its later stages, when the cancer has grown and spread. Instead, she says the focus should be on the very first stages the first cell, as her book is titled. She says this type of treatment would be more e effective, cheaper, and less toxic. Nermeen dr. Raza criticizes what she calls thehe protocol f surgery, chemotherapy, and radiation the slashpoisonburn approach to treating cancer, which has remained largely unchanged for decades. She calls for a transformation in the orientation of Cancer Research, writing little has happened in the past 50 years, and little will happen in another 50 if we insist on the same old, same old. The only way to deal with the cancer problem is to shift our focus away from exclusively developing treatments for endstage disease and concentrate on diagnosing cancer at its inception and developing the science to prevent its further expansion. From chasing after the last cell to identifying the footprints of the first. Amy for more, dr. Azra raza joins us to speak in her own words. Oncologist and professor medicine at Columbia University, she is also director of the mds center. Mds is myelodysplastic syndromes, a form of bone marrow cancer. In her book she notes again, that we spend 150 billion each year treating g cancer, get a patient with cancer is as likely to die of it today than 50 years ago. It is an astounding fact with a few exceptions. Dr. Azra raza, welcome back to democracy now how can this be . How can it be the lack of progress that has been made in this last halfcentury . Thank you for having me come again, amy, delighted to be here. Since 1903, it has been well appreciated, actually, that it is not cancer that kills, it is the delay in treatment that kills. So for whatever weve been making attempts to try and diagnose this disease early. The last three decades, weve seen a 26 decline and cancer mentality, which is about 1 a year as you pointed out. But that is not happening because we have developed some great new treatment strategy. It is happened because of two main things. One is the antismoking campaign and the second is because we started using screening measures to diagnose cancers earlier and earlier. This approach of preventive medicine, where you catch the disease early and intercept early, is what caused the drop in cardiovascular disease by 70 . Because theyre the cardiologists were smarter than oncologists. They realized that if they allow if a heart attack can damage the heart muscle, then the only treatment would be a heart transplant, which is so draconian and so terrible. They started to diagnose not only earlier and earlier, but try and prevent the appearance by using anticholesterol drugs, for example. That is a very clear case of and prevention of the disease. 70 decline in mortality. Why are we doing the same in cancncer . Nermeen what is the answer . We have been trying to do it and the screening measures that were put in place like psaography, colonoscopy, testing, pap smears, they are the ones that cause the decline to26 mainly, in addition antismoking campaign. But those measures were put in 50 years ago. Imagine in this day and age of technology, we are still putting a tube to someones gut and looking to find cancer. That is primitive. For today. Lithic amy and the alternative is . Milked these technologies as much as we could. The 26 e yielded decline in mortality. They are not going anywhere else. We need to invest in developing Technology Based on current imaging, scanning devices, detection of biomarkers for blood, sweat, ne, stoolliva ,urin, samples come and find the earliest footprint of cancer and see how we can intervene. This is a strategy that is not limited to just cancer, amy. This is a strategy that is going to apply to every single chronic disease in the coming years. Amy what has prevented that from happening . Neatwish there was a very kind of answer about this, but it is Something Like this. You take a frog and put it in cold water and start heating at slowly. Going to happen. On the other hand, you throw a frog into boiling water and it will jump out. But if you heat it slowly, the frog dies without jumping out because it slowly gets used to it. Is correct. Ly, it i have to add that. But the analogy is true. Things happen so slowly that we keep getting desensitized to the next step. One thing is there is so hyperbole around Cancer Treatment. If a few months of survival are welcomeby a drug, it is as a game changer. Life. T the end of exactly. I want to be very clear that theslash, poison, burn approach, we are curing some cancers. We are curing them. 32 that present with advanced disease, their outcome is the same exact outcome that it was 50 years ago. Curing, why are we still using these stone age treatments . You know how terrible it is to get chemotherapy and Radiation Therapy . Amy explain how it works. Nermeen what happens . Isthe first rule of medicine do no harm. Fact, when a patient is diagnosed with cancer, it is a silent killer. That is the problem. You can reach stage 4 disease without producing symptoms. So 70 comes to us i recently saw a 42yearold man who had just finished a game of tennis and come to see me and suddenly bebecause hehe was exhauausted d feeling so tired and now i diagnosed him with acute myeloid leukemia. I look at this tonened and tannd young man, andnd the first thout that comes to me is about what we are going to do to him with the chemotherapy we are going to give him. Unconscionable that in 2019, i am still going to give this young man the same combination of two drugs that we popularly known as 73, that i was giving in 1977 when i arrived in this country. Myself i feel ashamed of myself, having to repeat the same side effects that youre going to lose all out,hair, throw your guts and your accounts are going to take, you work blood counts will go down to essentially zero for weeks on end where you will be susceptible to all kinds of terrible infections. You will be in the hospital suffering with shivering next weds and fevers and all kinds of aches and pains and constitutional symptoms. And then there is a chance of percentage of those patients will improve. This is what we do with chemotherapy alone. Amy were going to going to break and come back to this discussion and also hear about your personal story with your own husband, also a renowned cancer doctor, who died of the very disease that he was storiess and hear the of your patient. We are talking to the renowned cancer doctor, professor of medicine at club university, dr. Azra raza. She has a new book called the first cell and the human costs of pursuing cancer to the last. Stay with us. [music break] performed by abby simon mustve abby simon pass toy december 18 at the age of 99. This is democracy now w , democracynow. Org, the war and peace report. Im amy goodman with nermeen shaikh. As we spend the hour with dr. Azra raza, a renowned oncologist, professor of medicine at Columbia University where she is also the director of the mds center. A form of bone marrow cancer. Her new book is just out, titled the first cell and the human costs of pursuing cancer to the last. Raza, we were talking earlier in the first part of the program about the slashpoisonburn approach to treating cancer which you have been very critical which involves surgery, chemotherapy, and radiation. You say this has been responsible for carrying 60 of cancers 68 of cancers. What had have been possible to cure such a high number of cancers using alternative methods . And what kinds of advances have been made in how chemotherapy is administered and how the effects of that of changes in the way it is administered have had on patients . Both very good questions. So the first question you asked is what could have been really done . What we have been aiming at doing. Sure, we started by using these blunt approaches. Is literally like taking a baseball bat to hit a dog to get rid of its fleas. That is how bad this kind of treatment is, but we have to do it because we had no alternatives. In the meantime, we invested billions of dollars in trying to study the biology of cancer, hoping we will identify some intricate pathway, some genetic defect that is going to allow us to target it specifically. And this did happen in two diseases. We develop a targeted therapy because as one gene had gone wrong and one magic liquid target it anand cure the diseas. Amy you are one of the worlds leading authorities on aml, this kind of cancer. Im talking about chronic myeloid leukemia. But yes, it youre right, i amm an expert in myeloid diseases. Advancements a huge that happened in the early 2000 that we can now use a targeted therapy which is not chemotherapy, which only goes and attacks the abnormal cell which is expressing this protein. While it helped patients, it has also put the field behind by 20, 30 years. Why . Because we felt this now establishes a paradigm. Every cancer will be caused by one genetic defect for which we just have to develop one drug. So one gene, one targeted therapy. Everybody and their grandmother has been trying to find the one gene for pancreatic cancer, for acute myeloid leukemia. It turns out, unfortunately, most of the cancers really are too many genes that are mutated simultaneously. So this targeted therapies we have developed, even for those multiple proteins or one protein that is dominant, it turns out it works for a little bit. So let me give you some statistics again. 95 of the new drugs that we are bringing, the experiment of drugs we bring to the bedside, 95 of them fail. And to bring one of those drugs o the bedside is 1 billion almost. Imagine how much we are losing. Why . Because there only prolonging survival by a few months. For example, theres a drug that extends the life of a pancreatic cancer patient by 12 days and the cost of 26,000 a year. Not every pancreatic cancer patient just a fraction. So think of the financial toxicity we are causing to these patients now for very little prolongation and survival. We are financially ruining 42 of Cancer Patients diagnosed, newly diagnosed with cancer today byyear two. Penny every pennant of their life savings. Amy before we go onto the incredible stories you described in your book, your thoughts on medicare for all . Ive spent a lot of time accompanying family and friends, for example, as locator, who are dealing with sloankettering, who are dealing with cancer. The astounding devastation of s lives, financial destruction, medicare for all, what would that mean for Cancer Patients . Expert on am not an these issues, i have common sense. And one thing i can say is the Current Situation is completely untenable. We are on the verge of a collapse with the health care system. We cant continue it the way it is going. And to m me, the only solution seems to be again, not speaking as an expert it is to have medicare available for everybody. I think that is the only compassionate and humane solution. Nermeen i want to ask about another incident that you mentioned in the book before going on to the longer case histories of patients and their own words as well as in the words of their family members. The cost of Cancer Treatment, as you say, in the u. S. Is exorbitant and many families have been driven to financial ruin. But what about and places where Cancer Treatment is so prohibitive, it entirely deprives patients of access. You talk about arriving in karachi and meeting in karachi, pakistan, where you are from, and talking to a cancer patient about whom you write how does one go in and talk to a 35yearold woman for whom dying from leukemia is only her second biggest problem . Could you talk about that, access to Cancer Treatment and who the people are who are entirely deprived of any treatment at all . Is a subject which is very close to my heart. Obviously, i am from that part of the world. The entire world looks to america for leadership. What kind of leadership are we providing . A leadership where we are developing drugs or cellular therapies now that will cost patient forion per helping very few patients . These are verified cases for whom this kind of treatment will work on stuff as you said, what about the 20 million new cancers being diagnosed universally all around the world . We just dont have a compassionate solution for them. Why arent we thinking, not just of those even in america, in the manye areas and many, places where health care is coming harder and harder to access just because hospitals are closing down from financial ruin themselves . Are we thinking of them why arent we thinking of them . Why arent we thinking beyond american borders . Be an, you dont have to genius. The only thing that works in cancer if you have someone who gets agnes with answer, the first thing jose is, was itit advanced and was a cut early . Why Early Detection are we investing money and chasing down the last cell in which the drugs, which have a 95 failure rate today because of clinical testing platforms we are using are so artificial, and that is why we are bringing up drugs that are not going to be successful, instead of doing that, why are we simply improving why arent we simply improving on what we know works . What works . Early detection. Develop new technologies so from one drop of blood, you can put it on a little chip which can be read by a cell phone, which costs 180 for 12 cancers to be diagnosed early. This is something that was Just Announced by japanese companies. So these are things that are not a pieinthesky. These are things that are happening now. Except, how fast bullet happened to reach the rest of the world how fast will it happen to reach the rest of the world . It is on the amount of resources we invest. Amy we are talking to dr. Azra raza. Her book is called the first cell. She is a leading oncologist, pakistaniamerican, muslim, a woman. You talk about your own story in the book of the story of your husband, also a leading oncologist, dr. Harvey preisler, died of lymphoma in 2002. You write cancer is what i had been treating for two decades, yet until i shared a bed with a cancer patient, i had no idea how unbearably painful a disease could be. Lets first turn to your daughter Sheherzad Raza Preisler speaking at a Memorial Service for her father. Had onect his condition the family. The 15th Harvey Preisler memorial symposium was held in new york in 2017. What april choice of irony was that as he was drugged in the Cancer Center in chicago, he was cut down inin the prime o os life by the e very disisease hed dedicated his life to cure. I was only three when he was didiagnosed a and eight when hee died. My parenents took great pains to never mention the c worord in my ear shot, and yet most of my memories of dadrelated at least in part to the presesence of ths name and our lives. And even though h i was too youg to know w what was going o on ay tangible level, i had some sort of Institutional Knowledge that somemething was s terribly wron. I could sense my mother struggggled she e was navigating through stagages of optimimism, pain, dread, despondency, and eventually hopelessness is my dad under with the seemimingly endlesess stream of experimemenl treatmenents. These stages are what most pays for deaf patients and their families and caregivers experience. Amy that is the daughter of our guest today, dr. Azra raza. Talking about her dad who died of one of the cancers that he specialized in. He was head of the Rush Cancer Institute in chicago. Tell us what happened your husband, what happened to harvey. First of all, amy, when i started writing this book i had no intention of putting harvey in the book. I was writing about my other patients. But when i wrote about them in such detail and with such painful granularity, i felt it would be dishonest if i held back my own story. And so that point, i decided to i decided that, this story became like a redline running throughout the whole book because then i could not escape at every level where harvey came in. I will give you one example. I mean, he was head of the Cancer Center. He gets the very disease he is trying to cure. And now he dies after a very, very exceedingly painful almost five years battle. My daughter was eight years old when he died. A couple of weeks after he died, she developed a terrible cold and flu and was very sick for a few days, and then started getting better. And one morning i was sitting the living room reading and she comenly comes out crying inconsolably. I was sure she had had a relapse and was much worse. I was able to calm her down and she said, actually, i feel perfectly fine now. Know what it feels like toto be so sick and how good it is to get better, and my dad never got better. Which brought on a second set of crying. So an eightyearold at a toceral level is able anguishce the kind of that Cancer Patients suffer. Widow did not make me into a different kind of doctor, but my perceptions changed entirely. Does said that real voyage not lie in finding new landscapes, but in having new eyes. And so he became a voyage of discovery for me and having new eyes. Amy and issue a prevention, of catching early . What happened in your husbands case . I mean, he was the head of a major Cancer Institute. The same thing that happens to all of the Cancer Patients. He was diagnosed way too late. And actually, that lymphoma did not kill him. Their treatment we gave killed him. Himchemotherapy we gave just write him so he eventually died of sepsis. He did not die of the lymphoma. Who a family friend of ours once told my younger brother, he the sun rose suddenly from the west one day, the entire world will stop and stare at it. But there are some people who watch the sunrise from the east every day and they wonder why. Those are the only kinds of people who can make a difference in the world. And that is the kind of person harvey was. He was an extremely thoughtful person with a great curiosity about life in general, but specifically scientific issues. Yet what i learned from taking care of him and sharing a bed with him as a cancer patient was a deeply humbling acceptance of his condition. His attitude was, i am a man and a man is responsible for himself, even though i know this is not going anywhere. Amy you r right at the begeging of your book in the introduction from last to first, talking about that idea the first cell. I learn new things about what i thought i already knew, like the difference between illness and disease, between what it means to cure and to heal, between what it means to feel no pain and to feel well. Can you elaborate on this . Really, the whole concept of this is can be expressed better in. 3. If you dont mind, i will recite a short piece emily dickinson. I measure every dream i meet with in a little guys i wonder if it feels like mine or has a different size if it was long or didnt it just begin . I cannot find the date of mind mind, it is been so long o of pain i wonder if it hurts to live in whetherhave to try, and could they choose between, they would not rather die. Nermeen i want to ask about another patient who you profile in the book who is in fact subjected to particularly brutal form of this slashpoisonburn. In that is andrew who died 2017 at the age of only 23. The book includes a testimonial from his mother, lena, who criticizes the attitude of the oncologist who treated him but says she would have wanted andrew to undergo any treatment that might have extended his life. Could you talk about andrew . He was also one of the bestt friends of youour daughter. Could you talk about the treatment he was subjected to, what happened, and also your decision, one of the most remarkable things about this book is not just of course were expertise in cancer and Cancer Treatments, but also these stories that you weave into the narratives of patients you have treated, of patients i families who have witnessed their family members being treated in this way, and ultimately dying . This is alena, andrews mother, saying that she would have andrew go through all of this treatment even if it meant the slightest possibility of extending his life. Yes. Andrew is the impetus for me to write this book. Diagnoseden he gets with cancer, he has weakness in his arm. He goes to the emergency room. They do an mri. They find in an operable brain tumor. They could not remove it. From day one, every oncologist that treated andrew knew that 0. 00hance of survival is beyond what is to be expected no matter what we give him. He was going to die. We all knew it. This boy, when he opened his eyes coming out of anesthesia, he turned to his mother and he said, mom, dori. Just callazra. Shes on the cutting edge. She will find the best treatment and care for me. And alena called me. This young man who has been in and out of my house since he is 15 years old because he is best friends with my daughter. I felt so ashamed of myself that there is nothing i can offer this poor boy. And the fact that we are failing the andrews in the harveys and omars of this world so spectacularly, and instead of feeling embarrassed, we go around pumping our test, claiming we are caring 68 of patients. And what we did to andrew even though we knew his chance is zero, we give them chemotherapy, Radiation Therapy surgery after surgery, more chemo, more radiation, more immune therapy. And he suffered the side effects of every one of them without benefiting from anything. But then lets say we did not treat him and let the brain tumor takeover. That is death h from advanced cancer is just hororrendous. Basically, the treatment what are the choices we offered andrew at this point . Either you dive your cancer or you dive the treatment, but youre going to die. And the question i asked myself is, why . Why was andrew diagnosed when his cancer was nine centntimetes long . We know that cancer is a silent killer. We know no age is immune to getting cancer. At 2 22, this boy got cancer. Amy specifically in his case, how could it have been detected earlier . Talk about the tests you think need to be developed and are actually already there but somehow missed him . Amy, im calling for a complete paradigm shift. Even the saying is screening measures that we are using annually, for example, doing a mammogram, is too late for some people. What we need to do is consider the human body as a machine can continuously learn to moderate it monitor rate for diseases whether it is cancer or diabetes. Catch these diseases early end of them and about. What has to be done for that . Hildren get cancer not that many, but certainly they do. We treat these children with draconian measures and they end up with all kinds of problems. What im asking for is we need to develop those markers that can identify cancer at its inception. It is doable. It is possible. A lot of research is going on in this country and elsewhere also to find footprints of cancer, for example, i will give you a couple of examples. When cancer starts, divides cells divide faster than normal orls, which means it needs nutrition. It starts making more blood vessels. The area becomes hot because of one blood going into that area. This hot area can be detected. People are developing bed sheets and mattress is where you can go to sleep and overnight you are being scanned for hot areas. Lets say theres a high. Detected my pancreas. It doesnt mean the next day should have surgery and removal of no, it means now there is something abnormal which needs to be monitored. I am now considered somewhat at high risk so i should be monitored for other biomarkers. These cells which are developing in my pancreas will be shedding their proteins into the bloodstream. If theyre not shutting camino one thing we can do . We can yell at them. How do you do that . You use soundwaves literally, ultrasound, to hit them and they start shivering and they start shedding their proteins into the blood and we get the blood and detect the biomarker. Amy is there cancer Industrial Complex that is preventing this kind of research and development of the preventive and the Early Detection approaches to cancer . Absolutely not. My contention and my conceit is here is an industry that is investing in an enterprise that has a 95 chance of failure, but they keep investing billions of dollars because if one of their drugs make said, if it improves survival by 10 seconds more dylan amy youre saying there is a cancer Industrial Complex close but theyre not preventing it. What im saying is we just set a new goal and we financially incentivize the goal that all of these people will turn around and come to the firirst cell instead of going after the last cell. About Vice President bidens moonshot challenge around curing cancer . I was one of the fortunate people to me Vice President biden in across the standing room table for the canceled moonshot and had a very wonderful discussion with Vice President biden. His heart is in the right place. There is a certain fraction of that billion dollars, the money he has allocated for Cancer Research is definitely toward prevention and Early Detection of cancer. But it is not enough. That kind of vision is what we really need, but we need im not saying all Current Research should stop. Nobody should misquote or mishear me. Im m saying we have correct patients. Of course we have to worry about them and we have to keep developing better treatments and better understanding of biology. But i think at least half of the resources and all of the resources going into these failing clinical trials, these billions and billions of dollars, can be redirected for future patients to try and detect the disease early. A solution which will be applicable universally. Amy when we come back from breaeak, we will come back to or guest dr. Azra raza, oncologist, medicine at club University Director of the mds , center. Her new book is just out called thehe first cell and the human costs of pursuing cancer to the last. Stay with us. [music break] amy new york by saint vincent. The photos in the video were compiled by kat slootsky for her brother andrew, one of the patienents profiled in dr. Azra razas book. The first cell and the human costs of pursuing cancer to the last. He died when he was 23 years old of a particularly aggressive form of brain cancer. I am any goodman with nermeen shaikh. We are spending the hour with dr. Azrara raza, the renowned oncologist, professor of medicine at Columbia University. Nermeen i want to ask you about one of the criticisms that your book has come under in the new york times, dr. R. Henry marsh praises the book that says youre too optimistic about the solutions you proposed. He writes on her diagnosis of the ills from which Cancer Treatment suffers strikes me as accurate, but her solutions seem infused with the same unrealistic optimism she identifies as the cause of so much suffering. This is dr. Henry marsh writing in the new york times. Are you guilty of too much optimism . No. That is the short answer. But i started my career in oncology basically 1977. I was 24 years old, fresh out of medical school. I had come here and started working at the Cancer Institute because i was going to cure cancer. Very quickly, i thought. Seven, eight years it was very clear to me the disease i had invested all my energies thatute myeloid leukemia, in my lifetime, this disease will not be cured. It is so complicated. So that point, i turned my attention toward studying an earlier form of the disease because many of my patients who came with acute leukemia, history of having had some low blood counts and being anemic for a few months before he developed into leukemia. I said to myself, why not catch this disease earlier and intercept then and not let it become this monstrosity . So i started collecting this is where being an immigrant helped me, amy. Had i gone to school in this country, if i had started to study acute leukemia, my next step would have been to make a mouse model of this disease which are very artificial and are just for drug development, at least. They are good for studying biology, but not for drug development. Because i was an immigrant, i civilly started saying, oh, ive study cancer so let me save these cells and i started thanking cells b anking cells by patients. Very repository was 60,000 this is a very precious resource, oneofakind, not one single cell comes from another position. I still do the bone marrows with my own hands, which im going to do in the next hour when i get to my clinic. But the idea i had was that earlier detection will have that was many yearars ago. Where is my solution . So the question you asked me in the criticism that dr. Marsh is giving, can be applied to me, yes, 35 years ago i felt detecting the disease early would help me. It has not helped me because preleukemia itself is a very malignant disease and can kill. Usingn i realized these samples of acute leukemia, working my way back to preleukemia, i can then ask the question, why did some people get preleukemia to begin with . Why did they get mds . Once we can discover that by using these tissue samples in wetest technology of will find the same kind of thing you have, say, for breast cancer, the braca gene. Can we find what people are susceptible because of and here did . Dna . Amy people think it is gone so far to help Cancer Patients. What is it and what do you see other prospects for . The answer is, first you have to understand what is the cell therapy. There are many, many different forms of immune therapies. But the ones that are receiving all of the attentions are basically two types, checkpoint abutters are drugs which cancer cells so every cell expresses proteins at either site each me or dont eat me. The dontls learn need to me. This is how they deflect. Do that. Drugs to we succeeded. The response does not last. The other form of therapy is cell therapies we use. Immune therapy using cells cannot establish between a normal cell and the cancer cell and the organ. All we can do is activate these t cells unsafe, go kill the whole organ and cancer will die with it. The only cells we have succeeded in killing are the only organ we have succeeded in killing so far is b cells. Kill them and then we replace b cell function by giving them hemoglobins for the rest of their life. We cant kill the liver and expect to replace it. That is what immune therapy using cells is not going to work. Amy we have to leave it there. People can pick up the book and take it from there stop dr. Azra raza, oncologist, professor medicine at Columbia University, heads up the mds center. A form of bone marrow cancer. Her new book, the first cell and the human costs. Graftotona crime traditional. Country town. We now have forever probably. The distinction of having given the world a man is turned out to be as strong as worst mass murder at this. Ten days ago chris