Transcript

Welcome to the new podcast, Cancer Simplified. My name is Duncan Darrow, and I will be the host for this program. I'm the founder of Fighting Chance, and for 22 years, I've run the charity, which is East End's only free cancer counseling center.

At our clinic in Sac Harbor, we have a staff that has included oncology social workers and clinical psychologists. They have provided over 5,000 free counseling sessions to East End cancer patients who feel the disease is eroding their mental health and their emotional well-being. The goal of our podcast, sort of like our free counseling, is to simplify what cancer is all about, so that the disease will be easier for patients and caregivers to understand, not to mention the general public.

In most circumstances, the medical experts who are available locally at Stony Brook Medicine can provide the highest standard of care. But there are a few times, really just a few, when patients must travel to specialize treatments in New York City cancer centers. Last year with our partner, Hampton Jitney, we provided this transportation in many cases.

And so with that, let's just get started.

Working with cancer patients over the years, some people often ask, well, what's the question you're asked all the time, Duncan? What do people always want to know right at the beginning of battling the disease? And the answer usually is, “What is cancer?"

Which, if you think about it, makes sense. So cancer is a disease rooted in the human cell that makes cells behave abnormally. For example, cancer cells divide and multiply faster than they should, driven by growth-producing pathways inside the cell.

Secondly, most cells have a programmed cell death signal, but cancer cells do not, which makes them basically immortal. And lastly, cancer cells have a unique wanderlust, meaning they develop in one part of the anatomy, but travel the bloodstream and colonize in a new location. That is called metastasis.

So now that we have some understanding of the what, as in what is cancer, the next question is the why. Why did cancer develop in my cells? Why did I get sick?

So the answer to that really lies in something called genetic mutations. And I'll explain those in a little bit. But it's enough to know now that in every cell, if you can believe it, there are 25,000 genes.

About two-thirds of them are called junk genes. We have them, but we don't know what they do. But there are some cells that are quite important in the development of cancer.

In every cell, there are 25,000 genes. They contain the blueprint for your development as a human, down to the color of your eyes. In 1953, two scientists named Crick and Watson discovered that the genes reside within the cell, and specifically are found on sort of two intertwined branches of a tree, which are called chromosomes.

And for that, they won the Nobel Prize. During your lifetime, of course, genes die and are replaced with more or less identical genes. But sometimes, there's a mistake.

Sometimes, the replication doesn't work out, and what you end up with is a mutated gene. And that brings us back to the phrase genetic mutations. So these are the genes, sometimes called oncogenes, that many scientists see as the primary cause of many cancers.

They're the driving force in changing a cell's basic characteristics, such that it becomes cancerous. By the way, since I've mentioned cells that can be cancerous, just a word about cells. Did you know that we have 30 trillion cells in our body?

Just think of that, 30 trillion cells. And in every cell just about, there's DNA. And it's those cells that can become cancerous.

Not a trillion, not even a bunch of million, but it just takes a few to get you started down the wrong pathway. So, in speaking with cancer patients, another question I'm often asked is, what are the recent breakthroughs, the big discoveries that might give me a better chance of survival, and others a better chance of survival? One answer certainly is known as genetic sequencing.

Big word, genetic sequencing. That process can be influential in deciding upon the best treatment for a cancer patient. And so, it's usually part of the diagnostic phase.

I'm always amazed when someone says, well, you know, the doctor's diagnosed everything, we're ready for medicine. And I'm like, have your genes been sequenced? And they go, no, he didn't mention that.

It's very important. Sequencing suggests that something's being placed in the proper order. As it turns out, our genes, all 25,000 of them, each have a place, a designated spot, in our chromosomes.

Recall that the chromosomes are those branches of a tree with genes perched like birds on a wire. If genes could speak, you can imagine that one of them might say to another, hey, you're in the wrong spot. You're supposed to be perched eight slots farther away.

Get out of here. And so the genes eventually get where they belong. Once science figured out that there were about 25,000 genes in every cell, and where they perched on the chromosome arms, it was time to figure out which genes were the real troublemakers.

These are the genes that kept showing up as scientists looked at cells under a microscope. And these are, as you might imagine, our friends, the oncogenes. The project took plenty of time and effort, but eventually, science identified these oncogenes, the troublemakers.

There are not a lot of them, but they're very, very important to understanding cancer. And that effort, which is generally called the Human Genome Project, took 13 years, from early 1900, 1990 to 2003, and is an example of what they call big science, which is when the private sector and the public sector cooperate with hundreds, if not thousands, of scientists. And the only three, I guess, well-recognized examples of big science are the Human Genome Project, A Man on the Moon, and the atom bomb.

There's that music again, which means we're coming to the end of this podcast. By all means, first of all, visit our website, fightingchance.org. At the top of the home page, you'll see a podcast button, press it and you can get access to this podcast and all the other podcasts that we've prepared.

The home page also lets you click through to other services of Fighting Chance, which are available to residents of the East End of Long Island. For example, there is counseling appointments to help patients get through the highs and lows during the battle with cancer. There are free local taxis to get you to cancer related doctor appointments on the South Fork.

There are free Hampton Jitney tickets if you need to see a specialist in New York City, such as Memorial Sloan Kettering. And there's also a free local resource guide, about 25 pages that we produce in partnership with the American Cancer Society. If you have any questions about what we've discussed in this podcast, please email them to admin at fightingchance.org.

And we will try to get back to you individually or answer your inquiry in the next podcast. There's that music again. Time to go.

Hope you tune in again to Cancer Simplified, brought to you by Fighting Chance.