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Solution proposed to a 2000 year old problem in oncology

Published on January 31, 2019   47 min

A selection of talks on Clinical Practice

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0:00
Hello. This is Michael Retsky. I am on staff at Harvard TH Chan School of Public Health. And I have a small business, Late Relapses, LLC. That's a startup.
0:13
What I'm going to describe to you is a research project in cancer that is far different from the usual research. Romano Demicheli and myself edited a book published by Springer Nature: "Perioperative Inflammation as Triggering Origin of Metastasis Development". This book was published last year, I think in July, and most everything that I'm going to discuss today, other than what has happened since April of this year will be covered in this book.
0:46
The foreword to this book was written by Robert Weinberg who was considered by many to be the foremost authority on cancer biology in the world. I'm not going to read through this, but there are just two points I wanted to bring out. First, Dr. Weinberg thinks that whatever we find in this research is going to be accepted only reluctantly by many in the medical oncology community. And the other thing he mentions is a very favorable comment that this research is likely to profoundly influence future surgical oncology and post-surgical treatment protocols.
1:23
So this project has been going on for a very long time. I can actually tell you when it started. I was attending a breast cancer conference in Europe in 1993 and I walk, I don't recall what city it was, into the building where the conference was held and outside in the lobby I saw posters setup by a person from a Milan National Cancer Institute. Romano Demicheli was showing a poster. And this immediately caught my interest. I had been studying breast cancer for about ten years to this point. I made a career change from doing physics research to doing breast cancer research, and I had never seen data such as Demicheli was showing. I'll describe this data in some detail, but just as an overview right now, there were 1,173 early-stage breast cancer patients with long-term follow up. These patients were treated by surgery only. You will see that there is a sharp peak in relapse at 18 months, then a minimum at about 50 months, and then it started up again as a broad shallow peak at 60 or 70 months with a long tail extending to over ten years. This general pattern has now been identified in over 21 independent databases from US, Europe, and Asia. There are more than 21, but I stopped counting them.
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Solution proposed to a 2000 year old problem in oncology

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