Peter Attia MD - What causes cancer to spread and metastasize? | Peter Attia and Robert Gatenby
The discussion begins by identifying cancers that can be fatal without metastasizing, such as brain and primary hepatic cancers. The speaker then explores the concept of source-sink dynamics, where certain cancers tend to metastasize to specific organs due to their biological environment. For example, breast cancer often spreads to bones, while pancreatic cancer targets the liver. This pattern suggests that the environment of the primary tumor and the metastatic site plays a crucial role in cancer spread. The conversation also touches on the limitations of current cancer treatments, particularly adjuvant therapy, which often fails to completely prevent metastasis. The speaker argues for a more strategic approach to treatment, considering the eco-evolutionary dynamics of cancer cells. They suggest that understanding the interaction between cancer cells and their environment could lead to more effective therapies, potentially involving a sequence of drugs rather than a single treatment.
Key Points:
- Certain cancers, like brain and primary hepatic cancers, can be fatal without spreading, highlighting the importance of understanding metastasis.
- Source-sink dynamics explain why some cancers metastasize to specific organs, such as breast cancer to bones and pancreatic cancer to the liver.
- Current cancer treatments, like adjuvant therapy, often fail to prevent metastasis, indicating a need for more strategic approaches.
- Understanding the eco-evolutionary dynamics of cancer could lead to more effective treatments, potentially involving multiple drugs.
- The genetic diversity and mutation rate in cancer cells increase with tumor size, complicating treatment and highlighting the need for early intervention.