“A common sense solution to America’s health problems?” asks Dr. David Agus, author of the best-selling “A Short Guide to a Long Life” and co-founder of Applied Proteomics, a big-data La Jolla diagnostics company. “How about making elevators coin-operated?”
Agus, head of the University of Southern California’s Westside Cancer Center, an expert in molecular medicine and a CBS News contributor, has become an apostle of prevention.
He once stood up in an auditorium of oncologists and declared that metastatic cancer was better approached with preventive measures — before cancer was diagnosed — since cure rates after-the-fact are only marginally better than they were 50 years ago.
“For the last 15 years, the discourse in our country has been about health care finance,” Agus says. “It needs to start to change and be about health. In the state of California, 26 percent of our costs are still tobacco-related.”
In “A Short Guide to a Long Life,” he lays out 65 preventive-health solutions. For example, “Eat real food. The quiet, lonely whole orange sitting in a produce basket will do more for your health than an eight-ounce glass of fiberless fructose.” Or: “Get off your butt more,” explaining that being seated for more than five hours at a stretch is the equivalent of smoking a pack of cigarettes. Or: “Stop taking vitamins!”
With this he once again takes on a whole industry, as he did with his longer and more data-rich book “The End of Illness” two years ago. Agus explains that men who take vitamin E are more, not less, likely to get prostate cancer, and that women who take high-dose vitamin D supplements are raising, not lowering, their likelihood of future bone fractures.
“Only 40 percent of Americans get a flu shot,” he says, “yet 40,000 people die of the flu each year, and if you get the flu and recover, the inflammation puts you at risk later for cancer and heart disease. The vaccine for the human papilloma virus would save 30,000 lives a year” — if only young children would get it.
Agus describes the hardest part of his job as looking two or three people in the eye each week and having to tell them that there are no more drugs he can prescribe for their cancers. He knows, but he doesn’t say, that if they had only changed things like diet and lifestyle — prevention — 20 years before, they might not be about to die. And, he says, they often know it, too.
The all-too human tendency to put off today what could save your life tomorrow comes with dire consequences. Hence, a basic business plan (if you will) for Applied Proteomics: make diagnostic tools easier.
An all-too-necessary check for colorectal cancer (the second-most-prevalent cancer for women, third for men) is the colonoscopy. The patient is anesthetized, medically plumbed for polyps on the intestine wall that may indicate disease. Since many people delay or shirk such procedures, Applied Proteomics is developing a blood test designed to assay the proteins indicating polyp growth may be occurring. This would reduce the number of warranted closer looks.
Similarly, if you feel chest pains and are rushed to the emergency room, you will undergo a barrage of ionizing radiation that, says Agus, may cumulatively put you at risk for later cancers. However, since proteins are released as a heart event approaches and occurs, a simple blood protein test might actually determine that the event was brought on by some bad food you had at a Scottish restaurant the night before.
Problem is, there are some 2 million proteins in your blood, some 22,617 protein-coding genes, and an enormous number of pathways and switches to be addressed or treated when your body is “cancering,” as Agus puts it. Developing diagnostic tools for proteins or the whole “proteome” therefore requires big-data solutions and a supercomputer, indeed.
Agus believes the 19th-century nomenclature of using body organ names for types of cancer is being challenged as advances in molecular medicine and digital diagnostics occur.
“To me cancer is a verb, not a noun. It is a process, not one cell. It is something your body is going through. Not something it has.”
He adds, “If you look at prevention, I don’t know how or why aspirin works, but it dramatically reduces the death rate of cancer, and it does that by changing the host so the cancer doesn’t want to grow. We have to think very cautiously before we get too reductionist in our approach because cancer is a disease not of the cancer cell but of the host.”
Before cofounding Applied Proteomics with Disney big-data systems engineer Denny Hillis, Agus founded and sold off San Diego’s Navigenics, a low-cost enterprise platform for delivering genetic information, to Carlsbad’s Life Technologies for an undisclosed sum. Before that, he did postdoc work in immunology at the Scripps Clinic. At one point he even investigated anti-cancer T cells in sharks at the Scripps Institution of Oceanography.
“Sharks are remarkable creatures. They eat garbage, but they do not have the significant disease you would expect. The T cells in sharks are generic, compared to ours, but highly effective. We didn’t have the reagents 20 years ago to understand why, but there is something there.”
Agus is curious about everything.
“I was a science geek with a passion for learning,” he says. Son of a kidney specialist, he made it to the finals of the Westinghouse (now Intel) Science Fairs, before medical school at Johns Hopkins, where he declared he would be an oncologist.
“That’s career suicide,” his supervisor told him. “Oncologists just give people poisons. Why not go into cardiology, pulmonary, where you can help people?”
He said that spurred him even further. “Because obviously a good portion of our population is suffering from cancer,” he says.
Apple co-founder Steve Jobs was Agus’ patient. Jobs died of neuroendocrine pancreatic cancer. “Steve was a remarkable patient in that he questioned everything. It was a remarkable discourse. I learned a lot from him. The best patients are the ones who ask: ‘Why?’ and ‘Explain it to me.’ Steve lived until the day he died, which is such a remarkable lesson, because many people, you know, die the day they are diagnosed with a deadly disease.”
Jobs didn’t like the original title of “The End of Illness,” eventually a best-seller, which was “What Is Health?”
“Listen,” Jobs told Agus, “you can’t put the word health in the title. It’s a bad word in our country. You put health in and people’s eyes roll back and glaze over. It’s like, you know, eating cauliflower.”
Prevention, Jobs understood, is still a dirty word.
Take the stairs.
Researchers Subin Ryoo, Terrence Zant, Jack Chapple and Carlos Caban contributed to this column. Join the discussion at stevechapple.com intellectualcapitalchapple@gmail.com
© Copyright 2014 Steve Chapple
Agus, head of the University of Southern California’s Westside Cancer Center, an expert in molecular medicine and a CBS News contributor, has become an apostle of prevention.
He once stood up in an auditorium of oncologists and declared that metastatic cancer was better approached with preventive measures — before cancer was diagnosed — since cure rates after-the-fact are only marginally better than they were 50 years ago.
“For the last 15 years, the discourse in our country has been about health care finance,” Agus says. “It needs to start to change and be about health. In the state of California, 26 percent of our costs are still tobacco-related.”
In “A Short Guide to a Long Life,” he lays out 65 preventive-health solutions. For example, “Eat real food. The quiet, lonely whole orange sitting in a produce basket will do more for your health than an eight-ounce glass of fiberless fructose.” Or: “Get off your butt more,” explaining that being seated for more than five hours at a stretch is the equivalent of smoking a pack of cigarettes. Or: “Stop taking vitamins!”
With this he once again takes on a whole industry, as he did with his longer and more data-rich book “The End of Illness” two years ago. Agus explains that men who take vitamin E are more, not less, likely to get prostate cancer, and that women who take high-dose vitamin D supplements are raising, not lowering, their likelihood of future bone fractures.
“Only 40 percent of Americans get a flu shot,” he says, “yet 40,000 people die of the flu each year, and if you get the flu and recover, the inflammation puts you at risk later for cancer and heart disease. The vaccine for the human papilloma virus would save 30,000 lives a year” — if only young children would get it.
Agus describes the hardest part of his job as looking two or three people in the eye each week and having to tell them that there are no more drugs he can prescribe for their cancers. He knows, but he doesn’t say, that if they had only changed things like diet and lifestyle — prevention — 20 years before, they might not be about to die. And, he says, they often know it, too.
The all-too human tendency to put off today what could save your life tomorrow comes with dire consequences. Hence, a basic business plan (if you will) for Applied Proteomics: make diagnostic tools easier.
An all-too-necessary check for colorectal cancer (the second-most-prevalent cancer for women, third for men) is the colonoscopy. The patient is anesthetized, medically plumbed for polyps on the intestine wall that may indicate disease. Since many people delay or shirk such procedures, Applied Proteomics is developing a blood test designed to assay the proteins indicating polyp growth may be occurring. This would reduce the number of warranted closer looks.
Similarly, if you feel chest pains and are rushed to the emergency room, you will undergo a barrage of ionizing radiation that, says Agus, may cumulatively put you at risk for later cancers. However, since proteins are released as a heart event approaches and occurs, a simple blood protein test might actually determine that the event was brought on by some bad food you had at a Scottish restaurant the night before.
Problem is, there are some 2 million proteins in your blood, some 22,617 protein-coding genes, and an enormous number of pathways and switches to be addressed or treated when your body is “cancering,” as Agus puts it. Developing diagnostic tools for proteins or the whole “proteome” therefore requires big-data solutions and a supercomputer, indeed.
Agus believes the 19th-century nomenclature of using body organ names for types of cancer is being challenged as advances in molecular medicine and digital diagnostics occur.
“To me cancer is a verb, not a noun. It is a process, not one cell. It is something your body is going through. Not something it has.”
He adds, “If you look at prevention, I don’t know how or why aspirin works, but it dramatically reduces the death rate of cancer, and it does that by changing the host so the cancer doesn’t want to grow. We have to think very cautiously before we get too reductionist in our approach because cancer is a disease not of the cancer cell but of the host.”
Before cofounding Applied Proteomics with Disney big-data systems engineer Denny Hillis, Agus founded and sold off San Diego’s Navigenics, a low-cost enterprise platform for delivering genetic information, to Carlsbad’s Life Technologies for an undisclosed sum. Before that, he did postdoc work in immunology at the Scripps Clinic. At one point he even investigated anti-cancer T cells in sharks at the Scripps Institution of Oceanography.
“Sharks are remarkable creatures. They eat garbage, but they do not have the significant disease you would expect. The T cells in sharks are generic, compared to ours, but highly effective. We didn’t have the reagents 20 years ago to understand why, but there is something there.”
Agus is curious about everything.
“I was a science geek with a passion for learning,” he says. Son of a kidney specialist, he made it to the finals of the Westinghouse (now Intel) Science Fairs, before medical school at Johns Hopkins, where he declared he would be an oncologist.
“That’s career suicide,” his supervisor told him. “Oncologists just give people poisons. Why not go into cardiology, pulmonary, where you can help people?”
He said that spurred him even further. “Because obviously a good portion of our population is suffering from cancer,” he says.
Apple co-founder Steve Jobs was Agus’ patient. Jobs died of neuroendocrine pancreatic cancer. “Steve was a remarkable patient in that he questioned everything. It was a remarkable discourse. I learned a lot from him. The best patients are the ones who ask: ‘Why?’ and ‘Explain it to me.’ Steve lived until the day he died, which is such a remarkable lesson, because many people, you know, die the day they are diagnosed with a deadly disease.”
Jobs didn’t like the original title of “The End of Illness,” eventually a best-seller, which was “What Is Health?”
“Listen,” Jobs told Agus, “you can’t put the word health in the title. It’s a bad word in our country. You put health in and people’s eyes roll back and glaze over. It’s like, you know, eating cauliflower.”
Prevention, Jobs understood, is still a dirty word.
Take the stairs.
Researchers Subin Ryoo, Terrence Zant, Jack Chapple and Carlos Caban contributed to this column. Join the discussion at stevechapple.com intellectualcapitalchapple@gmail.com
© Copyright 2014 Steve Chapple
