00:00this is frank islam chairman and ceo of fy investment group and your host of western calling
00:22where we interview leading voices from business and politics and journalism and doctor and explore
00:28the topics that impact you the viewer today our guest is dr azra raza professor of medicine and
00:35director of the mds center at columbia university medical center welcome to our show thank you for
00:41coming to our show dr azra raza thank you for having me frank i'm delighted and honored to be here
00:50okay you grew up in karachi in a traditional pakistani middle-class household of seven
00:55sibling as you've said in one of your interviews at what point did you decide to go into the medicine
01:02and when did you come to america when when did you come to america and how did you come to america
01:11it's an interesting background because i would have had a very different career had i grown up in the
01:19west i would have been a pure molecular biologist or a myrmecologist which is an ant lover because
01:28for some reason since i was four years old growing up in karachi there were plenty of ants around in
01:33every house and i was a curious person i would follow them and follow them into all over their trails and
01:42just got more and more interested with time and then i learned as i started reading about them when i was
01:48older as a teenager that the entire ant colony made of of even up to a million ants sometimes are all
01:56females that intrigued my interest greatly and these are the most altruistic creatures on earth they'll
02:03sacrifice their lives in an instant for the queen or whatever they're supposed to do and all these
02:09things interested me so much frank i wanted to be a myrmecologist then i got interested in cancer
02:16reading about the cancer cell and how a cell within our body that we give birth to literally can become
02:23immortal and mobile it can walk out of organs of origin you know in no other disease can a cell walk
02:30out let's say a cell is born in the liver it has to stay in the liver cell in the brain stays in the
02:36world and how did you fight with cancer start and where sorry what did you where where how did you
02:45fight with cancer and start and where well i was a reader as a younger person because there wasn't that
02:52much to do in pakistan i was curious i mean there wasn't because there was no television or anything and
02:59we just played a lot but in the afternoons you just had like three four hours to read and i read more
03:07and more in the sciences because i had a curious mind and i don't know why i read some started reading
03:13about biology because of my interest in ants and then the best way to learn biology turns out is to
03:19look at abnormal behavior of the normal cells and that's where cancer came in and the more i started
03:26reading things about cancer the more intrigued i was about how this cell attains immortality and mobility
03:34and as i said my next step would have been to do some graduate work in molecular biology but in pakistan
03:43really the only way to do any science was to go to med school as soon as i entered med school and saw
03:49my first cancer patient one look was all it took i knew that from that moment on my entire life has
03:56been devoted to suffering to reducing the suffering of these patients and that's how i came to america
04:03frank at 24 with the with the express purpose of curing cancer oh i came to united states when i was 10 years old
04:16great so you were part of president obama's cancer moonshot program president obama is a good friend
04:23have also developed a tissue bank of cancer patient that contains 60 000 plus specimens of patient tissue
04:32what is the significance and why did you do that what did you do with obama
04:38uh president obama actually had made uh president vice president biden whose son bo biden died of brain
04:47cancer that is a true statement yes and they're good friends yes and frank it was vice president biden who
04:58decided after his son died to do something about cancer and invest more money because the only way to move
05:05any field is to invest in it intellectual resources which come with financial resources when there are
05:11incentives that will support our work that we want to do the research we want to do so vice president biden was
05:19given one billion dollars by president obama to develop this cancer moonshot program and i was one of the first
05:28initial pilot groups that were invited to meet with the president biden at that time vice president
05:36president and um and the basic reason for my claim to having any individual voice in this field
05:47which is full of hundreds of thousands of researchers and wonderful oncologists but i think a little
05:54differently because once i came to america i could see things that people who are raised in the system
06:02could not because they had been kind of um you know it's like if you take a frog and throw it into
06:08boiling water the frogs gonna jump out and try to save its life but if you put a frog in cold water
06:16and start heating it up slowly the frog won't try to jump out because it keeps getting adjusted to the
06:23increasing temperatures till it dies the water reaches boiling point and it's like lobster same way
06:30yes so the point is that people who are raised in the system often are desensitized they don't
06:37see things and i came as an outsider and what i saw within i came and started seeing and treating patients
06:44with acute leukemia and doing research but within a few years two things became very clear to me frank
06:52number one that in my lifetime this leukemia is so deadly there's no way it will be cured
07:01and so the only good news we can ever give a cancer patient with that we say you have cancer but we
07:08have good news we found it early in other words the only way to cure leukemia would be to find it early
07:14but how do you find a cancer that has billions of cells circulating that is true that is a true
07:21statement so the early deduction and prevention of cancer may be the most efficient solution for cancer
07:28to summarize in your essay in the wall street general correct yes entitled cancer is still beating
07:35us we need a new start where are we now in this battle so i realized that the only good news you
07:44can give a cancer patient is we found it early and we can't give that news to leukemia patients so it
07:50occurred to me that the only way to find leukemia early is to go and look at people who are at high
07:57risk of developing leukemia before they actually develop it and that's how my whole interest in
08:04early cancer started that we need to catch cancer before it catches us we need to kill cancer before it
08:11kills us and the only way to do that is find it at inception don't wait for cancer to declare itself
08:19as the end stage monstrosity but seek out the first cancer cell and so in 1984 this was my first
08:28realization and the second was that all the scientists around me at the cancer center where
08:35i was frank they were studying mice i was at roswell park cancer institute in buffalo new york right and
08:46everybody was using animal models especially mice to figure out various signaling pathways
08:53genetic genetic mutations etc but i realized that that's very artificial in fact i was a follower of
09:02norbert wiener who said in 1940 that the only good model for a cat is another cat preferably the same one
09:14in other words the same cancer if it strikes me and then it strikes let's say somebody next to me
09:24may not have the same outcomes depending on our lifestyles the way we metabolize the drugs given to
09:30us for treatments etc so really the only thing is to individualize every treatment and for that
09:40you need to have some way of finding the first cell in everybody and because cancer is in no age is immune
09:51even children get cancer this means that we need to treat the human body as a machine and continuously scan
10:00and monitor it for the appearance of the first cell and this is how i met president vice president
10:07biden because i'm the only one in that moon shot who kept pushing for prevention and early detection
10:14at that time and even now frank 95 percent of our financial and intellectual resources are being
10:23invested in advanced cancers studying them treating them and five percent that are dedicated to early
10:31detection and prevention mostly go to anti-smoking anti-obesity campaigns and very little to the kind of
10:38thing i'm talking about which is that we should use all of the latest technology to develop miniaturized
10:45automated devices that can do all this that can pick up the first cell and the signals that is giving
10:52out from blood or not even go to the blood put things on top of the skin as sensors and be able to sense
11:00what is going through in the blood vessel we can do it but we need resources that's a good way to do
11:06you have suggested that the first cancer cell that gives rise to a tumor is like a grain of salt sand
11:13that starts the collapse of state sand pile research should concentrate on finding these early changes
11:20before an actual tumor develops that's what you said eliminating the first cancer cell
11:26rather than chasing after the last one can you elaborate on this
11:31first i want to tell you the sand pile analogy that i have used previously in my book the first cell
11:43and the human cost of pursuing cancer to the last the idea is the frank that if you take grains of salt
11:50of sand and start dropping them one grain at a time they're going to make a pile and the pile will keep
11:56increasing until one grain of sand is going to make the whole pile collapse now the grain of sand that
12:05caused the avalanche was no different than the million grain of sand that had gone before what was
12:12different was the pile had become unstable so i'm saying that with age and cancer is a disease of the aging
12:22let's say if there's two million cancer patients a year diagnosed in new individuals then only 15 000
12:30will occur in children the rest of the two million is in adults and in the elderly meaning over 50 years
12:36of age at least so what's happening with age is that each of our systems is becoming a little decrepit a
12:43little inefficient so the the just like the pile of sand it's becoming unstable and even a little
12:52thing can cause a collapse of the system and we need to catch that little thing and that's what i want
12:59to show you what i'm holding in my hand is in my opinion the cure for cancer what is the cure cure is not in
13:08the syringe the cure is in the needle so you'll ask what is in the needle well in the needle is a stent
13:15just like a coronary stent a tiny little stent which millions of people who have coronary stenting done
13:23are walking around with well we took that coronary stent and biomedical engineers at columbia university
13:30that i've been working with for a decade ken shepherd and sam sear basically perform fabricated electronics
13:39onto that stent so that the stent inside it we can create an electrical field and any cell that goes
13:48through the stent will cause impedance of electricity and that signal can be picked up and recorded on the
13:56stent in a computer that has been built into the stent this is a total miracle of of electronics that
14:04these engineers are supreme what they've done now my work showed that the first cell could be a giant
14:12cell so if a large blood cell is 20 microns in size the largest circulating blood cell then these first
14:21cells of cancer could be 300 microns compared to 20 300 if that bigger cell goes through the stent
14:30it will cause a very large signal so if we put the stent in your arm vein let's say and it stays there
14:36forever and every cell that's going through is being detected for size as soon as the large cell comes
14:44not only will it be detected the stent can be programmed to electrocute it wow catch and kill in the same go frank
14:54this can be in your arm and my arm looking for cancer in within a year if i can raise the right resources the
15:04problem is all the resources are going into end stage treatments i'm saying that the way to cure cancer
15:11is to revolutionize early detection and i'm saying that the entire health care paradigm has to shift
15:18from one of treating illness to one of maintaining wellness that's a good way to put it you you did a
15:28poetry as i understand
15:34galib urdu poet galib including the translation of his ghazal you have over a hundred videos on youtube
15:41about poetry where do you find the time and how did you relate your poetic pursuits with the medical with
15:51your medical challenges can you elaborate on that i don't think that can you decide some of the some of
15:58the mizah galib's poetry happy to recite because that's what i love to do meaning i love reading poetry
16:08and i was in pakistan in november and i met a wonderful poet contemporary poet fawad hussein
16:21a well-known political figure i believe also but what a what a wonderful poet and this morning
16:30uh as i was writing uh as i was writing completing one of my grants one of his couplets came to my mind
16:38let me read that to you this is fawad hussein fawad
16:43mana jaane kap se safar me hun lekin abhi meri jabeen par and because it really fits my situation
16:54wow isn't that so beautiful i do not understand is this mizah galib's poetry
17:21okay okay let me say this again i went to pakistan in november and i met in lahore
17:29a contemporary poet by the name fawad hussein fawad
17:35and it is his couplet and i'm reading it to you because it's very um suitable for my position i've
17:46been working hard in cancer research for 50 years and yet i refuse to give up
18:03because you said that you did not understand it let me explain it to you i've been in this journey for so
18:11long and yet my spirit is not defeated and neither is my forehead showing signs of abandoning the goal
18:21because that is so important that if we are failing we shouldn't question the goal
18:27and neither should we question our own devotion to the goal
18:30the goal because both the goal is very important and our
18:38striving for that goal is equally dignified yet the fact that we haven't reached it doesn't mean
18:47that only the moment of gratification would be worth it because in this journey how much i have learned
18:55my god unbelievable and let me complete it by reading a ghalib couplet for you now yeah please
19:05you're pretty good in this
19:06the heart is urging one to continue striving
19:26kawish is continuous struggle kawish ka dil kare hai taqaza ke hai hanoz na khun pe karz us gira hai neem baaz ka
19:39wow our nails owe a debt to even one half undone knot of a problem in the universe we need to continue working until even that
19:53half undone knot is resolved
19:56kawish ka dil kare hai taqaza ke hai hanoz na khun pe karz us gira hai neem baaz ka wow
20:05you're a supporter of south asia peace action networks sapon and have endorsed the sapon
20:10founding charter calling for ease of visa economic cooperation collaboration all areas in south
20:18asia what makes you believe in this cause and what and what in your view is the importance of cooperation
20:27and collaboration
20:34frank my whole life has basically
20:38been spent in trying to reduce the anguish of humanity that's a good way to put it and if the
20:47question ever comes up who deserves our love more god or man
20:55then my answer is always that the only way to show your love for god is to love man
21:03you have to love humanity and you have to be able to do everything possible to reduce the suffering of
21:10human beings that is our one and only goal in life sapon is trying to do just that
21:17why are we fighting and not just sapon all the organizations that i know of
21:28the first step to reaching the love for god
21:32is first to love humanity a person made of flesh and blood because you see frank it's very easy to
21:39love an abstract idea of a god whose existence can even be questioned by many people
21:46and very easy to love a god to whom you have assigned every perfect attribute right everything in
21:54perfection is what god is so it's easy to love a perfect being like that but it's much harder to love
22:03a person made of flesh and blood full of problems full of deficiencies full of inadequacies insecurities
22:13that is much harder that's your real test and that's why my goal is always yes you can sit in a mosque and
22:25say allah and for sure you'll go to heaven
22:37but if they had walked the walk and then reach that god through serving mankind that would be a different
22:45way of living very well said so that's our show until next time this is frank islam of fri investment group
22:54wishing you great week and thank you very much for coming
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