Cancer Researcher Dr. Siddhartha Mukherjee

today is world cancer day i'm kate mcintyre and today on cpr presents cancer genetic research and the future of treating hereditary element dr siddhartha mukherjee is a renowned cancer researcher an oncologist he won the pulitzer prize in two thousand eleven for his book the emperor of all maladies a biography of cancer his latest book is the gene an intimate history dr mukherjee spoke at the university of kansas leed center on september twenty six two thousand seventeen as part of the whole center for the humanities lecture series thank you for that very warm introduction to take your word for coming many view might have expected an abstract talk about medicine and science in the future which i will certainly try to deliver but we begin by asking you to just have a quick look at your neighbors just going to his around the victim lost to

face in all seriousness a mascot to three questions i want you to think about the new album to answer them based and if you want to if you want to abstain that's fine how many if you want to know the height of your unborn child the future height of your unborn child you don't know your child is about we mourn and maybe in twenty years from now a genetic pastor a counselor a private company says that with the greater accuracy sixty seventy eighty percent i can predict for you the height of her unborn child home if you would sign up for such a test as your hands look around that question to you have two children and far from being able to predict with that sixty seventy eighty percent accuracy we

not dropping august of five or ten percent but the consequences are quite serious so how many of you would choose to know if your child carries a five percent say risk all a severe psychiatric illness in the distant future and maybe we know that there are no treatments that now but ten years from now there might be new treatments for this is your hands the ground in these uncomfortable questions i'm sorry but they're important questions question three twenty years from now our society has changed fundamentally we routinely have in vitro fertilization and in that process and we sequence the genes of these the implant embryos embryos before that are implanted are you

comfortable with the word annuity sequence these embryos and would you be ok with the idea that we eliminate an embryo say weary detective five or ten percent chance of a future risk of cancer that's the only thing as green for you don't know whether this embryo happens to be the one that will be dr the president the united states a creative genius eccentric you comfortable with a society where we screen such embryos and decide only to implant embryos where we know that the risk of cancer is diminished from five percent to one percent who was comfortable with the society you are now some people are present and the problem is only on the idea a couple times ok so i'm going to talk to be about far from talking about what you might consider some abstract ideas on a truck when i visited a very relevant to us today because these kinds of questions are questions that we will i think face increasingly as

physicians as human beings as scientists bolts of course in society at large i would talk about cancer because i think the payoffs of all of genetic the genetic understanding of cancer has deep and consequential but i was a lot of talk about what might happen as we broaden our understanding why the outside very small rounds of cancer and talk about how what it means to each one of us individually vary widely speaking or what would get a conviction and manipulation or it would be learning i wonder what this ideal for susan madison for cancer was admit what does it mean i would begin to understand or have begun to understand cancer in a much more fundamental and rather precisely in individuals and one of things i will assure you of course is that these things these three ideas is the idea that you can lead much

much more deeply information about the human genome that was previously possible the idea that you can use computational algorithms to understand pieces of that information that were previously invisible to us and the level of comfort that we have or discomfort that we have once he only shot competition overlords on our own genomes and what that might do to our society's what that might do to ourselves whether these will create deeper inequalities within what's all diseases that be one of the big hype that been hard to solve i also talk about the brits playoffs the idea that you can use these this understanding to create new medicines in cancers and diseases neurological diseases heart disease things that we've struggled to turin treat in the last few decades so before we do all that i want to delve into a little bit of history a little bit of a story because this is the story all this talk of models is a

story of a larger story of three of the human genome the story begins in a strange place and doesn't begin in the laboratory and doesn't begin in university doesn't begin in a standard place that you might imagine the most consequential and i would argue the most dangerous idea in the history of the recent history of science came from it begins in a monastery and begins a musty i i spent time here i spent a week and a half here six years ago in a small town good right now and that's where in this or garden small area a man named gregor mendel began to perform some experiments he was a monk he had been rejected multiple times from university education he was a failed about distances should give us all a lot of reassurance that you can be sent to that the most important paper in the history of biological sciences

having failure examinations and biology but here he was he was that basically he was a monk and he was a substitute teacher and he began team began to experiment we think of them and so in this clip a lot of land with a witch's we had enough clout in the gardenia is but anyway but he of course men who began to taunt peas why you would take many routes garden regarding is that i don't know but anyway but mental began to tease and he made in eighteen sixty forty sixty five an incredibly important realization and that realization was that her energy the fact that you and i resemble our parents somewhat that is carried out not by some kind of me as next substance some kind of peculiar weirdness but in fact as caring in a discrete form like information moving from your parents do the

offspring from a parent's do you in a kind of discrete informational form like words in a sentence you can't hear those words apart they will lose meaning you got scad of the letters a party will lose meaning like the word n word it is inherited in full most from your parents to your offspring of insulin and mahmud described all this just by looking at in great detail by looking at pease i had many consequences you realize that in every generation information in this discrete for naught and the kind of blended form is moving from one generation to the next not just to contrast this with a very simple idea which existed before many people thought that your nose and your eyes as some kind of intermediate between your father isn't your mother's nose and eyes and this was human intuition for generations that the war the parts of some kind of lending that the genetic

information was taken from your father and from your mother and blended in some kind of biological grandparents and your nose came out of that it's a very intuitive idea makes a lot of sense except of course it has one big problem it takes you two seconds to figure what the problem is unspoiled gender right so it couldn't possibly be true that in every generation this come kind of blending going on because otherwise are matinees would become dentists so there has to be a reason that you and i are inheriting information for my parents that is some health that is somehow kept generation of one generation intact and it's astonishing that would take member in eighteen sixty for several thousand years after many of the fundamentalists and it's about to be discovered essentially to rediscover this idea that of course the information correct information the thing that makes us

gives us her anatomy our physiology our traits identified are and by extension identities is being blended in some kind of biological gender but was carried out in discreet in this form that reproduces itself generation upon generation that's the only way you could explain how gender male female remain anatomically physiologically remain intact as a war generation upon generation there's no other simple explanation for that what's interesting to me about that story about that the story of the discovery of genes as the fundamental unit is that soon after a man who had discovered this biologists worked on now the scenes in the early nineteen hundreds a speeding forward a little bit in the early nineteen hundreds began to realize that this was a powerful and dangerous idea long before they knew what it was

whatever this information how this information transmitted what was its relevance to diseases like cancer or metabolic diseases or diabetes what was his relevance of this information that move from character last very long before we knew all of this the movement to use that information to discriminate between human beings to make to identify those who were weak reese's those were strong oh i'm already was being practiced a couple of examples that it's interesting that the first the most powerful example the more we called eugenics the idea of using genes to understand and thereby the hope to create a better society by using genetics i was actually born very soon after mantle was born in the uk was born in england and let me buy a magic wand would be jack's itself france's gordon what was a cousin of violence and why darwin was

thinking what evolution boykin was thinking but sosin of houston how can we make better societies and of course one way to make a better society we thought was blessing acting selectively breeding the best together by selectively breeding the people work the best adapted the best looking the biggest surprise the smartest these local militants on ideas i'm so this was seeking this was so what was the eugenics the idea that he would use this feature the selective breeding of human beings to create better humans their societies that race is there are countries around the idea then morris and comes to the united states i recall that we haven't even spoken about germany and in the nineteen tens and nineteen twenties when it morphs into a kind of practical realm in the united states it becomes moves from selective breeding the selective

sterilization whether we sterilize women or men but of course women predominantly who are likely to carry defective traits into the next generation and thereby remove their influence from preachers size of this is carrie buck my book is dedicated to carrie buck i would encourage everyone to read that history and the histories their equipment to this state as well carrie buck was one of the first women to be sterilized under this small also trying to make sure that the best that that people were unfit to read or sterilized the case declined to the supreme court and that was a judgment passed down was very chilling it says three generations of ensues is enough and carrie buck was forcibly sterilize to prevent the prevent the fall i was then considered genetic defect of mentally ill children it turns out in retrospect that in fact terry about having a witness he was just one of us

but it's it's it's a reminder of how quickly from eighteen sixty four to nineteen twenty barry a flash of time but the idea of heredity of genetics of of inherent c was being moved from an abstraction something that someone was launching a monk was blunting in peas do an idea that was used as an as a mechanism of social and biological control is only after all this and that we still don't know what the carrier of this information is who's carrying this information with information comes from is it a chemical isn't a substance what is it we don't know any of this we're in the nineteen twenties nineteen thirties that that same idea morris from eugenics as a mechanism of reading the most the best and the brightest as gordon would have at indy in england eugenics as a route to sterilize it's an effort against that women who

carried what was thought to be jeans often the seventy eight another weaknesses and ultimately get more states most macabre form which is the foreman remembered today which is a nazi germany here are others a nazi physician measuring trends here is that on the most interesting images that i've found while working on the book ss could gets you can see a swastika in this man's hand i'm watching on the blackboard and look and the blackwood the man who is the young a captain of the nazi party and has meant those laws and mangoes diagrams up on the blackboard here is from the united states a better babies contest something like remember these bad reviews contests here are babies being judged for being the most eugenics in effect they are being judged for future the idea that you would create a future a race where this would now becoming

racially cleansed and therefore superior as a mechanism of social control barry as i said forty years after the discovery of the idea of the gene itself one of the consequences of all the war was there any broader sense of shame to this project the very important sense of centers rather than an embarrassment because of the nazi excess of that but what lot of things on talk about visiting never fully decapitated desire the desire to improve ourselves does it improve our society is designed to improve our own children to console of heredity is an ancient desire and that's why austin was first few questions dr squire sells about what we really desire what we desire what kinds of things and we don't allow our society is that you move into

as we move forward into and sang more and more about ourselves keep the bottom line so amenable back into this film to bring you up too quickly and we'll bring you up to where we are today and then we go back into these questions i just ask you before so i'm the explicit eugenic desires often nineteen twenties and nineteen thirties were contained partly because of the excesses of what happened in germany in the nineteen thirties and nineteen forties the extermination of human beings based on eugenics this that the file that the progression from better reading sterilization extermination was was of course a step away into the abyss of eugenics and by the nineteen forties we had decided to society's to keep aside those questions move them away and instead concentrate on what was it that was transmitted this information across

generations and that of course turned out to be a molecule that was very unknown to most biologists core dna if you said the word dna in the nineteen twenties and nineteen thirties cities were working on the naacp would say what a weird thing to work on it is a strange molecule on interesting probably some structural components of the human body who would've thought that this would be the carrier information and we didn't know anybody molecules but the but the substance that lay behind amend those idea that already was transferred across generations and the final stretch of the molecule was sold in the nineteen fifties well jim watson and francis crick of the double helix all must contain every cell in our bodies contains the lyrics if it's double helix was in a single so expanded out it would be its and put all together long chain it would be several meters all and each cell of our body contains this

information this twisted double helix and condense is it many for almost a million ford into that cell and that information tells the cell how to behave what to be how to act and it gets transmitted from ask your children through sperm and eggs and that is of course the secret behind the transmission of information from one generation to the next that if i took your genome it would contain this though it's obviously was the lyrics form this chemical form your critics three billion letters all of dna written a c t g if you think about that effort was standard a printed on them encyclopedia it would be about seventy four sets of the encyclopaedia britannica one human beings you know so although walls can imagine in

this in this room would be lined with your genome and if i want to move to your genome i would have to make another moratorium the size and lined all the laws again with the encyclopedia of your genome and so forth to each of what each one of us carries within our bodies one such seventies that encyclopedia britannica not win you this we began to understand this and he also began to understand that you could pick out one volume one page and it would be in school it to us in the nineteen sixties nineteen fifties they would read a c t g cctv and so forth we would have no meaning the idleness but how does this encyclopedia specify us how to specify us in our part of the structure of our body forms ourselves and does it all to specify things that are beyond simple much as the shape of your nose what is the color eyes but of course the

propensity to develop diseases does it specify fate doesn't specify the capacity to develop mental illness does it specify actually says doesn't specify identity how much of identity how does it interact with the environment this code but each of us carries and meet us these are the kinds of questions that we began to think about in the nineteen sixties and nineteen seventies when you know the answers to and as we understand the answers to these questions on one hand we acquire the capacity to take your and down and deliver promises for incredibly important diseases help book about that but also it opens up the deep questions about who we are and what we need to know and how much we're willing to know about the future but back then to the question of ok do you have this encyclopedia each one of us has an insight into how does that make us thousand

encyclopedia which is a kind of information a c t g c c t c c g sold for three billion letters houser may human beings well the simple answer is that it makes human beings it makes animals organisms by creating messages and those messages ultimately become functional businesses become actual laws the difference between sydney reverend jim watson division younger jim watson and an origin what's an upset are because they say the genome be that they're two different genomes in two different cases they've interacted with invited to different environments they specified functions and these two functions have ultimately translate themselves into two very different people and or molecular course wants to this shouldn't ignore the details but the point is that the gene was carried indiana and they said this message is our ma and the form

function is a mixture of really aligned in protein but really is this this piece of it besides the details of an important the most important pieces that somehow or these out somehow or the other for most bought purposes this encyclopedia britannica seventy four limbs if it gets that misses the information carried as much like the computer gets translated into real words real information and it banned its actual laws in our bodies and work done by several of the people this is what the moment when their ember and we learn to read and how this information he began to the greenhouses commissions act and it's actually lies and by the nineteen fifties or nineteen sixties again this idea that dna makes a message makes a protein was was very obvious was one last thing you need to know and that's important and that is that this is a dynamic process is the best example of that and dynamism this process somehow or the other in this state the genome of

this caterpillar reads out caterpillar and within this within the matter of several days and several hours that same genome is that out to make a butterfly if you understand this you begin to understand how you could have thousands of different cell types in your body which every self carries its own genome your lever sell your brain cells your nerve cells your blood cells all carry the same genome they interact just the gnomes and expresses itself this encyclopedia makes differing versions of itself to actualize itself differently in different sounds and different organs and that is for a gene regulation so by the nineteen fifties and nineteen sixties we had realized all that there was a master encyclopedia that we carried in ourselves this mass encyclopedia that allowed the creation of a very different forms by weeding out some parts of it but in fact despite that them that

the massive message the encyclopedia remain the same but the question was there are two questions could we leading the actual letters and number two could be changed the actual letters and that's going to spend the rest of my top thinking about what if we learned to read all this it's information and what we need to get some information and the reading of information began in the nineteen seventies when a fred sanger do some mechanism you don't even need to know what the beatles but to really decipher what the actual code was so all of the sudden we began to lead a ct decency we wouldn't understand what the actual manifestation of the cold war so you could say what is the coating on page three seventy of your encyclopedia it was unknown to us we knew there was a code was unknown to us who began to read that quote

psychology reading genetic information and the second part of that was that we began to find mechanisms in science dude same genetic information to combining from one to the other of doing the simplest example what if i took your encyclopedic to pity and seventy and swapped it with someone else's move those two pieces around it would be like riding a new volume of a new encyclopedia correct so by the nineteen seventies we had just begun to do this we had just begun to find ways to sequence or read the human genome and they'd just begun to create ways to swap the human genome and this already had many many consequences of even the simplest consequences take medicines like insulin most like insulin tube it's very hard to extract but what if you could make you would take human insulin tear that page

out of the human encyclopedia and put it into a bacteria and make the bacteria make human insulin or make a yeast or some other cell make human insulin all the sudden you just essentially swapped one gene from one organism for you can move genes across the biological kingdom and you begin to mental universe of new medicines because you've taken one out one piece of the encyclopedia moved it to another animal moved in on the plot and begin to manufacture in fact this is what's done by her boyer bob swanson is a was a venture entrepreneur capitalist that happiness and here there actually showing how you how they started making thinking about making drugs like incident obviously this reading and writing muscle eight years of that who we are as human beings and that the fear is what would happen if we quickly started swapping this information without actual the evil brotherhood of mutants what would happen if you started

moving information from one organism to be another over them making he is not my natural means make to make students all the time but making mutants by artificial means by tearing out words moving words from one once i can remember and what happened when you began to understand human diversity in terms of these kinds of methods what would happen when you started asking the question what's the difference between this human being goes obviously much more than the rest of us and this human being who's a physician who carries on the genes that make him a much taller and these patients that here he's treating what happened between those differences what we could meet those kinds of it is that i ask a question how many of you would like to know about the height of a future target and this reading and writing information this is my mentor paul boyer who was one of the first people in madison to start

swapping genetic information between organisms he invented techniques to say take a gene from a human being and move into a virus gene from a virus and movement of bacteria and the fear is that that created of course went back right back to the great fears of the nineteen twenties which is the fears of eugenics one priest of this information used incorrectly would be start worrying about creating a soap opera for greece so this is where we sat at the eggs are all reading and writing in the two thousands and then we moved over that eventually went over the edge because we really started reading and writing human genes in a way we hadn't before and this was the at the sequence the human genome this was the beginning of our leading revolution so what did we learn from all this reading we learned a lot number one we learned that most human traits i control my

multiple genes very important thing to realize your nose your eyes you're the color of your character heights aspects of who you are are controlled by not wanting to pity but within the exceptions to this obviously and therefore as a consequence most common diseases are poorly but what it means multiple genes so heart disease cancer most common diseases that we encounter aside from the rare diseases are control the multiple genes we should know all these facts actually these are going to be principles that allow us to tackle the questions ask you to start with many diseases have a genetic links but right now we're still in the reading face we still don't know the exact things for most diseases we certainly don't know most at most genes that govern and fundamental aspects of human normal human traits i

don't have color eye color and so forth this is a very important equation i think it's sort of like the equation that governs fundamental laws of physics the question that governs fundamental laws of biology is that genes plus environments plus john's gives rise to traits most human prism you really need to understand this most human traits are not government entirely by government id but on my thumb there's a contrast somethings are highly genetic so in some fifteen so dominant in some fits environments were dominant and occasionally chancellor dominant and drummond what ultimately sought or we can ask this question feature by feature disease by disease tray by tray sin other words if someone asked me the question is it makes your next is a gene or environmental chance i immediately asked them back the whistle what we talking about just to give you again

classic examples most off gender anatomy and physiology as a genetic component whether you're born in antarctica or whether you're born in tanzania fundamental features of male and female biology for the most part will be governed by genetic components the anatomy and physiology the other aspects of all of gender identity feature as human identity that will be governed by some combination of genes plus environment less chance that aspects of diseases that we govern by environments and chance and this will go on or an overnight celebrity plus we question what is a teenager in a show it's a close ups that were what feature republicans going to differ from three to the future and b can i get it on no question but it's a question that's very dependent on what we're asking about and as a consequence of all of this if we go after imagine a genetic report congress gets back the first person i asked him in the beginning what if i give you report card that said

you know you had a five percent capacity to develop a lethal disease or a terrifying psychiatric illness that in a report card will usually be given a uniform and says it won't be a plus b minus c plus v you have a twenty percent chance of ten percent chance a five percent chance or given a breast cancer in the future a twelve percent chance to become manifest x or y featured him in your future what's interesting about all of this is that that's all this is true most human traits of control are multiple genes most common disease apologetic most of genetic links at the exacting the still unknown the genes doesn't virus for science deserve to features and that we generally will give us only propensities what's interesting about this is that our computational power our understanding of where genes is going for some features is reaching the place where we can actually start predicting and here is

exactly the question asked him before this is something like iraq two weeks ago and it took me by surprise this is a genetic critic of human height based on scenes along so here is the actual height of a human being and this is the predicted either the human being and obviously to exactly correct it would be a straight line up like this these are about two thousand human beings what's shocking to me is described doesn't look like a mess it looks pretty good nba for statisticians bit here late this our values point six four economics have some arguments with it all is that people that offer a straight line but it's not bad either and that's what's shocking to me at least another was in this experiment they knew nothing about a human being except for the sequence off their genome

and based on that sequence alone they predicted one feature that we find pretty complex human height and the graffiti predict that just by reading that encyclopedia they radically in the encyclopedia was the most predictive all human heart why this matters it matters because it has consequences for virtually every human disease it matters because we are trying to understand maintenance and risk it also matters because we really need to figure out how to deal with it who's like insurance what if we were to predict our own risk in the future calmly insure anyone how on earth can insure anyone if we knew began to understand what the risks were in the future so that part is about reading what happens when you begin to read but in the midst of all of his faults and beginning to write and by right i mean remember i said if you can

change the actual content of the encyclopedia of course mostly writing the human genome and these early days yet but these are some scientists jennifer doudna many of you come in you have heard the word christian literally everyone does what was obviously not even heard about ten years ago jennifer is one of the inventors of christmas trees are calling me actually my own lab work some disappointment but in brief again nominate the analogy is intact here is a mutation that causes breast cancer and here's a schematic in which you could go into the encyclopedia and potentially in some soul maybe an embryonic cell named the southern embryo you could correct the nutrition you can erase that go to pay sixty seventy five in that encyclopedia rotates the seventy five paragraph for and where it says cctv see naked cc agency or something like that and on one hand you and i can appreciate how powerful it would be to eliminate terrifying

diseases or terrifying risks of terrifying diseases breast cancer pancreatic cancer new agenda diseases huntington's disease a lot of we just extended that concern outside and began to think about changing fundamental feature of human identity what about someone who wanted to have a very poor child to be a loan that was rescinded and so in other words a combination of embryology in gene editing techniques have really pushed us to a point of time what we really have to take these questions quite seriously how should be allow ourselves to intervene on thing to reconsider most human of all alone things you consider most vulnerable which is the genome you could do things like the questions i've asked before what you read once you created what one created a model one embryo with several dozens and sequence all of them potentially change some of them and you had the capacity for

selective implant only the ones that you want to change or you have changed already so called pre implantation genetic diagnosis these questions have not fallen on that year as they have been taken up with the highest levels of concern in the united states of very large committee met several months ago to us to pursue a what should be allowed which should not be allowed to stop this kind of intervention another concern that was in one of those bills introduced again and yet again one concern as he wouldn't wish that he leave human this is edison border when you didn't exist at the polling and finally there's a lack of humility we will be i'm humble in the prospect of being able to change our own genetic information have we started actually doing this stuff on human embryos the answer is yes we have we have started there have been treated for attempts at all things using human embryos the

safety and on target effects remain unknown but here's the important nothing in principal stopped the future moving forward and there will be inevitable clashes to come and so the committee decided there was going to be there were leaked secret cheerio to develop to allow un human genetic serious stuff was so secret here is this is kind of technology that makes a mentor and facebook seemed like south la because we're intervening on things that we hold stewardship of and you've got everyone here needs to know the vocabulary because the will have to make decisions about what's permissible or not so three criteria for manipulations off human genomes was decided and one is that the disease in question have extraordinary suffering second that we are confident that when you make a change and again you actually are

producing the disease in other words this is not some kind of five percent relationship that some very direct relationship between the genes of consequence in the disease and third there's no other justifiable autonomous status of course individual rights these seem like very reasonable criteria the problem is it takes two seconds to understand that they're very subjective as well who defines an extraordinary suffering what is the limit one of the continent where we draw the line in the confidence of the genetic that the gene disease interactions type as if fifty percent of the fifty seven percent fifty two percent five percent and what saved me was justifiable criminal court should mean amy when it becomes privatized when you could make the decision the state says it's not my problem it's your problem you would now could make the decision to implant certain embryos you then in twenty years' time and sequence your bid the genomes of on him i'm implanting embryos who has to make that

decision imus and we spend a little bit of time on the last phase of all this which again has the consequences for all of us to spend a lot of time on this and that is just emphasize that if these techniques of leading already powerful and you can imagine that using very deep learning algorithms competition adam computers that letter and using them to understand genetic information would be would kick this information to yet another stratosphere i have a couple of examples of this one example i gave already about it a couple more here is an example of a young man that i know who has a genetic predisposition for melanoma or develop melanoma is we didn't know that there was no no one knew this but in fact he developed one melanoma hear a second

melanoma hear a third cancer here and it turns out that there are now the programs that will scan photographs of you or skin lesions that you develop and the band and divided them into benign mrs lippman lesions their programs they're going to vote that will scan your genome to allow us to really incisive really understand the risk of cancer you couldn't sell the benefits of such therapies could be you could be pre screened one proposition is to use facebook passively so that while you see if you really want to see your own pictures are doing stand four sets of the development of cities is coming to be comfortable in the word we put my consent give consent to the idea that why you see a competition rather than fifty years pictures of you on social media to find other diseases that you may

have in the future are we comfortable with that idea i mean you come from the idea that your cell phone begins to pick up in combination with your genetic predisposition futurist for new orleans is like parkinson's easily you pause when you're exchange when you begin to understand what that a fifteen begins to pick up in combination with a genetic risk with youth that are at an increased risk of a newer model disease and if they're comfortable with this invention which uses in combination with a genome similar to gin genetic you getting sequenced and then in about job as you take your ball up an ultrasound device scans you for the various development of pancreatic it's important consequences for all that we think about and finally this curve that i showed you of heights isn't an abstract her this was not possible before because we didn't have competition power this study

uses deep learning and it's only through deep learning that they could get this kind of prediction of human height so we are on the words of making some important developments and precision medicine the capacity diagnose cancer early or the capacity to sequencing genes per year so that you can predict risks for future disease is the capacity to understand information and he we didn't have before those early great upside saw these technologies and some of you in this audience actually are or even a fish that fishes of these detection only detection wake up competition technologies early detection through genetic technologies bracco one gene the breast cancer genes that we can see ponds and therefore predict your future risk of cancer on the other hand there's a concern that as we delve deeper and deeper into these technologies the three d printer on genomes that we would begin to a sort of things that we consider fundamentally human

but we needed to sort of things that we consider private information information that we changed about ourselves and with my other person i don't my family history of us that history of mental illness my family schizophrenia and bipolar disorder and the question i have two daughters and the question arose at some point of time that we do now begin to have thirty days we're beginning to have the first genetic hints of what might increase risk of these two diseases and the risks are on the orders of you know two percent increase five percent increase ten percent increase in this and the question that my wife and i sat down with the other night was truly sequence a two daughters and it is both of them are very well thank you but what if one of them both of them mean completely well fine no other illnesses like only one of them was to find out that five percent increases would fundamentally change the way we imagined that china on the

other hand would make us more cautious more thoughtful about the future of their child would make us think twice screen better think better think deeply about that child it's a question that will resonate but does this have already within society at keeps resonating deep that would be printed repentance so i've tried here today to do several things at like to so you historically where we've come through bubbles subsidy that where we've really landed there he's extraordinarily complex territory on one hand we have the capacity deploy technology used to make medicines for size for individuals including too many diagnoses for cancers in a diagnosis for many diseases on the other hand the moral questions the ethical question to be raised by these technologies are deep and profound and we don't have simple answers to them it is an inevitable consequence that

we will have to answer these questions the next ten or ten years and if all of us don't get into the conversation you don't learn the vocabulary feed on the science and the history will be left out of the conversation so i'm an engineer and opened up the floor to potentially million questions in a fourth floor listening to dr siddhartha mukherjee renowned oncologist cancer researcher and pulitzer prize winning author of the emperor of all maladies a biography of cancer his latest book is the deed an intimate history dr mukherjee spoke at the university of kansas leed center on september twenty six two thousand seventeen as part of the whole center for the humanities lecture series and i met dr mukherjee takes questions from the audience you're listening to kbr presents on kansas public radio support for kbr come from grace cathedral great spaces music announcers in

topeka hosting the concordia quire renee cause and conductor with local gas the robed choir from topeka high school money for more twenty six seven pm to get a great spaces doubt orgy i mean reading sun and the national geographic and some other publications about nine children who i hadn't been born a girl or a boy a very deeply recognize that they are the opposite sex is there a genetic connection and if so how much are what do we know about that genetic very complicated question thanks for asking a click on saturdays most people i would say most people and i think i mean fear here most people in medicine about you think that there will be a strong genetic connection most people in medicine would suspect that it is not one gene but multiple genes so many a combination as it were of jeans and most people would say would

suspect that it sits in the future very near in the future we will be able to decipher what these are only the classic example some of you might think this is a lobbyist for them to tell you what's interesting about her the classically they did the important story is going back to the anatomy and physiology of gender so male vs female it turns out his contract not surprisingly is only one gene that controls it's a gene contests are wife in china offer you one one direction anatomically or physiologically you turn on you one other actions that you can take animals in which you just change the utter whiting and they become embryos switch like a toggle switch familiar to sadat's the top of the hierarchy the top of the hierarchy is one gene that controls a master gene that controls and the anatomy and physiology of sex now obviously gender identification is more than that i'm in physiology and it involves the a kind of

computational algorithm as it were to make the south let's track that we take all of this and ultimately bring in to drain the identification whether you are one gender or both or neither or war or the spectrum they live and the terrain that is now we might be suspect that is not one gene that multiple genes but we also suspect that they're largely genetic components to this strong genetic components to this and so i suspect you're asking a very important than analysts department questioned york times has been politically discussed all across the board microscope feeling my instinct is that is likely to be highly genetic one number two is it's very likely that we were decipher the code in the next five or ten years using you know i showed you one example very complicated feature of height where we've begun to decipher the code also backed the question i knew if we deciphered

that coat would you be comfortable in sequencing your unborn child to know the code i think my immediate answer is yes because of the right now that can hear show an isolation can just a general an extraordinary suffering that i think these people go through who are born genetically if e mails say i know very deeply and so i think they are made because of those factors does yes i would want to know and i would also one unknown the other genes that impacts not just the acts and why i wanna know what other genes in fact that the corps would actually want to be going into my embryo master master tougher question

suppose there was ten fifteen years but one of them was very strong would you be comfortable with technology is that in your case you would say yes another kiss people would be comfortable technologies allow to change those genes i think i would be so that my child could be definitely either male or definitely female how many people are comfortable with that idea williams complexities the gunfire robberies actually like thank you for raising this but this is morally complex territory we have but it's not as if we can put our heads in the sand like ostriches and say take them away as we've discovered them were covering him day by day and we will continue to cover them so i think the point of my talk today was that we need it may be out of the humvee and you were wearing you these questions the west that abbas the question that race and the issues that these must have been burning in the

background of everyone's minds right there section one option you would think they must have been in some snow level also the lead the back burner of humankind the filaments that drive the backbone is a few questions when you're driving across hospices of kansas must have then sitting in the back of your mind my point is to just bring that to bring them right up front because i think they will become the already become important to look into the important and it would drive some the fundamental of the observations and and concerns of the next generation so again to go back to a question that there's no way that a young scientist a young pharmacologist joe young physician ken engage with these technologies without bringing these things have been sitting in the back burner as it were right up front and really confronting them what is in me to acquire information which we didn't have before or does it mean for equality was it mean for insurance would mean for health care

what the found thing is gonna do do our health i mean he'd let me not so these technologies short the capacity to annotate cancer genetics at and tried to get precise medicines for your cancer which is now the medicine for someone else has cancelled a wonderful idea the prospect of not have a child who has huntington's disease and therefore might suffer mike be a wonderful idea but on the other hand they could just lying next to those ideas ideas those technologies those events are things that obviously are concerning and quite scary so i want to pinpoint those bills is well we could go on the entire handling this is what one amazing things were giving this talk back to say is that it becomes very quickly a top model of us in all of all of us it's involved or individualize it becomes very quickly nor

announced it becomes about things that are very very close thank you very much of the provocative important questions you've just heard dr siddhartha mukherjee renowned oncologists cancer researcher and pulitzer prize winning author of the emperor of all maladies a biography of cancer his latest book is the gene an intimate history dr mukherjee spoke at the university of kansas leed center on september twenty six two thousand seventeen as part of the whole center for the humanities lecture series special thanks to mark crabtree for audio of this event i'm kate mcintyre kbr presents is a production of kansas public radio at the university of kansas it