Dhru Purohit Show - Catching Cancer Early and A Detailed Breakdown of My Prenuvo Scan Results with Andrew Lacy

Episode Date: September 7, 2023

This episode is brought to you by Cozy Earth, WHOOP, and Rupa Health. Conventional medicine takes a “wait and see” approach to health and disease, which leads to poor health outcomes for patients and their family members. Thankfully, new advancements in science and technology are allowing us to become more proactive than reactive by gaining a deeper look into our health and risk for chronic disease. Today on The Dhru Purohit Podcast, Dhru sits down with Andrew Lacy to discuss the latest tool in early cancer detection and chronic disease prevention, Prenuvo.  In this episode, Dhru and Andrew discuss how Prenuvo uses anatomical and functional imaging to help us become aware of what’s happening inside our bodies so that we can feel empowered to be proactive about the future of our health. Andrew Lacy is the founder and CEO of Prenuvo, a revolutionary new MRI scan that uses AI technology to detect early signs of various cancers and diseases. It also detects visceral fat and various other anatomical and structural components integral to our health so that patients can feel empowered to take control over their health.  Andrew is a product technologist with extensive experience taking transformative digital products from conception to launch in startups and large corporations. He holds an MBA from Stanford University and a Patent and International Law degree from the University of Melbourne. He’s passionate about using technology to help our healthcare system shift from one focused on treating disease to one focused on prevention. In this episode, Dhru and Andrew dive into: (audio version / Apple Subscriber version): -What Prenuvo is, what it tests for, and how its innovating preventative medicine (1:29 / 1:29) -The science and technology behind Prenuvo for early cancer detection and chronic disease prevention (4:27 / 4:27) -What makes the Prenuvo experience different from traditional medical offices (16:37 / 14:00) -Advantages and limitations of the Prenuvo scan (19:36 / 16:37) -Unpacking Dhru’s test results (34:28 / 30:40 ) -How Prenovo empowers patients to take a proactive approach to their health (42:00 / 37:50 ) -The various conditions Prenuvo can detect and how it compares to other tests (54:18 / 50:30) -Cost breakdown and accessibility (1:02:33 / 58:58) -Kim Kardashian and other celebrity figures that endorse Prenuvo (1:15:10 / 1:11:27) Also mentioned in this episode: -Get $300 off Prenuvo promo code for your listeners: prenuvo.com/dhru (not an affiliate link) -Learn more about Prenuvo at prenuvo.com. Right now, get 40% off your Cozy Earth sheets. Just head over to cozyearth.com and use code DHRUP. WHOOP is a personalized digital fitness tracker. To get yours, go to join.whoop.com/dhru and get your first month free. Access more than 3,000 specialty lab tests with Rupa Health. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com today. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

The average cancer is caught at late stage two, early stage three. And the difference between catching all those cancers at stage one and the average stage of diagnosis is something like three to seven times better survival. If you're curious about the latest advances in cancer detection and preventative chronic disease screening, today's episode is absolutely for you. Welcome to the Drew Proet podcast. Each week, we explore the inner workings of the brain and the body with one of the brightest minds in wellness, medicine, and mindset. This week's guest is Andrew Lacey, and he's here to talk to us about the pre-novost scan. A full-body MRI scan combined with AI technology and how this scan can be used to help people detect cancer much earlier than we typically have access to, catch neurodegenerative diseases earlier, and even see how much visceral fat is in the body. We don't want a lot of visceral fat in the body.

And we're even going to be talking about my own scan results that I did earlier this year and what those results showed. Now, a little bit more about Andrew. Andrew is Pinovo's CEO and a product technologist at heart with extensive experience taking transformative digital products from conception to launch in startups and large organizations. He holds an MBA from Stanford and a JD from the University of Melbourne. And he's passionate about using the power of technology to help our healthcare system shift from one that's focused on just treating disease

to one that focuses on prevention. Tell us about the company. and what you guys do, just so the audience is with us. Yeah, sure. So the company is called Prunivo. We do a clinical diagnostic quality screening MRI exam. So we bring patients in to our own clinics. We have, and I can talk a little bit more about the technology,

but we have this machine and imaging protocols and radiologists that we collect images for about an hour and we look at every single organ of the body. and we give you a very detailed report that goes organ by organ, condition by condition. If we see something, you know, what is it? What did we see? And most importantly, what should you do about it? So it's something like a 500 point checkup for your body, the same way you might get a checkup for your car.

Yeah, I actually did the scan. I am a big fan of the All-in podcast. And I was listening all last year. And then I heard them mention it, I think once in November, and then I heard them mention it again in December. and I believe it was Chimath, who was one of the early team members of Facebook and he's a billionaire. And he had told a few of his friends to do it. And I don't know if they have any formal affiliation with the company or not.

They were just sort of mentioning it. And he's not an investor either. Yeah, he's not an investor. They're just very excited about what we do. Yeah, yeah. So they're fans. And the recommendation came, you know, authentic. They talk about stuff on their podcast, they like.

I was like, oh, you know what? I'm always interested. I'm always getting different scans done. And I come and I share with my audience. You know, I share with them. Hey, look, I did the scan. Here's what I saw. Other things, not that my results is going to be your results, but more just I want to

see more health transparency. And people can know what the options are that are out there. And generally, whether it's good or bad, I like to just share my information that's there. So we'll go over my scan results. Like, I will talk about my scan results. And I already gone over it with my doctors and other stuff. And we can talk about some of the things that showed up in there.

And we'll share the screen for those that are watching on YouTube. And if you're listening on audio, you know, you can click on it later. on if you want to see some of the imaging that's there. No, that'd be great. And really, what would be helpful in going through that really is to demonstrate one of the core philosophies of Prunivar, which is we want to empower patients with knowledge and recommended action so they can really take control of their health. And I think coming out of COVID in particular, we're all statistically a little bit

less healthy. We have missed many of our preventative health checkups. And I think there's whether or not we feel this to be justified or not, there's, I think, a feeling that the health system may not necessarily be looking after our sort of health needs as well. The health system is reactive. And how do we go from reactive to maybe being more proactive? And so people, we see this, we see just tremendous enthusiasm for getting ahead of our health issues and for focusing on preventative health. And I think that's really healthy for the individual and I think it's healthy for the system as well. Yeah. Have you been following it all some of the work of Peter Atia and his new book?

Yes, absolutely. Yeah. One of the core concepts in Peter Atia's book for the audience that may not be familiar. We've written a little bit about it and recommended the book to people is this whole chapter that he has about cancer. And in cancer in particular, the statistics are crazy. I don't have him in front of me. But just by discovering cancer earlier for individuals that have it, our rates of survival increase like, you know, exponentially. It's kind of nuts. Pretty much across the board.

If you can find a cancer earlier, even without sort of the whole seed and soil theory of cancer that a few people like Jason Fung have come on this podcast about and they really recommend, you know, getting in control of your metabolic health. My mom was diagnosed with cancer probably about 10 years ago. And the way that she found out that she had breast cancers, what happened to a lot of women. She was in the shower one day. She's, you know, washing herself and she felt a little lump. Yeah. And she went in. And when she went in, it was diagnosed at the time as like a stage two cancer. And we unfortunately have this place where even though it's America and we have all this

great technology, that's how a lot of people find out about in particular breast cancer. Or they start to notice that something in case of another cancer is not working well in their body. They're having pain. They're having pressure on something. They feel something in their abdomen. They don't know what's going on. You know, they're going in for regular colonoscopy because maybe they have some blood in the stool and they see, oh, they have colon cancer. It's very sort of reactionary in our cancer approach. I mean, and the last thing I'll tie in before I teed up for you.

One of the reasons I got excited about per newvo is when I, after I did in my scan, there's a few celebrities that we're connected to in our podcast and our medical clinic that were really championing that they felt, not that people go there just to get scanned to see if they have cancer. It's really preventative for all categories. But the ones that I felt that were being most vocal in sharing with the rest of the audience was they felt super excited about this scan, helping them detect cancer years ahead, maybe even decades ahead of when they would have naturally found out about it. Any thoughts in that? Yeah, no, I mean, they're such great stories to hear and help build awareness about what we're doing. Maybe just to,

jump in with a few stats first. So one of the unfortunate things about our health care system is we don't have that much preventive screening test for cancer. And in fact, only 14% of cancers are caught during a routine preventative screening exam. So this would be mammogram, potentially PSA test for men, and lung cancer screening for people that meet the clinical, meet essentially a definition of a certain number of pack years of smoking. And, the other 86% of cancers are caught either incidentally or they're caught at a time when a patient presents with symptoms. And we know that oftentimes that can be when cancer is quite advanced. The average cancer is caught at late stage two, early stage three. And the difference

between catching all those cancers at stage one and the average stage of diagnosis is something like three to seven times better survival. Wow. And then even when patients present with symptoms of cancer, our health system takes oftentimes quite some time to diagnose them. So there was a study in the UK where, in fact, 50% of patients who would diagnose with cancer were diagnosed in an acute setting, so in hospital when they presented with acute symptoms. But also in the UK, the average cancer from the time of symptoms presenting to being diagnosed is something like six months. So as Dr. Othia says, cancer is really a race against time.

The higher the cancer load is in the body, the more difficult it is to treat it effectively. So the early you catch it, the better. And what Pruniva offers is a possibility to really diagnose cancer in patients that are still asymptomatic and therefore very early. This episode is brought to you by Cozy Earth. I've recorded over 400 podcasts to date. And experts of all types have continuously reminded. my audience that their number one factor for better health and longevity is, can you guess, sleep.

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how early, like let's take, for instance, breast cancer, right? And with this full body MRI scan that you guys have and the whole AI technology behind it, what's the earliest cancer that can be detected? Sure. We typically can find cancer that's around one centimeter or greater, so that's 10 millimeters. That's not to say that we haven't diagnosed lesions that are very concerning smaller than that, but also they become very difficult to biopsy smaller than 10 millimeters. And oftentimes you can miss the lesion on the biopsy and therefore not be able to really identify one or the other what it is that we're seeing. So it's about 10 millimeters ever in the body. For men, we do a detailed prostate MRI so there we can see things a little bit smaller. But one centimeter might sound

big to some of your audience or might sound small or might not be understandable because we're talking about centimeters and not inches, but it's still relatively early in the life cycle of a cancer. Is that generally, that won't even be, in most people, that's going to be probably either stage zero or stage one, right? Correct. It would be stage one. It would be cancer still localized to the organ of origin.

And that represents the vast majority of cancers that we're diagnosing. Yeah, that's huge. And it also really represents just the way cancer grows. So cancer grows obviously geometrically. So it starts with one cell and then two and then four and then eight and so on. But also cancer has to acquire a certain set of mutations to sort of proceed to the next stage. So we can spend quite some time at an early stage. In fact, if the average pancreatic cancer, there was a study at Hopkins a few years ago

where they looked at the average age of a pancreatic cancer at the time of death of the patient. And they were able to age these cancers as being somewhere between, I think, seven or eight years. And when we are seeing pancreatic cancer at prenuvo, we're still, the vast majority of those diagnoses are still confined to the organ of origin so early. And it sort of makes sense that in the seven-year lifespan of a cancer, there's probably a couple years where it's too small even for us to see. And then there's two or three years where we can still diagnose it at a very localized stage, and then it starts to sort of run away towards the end of its life.

Yeah. Well, I want to complete the story with my mom. You know, she's doing great. It's been 10, 13 years. I can't do the math right now. And she's been fantastic. She worked with a really incredible doctor. Had a whole team, had a whole team of individuals.

who were helping her, and a big part of that was, we've done some episodes on this before, but some practitioners using therapeutic approaches like the ketogenic diet and then significantly lowering carbohydrates, in addition to all the other stuff that was there. There was plenty of things. I'm not by any means telling people that I've breast cancer that it was that simple. There was a lot of stuff that she was doing and a lot of root issues, including kind of looking at some dental health items that seem to might be connected to her situation, but she's doing great and she's cancer free. That's great. Yeah, but I would have, I wished I would have had that.

I'm always transparent with my audience. You know, I did your scan before, you know, I ever had somebody from your team reach out and say, hey, would you like to have a conversation about our technology and everything? But then you guys are really kind. I said, hey, listen, I've already paid for my scan. You know, nothing, you know, don't worry about giving me a free one. I've already done it and I don't feel like the need to do it again so soon. They were like, okay, well, what about giving it to somebody else? And I was bringing it up with my mother-in-law, Neelufar. And I was like, hey, do you want to do this scan? You know, I typically don't accept things, you know, from people for the audience, sorry, for like potential guests. But she was really excited. And she went and

did her scan and she had a chat with your team and everything. So thank you for that, of course. No worries. And there was a couple things that she had to pay attention to on her area, but largely it gave her kind of a sense of peace of mind. I'm sure you hear that from a lot of people that go in and do your scan. Yeah, no, I think often people will come in worried that we might find something that is life-threatening. And of course, when we do, that's a potentially life-saving diagnosis. But also, all of us have some degree of worry about our health. When we have headaches, we have abdominal pain that comes and goes. There's always that little voice potentially that is asking, well, what might this be? And I think just having that clarity and peace of mind

is such a priceless thing. And particularly for patients that might have had cancer and they're worried about it coming back or for people that might have a strong family history of cancer or aneurysm or disease and just being able to, you know, for those people not being screened in some ways is affecting their quality of life. Yeah. Yeah. So just to set the stage a little bit more. I did my scan in January of this year. I think it was like I got my results back on January 27th. You know, you have eight clinics around the U.S. right now and you're probably going to be opening up more soon, I imagine. So I'm here in Los Angeles. So there's one literally down the street over here in Wilshire.

What are some other cities that you guys are in right now? So we started in Vancouver, Canada. So we screen patients there. Then we are open in Silicon Valley, in Los Angeles, in Dallas, in Boca Raton, so Southern Florida, New York, Chicago. And we'll be opening another three or four locations this year. Yeah. So you basically make an appointment, right? I think you guys gave us a discount code our audience can, you know, use.

And I don't have, it's not an affiliate link or anything like that. There's no compensation just if people want to do it. it, great, get a little discount. We'll include that inside of the show notes, mentioned at the end. So let's say you book it. You go to the center during your appointment. The clinics are really nicely set up. They look more like a hotel lobby than they do like a doctor's office, which is always nice because there's a lot of people that are always worried. You know, they get the anxiety, you know, going to the hospital and sort of that very clinical white lights, everything like that. It kind of sets the stage for kind of inducing anxiety. So it's a very chill setting. You go to

the waiting, you chill in the waiting room, they call you when they're ready. They were always on time for all my friends. You know, I've had a buddy of mine that did it as well too around the same time that I did it just because he was curious. And then you get put into sort of a changing room that you have. You change into like a typical sort of, you know, what do they call it, like nightgowns or whatever it is. Yeah, it's a comfortable gown. A comfortable enough. Some people want to purchase them when they leave. Okay, okay. And then you go to the MRI room. And in the case of Los Angeles, there's a few different rooms that are there. And what was really cool is that basically, you know, the texts are all nice. They let you choose a movie on Netflix or you can listen to a

podcast on Spotify. Hopefully you guys want to listen to my podcast when you're there, but I won't be heard if you pick a documentary on Netflix or something. And then actually you are there for an hour in this full body MRI and you kind of are just like watching a movie. And then every so often your text there give you sort of instructions like, hey, just you're going to hold your breath for about five seconds so they can really get a scan on a particular area. And the whole thing takes about an hour. Is that generally the basic experience? That's the general experience. And I would sort of double click on this, the sort of spa like and welcoming environment because we found just so critically important that patients really do have a negative connotation with healthcare. Because

our whole concept of disease is based on this idea that we diagnose things late and therefore, if we're looking for anything, it's always going to be serious. And so anything that reminds people of this, like you said, white walls or you won't find a white wall in one of our facilities. Our staff are very, very focused on making patients feel comfortable, and that's important because some patients might feel a little claustrophobic or a little anxious. For us, really, it all can be summed up by the fact that you are in some ways our customer. And in most imaging settings, the insurance company is the customer.

And that means that we want to make sure that you feel comfortable and supported in this journey to better health. What is the test the best at looking at? And then also, where are there limitations? You know, no one test, as many clinicians on our podcast have talked about, is we're not at the level yet where we're living in the Star Trek, you know, age where you can literally go to one scan and you find out everything in your body. Yeah. Right. So every test has things that it's great at, and every test is going to have limitations. So tell us about what is the test good at looking at? What are the most common things where it really feels like there's actionable items that are related to where your health is for people who are wondering, like, hey,

hey, am I really healthy? And then where are the genuine limitations? Because we like to be honest with our audience and share them like, hey, great. Like you may not know about this or that, but you'll still know about these things which could make it worthwhile to do. Sure. Well, the best way to think about this is there's sort of two screening modalities that have historically been used for whole body.

And the first one is CT. And CT is an x-ray essentially that spins around your body. So you can take a three-dimensional picture by taking hundreds of little x-rays. And then there's MRI. CT actually was a technology that a couple of companies deployed in shopping malls 20 or 30 years ago, and you could go there and get a whole body scan using a CT machine. And the problem with CT was that it didn't image soft tissue very well. As an x-ray, it's very good at bones.

It's very good at imaging calcium in the body, but it's not very good at soft tissue. And a lot of the concern, in fact, that physicians have about screening in general really is rooted in this phase 20 years ago where people were doing this with CT machines. MRI is a, it's an imaging modality that does involve radiation. We use magnetic waves to look inside your body, and it's very, very good at soft tissue. And that means that it's very good at identifying physiological conditions that we might see in almost any organ of the body. There's one exception, which is the heart.

And the heart really is, you can take beautiful images with MRI, but it just takes a long time. And the reason for that is that your heart is always beating and you're always breathing. So there's a couple of things that we have to gate for. And so we, at the moment, as a company, don't do detailed imaging of the heart. That's the main limitation. Whereas CT actually is quite good at this because if you're looking for any blockage of the arteries, you're essentially looking for calcification and calcium being the same thing that bones are made of, CT being a spying x-ray is very good at detecting. And so that's the real, that's the primary

limitation of the screening that we do. But one final caveat would be that this is an adjunct technology. So we don't recommend that people not do their routine screening. Yeah, you still need your normal lab work and other stuff that you're working on with your doctor. Correct. This is a bonus thing. And test like, so we still recommend that women continue to get mammograms, that we continue to do colonoscopies. That doesn't. mean that we obviously don't see breast cancer or that we're not, that we're unable to diagnose cancer of the bowel. But certainly for anything that a physician can see with their own eyes, for example, through a scope, it's always going to be more accurate than any type of imaging.

You know, there's obviously the mammogram topic is a very debated one and it's the recommendations of shift over the years. And I know you're the CEO of a company, so, you know, you may not be able to comment or whatnot, but I got to ask the question anyway, is this scan better than getting a mammogram? Like, not that you're telling people not to get it, but is it better than getting a mammogram? Like, can you detect cancers earlier than typically a mammogram would? Or is that based on sort of who is the person interpreting the data? I think it really depends. I for sure would not answer that question, yes.

It depends on the patient and also depends on stage of life. So for postmenopausal women, well, when women go through menopause, what happens is glangular tissue in the breast. This is the milk-producing tissue starts to envalude and turn into fatty tissue. And mammogram is very, very good at seeing through fatty tissue and seeing lesions in post-menopausal women. The problem is for women that are still premenopausal or going through menopause, there's still a lot of glangeloid tissue there. And it's quite difficult with mammogram to see through. that tissue. Yeah.

And so increasingly today, in fact, in a number of states, women that are premenopausal now are able to get what's called a breast MRI. And that tends to be a with or without contrast technique. And I can describe this in a little bit more detail, if you like. But prenuvo or a contrast MRI or even ultrasound is, I think, more and more being seen as a good adjunct to mammogram for women that are still premenopausal. Yeah, I guess the question that I've always just had, and we have a physician at our clinic, Dr. Liz Boehm, who is always discussing the nuance of this with the patients. She's a breast cancer, no, sorry,

she's a cancer survivor herself, not breast cancer. And she's a nutritionist and MD and trained in functional medicine. And obviously, people have to weigh their pros and cons with the physician. but the anecdotal component that I've always had is that I feel like I've heard of multiple stories of women above the age of 40 who get their regular mammograms but then they were the first to detect the cancer in themselves just through the like being in the shower and kind of seeing it so I'm like if you're getting your normal mammograms but then you found your cancer first yourself or the tumor right like is the is the mammogram doing its job and I'm not asking you to you know comment on that but that's just an anecdotal thing that.

that I've dealt with in my own life and with my own mom. I think it's just a very unfortunately difficult part of the body to image. And if you actually go back and read the USPretive Task Force recommendations around mammogram, where they recommend that they be performed, I believe, every two years for women over the age of 45, if you read why 45 was a cutoff, it has nothing to do with incidents of cancer and it has a lot to do with just that there are a lot of false positives and false negatives with mammogram for younger women. because of this dense glandular tissue. And that's why you end up with either mammogram, identifying lesions,

and biopsying, and only one in five lesions actually is cancer. And you also have the opposite happening, which is there being a lesion in that dense tissue, that's really hard to see. And again, that's why I think a lot of women now, particularly women that have a high risk, are starting to use more than one technique, and that provides an opportunity to triangulate. Yeah, and then there's also the pros and cons of radiation, right, that people have to like weigh out and you know think about which i know my audience is obviously very concerned about but sometimes you know you need radiation to get really good results when it

comes to the heart i had my cardiologist on the podcast and he went through my latest metabolic labs i have familial hyper cholesterolemia my apobie was really high you know i was walking through some of the decisions that i was making with him of whether or not i get treatment where he's going to be back on the podcast we're going to talk about that but one of the best things is because i come from a south asian background Indian, which in America has one of the highest risk of cardiovascular disease out of any ethnic minority, he turned me on to, you mentioned CT. Traditional CTs are not great at looking at soft plaque. They only look at hard plaque. So he put me onto a scan that we walked people through. It was called the Clearly scan. And it gave me a lot of peace of mind, you know, not too different than

doing, you know, Pernovo that I in my instance actually had the best score that he had seen for any 40-year-old male. He had seen women that had less soft plaque, but I had the tiniest amount of soft plaque that was there. So, you know, that was radiation. It was contrast and everything. But that type of scan, especially because I had been hearing sort of multiple different things from different practitioners, somebody saying, oh, your cholesterol is so high, you need to go on a more of a plant-based diet. And then somebody saying, no, just continue what you're doing. And his approach was more about protecting the endothelial health. And then once I got my scanned and I was like, okay, you know what? I feel really good about this. Like, I can continue on my lifestyle and just continue eat healthy and whole food. So, you know,

you're always weighing the pros and cons of any intervention, but I think getting these tests done is just a helpful part of you having peace of mind of making important decisions in your life. Yeah, and we actually, a lot of patients ask me, when I go into clinics, I like to talk to people, ask them why they're there, and they ask me what else to do. And I believe, particularly for men, but also women in their 40s or 50s, if they haven't, it's worth doing, for example, calcium score just to under. understand if they have a genetic predisposition for calcification. Have you heard of the clearly scan?

Yeah, absolutely. And we have people that do clearly ampernewing together. Yeah, I find that just regular CT scan, it's like almost, like I'm not saying it's not worth it, right? Because obviously it's still recommended and doctors mention it. But generally, if you're pretty healthy, like a lot of listeners on this podcast, like you're not smoking, you're not like a binge drinker, you know, you're not severely. overweight you're going to score zero but it doesn't tell you anything yeah but but a lot of people it gives

them a false hope from my understanding right i'm not a physician but just talking to all these cardiologists but you really want to know about soft plaque and you could actually have a shit ton of soft plaque but end up having a zero or a one on your calcium score that's why like again i have no affiliation with clearly i've just like it gave me a lot of peace of mind for my heart health and that's why i ended of doing it and sharing the results with people. And actually with Provo, you know, everybody's always worried. Like I came in, I'm like, look, I'm doing everything healthy. I minimize my environmental exposure, you know, my heavy metals reports on all my labs

and I'm doing with all my functional docs are great. I give good metabolic help. But shit, you know, do I have prostate cancer or something like that that I need to pay attention to? And it was nice that I found out that I didn't, you know, have any of those things. Well, I think the way I think about it is your health really is a function of three things. how you live your life, your genetics, and luck. Can I pause you on genetics, right?

You know, the way we always talk about GenX on this podcast and different experts that come is that genetics may load the gun, but lifestyle pulls the trigger, right? So your genetics, in a way, because our lifestyles are so out of whack, even now we have, you know, top figures in public health here in America going on 60 minutes and saying that, hey, obesity is genetic. And when they explain their version of what they're saying, they're really talking about epigenetics, that their lifestyle has activated these things. So I'm not saying that genetics don't play a role, but how many chronic diseases are purely genetic related? My estimation that I've heard from individuals is like less than 5%.

Yeah, although I think what you're saying is factually correct. It's a semantic difference that matters. but in real life, oftentimes at the end of the day, this is about people understanding what's going on of the skin. And I'll give you a couple of examples. Yeah, please. This episode is brought to you by Rupa Health. You know, as a CEO of a functional medicine clinic

and someone who spends a lot of time with functional-minded practitioners, one of the top complaints that have heard from my friends in this field is how complicated it can be to order comprehensive lab testing for patients. Thankfully, my friends at Rupa Health have found an easier way. Many of my friends who own clinics and many of my friends who are doctors now use Rupa Health to order, track, and download test results, and they've never looked back. You want to know why? Because with Rupa Health, you can order from over 30 different lab companies using one convenient portal. Did you catch that?

That's one invoice for all your labs, paid online, up front, all in one place. Plus, patients receive practitioner pricing, full patient support, personalized collection instructions, automated follow-ups, billing breakdowns, answers to, to testing questions and so much more. Ordering your lab work has gotten so much easier with Rupa Health. And best of all, it's free for practitioners to sign up. You can find out more by going to Rupa Rupa, R-U-P-A-health.com. That's RupaHealth.com to sign up today. We almost always diagnose a spine issue with everyone that comes in.

Everyone has a slip disc or something going on with them. And particularly in the, particularly amongst younger people today that are spending a lot time in front of computers or they're looking at phones. We're seeing degeneration of the spine that sort of is running oftentimes 10 to 15 years ahead of where they should be given their biological age. Now, the question might be they're still asymptomatic. They feel no pain. And whether or not they're going to feel pain, oftentimes, of course, is a function of the progression of that disease process, but also maybe a function of just how narrow their spinal canal is. And there are people that have congenitally narrow spinal canals

for which slip disc, a moderate or severe slip disc is going to be debilitating to them. And there are other people where we see very severe disc slipage, but they have a very wide spinal canal and they may never be symptomatic. This may never affect their quality of life. And you were born with a large, a wide or narrow spinal canal. So really the genetics does, it does matter. I have a friend of mine that came in, another story, a friend of mine who came in who was a police officer in Los Angeles. And he's around 60, but he looks like he's 40. He's very fit guy of Italian, of Mediterranean heritage. And he came in and he did a scam with us. And he asked me about, you know, what else should I do? I said, well, go and get a calcium score. And he got

a calcium score off the chart. And this is someone who, um, and this is someone who, um, he did a scan with us. And he drives through LA traffic with one of those percussion guns hitting his neck to make himself feel better. And, you know, they went and did an ultrasound of his crot arteries and he had quite a lot of calcification there. So he was like a few hits away from, you know, potentially giving himself a stroke. And he had no idea and he's a fit person that works out all the time. Yeah. So I do believe that genetics matter. That doesn't mean that you can't influence the outcome with your lifestyle. but we all have a certain sort of starting baseline. Yeah.

And if you don't know where you are on that genetic spectrum, then you don't really know what type of lifestyle interventions and with what seriousness or severity you should be pursuing in order to achieve the outcome that you want. I would love to go to my scan for a second. So, Tessa, if you can scroll down, what's cool about here on the right, I'm logged into my Pernova account.

on the right hand side, this medical images and report is kind of walking you through sort of slice by slice by body. So this image, for those that are looking at YouTube and for listening on the podcast, we'll kind of describe it. Just describe what that image is that that's there that we're taking a look at. Well, these are all the images that we took in that one hour that you're inside the machine. You're showing the inside of my body. Absolutely. And we're rotating through a bunch of different images. Wow, it's hard to annotate as they go. But here we're looking for hardness in the body, this one as well. And this is one of the primary techniques we used to look for cancer. Here we're looking at your prostate. There you go. And the way that you guys divide these

images up in your findings. And of course you have like a team of, I believe a nurse practitioners that basically hop on the phone with you afterwards. So you have your nervous system, respiratory system, circulatory system, endocrine system, urinary system, reproductive system, digestive system, and the musculoskeletal system. So those are the sort of systems that you're you've identified in the body. And what you do is you walk people through how many findings and you categorize those findings. Can you explain how you categorize those findings? Yeah. And this is, it's a work in progress for us. So we've been doing this now for 13 years. And when we started doing these scans, really no one was using MRI to screen for cancer

and disease. So we've sort of had to build a risk stratification approach for categorizing anything that we see in the body in the context of screening. So typically in the context of someone who is asymptomatic. And so as we go through every organ of the body and every condition that we look for, if we see something, we categorize it low, medium high. And typically low or informational is just something that you should be aware of. Sometimes we'll image patients and they'll realize they won't realize they only have one kidney or they have a horseshoe kidney. That's where when we're a fetus, our kidney, we only have one sort of organ that's fused. and then it separates into two kidneys.

And sometimes in about one in 300 people, that doesn't happen. Wow. And so there's these informational findings that are useful to know. They sometimes affect your risk for certain diseases. Oftentimes they don't. And then medium oftentimes are things that we just want to follow over time. And then there are what we call high sort of red findings, which are things often that require a follow-up test

or additional labs or clinicals just to, just to get closer to a diagnosis about what's going on. Yeah, there's an alert. You need to talk to somebody to go deeper on this thing. And that's typically when people get flagged as potentially having cancer. You're not telling them that they have cancer, but you're like, hey, look, these findings, if I understand correctly, are very similar to what we think could be cancerous, a tumor. Go get it checked out. And then you might say, hey, talk to your doctor to get a referral to an oncologist.

team or do a biopsy or whatever. Is that right? Yeah. And really, this is, this differentiates us from previous approaches here. So previously with CT, you would see a shadow in a liver and you wouldn't know what it was. And most people are used to looking at these things in a diagnostic context, so they have to go and investigate further. Here, the technology we're using makes it a lot easier for us to separate things into benign, don't worry about and concerning do something about. And what's left in the middle is a very, very small number of things that typically are just too small. to characterize. Yeah.

And the test is intended not as a one-off, but a test that you would do every year or two. And so those things that are too small to really characterize, but most likely benign, we just follow over time. And there's no greater or no more sensitive tests than to compare you against you a year ago. Sure. And see what's changed. So just looking at my findings here, right? I have a few things that have been sort of flagged with sort of moderate findings.

One is nervous system, one is respiratory, and one is digestive system. think the main one and I had a call with your team and uh you know this is just me commenting on my own findings here uh test if we click on the nervous system one i believe one of the things that showed up for me was there was some tiny lesions that they found in my brain which is not you know coming with a diagnosis but were hey these lesions the way that they were explained are typical goal in the earliest stages of multiple sclerosis. It's something you want to watch. You want to pay attention to.

I also reviewed with my own practitioner team. And they said, look, there could be a combination of reasons that you could have had these. And these may not be recent. They could have been something that's been there for a while. Yes, definitely pay attention. Obviously, in my instance, we've had some of the world's top experts on MS and multiple scroses like Dr. Terry Walls. And I live a lifestyle that's very much in alignment with, uh,

you know, a lot of the findings that she's seen to help you sort of be in a place where you're avoiding, you know, a chronic diagnosis of multiple scrosis. But that was really interesting to me, you know, and there was a whole list of things that was presented to me by my functional medicine team that I show the scan to that said, hey, this could have come from some sort of, you know, MS is ultimately an autoimmune disease. Correct. And in our world of functional and integrative medicine, usually autoimmune diseases come with some sense of leaky gut. You know, gut permeability, intestinal permeability is the first sign of an autoimmune disease coming, whether it's a Hashimoto's, whether it's an MS, ultimately, or whatever it might be.

So there could have been early damage that was done from the time that you were dealing with severe sort of intestinal permeability, being on antibiotics and other things like that at a stage in time in my life. It could have come from, you know, environmental toxin exposure. But again, like your own team said, okay, great, pay attention to it. I don't have any symptoms that are there. But it really brings up this larger point. I had a friend just literally the other week who called me up and said that, hey, I got diagnosed with multiple sclerosis. This is a young woman. She's like, in her 45 years old. How she found out is that she ended up going to the emergency room, Stein Eye Center here in UCLA because she was losing vision in one of her eyes and was like freaking out what the hell is

going on. We have an amazing emergency urgent care at UCLA for eye health. She went in and they did a bunch of tests and they said, listen, this is seems like it's like the earliest stages of MS. You've got to go to this doctor, this doctor. And then ultimately got diagnosed with, you know, MS. And obviously now is trying to unpack it and everything with the diagnosis. For me here, you know, nobody wants to see that you have a lesion in your brain, even if they're tiny. And it's something to pay attention to. But yet for me, I'm the type of guy, which is like knowledge is power. Okay, cool.

Let me know about this. And in combination with all the other things that I've learned from experts on here, it might even have me double down more on some of the preventative things that I personally feel and have learned from my clinical team. that would keep me away from, you know, ultimately getting, you know, MS. Anything you want to comment on that? Yeah, I think, well, a few things. First of all, I think it speaks a little bit to, again, this very reactive healthcare system that we have. And when you think about these diagnoses, your mind immediately goes to a pretty dark place.

MS actually is a, I think, about one in a thousand people on average during their lifetimes will have MS. And MS has different severities, obviously, as I'm sure has been explained. But here we're picking things up potentially early enough that, again, there's a lot that you can do to manage the condition and hopefully do so potentially without involving medication and more lifestyle-related changes. MS is a tricky one. It's, of course, as you look to see things a lot earlier, MS is a clinical diagnosis, so there are other things that can cause. demalination, as I'm sure has been explained. Like chronic mold exposure for some people. Correct, or lupus or Lyme disease, or there's a number of these

auto-inflammatory diseases. Also in older patients, just vascular disease can sometimes mimic MS. So we're seeing, obviously, as you start imaging patients earlier and earlier, there are sort of two consequences. One of which I think is very positive is you get early insight into what might be a potential underlying disease process at a time when you can do more about it, you have more options. The second also is you start to see things that might also have differential diagnoses. And how do you handle that is that you continue to monitor over time and see if

this is a process that's an active process or as you mentioned, it might have been something that you were born with or it might be a very stable condition that therefore is not classic for MS. Yeah. You know, the family members that I've told to get this test done and one of my friends, I always let them know, like, look, you're going to find something, right? Do you have any data on what percentage of people have no findings at all? I know we have that.

There is some data on MS that I remember reading, which is now that we're doing a lot more, we're diagnosing a lot more. We're identifying it a lot earlier with imaging that about 5 to 10 percent of these cases are another disease that's mimicking MS. So it's not, obviously it's not a perfect test and that's why you follow over time. And what I meant more so is that like, look, everybody's going to have something, some structural components, some of this, especially the older you get. Yeah.

That we know that obviously there's this whole approach and vision of aging itself as some version of a disease, right? And so naturally certain things are going to come with it. So I always tell people, you know, your team has this own version too. Like, look, don't freak out. It's not about getting sort of overwhelmed by these things. things. That being said, like, I do feel my friends that have or have sought out people that are on the sort of web, sorry, not web, medicine 3.0 train that are used to saying, if you go to your

regular doctor and you say, hey, look, I found this finding that's there, right? And they don't know anything about the latest in MS and some of the latest clinical trials that are happening and some of the early, you know, evidence that we have of sort of stopping it and even potentially, you know, putting some of the worst type of MS, like progressive MS, which Dr. Terry Walls has shown with her, you know, studies. They're early. If they don't know about that, I find that people get very bad advice and that advice is, okay, just wait and see and let's wait until this gets worse off.

Yeah. Right? And that's where I find that these, some of, I've, I've read all about, you know, where people are very excited about, you know, your company in the test. I've also read the backlash that's there. Yeah. And, you know, we'll get a chance to talk about it. But I find that the backlash or people, you know, there's a doctor that I really love and respect. His name is Dr. Venae Prasad.

And he had written because I think like Kim Kardashian did this super viral post and was talking about Pernovo and why she recommends people do it. And I saw all these practitioners come out of the woodworks who are more in this sort of medicine 2.0 camp that if it's not. complete clinical evidence behind something, then we're like wasting their time and we're putting all these patients on sort of a rat race of trying to figure it out. But those are people that I find that are not aware that there's so much that can be done. And this is even more of a reason why I say, if you get this scan done, which I hope a lot of people do, make sure you're working with a team that is at least in the direction of being open-minded to medicine 3.0. because for every single one of these major areas,

there is already published evidence that is emerging, that is cost-benefit analysis, there's going to be no harm to doing it, and they're often lifestyle interventions, radically improving your sleep, radically getting away from certain food intolerances or discovering if you have celiac or certain autoimmune triggers with foods,

you know, consistently exercising and improving your muscle mass. There's so many things that you can do. But if your regular doctor is just going to Google or look up, yeah, MS doesn't have any cure. So there's nothing that we can do until you have a diagnosis. Then we'll treat it at that time. And I find that that is very infuriating. I mean, you guys are doing your part, but then the team that they're being sent to is not being told about or the doctors they have or not being, you know, giving them any kind of hope that there's things that they can do today about it. Yeah, I think there's really, to unpack it, there's two assumptions here that we're challenging.

The first assumption is an assumption that physicians have, which is arming patients with information about their health is dangerous. And the second one is patients have an assumption that the physicians really understand what's going on and are going to do a great job helping them look after their health. And on the first one, when we started doing these scans, in fact, we sat down, so the radiologist sat down and spoke to every single patient immediately after the scan and we went through the results straight away. And oftentimes these were patients that might have had indeterminate symptoms and they really wanted to understand what was going on with their bodies. And I myself got involved

four or five years ago and I remember sitting in some of these consults. And it was incredible at the end of them. Oftentimes the patient would get up and hug the radiologist and say, you know, like for the first time I feel like I really understand what's going on with my bodies. And so this opinion, this sort of anecdotal opinion that you hear sometimes from physicians, we've never seen this play out. A patient armed with knowledge is, feels more in control, is happier, and is just relieved that someone's really telling them what's going on and gives them agency to sort of decide what to do about their health.

So that assumption, I think clinically over 13 years now, we've completely debunked. Yeah, the assumption that people have that's like, don't give the patient too much Because they'll freak out or they'll freak out crazy stuff. By the way, I don't know if you know a little bit of the history that's here, but the standard of care in the United States in the 50s was it was left up to the doctor to determine whether or not you tell a patient that they have cancer in the first place. Because back then, you know, the approach was that some patients, and in particular they believe that women would basically become depressed, psychotic or something,

suicidal even, if they found out that they had cancer. So many doctors, in the earliest of sort of our approach of diagnosing and finding cancer, they would determine to say, hey, I'm not going to tell this patient had that because we can't do anything about it in the first place. It's only going to give them bad information and then just let them live their life because they're going to do better off that way. And now we can look at that and say, like, actually, that's pretty f*** up, right, to not be able to tell. Right. So, you know, but I do also, I feel for people, who just believe that there's no preventative approaches and are not on the emerging science, the web, the medicine, I keep on wanting to say web 3.0, medicine 3.0, which a lot of the

functional medicine world is very well equipped on that, no, there's actually a ton of things. And they're now, just like when it comes to Alzheimer's, you know, we've had some of the top experts in the world on Alzheimer's on this podcast. They're like, these are the tests that I want to want to do. to look at pre-Alzheimer's. Let's not wait till you have a diagnosis. Yeah. And they're not just brain scans.

They're your metabolic health. They're your fasting insulin. They're your visceral fat that's inside of the body. And like that, just like we know that pre-diabetes is an issue that affects, you know, hundreds of millions of people around the globe. You don't have to wait till you get diabetes. You can actually start treating it earlier

and that your fasting glucose is one of the biggest indicators of pre-diabetes. There's a ton of things like there's pre-MS. There's pre-cancer. There's pre all these things that we're getting better and better at until one day you guys come up with a test where we can just scan on our iPhone and we figure out everything that's wrong with us. So I do, my heart goes out to people like Dr. Vene Prasad, who I really appreciate, that are saying these tests are a waste of time because I can see it through their lens that most people do not have access to even knowing what to do with that.

But that's how everything starts. Most people didn't have access to running water, right? Most people didn't have access to indoor plumbing. So it doesn't mean that we still can't make progress on those things. Most people didn't have access to automobiles, right? Yeah. But we still have to get this information out and it gets better over a period of time. And that's the positive side of capitalism, I feel. Well, and how does it start? It starts with patients really understanding what's going on. And then they can really advocate for themselves in this health system. So if they, if we find something and they have a physician that doesn't really care much for it or it doesn't want to deal with it, they can then go somewhere else. And they're not able to do that if they don't

have access to their own findings or they don't have access to their own images. So that for us has always been fundamental to the philosophy of the company is that this is about equipping you with knowledge and no one is going to be more interested in taking care of your health than you are. And we've just seen so many cases where we have contacted patients after they've done a scan, if we see something concerning and they won't have been able to see their physician for months and we'll pass them, we'll refer them to other physicians that will take these things more seriously. We did a review at one point of a patient who we found a 10mm aneurysm, this is a huge aneurism that is very, very likely to rupture.

And we called the patient, thank God they answered the phone. And we said, well, what happened there? And they said, I went to my doctor and the doctor said, everyone has aneurysms. You know, don't worry about it. Wow. And so this is not to find a new doctor. Yeah, this is not to throw physicians as a category under the bus, but physician is just like any other profession.

There are good ones and bad ones. And if you have the knowledge and you have some really clear direction, which is what we provide patients, then you're better able to assess whether you're getting the care that you need. Is this test just for rich people? I mean, the answer is no. The mistake that people make here is that this is a test for the worried well, so the Fitbit worrying Silicon Valley types.

The two biggest categories of people that come in for an exam are patients that have had cancer or have a strong family history of cancer and they really want clarity about what's going on with their health or patients that have symptoms, so indeterminate symptoms that the health system they don't feel is addressing fast enough. Yeah. And these are people, you know, all of us have a right to good health. All of us care about our health. And people are willing to take sort of things into their own hands if that means that they can get treated faster or more effectively.

The cancer really is still, you know, I know there's a lot of things that you guys have told me that the test is great at. Still for me primarily, it's like any time I feel somebody is worried about that, has a history, you know, maybe is at a particular age. the cancer component is really, to me, like the best part of the test. Because I feel like it's one of those things you do not want to find out much later. Not that everybody, you already gave all the disclaimers and everything that, you know, you can only find up to a certain level. You can only do at that level. You had to work with your doctor or physician.

But that to me is huge because outside of this, the only other innovation that I've seen in the cancer space when it's not perfect is there's blood biopsies. Correct. And the problem with blood biopsies like grails and the other ones that are out there is that great, they're interesting, but they're so sensitive. And you really have to work with the physician that knows what they're doing. And there's so few physicians that are out there in the interpretation.

And actually, a lot of people that have tested positive on a blood biopsy because maybe their physicians order it, I know a lot of them that have actually gone and done your scan to actually get a better sense of where in the body is this cancer. Do you have any comment about blood biopsies? Yeah, actually, my experience has been different. So these blood biopies are computational tests. And so what they tend to do is set the specificity very high. So they set those tests at a 99% specificity. And that actually makes them not very sensitive for stage one cancer. Interesting. And there was a study, I believe, amongst a group of firefighters a few months ago where I don't know which liquid biopsy test it was that they did, but there were quite a number of cancers that were being missed on. on those liquid biopsies.

And so in some ways, liquid biopsy is a more specific test, but less sensitive for stage one cancer. Techniques like prenuvo are much more sensitive, but, you know, still sometimes requires follow-up to confirm a diagnosis, so perhaps a little bit less specific. And those two tests, therefore, to some extent, can complement each other. And that's why we do see people that are doing liquid biopsy and then also doing prenuvo imaging.

And certainly if there's a positive result, before you, at any rate, you'll need to do some imaging to identify the organ of origin and where it is on stage and a prenevo exam is really helpful for that too. I want to go back to my findings for a second here and just pull up another one. Another one that showed up as a moderate finding for me was my digestive system. So papillary mucoc... Yeah, so can you explain what this is? So this is just a little, a small cyst in the pancreas.

Yeah. These are, we see them very commonly in a lot of patients. And there's actually an image of it over there. There's my pancreas. Looks pretty good. Yeah. So that's, in fact, the, there's a little wispy line off to the right is your pancreatic duct. And there, we do a diagnostic sequence called a MRCP.

So this is a very fluid, sensitive sequence that can look at that, that little duct that runs through the middle of the pancreas. You can think of a pancreas as a very ugly. banana. And that little thing that runs down the middle of the banana, that's the pancreatic duct. And what we want to see is to make sure that that's clear. Because pancreatic cancer, what it tends to do is it blocks that duct. So here we have a little small cyst. It's a fluid-filled lesion. Most often, these are benign. We monitor them over time. And I mean, we see cysts everywhere. These little internal pimples, you can get them in your livers, in kidneys, obviously in the pancreas.

we see sometimes in the brain and they're benign and at any rate we can track over time to see whether they evolve into something else. Does the machine able to pick up if women are suffering from polycystic ovarian syndrome? Can it pick up that? Yeah, we do. It can. Yeah. Okay.

That's another thing that we've done a lot of episodes on and that, you know, is a big problem. For a lot of women, especially in their prime fertility years, it's one of the top causes that can contribute to infertility. it can cause a lot of, you know, terrible period pains, other things like that. We've done a bunch of episodes, but yeah, that's very interesting. No, we've seen, and ovarian cancer actually is one of the cancers that we, I would not say diagnosed frequently, but it's definitely a, you know, it's a life-saving diagnosis because that tends to be a cancer that is caught once it has kind of burst and spread to other parts of

abdominal cavity. So there's no screening test for ovarian cancer. We're able to visualize the ovaries very, very clearly with MRI. In patients that are postmenopausal, we hope to see them disappear completely. But for people at premenopausal, we can often, the image quality is so good, we can tell which follicle is likely to be the dominant follicle in your next cycle. We can count follicles potentially. And we can start seeing these cystic conditions and not only see them in the, the ovaries, but also look for the more concerning clinical signs of what we call septations

and areas of where we might see solid masses. I think there was one more other moderate finding. It was my respiratory system, and this was sinus nasal polyp. Look at that. So we detected a little lesion, which is suspicious of the polyp. The polyp is located in your left. Sinus is measured, and it gives the measurements. you should discuss it.

Yeah, so any thoughts on this? Big picture? Just another sort of polyps cyst in the body. There's multiple reasons these could happen. Another, yeah. Just, I mean, if you're asymptomatic, it's just another unique feature of your body. And sometimes that's important information to know. We'll often find people that have chronic sinusitis by looking at the sinuses,

and they won't realize that. Or it might manifest as migraines, for example. Yeah, the way that it was explained to me, by my physician was in my history, in functional medicine, they do this whole, like, deep history with you. And as part of that, they're asking you literally starting from the beginning, you know, how are you born? Were you born naturally? Were you born via cesarean section? You know, were you this, that, what exposure to bacteria did you have? So when I was young, I had a lot of sinus issues. And my family didn't know it at the time, but I was, I grew a vegetarian and dairy was a big

part of my diet and commercial sort of westernized dairy was just not working for me. I wasn't lactose intolerant, but I would have dairy and I would have chronic sinus issues and that this could have been inflammation that was there, a polyp, a protective sort of thing that happened in the body. Once I in particular got off of commercial dairy, which happened when I was in high school, I never had those issues again. There's attacks again. And I was in a good position. And I, um, Didn't have to take regular antibiotics and other stuff. I've told my story multiple times in this podcast. So this could have been left over from that time period because I don't have any symptoms right now.

But again, something to just pay attention to in the future. And my understanding is these things can come and go. So you might come in next year and it's not there. So what we like to do is we like to do a very comprehensive cataloging of what we see. And I'll give an example. My wife, we scanned her and she has a benign but quite large lesion in her. her liver and we know it's benign because of the different collection of images we're able to take. We know it's filled with blood and not solid.

And therefore we know that this is a her man germ. It's like sort of an internal Gorbachev-like birthmark that we can get inside the body. And it's there from the moment you're born and it'll be there when you die. But it looks big. It's the size of a golf ball. And she also just happens to have some liver metrics that are a little bit unusual. and in another context, that might look suspicious for cancer. And then you might end up getting a biopsy.

And we know, because we've cataloged it and we know that it's benign, this is really important information that she has then to go out and be able to provide to the health system should this ever be questioned at some point in the future. Talk about the cost of the test. And also, is there ever a vision of this being covered by insurance? Yeah. So before we started doing these scans, the closest thing to this would be a scan that is sometimes done at tertiary institutions for

people who unfortunately have this certain cancer predisposition syndromes, and often those might cost $25,000 to $50,000. So already we sort of reduced the cost by an order of magnitude. Even at our current cost, you have 78 organs in your body by last count, according to Wikipedia. And so the cost of our scan is something like $32 per organ. And we believe that over time we can get the cost of these exams down to something like $500 from where they are today, which is $2,500. So now we're screening every organ in your body for something like $7.

There is no other preventive health test anywhere in the world that is as inexpensive as this. And that's one of the often overlooked benefits of screening the entire body in one go is it becomes extremely inexpensive to screen any one organ. And therefore, potentially not only a solution that can save lies, but also much, much more cost effective than sort of the piecemeal approach that we have to screening of patients that have high risk of certain conditions. Do you ever imagine a place where insurance is picking up at least part of the tab? Yeah, we're already in the process.

So we have now 13 years of clinical evidence, and now we're in the process of kicking off both prospective clinical trials and retrospective clinical trials to really collect the sort of evidence that's required to engage in dialogue with insurance companies and healthcare systems so that one day this becomes standard of care. It feels to me like just based on the cancer component alone, just knowing how expensive it is to treat cancer, having had multiple family members, unfortunately, that have gone through cancer in the past. It seems like that alone is like a no-brainer for the insurance companies. Yeah, the stats on cancer are crazy. So we spend $150 billion odd dollars on cancer medications

alone in the U.S. And most of those are therapies for advanced cancer. We sort of estimated internally that were we to use an abridged technique that just look for cancer in the torso and to screen the entire population in the US, we could probably do that for 60 or 70 billion. So on a pure financial basis, this is a win for the health system. And then, of course, on top of that, and more importantly,

would have the potential to save millions of lives. So I think that's, as a company, really, the mission for Pernuvo is to work towards that goal where there is coverage for everyone, and this becomes standard of care and a healthcare system that is completely reinvented to be much more preventative. Yeah.

On top of that, obviously, there's a whole discussion about just health care access in the U.S. in general and not having universal health care, which we chat a little bit on the podcast. When we, you know, what's interesting, I got to look back at the paper, but they brought this up on one of my favorite podcasts is called Breaking Points. And it was comparing wealthier individuals that have, you know, good insurance in the United States comparatively to well-off individuals in U.S. Europe. And even when you compare, you know, those two sort of population sets that have really great health care coverage, the ones in Europe had general better health outcomes. Obviously, there's so much that goes into it. Society, food exposure, et cetera, other stuff. But they isolated for a few different things. And they were just showing that when you have access to, you know, this universal health care, those populations that have access, even when you sort of,

equate for income and a few other components that generally people having access to health care is going to lead to a healthier population. Obviously, there's a whole bunch of problems. My friends that are in the NIH in London, in the UK and Canada, you know, there's a lot of problems because everybody's getting sicker everywhere in the world and nobody, none of these health care systems. And this is where actually I don't think there's enough criticism on the universal model that like Canada and England have and a lot in Europe.

it's is very hard to get any kind of preventative component. It's like you're prioritized to the top of the line if something is urgent right now. If it's not, you got to wait like, you know, years sometimes to do it. So I think there's a bigger discussion about whether you have universal health care or not. We just need an entire system that shifts towards prevention. And I really feel that technology, AI, all the future stuff that are coming is going to be a part of that. Well, and I think there's no one model that has got anywhere close to. the solution. In the U.S., you have a system that there's no better place in the world if you have

an acute problem to be treated than the U.S. We have fantastic doctors. We are able to utilize cutting-edge approaches. It's just sort of precision acute medicine system is sort of the envy of most of the world. Then you have other parts of the world where there's perhaps a greater focus on preventative health, but they don't have the depth that the U.S. has for treatment of acute conditions. And I think the answer somewhere is in the middle, which is we're looking for really a preventative but precise system and something that's tailored to the personal needs of every individual. And I think that's the world that we're trying to create. Does this show me how much visceral fat I have in my body? Are you guys at a level

yet where you kind of provide that information to patients? Not yet. I mean, you can eyeball it. And oftentimes, if you have a lot, it's mentioned in the report. But this speaks a little bit to some of the research that we're doing as a company. So we're really, really excited to, and are investing a lot of time to understand some of these lifestyle factors and early disease processes of age-related degeneration. That could be brain degeneration, that could be spinal degeneration, liver, kidneys, and so on. in fact can we peel back the clock on diagnosing disease a lot earlier and the early we can the easier it is for you to treat and sort of positively affect your health trajectory it's incredible what we're able to see I have a team of now 20 people that are sort of doing

actively doing research across every area of the body developing models that are able to tell us in a much more quantifiable way how your health is tracking. And one of those is visceral fat. And we're in the process of putting that through an FDA regulatory process so that we can present that to patients as part of their reports. Having said that, we've already acquired those images of you. So when you come back the next time, we will be able to tell you how your visceral fat has evolved, how your liver fat has evolved, ideally your pericardial fat, your pancreatic fat, if you have any there. And this, I think, is really the future of health, which is precise, quantifiable metrics of things that we know are highly correlated with age-related degeneration so that you can do something about it.

I'm guessing you had your scan done. And was there, you know, how did you feel after you getting your own scan done? Well, I did my scan five years ago in that first clinic in Vancouver, Canada. and I was just really looking to understand how I was tracking in my health. I hit my 30s, my 40s, and I'm a serial entrepreneur, so I work way too hard, do not sleep enough, and I really haven't looked after my health if I'm being totally honest. And so I wanted to take stock. And this exam was, for me, just an incredible experience.

I learned more about my health than I had learned my entire life. I had learned that I wasn't. Thank God, I didn't have any cancer or I didn't have any aneurysms. There were some things that I could work on. But I remember this feeling after I did the exam. And I don't know if I'm sure you might have some listeners that or I don't know if you've been skydiving or something, that feeling of adrenaline you get for a couple of weeks afterwards where you sort of look out on the world and everything feels a bit more colorful. That was the feeling that I had, that tremendous peace of mind,

to not really have to worry about what was going on inside my skin. And I'm not a hypochondriac. So this was not sort of a panacea for a problem I had. It's just, I think, as a normal person, I had these very normal questions that I wanted to have answered about my health. And from that moment on, it really felt like this was something, a mission that I wanted to dedicate my life to, which is to find ways to continue to prove out this technology,

to find ways to bring it to as many people as possible, to bring the cost down and eventually through Pernuvo and other tests, like clearly, you know, present a alternate model for health care that we think can be transformative and, you know, possibly, of course, also less expensive than our $3.5 trillion health system that we have in the U.S. Yeah, nothing is more expensive than treating disease at a later stage. I want to say from my side, you know, we went through my findings and everything. it's really like knowing that nothing major on the major things that you guys look at, and we talked about the areas that you do look at, that areas you don't, that there's nothing

that is showing up in the test for what you do. I usually, I, not usually, I will combine that with my normal sort of metabolic labs, some of my advanced, you know, genetic testing, other things. And then with all that information, you get kind of a complete sense of like, okay, great, you know, I'm doing good. I want to, or here's the areas that I want to improve on. And so this was really helpful to know. that, you know, I didn't have anything major going on that had to be addressed immediately.

Yeah, and by the way, I'm sort of living proof that this is not just for people that have six packs and, you know, are into the latest in preventive health. I'm a very normal person. I have very normal health. I look after myself in, you know, a very normal way, shall we say. But just, you know, I feel more comfortable knowing that there's nothing going on under the skin. And I know that if there was, I would want to know about it so that I could make those lifestyle adjustments earlier rather than later. So we have a lot of entrepreneurs or business owners or people that just want to have that sort of peace of mind so that they continue to do great things for the country. Probably because people will see it on the screen. I'll just mention it.

There was another finding that was in my reproductive system, which was the one we didn't go over. It was basically saying that my prostate is smaller than the average. prostate is 21 milliliters, ML, and the normal prostate on average, and I know I'm definitely like a leaner guy, but, you know, why would this come up as something to pay attention to? It's just comparison. This is just an informational finding for you. So we actually want the prostate to be small. Yeah, so I thought it was a good thing.

It is a good thing, actually. So yeah, prostate is one of those organs where you actually want it smaller and not bigger. And what we tend to find as people get older is the prostate grows in size. that can grow. And of course, prostate is the most common cancer for men. In fact, the saying goes, you know, most men either die from prostate cancer or with prostate cancer. And by being able to precisely measure the volume of your prostate, we can start to tease apart three conditions that are often confused by other tests, notably the PSA test, which is prostate cancer. which elevates PSA, prostatitis, which is an inflammation of the prostate,

which elevates PSA, and something called benign prostate hyperplasia, which is an enlarged prostate, which also increases PSA. So because we're able to more precisely separate those, we can avoid the need for men to go and get biopsies, which is what used to happen when you had an elevated PSA. We mentioned earlier you guys had, I think it was Kim Kardashian, did a big post about it. Did that break your clinics in good and bad ways?

Well, there's nothing unique about her, to be honest. This is, for us, is a very sort of, this is an old-fashioned business. We're a medical company that is hell-bent on providing the best clinical quality screening exam in the world. It's the only thing that we do. We're not an imaging clinic that's trying to do this on the side. We spend 100% of time doing this. optimize the experience, the hardware, the software, and so on. And when we provide a great experience,

people tell other people about it and they come in. And the vast majority of patients that we have are coming in through word of mouth. And that includes people like Kim, who heard about us through other folks. In fact, most of the celebrities that have spoken about us have reached out to us because they heard about it through a friend. It's not necessarily through any active outreach from the company. And certainly we don't pay people to promote us because that sort of runs against the ethos of the company. It just so happens that people like Kim have like a massive audience and have this real potential to raise awareness for these new techniques like Prunivu, and hopefully that's going to lead to lives being saved. Yeah, there's nothing wrong as a CEO when somebody

who has a couple hundred million followers decides to organically talk about you. But I can tell you, you know, when that happened, we didn't know it was happening. Yeah. You know, I was on a plane to New York, actually, to our clinic there. And I just happened to be monitoring Twitter or Instagram. I forget what it was. And I saw this notification pop up that she had posted. I'm like, okay, here we go.

And obviously it raised a tremendous amount of awareness. A lot of people reached out with questions. And we've tried to help as many people as possible. And obviously, it's been great for the continued growth of the business. Yeah. And I think in a good way, you know, if you believe in what you're doing, you're okay with people stress testing what you're up to. Yeah. When somebody that big promotes you, obviously you're going to get the good, bad, and ugly from all sides.

But if you believe in what you're doing, you're not afraid to have the conversation and dialogue. What were some of the, you know, we brought up some of the stress testing criticism ideas earlier. But was there any other valuable sort of, I don't want to call it. a negative response, but was there any valuable criticism that you guys were hearing? I know you've been doing this for a really long time, so I can't imagine you heard anything new. Maybe the scale was different. But was there any valid, valuable criticism that is really part of a larger dialogue about healthcare and access that came from that incident? No, I think most physicians are asking what I think is quite an appropriate question,

which is, you know, we need more clinical evidence to be able to prove. or disprove that these techniques are useful at the level of population health. And my answer to that question is absolutely. But it takes time for this to, it takes time to collect that evidence. Techniques like mammogram, they were in clinical practice in the mid-60s, and they didn't get covered by health insurance until the 90s. And they got covered because there was evidence from millions of people that actually had done these things in clinical practice.

and you are able to therefore collect the quality of clinical evidence that's required to make a decision to cover this at the population level. Now, I hope that this process is faster for us, but I also acknowledge that, you know, and we are very intent on collecting more evidence beyond what we know from our clinical experience. Most of the criticism that we get just relates to folks that don't really necessarily understand the techniques very well. one thing perhaps that's important to stress to your listeners is that these techniques that we use with MRI these are MRI is a qualitative imaging modality it's not a quantitative imaging modality

what do I mean by that what I mean is just like you have good surgeons and bad surgeons the the efficacy of a screening technique using MRI is going to depend tremendously on the hardware that's used, to rentously on the images that are taken on the training of the radiologists and increasingly on techniques like AI. And any sort of criticism of the space without really understanding what any particular company is doing should be taken just as that. And oftentimes when we get received criticism, my first response is to reach out to the physician and invite them to learn more about it and learn about how these things are different. And you, you'd be hard pressed to find a physician who has firsthand information about what we're doing

that hasn't brought their partner or spouse in and isn't referring appropriate patients in for screening. So education really is an important part of what we need to do to also help provide knowledge to physicians so we can sort of change hearts and minds. Yeah, and just even the dialogue, right? Yeah. We live in a day and age where everybody wants everything to be ready for everyone. It's actually kind of like a little bit of a messed up privileged point of view of the world that every single innovation recommendation should be ready for mass adoption.

And it's kind of a byproduct of I personally feel of a time and day and age that we're living in where we have it really good. You know, we have so many things around us, even though there's plenty of people that are suffering, even though there's so much economic disparity. Yes, there's things that are really wrong, but our expectations are quite high. at least in America, of how things should be ready for everyone. And I think the thing is that innovation, innovation is messy sometimes. And so many things, like, I'm a big fan of a lot of the work that's being done in the

space of psychedelics. And if you understand that this is a movement of individuals that for many years had to operate underground to kind of slowly convince people one by one of the therapeutic approaches of psychedelics like MDMA to have amazing. major impact on PTSD and trauma and other stuff, way better than medications that are out there, you realize it was a small few people that had to fight, even when certain drugs were illegal, to actually get us to a place now where you have members of Congress in a bipartisan way talking about, okay, hey, we need to rethink about the classification of these as drugs,

and at least open it up to more research and potentially FDA approval. Like, everything goes through a battle before it's brought there, and nobody understands that better than the people that are involved in that fight. I'm glad that you guys launched, you know, direct to consumer because I've seen plenty of companies try to go down the route of waiting for insurance one day and they don't have enough momentum or data set to convince the gatekeepers. And so they never take off the ground. Yeah.

And they call it like death by clinical trial. You have keep on doing different trials, trials, trials, trials, trials. But, you know, you're trying to get some hospital system or some place to approve you. But, you know, at least this is available. This is an option. And not every option is for everybody. but at least this is another option that's on the table for people that want to pursue that option. Yeah, and we do a lot of education.

So every month or two, and if you have listeners that are interested, they should sign up on the website at prunivar.com, but we do a webinar for consumers where we literally take, we have a radiologist to take people through a study and we go through someone's body and we have a conversation about what we can see and what we can't see. and we take a lot of questions from consumers that are curious. We do a similar thing every couple of months for physicians where it's a similar process. We take them through one or two exams and we have a more clinical discussion about, you know, what we can see and what are the drawbacks and false positives and incinalomas and sort of answer some of the questions that physicians who may not be familiar with these techniques have.

And slowly but surely we've now got hundreds of physicians that are referring as patients. and thousands of consumers that are looking for forward-thinking physicians to work with to help them on their health. Yeah. Andrew, this has been great. Thank you so much for coming on the podcast. I think your team set up a little code for people. And just to be clear, I'm always about disclosing everything. I don't get any kind of compensation for this code or anything like that.

It's just a code that gives people a discount if they want to do it. I think it's $300 off. and it's uh we'll put it in the show notes but it's pro novo.com slash drew dhr u and that'll give people three hundred dollars off the twenty five hundred dollar price um tessa can we just see if that's active for the people that are on youtube we could just see if that link comes up and okay great perfect the discount code is applied drew pro it cares about you and so do we yes i care about all my listeners so yeah if you feel like this is a test that is something that can be beneficial for you And that's why we wanted to have you guys on to talk about, you know, the pros and cons of it.

And I think especially in early cancer detection from my, you know, personal thing. I haven't seen many things that are out there that really can find cancer this early in a way that's so specific. This test is great. And we have to keep on fighting the good fight and tell people, you know, to practice all the healthy lifestyle habits, to reduce chronic disease. And yes, maybe one day, Prunov will be part of insurance and all those things are there part of the equation too. but if you can afford it and it can be part of your plan, you can sign up now at pernova.com slash drew. Andrew, thank you for coming on.

Any final words? Yeah, no. So I tweet a fair bit about Preventive Health. So if people want to follow me, I'm Andrew Lacey on Twitter. And of course, if people are interested in learning more and attending one of these webinars that we do routinely, either reach out to us through the website or they can follow us. They can follow Perniva on Instagram or on Twitter

and we give people a lot of notice when these webinars are happening. and we just hope that people, you know, learn as much as they can about some of these new techniques. And if they're right for them, we're really happy to help them on our path to better health. Amazing. Appreciate your brother. Thank you for coming on. No worries. It's been great to be here.

Thank you. Hi, everyone. Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would mean the world to me. And it's the number one thing that you can do to support this podcast is share it with a friend.

Share with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter. And it's called Try This. Every Friday, yes, every Friday, 52 weeks a year, I send out an easy-to-digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from nutrition to mindset to metabolic health, sleep, community, longevity, and so much more.

If you want to get on this email list, which is, by the way, free and get my weekly step-by-step protocols for whole-body health and optimization, click the link in the show notes that's called Try This or just go to Drew Perot.com. That's D-H-R-U-P-U-H-I-T-com and click on the tab that says, try this. Thank you.