Science Friday - Spy Balloons, Cost of Cancer Care, Seaweed, Chocolate Mouthfeel. Feb 17, 2023, Part 2

Episode Date: February 17, 2023

Eyes In The Sky: The Science Behind Modern Balloons This month, the news cycle has been dominated by updates about suspicious objects being detected in the stratosphere. This bonanza started with a balloon from China, and escalated as four more objects—not all confirmed as balloons—have been shot down from the sky. Although this might sound like a new problem, there are probably thousands of balloons floating above us—some for spying, others for exploring near space, or studying weather patterns. Dr. David Stupples, professor of electronic and radio engineering and director of electronic warfare research at City University of London, joins Ira to talk about the science behind modern balloons: how they work, what they do, and just how common they are.   Low Income Patients Hit Hardest By Cancer Treatment Costs Being told you have cancer is not only terrifying, it’s expensive. In the year following a diagnosis, the average cost of cancer treatment is about $42,000, according to the National Cancer Institute. Some of the newer cutting-edge treatments may cost $1 million or more. While insurance may cover some or all of that cost, many people are uninsured or under-insured. And the bills add up. A quarter of patients with medical debt have declared bankruptcy or lost their home, according to an analysis conducted by KHN and NPR. While there’s been remarkable progress in treating cancers in the past several decades, less attention has been paid to just how astronomical the price tags can be. Researchers at Augusta University wanted to track the results of the financial burden after patients’ treatment was complete. They found that poorer patients were hit harder financially—which not only resulted in more bills, but also worse health outcomes. Ira talks with Dr. Jorge Cortes, co-author of this study and director of the Georgia Cancer Center at Augusta University, about the importance of making cost part of the discussion in developing new cancer therapies.   The Unseen World Of Seaweeds Chances are you don’t give much thought to seaweed unless you’re at the beach, or perhaps when you’re considering a dinner menu. But the thousands of seaweed species around the world are a key part of our coastal ecosystems. Seaweeds photosynthesize, provide food and shelter for marine animals, stabilize the coastlines, and even contribute to making your ice cream creamier (through an ingredient called carrageenans, extracted from red seaweeds in the Rhodophyceae family). Increasingly, they’re also being investigated as a source of biofuels and as biological factories, due to their fast-growing nature. Dr. John Bothwell, a phycologist at Durham University in the UK, has written a book in praise of seaweeds. In Seaweeds of the World: A Guide To Every Order, he highlights beautiful, unusual, and important species from each of the three seaweed lineages—green, red, and brown. In this segment, he talks with SciFri’s Charles Bergquist about some of his favorite species, where the seaweeds fit into the web of life, and the importance of seaweeds to the global ecosystem.   Why It Feels So Good To Eat Chocolate When you eat a piece of good chocolate, chances are you don’t just bite down and chew away. There’s a good chance you hold the chocolate in your mouth for a moment, feeling the silkiness as it softens, melting into a molten mass and mixing with your saliva. That gradual phase change process—as fats in the chocolate melt from solid to liquid—is a big part of the chocolate mouthfeel experience. Researchers at Leeds University in the UK have constructed an artificial tongue that doesn’t focus on the taste of a food, but rather its texture, and how that texture changes over time. Using the artificial tongue, they explored the textures of materials that can change phase in the mouth, such as chocolate, butter, and ice cream. They reported their findings recently in the journal ACS Applied Materials & Interfaces. The researchers found that in dark chocolate, the sensation in the mouth is governed largely by the fat content, as the surface of the chocolate begins to soften. A few moments later, as the chocolate melts completely and mixes with saliva, the fat content of the treat is less important to the mouthfeel experience. Dr. Anwesha Sarkar, an author of the report, joins Ira to talk about the research, the challenge of designing a lower-fat chocolate that might exploit these findings, and the importance of learning about textures to determine why people like—and don’t like—certain foods.   Transcripts for each segment will be available the week after the show airs on sciencefriday.com.   Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Ira Flato. Later in the hour, we're going to dive into the hidden and underappreciated world of seaweed. Plus, what a new study says about the cost of cancer treatments, and as a belated Valentine's Day treat, we'll learn about the physics of how chocolate feels in your mouth. So go ahead and grab that box of leftover chocolate. But first, the news has been dominated by updates about suspicious objects being detected in the stratosphere. The Spananza started with a balloon from China, then escalated into other objects,

and now even Russian spy balloons shot down over Kiev, the capital of Ukraine, this week. And although this may sound like a new problem, there are probably thousands of balloons floating above us. A few for spying, others for studying things like near space or the weather. So today we're going to look into the technology behind balloons and focus a bit on what kinds of electrical spying balloons are capable of. Here to tell us more is Dr. David Stupples,

Professor of Electronic and Radio Engineering and Director of Electronic Warfare Research at City University of London. Welcome to Science Friday. I'm very pleased to be here, and hello to all your guests. Dr. Stupples, I feel like I've heard the word spy balloons more in the last two weeks than I have in my entire life. What's your take on all of this news? Is it surprising?

No, not really. As you mentioned in your introduction, the balloons are used for a variety of things, including looking at the weather and also looking at the winds in the stratosphere, the jet stream. So they've been around for a long time. They've also been around, of course, for people who want to spy on other people because it's a way that you can sneak up onto them because they're very quiet and you can spy on them from above. So they've been around for hundreds of years, but today they're much more sophisticated. Is there any way to tell whether a balloon is a spying balloon or a corporate or research balloon? Not really, because they normally have the fabric which is inflated and lifting the payload. The payload will have solar panels on to provide the power, and they will also be carrying electronics and antennas. So that's a weather balloon and a spy balloon.

So you probably can't tell the difference. I suppose the spy balloon or reconnaissance balloon might be larger. Could you tell, of course, after you've taken it down what the payload is, whether it was spying or just doing some sort of other surveillance? Certainly, as soon as they get the electronics back to the laboratories, they will know exactly what that balloon is being doing. Is the stratosphere, the altitude where the balloons are flying? Is this a new spy versus spy battleground?

Well, I think it is in some way because the balloon when it was first entered the states from Canada, I'm talking about the first one now, was probably between 20 and 30 kilometers, so up to 100,000 feet. So it was certainly in the stratosphere, and it was certainly being driven by the jet streams up there, the high speed winds. So it could be seen by the ground, but only if you're looking for it. Only if you're looking for it. And it seems to me that from the reports we've been hearing over this time period that they haven't always been looking for them, or we just say they always have been. No, well, I don't think so. Just take the United States for the moment, if you took the air defense radars, the ones that protect the country from attack, these would be looking for moving objects. And I'm talking about fast moving objects, so like aircraft. So they would have a device. called Doppler shift facility on board, which will actually look for a moving object. What it does then is to take away all static objects, which would appear as clutter on the

screen. So if the radar is set up to look for aircraft, it probably wouldn't see balloons, and I know for a fact it wouldn't. Can you recalibrate the radar so it can't find balloons? Yes, they can. And of course, NORAD announced this recently saying, that they were going to calibrate the Doppler so that it would look for very slow flying objects and yep it can do that but of course then you're left with the fact that the

balloon is not a very good radar reflective material so it would probably only work on the metal parts of that or the parts which would actually reflect the radar and they're quite small so first of all the Doppler

will shift is a problem but then you've got the problem of having to wait until it gets close enough to see it. So this is not as easy as it sounds, is what you're saying. No, it's not. And I sympathize totally with the U.S. Air Force on this. I mean, they didn't expect this type of spying on this scale. That's, of course, if it is spying.

And so, therefore, that the systems wouldn't be set up to see or to see them or find them in the first place. Hmm. What's the difference between the data we get from balloons versus satellites out in space? No, the problem there is that the, first of all, let's just take two types of satellite, the ones that rotate around the Earth at the same rate as the Earth, and those are called geostationary satellites. Those are at 36,000 kilometres above the Earth's surface. So what would happen then is any signal, any radio signal, whatever it is, on the ground, if it's very weak, might not be heard by that satellite. So that's the first thing. So then you say, well, okay, then let's have a much lower satellite.

So we have one in what they call low Earth orbit. But the problem then is, is that the satellite will then orbit the Earth, and it would take about 70 to 80 minutes to orbit the Earth. But as it's orbiting, the Earth is turning. So it would see it once and then not again, probably for 14 hours, and then it would fly over the same point again. And in the technical terms, we call that dwell time. So the satellite is dwelling on a target for,

let's say 20 minutes in every 14 hours. So one satellite would miss an awful lot on the ground. How common do you suspect then if this is a cheaper way and you don't need to use satellites for this observation? How common is it for surveillance balloons to be around? Well, it is. I mean, certainly countries that can't afford the defense expenditure of the United States, they would have cheaper solutions. One of them would, of course, be very cheap satellites, and the other one would be using air balloons. So this is not new. And of course, what it can do is that it can dwell a long time over a target, perhaps, you know, three, four hours before it drifts away again. So it actually then is picking up a lot of signals from the ground. But how do you steer it then to get to that target that

you'd like it to dwell over? Is it subject to the whims of the jet stream, so to speak? You raise an interesting point there. It's a lovely, lovely point. China and, well, the United States, Russia, UK, whatnot, would study very carefully all of the winds in the upper atmosphere. And these jet streams can be, in fact, monitored and then predicted. So over a period of time, a few days, for instance, you could then predict exactly where, or closely, where the balloon can fly, even to points where the balloon would be stationary for a period of time and then move into another jet stream and move away. So because of the sophisticated weather computers, we can do that. Some of the objects that have been shot down were for national security reasons,

but others seemed pretty benign. And one big reason for shooting them down is because of air safety for airplanes and such. How big a deal is that? Well, it's a big deal because these balloons are certainly the one that flew over the states was massive. We're talking, I think the press called it several greyhound buses in size, in probably height and in width. So if this came down into a commercial airway and it got close to an airline, it would certainly bring the aircraft down. So it's a big hazard. The other thing is, of course, is if you bring it down by shooting it down, then you have really no idea where it will end up.

Because as it drifts down through the various layers of the atmosphere, it will be. moved away in different directions by the wind currents. So where you think it might come down in the Mojave Desert, it will end up really on top of someone's town or roadway, railway, even an airport. So it's quite dangerous. So the US made the right decision there in shooting it down when it was over the water. And of course, since the payload could be, what, a few hundred pounds, you don't want that to start falling at terminal velocity, do you?

That would give you a nasty headache. Let's talk about how you shoot them down. The U.S. used missiles, but you really, do you need missiles or do you need guns? From what I understand, the fully inflated balloon is not like a toy balloon where if you puncture it, it pops. The gas inside is at equal pressure to the gas in the atmosphere. So hitting it with gunfire might put holes in it but might not take it down. That's true. I mean, it would eventually come down because the helium would leak out.

But if you just put a few holes in it, it would certainly would leak. and then and descend over time. Hitting it with a missile is really very difficult as well because if it's a heat-seeking missile, the balloon's not putting out any heat, so it's got very little to home in on. And then the radar-controlled missiles work on Doppler again, a moving target.

So it's difficult for them to shoot it down. And also, if the balloon is at, say, 90,000 feet or 100,000 feet, the aircraft, in this case it was an F-22 raptor. it can probably get to about 70,000 feet. So it couldn't put its guns onto the balloon. It's too far away. So it would have to fire a missile.

And that's a little bit hit and miss as well. So bringing them down is not such a simple task. And finally, how many balloons do you think they are up there right now and undetected? I don't think very many because I think that after the NORAD has adjusted the radars, they would certainly be looking for this. now and they would have other means of locating them. So there are probably not very many there are undetected,

but there may be one or two, because there are a lot of weather balloons, and the US will, in fact, launch weather balloons from different parts of the country once or twice a day. So is this normal, or are we in a new normal? Or, I mean, if these spy balloons have been around for so long, how normal is it that we're now only detecting these balloons? That's a good question that. I've often wondered why we haven't been looking for them,

but then I thought to myself, well, I haven't been looking for them either. Because I would have expected it to be done from satellite and then from a spy aircraft. But of course, the aircraft such as the rivet joint can't fly over China or Russia, and likewise the Russian aircraft and China wouldn't fly above the US because they would be shot down. So the only way of doing it is by satellite. But I've said the weaknesses of the satellite system. It was probably just filling a gap that the Chinese, in fact, intended to do under these circumstances. I haven't heard of any Russian balloons going over the U.S. or the U.K., but that does not say they haven't.

David, thank you for joining us. It's a pleasure, I am a pleasure. Dr. David Stouples is a professor of electronic and radio engineering and director of electronic warfare research at City University of London. We have to take a quick break and when we come back, the hidden world just off the coasts, exploring seaweeds, why they are so important to our coastlines. Stay with us. This is Science Friday. I'm Ira Flato. I'm guessing most of you don't give much thought to seaweed, unless, of course, you're at the beach or maybe when you're,

you're considering the dinner menu, but the thousands of seaweed species around the world are a key part of our coastal ecosystems. Syphirize Charles Berkowitz is here to tell you more about it. Hey, Charles. Hi, Ira. You're right. I hadn't really given seaweed that much thought, but recently I saw a book that made me think a lot more about all the types of seaweed out there. Dr. John Bothwell is a phycologist. That's a scientist who specializes in algae and cyanobacteria. He's an associate professor in the Department of Biosciences at Durham University in the UK. And he's author of the book, Seaweeds of the World, A Guide to Every Order.

I asked him why he felt the need to write it. Because they're really important. They seeweeds do in the sea, and certainly along the coast, what trees do on land. If we didn't have seaweed along the coastline would die. So this book is beautiful. Listeners can see some pictures on our website at sciencefriety.com slash seaweed. There are things that look like clusters of tiny green grapes. There are pink feathery fronds.

There are things that look almost like undersea mushroom caps. How many different kinds of seaweed are there? Thousands. The main division is between the three major kinds of seaweed, the reds, the greens, and the browns. But within each of those major groups, there are several thousand species. The reds are probably the most diverse. but they're also the hardest usually to find because they tend to live under the bottom of the tide limit. The browns are usually the ones with most people will be familiar because they tend to live in what we call the intertidal.

So the part of the shore that is exposed when the tide goes out. When we talk about the greens, the reds and the brown seaweds, is it really that straightforward? If I see something that's red, it's a member of the red seaweeds? It's pretty much that straightforward. The colour does depend on a number of factors. One of the reasons I think why people don't appreciate sea weeds is they never see them at their best. They always see seaweed when they're dried out, or they've been left to dry out on the shoreline once the tide has gone out. It's like judging the beauty of a plant by looking at your compost heap or by looking at what's been cut down in a storm.

In order to see the real beauty of these things, you actually want to go diving, you want to go offshore, you want to look at them in their actual environment when they're underwater. Help me to work out the family tree here. Should I be thinking of seaweed as something like, sort of like the grass on my lawn or more like the slime in my fish tank? Ooh. People often talk about seaweed as plants that live in the sea. It's actually the other way around. The land plants that we're familiar with are seaweed that about 600 million years ago made

the move onto land. So the seaweed came first, and the land plants are there. descendants. The division between the slime in their aquarium and the grass in your lawn is actually a really smart thing to point out because there's two kinds of algae and the sea weeds are a subdivision of the algae. Algae is a very broad term that means things that photosynthesize that grow in water and the big division in the algae is between what we call the sign of bacteria and between what we call the eukaryotic algae. The eukaryotes are basically things that you can see with a naked eye.

Anything you can see pretty much as a eukaryote, it's not bacteria. So the division between the cyanobacterial algae and the eukaryotic algae is a really important one. In general, the aquarium slime is the bacterial algae, and a lot of the phyto plankton will be the eukaryotic algae. So, seawoids are a division of, or three divisions, red, greens and browns, of the eukaryotic algae. You mentioned landplants being seaweed that managed to crawl out onto the ground and live. Pretty much. Should I be imagining them as something similar to a land plant with structures like roots and stems and leaves?

Or is it completely different? Are we not at that stage yet? That's a really good question, actually. The morphology, the shape characteristics of a seaweed and of a land plant are determined largely by the environment in which they find themselves. Seawydids are in the sea, landplands are on the land. They both face common challenges, though. They need to find nutrients, they need to reproduce, and they need to spread their proper gules, their reproductive cells, a long distance. They need to spread their populations.

But in the sea, the nutrients are all around you. They're in the water. And water is a very good carrier of things. It supports weight. And it will also support your offspring. When you produce your offspring, they'll be carried away on the tides and with the currents. And seaweeds have adapted to live in an aquatic environment. So they don't need much support because the water carries their weight. They don't need very specialized reproductive organs. because the water will carry their offspring away from them. They don't need, you mentioned roots, they don't actually need roots because roots are specialized structures that extract nutrients from the soil. Seawoids don't take their nutrients from the soil, they take it from the water. So in fact, in seaweed, the thing that looks like a root, it's called a holdfast. It's just a device for attaching it to the rocks or to the sand. It doesn't actually absorb nutrients.

Land plants, in the other hand, all of the things we think of, the flowers, leaves, roots, the specialized structures of land plants, they all evolved after ancestors of land plants, moved on to land. And they evolved afterwards because land poses particular problems. You have to absorb the nutrients in the soil, so you evolve roots. You have to spread your offspring a long distance away, so you evolve seeds. You have to lift your leaves up to out-compete other plants to gather light, so you develop lignin and wood. Again, sea, we don't have that because the water supports them. So it's a really, really good question.

Tell me about some of your favorite species. You must have ones that you specifically love. I do. It's a very personal question. I got a couple. I have one from each of the major groups, one green, one red, and one brown. My favorite green, and I'm very biased here, is Ulva. Ulva is the Greek word for sedge or grass, and it's probably the most common green seaweed.

If you go down to any northern hemisphere, certainly, beach, you'll see a layer of green. Looks like lettuce leaves on the shoreline. We call it sea lettuce. Olver is my favorite green because my group sequenced the genome of Ulva. So we did a lot of work on Alva, and my group currently works on it. It's a cousin to the land plants, so we can work out a lot of the fundamental evolutionary biology that drove the divergence of land plants and green seaweeds by looking at over and comparing it to land plant models. My favourite brown seaweed is fucouseratus, which is serrated rat, which is very common on the shorelines around certainly the North Atlantic.

That was the first seaweed I did experimental work on. And one of the nice things about Fucosuratus is that the plants can be either male or female. So if you see a plant that has orange speckles at the tip, that's male. If they're green at the tip, that's female. And my favorite red is one called conjures Crispus, which is Karagin moss in Irish, which is a beautiful little branching seaweed that looks very, again, very common in the shorelines around where I live. You mentioned just now the male and female nature of some of these species. Talk to me a little bit about the reproductive cycle in these organisms.

You ask easy questions. Seawweed reproduction is very complicated. And we're not quite sure why. So it varies between the greens, the reds, and the browns. But as a simple overview, seaweed tend to have at least two life cycle stages. And one of those life cycle stages is diploid, which means that it has two copies of every gene. The other of the life cycle stages is haploid, which means it only has one copy of every gene. Humans have one diploid generation, which is us. The forms

that we see walking around, that's the diploid adult stage. We produce haploid gametes are sperms and eggs. The sperm and egg fuse to form a diploid zygote that then grows up into the diploid adult again. So we do produce haploid cells, but only for a very, very short stage of our life cycle. In a lot of seaweed species, that haploid stage can actually develop into a free-living organism. So it's as if we could produce a sperm or an egg, and the sperm and egg could independently effusing could just grow up into another person. So there'd be an adult male walking around who was haploid, an adult female walking around who was haploid. So this, it called this alternation of generations. And there are variations on that particular

theme in the greens, the reds and the browns. They each do it slightly differently. But this basic alternation of generations is very longstanding. And we're not in time. sure why it happens. What it does do is allow seaweed to grow without having to find a partner. And that's a very powerful technique because if you are a species that is buffeted around by the currents and you produce your sperm or your eggs and they float off somewhere else where they can't find a partner to join with, you can still grow up to become an organism. So it allows for much more We know there are some populations of seaweeds that reproduce sexually in one region of the ocean, but then reproduce asexually in other areas of the ocean.

So we think this alternation of generations helps with the spread and survival of seaweeds in what is a very extreme environment. How specialized are these species with respect to their niches around the world? Are they sort of generally widespread or are their seaweeds? that you would only find in, I don't know, one specific African bay or something? The answer is a bit of both. There are some species that are what we call cosmopolitan, so spread worldwide. There are some species that fill very, very narrow niches.

One of the problems with seaweed is we've talked already about their simplicity. And so just to give a comparison, we often talk about multitellular organisms as being simple or complex. and that can be defined by the number of different types of cell that an organism can produce. Humans produce a couple of hundred different cell types, red blood cells, various kinds of white blood cells, neurons, etc. A land plant will usually produce maybe 50 different types of cell. Most seaweed only produce half a dozen types of cell at most. So they're very, very simple. That allows them an awful lot of plasticity.

So they grow very well in most places. And the clue is in the name. They're called weeds. They grow like weeds. But it also actually makes them kind of hard to differentiate. Because when we identify two different plants, we'll often look at a particular structure on the plant, the flower, for example, or the leaf shape. It's a lot harder to do that with seawoids. So a lot of seaweed species are very difficult to tell apart, which means that.

that we are probably underestimating the number of species that are there. There's a lot of what we call cryptic diversity. Cryptic diversity is where you have two things that look the same, but are actually different species. There are certainly cosmopolitan species, but we are only just really starting to get into a proper species-level description of exactly which species are filling, which in niches. Sea which are extremely diverse, but so are the people and cultures that study them and use them. These things are spread worldwide, and particularly in island cultures, seaweeds are much more important to island cultures than they are to inland cultures for obvious reasons.

So there's a lot of cultural interpretation and cultural importance to different seawoods. And I think it's really important to recognize that seaweed do mean different kinds of different cultures, and the diversity of seawoids is increasingly being matched by the diversity of people who are studying these things. You're listening to Science Friday from WNYC Studios. I'm talking with Dr. John Bothwell about the wonderful world of seaweed. Let's talk a little bit about uses beyond the obvious animal habitat and food. Part of your day job is working in biofuels. They're biomass. They can be burned just like any other biomass.

So humans have been burning plant-like material for thousands of years, and dried seaweed will burn as well as wood. There's a lot of interest now in using seaweed as biofuels or as biotechnology precursors or as feed. There are initiatives certainly in Alaska. There's a lot of kelp farming going in Alaska. The giant kelps of California have been used for decades and worldwide, particularly places like Indonesia, increasingly in Africa. People are growing these things to see if we can use them as a feedstock. They do have advantages. one of them is we talked earlier about the lack of specialized structures in seaweeds specialised structures take a long time to make trees grow quite slowly seawoids on the other hand don't have to make the

specialised structures which means they grow really fast seawood will grow two three four five times faster than land plants so they're very productive it's one of the reasons why people are interested in them and certainly at kelp farms they're just a very very fast growing form of biomass. So there's a lot of potential there to grow biomass offshore. And of course, one of the problems with certainly a lot of the global north is there's a lot of pressure for land. There's more people. We're running out of land to grow stuff on. One answer to that is to start moving some of our production offshore. So, yep, there's potential. This is fascinating. And it's obviously something you care a great deal about. Talk to me a little bit

more about why people should care about seaweed? Well, the best way I can explain it is go to the shore sometime, go to the coast, and stand on the beach and turn around and look behind you. So look back at the land. What you'll see on most shorelines is dunes, grass on the dunes. You'll see behind that, grass on the shoreline. You'll see trees in the distance. So you'll see all of these plants that are keeping your environment alive. Now turn back around and look out of the sea, and you won't see anything. You'll just see this flat horizon. You'll see the water lying there. But underneath that flat sea is just as much life as was behind you when you were looking back at the land. We can't see the seawoids. They're all underwater. A couple of miles offshore, there'll be kelp

there'll be kelphe. There'll be asparagus. There'll be older. There'll be all sorts of species that you can't see. But it's there doing its job looking after the coastline and looking after you. Dr. John Bothwell is author of the book Seaweeds of the World. You can see some images from the book on our website at ScienceFriiday.com slash seaweed. He's also an associate professor in the Department of Biosciences at Durham University in the UK. Thanks for taking time to talk with me today. It's a pleasure. Thank you very much. For Science Friday, I'm Charles Bergwist. Thank you, Charles. We need to take a break, and when we come back, the staggering costs of cancer treatment and how financial stress can lead to poor health outcomes for patients. Stay with us.

This is Science Friday. I'm Irafledo. Getting a cancer diagnosis is not only terrifying, it's expensive. In the year after diagnosis, the average cost of cancer treatment is about $42,000, according to the National Cancer Institute. But some of the newer cutting-edge treatments could cost a million dollars or more, and while insurance may cover some of that, many people are uninsured or underinsured, and the bills add up. A quarter of cancer. A quarter of cancer. patients with medical debt have declared bankruptcy or lost their home. No doubt there's been remarkable progress in treating cancers in the past several decades, but less attention has been paid to just how astronomical the price tag is. So researchers wanted to track the financial burden of cancer treatments on patients, and they found that poorer patients were hit harder financially, which not only resulted in more bills, but also worse health outcomes. Joining me to talk about this Research is my guest, Dr. Jorge Cortez, Director of the Georgia Cancer Center at Augusta University based in Augusta, Georgia. Welcome to Science Friday. Thank you very much for having me.

Let's talk about this study. I know you looked at leukemia and lymphoma survivors across the U.S. and you found that lower-income patients were nearly twice as likely to report poor health outcomes, just about 60 percent of low-income patients. How does this financial burden translate? into worse health? The main focus here is cancer survivors. So we're talking about patients that already went through all this process of their cancer therapy. And what we found is that there's a significant number of patients who are in the lower income category. And these patients definitely have worse overall health, both physical and mental health, after being able to defeat cancer. So it maintains that lingering effect of the other health issues, as you can imagine,

once you survive cancer, you could have heart conditions, diabetes, other health problems that you also need to take care of. Some of them may be that you had them already. Some of them may be consequences of the cancer or the treatment itself. And one important thing is that these patients, there is an excess of these lower income patients in the younger population. So these are patients who could potentially contribute to society, who have families, who have a long life ahead of them, and yet they have more issues being able to deal with their other health problems. Were you surprised by this?

I mean, why would you expect treatment of lower income patients vis-a-vis cancer to be different than how these other illnesses affect? lower-income patients? I think what happens is that some of these patients, if you are lower income, you can go through your cancer therapy because there are some emergency support systems. You can get them into an assistance program for one of these expensive medications. You can provide them housing during the course of the therapy. You can provide them transportation. You can provide them vouchers. There's food vouchers. There are many. organizations that support that, and that's very good because it allows them to go through the

cancer therapy even when they do not have insurance, when they don't have the means, etc. The problem is that once they finish their therapy, all of that stops, and then they go back to be on their own, and yet they remain uninsured, they remain with lower incomes, and they have much less of an ability to take care of all the other medical problems, which again may be amplified if there are some residual issues related to the cancer or the cancer therapy. So what can you do? I mean, what do you do then about post-treatment for cancer and having your patients have a better quality of life? Of course, an obvious answer is, well, you know, we need health care for everybody,

but that's a difficult topic and it's obviously something that we need to aim for, but it's not as easy to implement. But I think there are other elements that we can start being more proactive in doing. One of them is there's more and more emphasis on starting considering the survivorship of a patient at the time of their diagnosis, not at the time that they finish their therapy for cancer, because that allows you to identify the social circumstances, the financial problems that the patient may have, their family situation, their work situation, et cetera, and try to assess how you're going to navigate through that during the course of therapy and after the course of therapy.

The other thing is there is an increasing use of what we call financial navigators who go through all these financial issues with the patient. And again, trying to use that support not only for their current needs, but also what they will need later on so that they are better prepared. Now, that's certainly not enough. You know, they're not sure there's sometimes not too many options, but you can help them investigate the potential support elements that they might find. And that's my next question.

Where do these people, where do poor people? who may not have access to transportation or other resources? How do they find the help they need, the kind that you're talking about? Well, and that's an important element. You know, for the cancer itself, the distance from where you live to a cancer center has a negative impact. The farther away you live from a cancer center, the less likely you are to survive. We've investigated that, and it is very clear. And it's not just a matter of providing transportation because you can give it.

them a means of transportation, but they still cannot leave their families behind, they cannot leave work, and so on. So it's a complex issue. For their primary care needs, the important thing here is to communicate very closely with those physicians and their oncologists so that they integrate the therapy and they only come to see the oncologists when it's absolutely necessary, but take care of their needs locally when that is appropriate. Integrating the care of the specialist and the primary care is critical to provide the best care for their patients closer to where they are. Have you been able to implement these ideas at the Georgia Cancer Center where you were?

We are certainly implementing the financial navigators much more proactively at the beginning, and we are starting to do these survivorship plans at the time of diagnosis. There's a lot of work that we have to do. I think that telemedicine is something that we need well during COVID, but I think that we need to take advantage of that a whole lot more so that we can continue supporting our patients from a distance, but unquestionably, we need to do more. And what can you do about the exorbitant cost of cancer treatments?

I know you've been pushing for more conversations about these for years. Why haven't cancer researchers been more focused on this? I think that the problem with the cancer therapies is that there's no question that developing a new drug is very expensive, but I think that we need to start looking at better models that keep a balance of being able to make these very remarkable advances that we still need, no question, but where there is more of a balance of the value of the benefit that they bring. Some of the new agents that come end up being very costly and the return is very modest, a possibility of living for a month or two longer, which statistically may sound great,

but realistically especially if the cost is exorbitant, talking about a month or two and you leave a family in financial ruin. So I think there has to be more of an analysis of the value and more of critical view at where are the biggest needs. Do you sense any shifting the conversation among your peers, among cancer researchers, thinking more about cost and access when developing new treatments? Yes, fortunately, there is more conversation. I think there has to be more action as well.

But definitely this is something that's even on the scientific papers that used to focus only on high-end research in the laboratory and these very complex clinical trials, you're starting to see more and more discussion and studies about the impact of the financial consequences of the drug, of the care, and things like that. Not enough, undoubtedly, but at least it's taking more of a frontline discussion rather than just being there as a, well, you know, what can we do? Dr. Cortez, I'm glad we could have this discussion today. I really enjoyed it and thank you very much for having me. Dr. Jorge Cortez, director of the Georgia Cancer Center at Augusta University based in Augusta, Georgia.

Maybe you have some chocolate left over from Valentine's Day or you've picked some up when it went on sale the day after. Good move. Well, go grab a piece right now if you have one because for the rest of the hour, we're talking about how chocolate makes you feel. And no, no, no, I'm not talking about loved or have. but the actual physics of how it feels in your mouth, because that's part of the secret of enjoying chocolate, isn't it? Joining me now is Dr. Anwisha Stalker. She's a professor of colloids and surfaces

at the University of Leeds and Leeds UK. Her group recently wrote about this phenomenon in the journal ACS applied materials and interfaces. Welcome to Science Friday. Thank you so much, Ira, for having me. You're welcome. Now, I know your team developed a sort of artificial tongue, Not so much to taste the samples, but to investigate the feel of the food.

Exactly, to understand the friction, what happens in the mouth, what more from a textual perspective. And why is that important? So, you know, most of the aversion per food, if you think, or for liking actually comes from texture, which is much, much less studied. We always say about taste, but food is much more than that. So we developed this tongue to really understand the physics, what goes on in the mouth when you rub a food against the surface, that chocolate happens to be the fun material to work with. All right, let's get right into that. If I take a bite of chocolate, what's going on with the chocolate in my mouth?

With the premium chocolates, what do you do? So you just don't chew, chew, chew. You put it in your mouth. Either you lick it against your tongue, like appreciate the feel. and then gradually and gradually it starts melting in your mouth. So it's a face change material. So it melts in your mouth. But this whole process happens in a couple of seconds.

So what we did in our study was to understand this process, to dissect this few seconds into exactly what happens in the mouth. So when you put the chocolate in your mouth, when you rub it against your tongue, when it melts, when it mixes with saliva, what are the exact things that goes on and why, for example, fat matters, does it matter, the content of fat and so on? Well, tell us, what did you find happening?

What happens? Take us through the steps of what's going on in your mouth with the initial feel and then the melting and so on. So what we did is we took that shop here as a model and then with different fat content and then we rubbed it against this artificial time. And what we realized was very interesting. So when you take the chocolate in your mouth, which is the first step, that is where it matters most the calorie content. That we see, there is a very interesting difference in friction between 70% fat chocolate versus a 90% fat chocolate.

But after that, when it has started mending and mixing with saliva, it's actually saliva drives the game. So you don't see so much of the calorie content affecting. Of course, you need those fat to create the feel, but it matters less as compared to the initial touch. Hmm. So if I wanted to optimize that silky feel, would I front load the fat content into the surface of the piece? In principle, yes. Exactly. So there it matters way more to think about the silky mouth field, to think about the right texture of what you create for.

virus in the body it matters less as maybe the protagonist there is much more saliva-driven rather than the fat-driven. Now, I know that you did not invent a new chocolate. Your work was done using off-the-shelf chocolate samples from the store, but how easy would it be to engineer a chocolate with the properties that you would like? Is it as simple as have a low-fat piece, then dip it in a shell of fatier stuff, or how difficult is it? Yeah, that will be the obvious one, isn't it, to create a clear kind of material.

But, you know, if you look at the history of chocolate making, it will be difficult because it is made from cocoa beans and stuff and a lot of flavoring material come in that picture. But if you see how food manufacturing is involving, we have 3D printing now. So there are a lot of things that's going on in terms of the technology. So imagine a situation where we are printing our chocolate in the way we want at our home. So that is the kind of, you know, utopia, it seems like, at the moment, but it's not. Like in few years down the line, we will have that. And we had that actually in manufacturing in many countries.

The other thing to think about is that there are also a lot of chocolates which are not made with cocoa butter, like composites and compound fat, vegetables, fat and so on, where we can make a lot of changes of the process to make those kind of chocolate, which has a much more outer surface layer of pad versus inner. But again, I want to stress we did not make a chocolate. So it would be an interesting challenge to take, of course. I'm I Refleto, and this is Science Friday from WNYC Studios. If mouth feel, as you talk about it, if the texture is so important for that first bite of food, does your tongue know this?

Is it especially equipped to feel the texture as well as taste it? So this is very interesting, you know, so if you think of the tongue, it's a muscular material, it has a lot of features. And if I make it very simple, you have a fungiform papaly which contains taste part and the philippa papaly, which does not contain any taste part. And they are much more numerous in the number.

So these features in the mouth, they are just there for speech and for friction and for detecting texture. So how cool is that? That is cool. So I think a law and studies needs to be there in this area to understand texture, how does texture contribute to liking of food? We know it does contribute to disliking. People don't like, you know, mushy material, for example. It's all linked to texture

rather than the taste. It can still be sweet, but the texture matters. Are there other foods that this research applies to as well? So we said it will definitely the mechanisms which we propose will apply to face change materials like ice cream, like cheese and cheese and stuff. so on. But we need more work to understand whether it can be applied to other section of food, which is non-paste change material as well. But at the moment, we have only looked at face change material like chocolate or ice cream, which contains some amount of fat as a key ingredient. That's crazy to learn that most of the papillet in the tongue have no taste buds, but are there for touch. So if we know this now, and our listeners have that piece of chocolate that

I asked them to get, and they want to try this for science. How should they taste their chocolate sample? So they should taste their chocolate sample like the way it is, but just close your eyes and don't think about sweetness means. Don't say it's just sweet. That's the last thing I want to hear. You want to hear how it feels. Exactly.

That's correct. Dr. Sucker, thank you for joining us today. Thank you very much. Dr. Anwayche-Sarker, she's a professor of colloids and surfaces. Yes, that exists in the School of Food Science and Nutrition at the University of Leeds in Leeds, UK. And that's about it for today. If you missed any part of the program, you'd like to hear it again, subscribe to our podcasts, or ask your smart speaker to play Science Friday.

And of course, you can say hi to us on social media all week long, Facebook, Twitter, Instagram, or if you'd like to contact us the old-fashioned way. Our address is SciFri at Science Friday. Have a great weekend. We'll see you next week. I'm Ira Flato.