SciShow Tangents - Cancer Revisit with Deboki Chakravarti

Episode Date: March 4, 2025

We're thrilled to be joined for a special return to the topic of Cancer by our own magnificent editorial assistant, Deboki Chakravarti! We cover a ton in this beefy episode, so grab a snack, get comfy, and prepare to dive deep on a topic that's well worth the revisit. SciShow Tangents is on YouTube! Go to www.youtube.com/scishowtangents to check out this episode with the added bonus of seeing our faces! Head to www.patreon.com/SciShowTangents to find out how you can help support SciShow Tangents, and see all the cool perks you’ll get in return, like bonus episodes and a monthly newsletter! A big thank you to Patreon subscriber Garth Riley for helping to make the show possible!And go to https://store.dftba.com/collections/scishow-tangents to buy some great Tangents merch!Follow us on Twitter @SciShowTangents, where we’ll tweet out topics for upcoming episodes and you can ask the science couch questions! While you're at it, check out the Tangents crew on Twitter: Ceri: @ceriley Sam: @im_sam_schultz Hank: @hankgreen[Truth or Fail]Water-logged diaper scanshttps://www.nist.gov/pml/about-pml/pml-working-you/pml-working-you-archives/fighting-cancer-diapershttps://www.nist.gov/news-events/news/2017/11/how-disposable-diapers-can-improve-measurements-tumor-growthToothbrush cancer camerahttps://www.forbes.com/sites/rachelsandler/2022/09/22/why-billionaire-eric-schmidt-is-backing-a-high-school-senior-making-a-cancer-detecting-toothbrush-and-other-brilliant-teens/https://www.mayoclinic.org/medical-professionals/obstetrics-gynecology/news/a-substantial-step-toward-earlier-endometrial-cancer-detection/mac-20560620Cancer-cell kleenexhttps://www.statnews.com/2017/09/06/masspec-pen-cancer/[This or That: Researcher, Patient, or Both]Round 1 - Sister Mary Joseph Nodulehttps://www.sciencedirect.com/science/article/pii/S2468294222000089#sec0006https://link.springer.com/article/10.1007/s00261-016-1031-1https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31864-6/abstractRound 2 - Trousseau sign of malignancyhttps://www.sciencedirect.com/science/article/pii/S2468294222000089#sec0002https://pmc.ncbi.nlm.nih.gov/articles/PMC1022062/Round 3 - AOH1996https://www.alexslemonade.org/blog/chance-meeting-leads-promising-cancer-treatmenthttps://pmc.ncbi.nlm.nih.gov/articles/PMC10592352/https://clinicaltrials.gov/study/NCT05227326Round 4 - Papanicolaou (Pap) testhttps://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncy.22734https://www.sciencedirect.com/science/article/abs/pii/S2213294514002178[Ask the Science Couch]Proposition 65 in the state of California & carcinogens in studieshttps://oehha.ca.gov/proposition-65/about-proposition-65https://oehha.ca.gov/proposition-65/proposition-65-listhttps://oehha.ca.gov/proposition-65/how-chemicals-are-added-proposition-65-listhttps://pmc.ncbi.nlm.nih.gov/articles/PMC6349368/https://link.springer.com/article/10.1007/s10311-023-01668-1https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/wood-dust Patreon bonus: Treatments for different cancers and why there’s no singular curehttps://www.cancer.gov/about-cancer/treatment/typeshttps://www.aacr.org/patients-caregivers/about-cancer/what-is-cancer/https://www.cancercenter.com/community/blog/2023/10/cancer-is-not-one-diseasehttps://medlineplus.gov/cancer.html[Butt One More Thing]A trained dog could sniff out colorectal cancer in poop sampleshttps://gut.bmj.com/content/60/6/814https://www.cshl.edu/the-doctor-will-sniff-you-now/

You're listening to a Complexly Podcast. INTRO Hello and welcome to SciShow Tangents. It's the lightly competitive science knowledge showcase. I'm your host Hank Green and joining this week as always is science expert in Forbes 30 under 30 education luminary Sari Riley. Ahoy! But also our resident everyman the gregarious and Hank Green 30 under 30 education luminary Sam Schultz. Is that true? You're giving me the Hank Green 30 under 30? Hell yeah. I didn't get that. That's very exclusive. You're over 30 though, I think.

I'm so far over 30 that I'm almost to the next one actually, which is horrifying. You're 30 under 40. Yeah, under 40, just squeaking in there. Yeah. Jesus. And also, we have a special guest this week in a rare and wonderful tryst. Tryst? No.

You're going to get in trouble. Maybe instead of a twist, joining all of us instead of tagging in for one of us, making her 15th Tangents episode appearance, it's the incredible behind the scenes science expert, Deboki Trakravarti. Yeah, I didn't realize this was number 15, but that's a lot.

But you've never been here with all of us, is that the case? I don't think so. You're always here when one of us isn't. Yeah, I feel like a little overwhelmed. I've never seen so many faces. I've never had to play against so many people. I just, I didn't even know you were all here. So. It's like Times Square in here.

Yeah. Deboki, you've been working on Tangents for a long time. What's it like and do we also, did you create the gauntlet? No, no, no. I cannot take credit for the gauntlet. The gauntlet is all Sam and then you guys adding chaotic levels to it every single time. It's my intellectual property. I'm taking it with me when this gets all over.

Yeah, it's going to be commitment gauntlets coming to you in the future. That's right. But I do think the gauntlet does exemplify what working on tangents is like. It hurts your brain a little. And if you're not good at games like I am, it's been a real character building exercise. Every week I listen and I'm like, oh, can I lie to these people effectively? And I don't know, I still, the jury's out. But sometimes it is kind of your job to lie to and mislead us.

Yeah. But really, I'm counting on you to do it for me. So that's like that's a huge me, the host, me, Hank Green. Yeah. Yeah. And then Sarah's just like, oh, I know this one. And I'm like, come on. Yeah, I either know it or I'm the most wrong. It's a really binary performance here. I've never just like, okay. There's a whole layer to my friendship with Sari that's us just realizing we're playing mind games with each other, but we're both really bad at mind games.

And so, again, it circles back around and I think we're just playing mind games with ourselves. Yeah, that's what Sari's definitely doing. Sari does a lot of mind gaming herself into the wrong answer. 100%. I mean, I guess for people who don't know, we've tipped this off before, but Deboki writes all the games for Hank, basically.

That wasn't always the case, but yeah. We have started to say, Deboki? Yeah, this is the Deboki we're talking about. Yep, this is the Deboki. Every week here. Yep, yep, this is the Deboki. Every week here on SciShow Tensions, we get together to try to one-up a maze and delight each other with science facts while also trying to stay on topic. Our panelists are playing for glory and for Hank bucks, which I'll be awarding as we play. And at the end of the episode, one of them is going to be crowned the winner, except

this episode might be different because I didn't get anything. So am I playing like a normal person? I think so. Yeah, yeah. It's me. Yeah, that's the plan. Oh, it's just me versus Sam? Well, Ansari and Deboki's trading off, but only me or you could possibly win, I would imagine. Well, if we could really lose.

Yeah, it's possible. We'll figure it out. For any of our listeners who have not heard the news, SciShow Tangents is sadly ending this year. This is our, oh my god, second to last episode. Our final show is coming out on March 18th. Between now and then, we're celebrating all things tangents with dream topics, dream guests, and as always, traditional science poems, butt facts, and our other regular shenanigans.

Deboki, of course, always a dream guest. So without further ado, we're going to introduce this week's topic with the traditional science poem this week from me. In the bustling halls of flesh and bone, where all your cells make their home, a rebel stirs, a twist of fate, a cell that craves to replicate. A faithful clone it once obeyed, but day by day that duty fades. With clever tricks, adopting roles, it bends the rules, escapes control. A flickered gene, a copied flaw, no master plan, no guiding law, just chance and time, a blind advance, a game of odds, a fatal dance. It learns to grow. It learns to spread. It becomes the thing that we all dread. It hacks the code.

It bribes the guards. It takes up space, it stacks the cards. And so we fight, and so we learn, to tip the scales, to cut and burn. With steady hands and knowledge deep, we lull the beast and hope it sleeps. The topic of the day is cancer. That was a hot one. Good job. Yeah, that's like years of poem writing experience.

Right. Cancer experience. I really like the flickered gene. I feel like that's either an indie album or a thriller set in the genome somehow. That's right. Yes. Epigenetics is important. So we did an episode on cancer back in season one, but we're doing a well-justified revisit

now. But before we dive in, we're gonna take a short break and then be back to define what is cancer. And I'm gonna fight Ceri about it. No, you can just do it. ["Sweet Home Alone"] Welcome back, everybody. Sarri, what is cancer? This feels even worse than when you introduced me as a science expert because I feel like I'm cancer-splaining to not only someone who has had cancer, but someone who's done way

more research on cancer than I ever have. My lab job was working with HeLa cells on BracaGenes, but that was an undergrad and I didn't know anything. Yeah, I also worked with cancer in undergrad and didn't know anything and just did what I was told. I worked with cancer in grad school and I also don't feel like I know anything.

Okay, okay, we're all kind of on an equal playing field, aside from Hank knowing way more about this. Yeah, and Sam also probably has never been in the same room as a HeLa cell, but that's okay. Yeah, I am a cancer. Oh, what? No, I'm not really, I'm a liver. Wouldn't it have been cool if I was a cancer though, in this particular moment?

Oh, that astrological sign. Yeah. I thought you were just being extremely mean to yourself. No, no. I thought so too. I was like, Sam, that's a new love for your self-deprecation. Proud cancer, the crab. My defining characteristics are. Snappy, snappy.

Om, om, om, om. Yeah, that. OK, so I'll try my best, and then Hank will immediately poke holes. But cancer is an umbrella term for lots of different diseases that follow the same general pattern of disorderedness in that a disease is when something breaks or goes wrong. But each are unique and each have different treatments. And specifically cancers are when there are genetic changes that happen to cells, either

because there are natural errors that accumulate as cells divide, because we've got a lot of DNA going on, cells got to replicate all that DNA, sometimes they do it wrong, and sometimes we don't catch it and the cells don't die. Sometimes because of damage to DNA because of stuff in the environment, whether that's like a toxin that gets in our body that messes up that DNA replication repair, UV radiation from the sun or a tanning bed, things like that, or a genetic predisposition because we inherited some form of gene from our ancestors that are proto-oncogenes or oncogenes, which are what we call those genes that we've identified

that are like more likely to produce cancer cells in some way. And most of the time, our body's really good at making sure everything stays working and eliminating any cells with weird-looking DNA before they become cancerous. But sometimes those cells have a mutation and then they replicate and divide and form a mass and then we've got a cancer somewhere in some tissue of our body. How much did I get wrong? Oh, yeah, I identified three things. Okay.

That's less than I thought. I'll try to go in reverse order to see if I remember all of them. First, it doesn't necessarily have to form a mass. Blood cancers, there's two basic kinds of cancers. There's liquid tumors and solid tumors. Blood cancer is also called liquid tumors, which I find very gross. Like in my case, I did have tumors,

but they were just my normal lymph nodes, but swollen up. And they do call them tumors and lymphoma, but they are, there's sometimes you get a blood cancer and you never really have tumors anywhere. And that's because blood cells, white blood cells specifically, you can't get a cancer of red blood cells because red blood cells don't have genes. Yeah. So they can't do anything once they're created. They just slowly degrade and die. But pretty

much everything else, anything with a genome in your body, so you can figure out one way or another how to do a cancer, though there's lots that are more likely to have it happen than other cells. And what was the second thing? It is genetic, but I think that it's important to say that it's not just genetic. Like there's all kind, like it's epigenetic, it's metabolic, it's immune system, like it can be immune system dysfunction. Like you can, like there are reasons that cancer happens that are both because the cell itself is good at evading controls. And there are cancers that happen

because the body is bad at controlling cancer. So there's all kinds of these different things all interplaying and being stupid. And the body is so freaking complicated. It is almost always the case that at the root of cancer is some kind of genetic change. And also really interestingly, that genetic change tends to be not just that it escapes control

and starts being able to replicate itself really fast, but that it becomes better at evolving. It's like a mutation that makes it so that more mutations happen, which allows it to have greater genetic diversity among the cancer cell population, which then allows it to continue to evolve, to grow and have there be more of them.

But I am very much picking at NITS here. And I guess like the third thing is just generally that there is like a disorderedness to, you know, all disease, but to cancer specifically. But the main thing is that, is that what people will say is it's cells growing out of control. And so it is little pieces of you

that are no longer acting for the broader perpetuation of the body, but are only acting for their own perpetuation. I get in arguments with cancer people about this all the time that it's just cells growing out of control. And I'm like, yeah, but there's like a mechanism underlying that, which is that anything that makes more of,

is able to make more of itself, there will be more of that thing. And it's just like kind of natural selection happening at a cellular level. And it's like a cell, basically a single celled organism that has descended from you that is existing inside of the environment of your body and trying to like

Evolve to live there. It's doing what you'd expect it to do But all of that is just is just nitpicking and I think you did a very good job Could you take it out of your body and it could live outside of your body in very rare situations? It it can live outside of your body like like, you know, cells can live in a lab. So you can take cancer cells and grow them in a lab. You can also, they're in really weird situations, cancer cells can be transmitted from one organism to another.

And usually that has happened in people, but it's only happened in weird situations where usually in an organ transplant where people are taking immune-suppressive medications so that the other person's cancer has time to grow inside of them but it has also happened in other organisms several times and become an actual pathogen so a disease that passes from individual to individual and like there's a dog cancer that is sexually transmitted. We talked about that in the original Cancer Tangents, which I didn't remember. It was one of the weirdest cancer facts.

We did, yeah. We talked about dogs, Tasmanian devils, and clams, I think, which all have different forms of transmissible cancers. Hank, I'm curious, like, since we're revisiting cancer here, like, is there something from the last time we did the episode that was, like, you've really changed your view or something about like...

Well, Dubok, you imagine that I somehow remember that episode. Or just I guess like a pre-cancer life and like doing a lot of reading on cancer. Yeah, I think that the big difference for me is seeing it as even like one person's cancer isn't one disease, it's a population of cells. And so like two tumors in one person's body can have like genetically distinct populations and that doesn't even account for like metabolic and epigenetic factors. And I also like one thing that I like sort of was an unlock for me was a cancer cell is like a pathogen that is obviously going to be good at escaping your immune system because it's made of you, but it has all of the tricks

that your cells have, if only it can figure out how to unlock them. So if like, you know, a lot of cells in your body grow really fast, like the cells in your hair follicles. So like there is, or like there's healing factors so that your skin can heal itself. And those things can be co-opted by cancer cells or they can be like, there are systems that can be like evaded or hidden. We have, our cells have these like little flags that say, that like take proteins from the inside

and they display them on the surface to say, look, these are all the proteins from the inside of the cell and they're all normal human proteins of a healthy cell. And cancer cells don't display normal human proteins. They just stop displaying anything. So the immune system kind of doesn't even know they're there, which I love. They're like, nope, I'm just a ghost.

Don't mind me. They're like, nope, I'm just a ghost. Don't mind me. They have all of these. I love that cancer cells, if, you know, it's actually quite difficult for them to do this, but if they can figure out how to do it, they can unlock any ability that any cell in the body has. And, you know, a nerve cell is very different from a skin cell. It's very different from a bone cell, you know? Well, I got to know where this word comes from because I got to know why there's a zodiac

sign named cancer. Oh, yeah. The word cancer. Crab related somehow? Crab related. So, the Greek word karkinos has separate meanings of a crab, a tumor, and the zodiac constellation as far as I can tell. Okay.

Like, they're referred to different things. And the origin of using kind of carcinoids cancer for cancer is Hippocrates as far as we can tell. A lot of things traced back to Hippocrates, my guess is cause he wrote a lot, left a lot of records. Maybe somebody else named it and he just the first one to write it down. He just wrote it down.

The only one that got preserved, yeah. Yeah, he got preserved. So like a big old asterisk there. And the story goes that like sometime around 400 BC, he was examining patients, people who had what we would call like some form of end stage cancer. They were dying of something. And specifically with those tumors, so not blood cancers. And if you, uh, malignant

tumors can get quite hard. And so the, the story goes, the tale goes that it reminded him of a hard shell of a crab. Why did he choose the same word as the crab? Maybe because it was like a hard shell of a crab. And then that kind of like spun throughout history. There's like another philosopher named Celsus who wrote about it and like called it cancer. And then Galen, who's another guy that I get cited all the time because he wrote a lot of words,

said that the malignant tumor looked kind of like a crab because there was like spindly stuff coming out of the mass, like the veins basically, that are feeding blood into the tumor. Because cells need all the nutrients and cancer really co-ops that nutrient system or can co-op that nutrient system. So like maybe it looks like a crab leg.

And then it just kind of stuck around. People kept looking at probably the older people and were like, oh, they're calling it cancer, like a crab. And then just kept calling it that over and over and over again. Really weird because it's like, it makes no sense and we don't really know why. There's no association.

It did not survive to modern day that anybody would associate it with crab at all. No, in fact, some other languages call it wolf, which I like much more because it's more threatening and I'd rather be killed by a wolf than a crab. Well, depends on how big the crab is. I guess that's a good point. Yeah, crab is mostly cute

once you're already dead. What is the optimal size of crab to die big enough to cut your head off really fast? Really fast, yeah. That's a good point. And then the word onco, so you said like oncogene, oncology, just means bulk or mass from the Greek word oncos. So much less crabby.

Makes more sense. It's just like, oh, look at that bumpy thing. Again, looking at like the tumors that are visual that we can recognize with our eyes because that was the state of medicine back then. Yeah, yeah, they didn't know about blood cancers. They just thought people got sleepy and died. Humors were imbalanced.

Yes. Or whatever was before that, just like the vibes were off and then you died. I mean, the humors were imbalanced is actually very much the vibes are off. Yeah. And since we now know roughly what cancer is, it's time to move on to the quiz portion of our show

with our first game, it's Truth or Fail Express. It's actually truth or fail. I changed it at the last minute. It's just a regular truth or fail. That's on me. But fun fact, this kind of like brings us full circle because actually the first episode I ever did for Tangents was the cancer episode, and I did a truth or fail.

I had no idea what I was doing. I made these stories that were like paragraphs long, and I was so proud of it at the time, and then I heard the episode, I was like, oh, those were too long. They were very, very long. But now they're shorter, so I won't make you guys sit here through a whole story. Did you ever get worried that someday you're gonna be online and you're gonna see something

you wrote that's wrong presented as real? Yes. Yes. All the time. I'm gonna trace back directly to you. Especially like microcosmos where like a lot of the times we're like the one popular science source on like a certain microbe. It's like, well, that's the truth now about that microbe.

At least you're not trying to lie on purpose on that show though. I feel like I saw someone post that there was a tangents like fake fact that got like, some AI thought it was real. Oh no. I don't know if I'm making this up. I could also now be making up a fake fact.

AI's gonna love us. I can see that though. Sometimes fake facts get stuck in my head like they're real. I don't even know what a fact is anymore. My job is making them up. Do we even know anything? Yeah. Yeah, well, I guess I will start my truth or fail.

And really, when we think of cancers, we're thinking about like these diseases that have to be studied with a number of different tools and techniques. And sometimes those techniques are based on really like fancy tools and sometimes they're based on things that are just like kind of normal everyday objects. So today I was looking around my house and I was wondering

how many of the things around me have inspired some kind of tool in science's everlasting quest to deal with cancer. Wow. So today's Truth or Fail is inspired by Objects in My House. I will present to you three stories of everyday objects being reconfigured against cancer, and it's up to you to figure out which one is the true story. All right.

So story number one. Doctors can use different imaging techniques to diagnose cancer, including x-ray computed tomography or CT scans. Story number one, doctors can use different imaging techniques to diagnose cancer, including x-ray computed tomography or CT scans. And to make sure that the machines doing those CT scans are working well, scientists created fake tumors by injecting water into disposable diapers and imaging them. So story number two, brushing your teeth is inconvenient, but multitasking might be a way to make it better.

Researchers have developed an at-home test for oral cancers that consists of just a toothbrush loaded with a tiny camera to take pictures of the inside of your mouth, which are then analyzed for signs of abnormal cell growth. Story number three. When surgeons are operating on patients, they can end up delayed by the need to determine whether some of the tissue in front of them is cancerous. To make that process faster, one team of engineers have created a Kleenex that has cancer detecting fibers in it so they can rapidly identify

cancerous tissues. It's a little like a little pregnancy test. Yeah. Yep. What do you mean rushing your teeth can be inconvenient? It's like it's a step before bed. That's a little editorializing from Devoking. Yeah, I never want to brush my teeth.

I'm either cranky in the morning or want to go to bed. No way. Brushing your teeth is incredibly convenient. I like brushing my teeth, but I'm always listening to an audio book right before bed, and my toothbrush is very loud. Oh, yeah. And I'm like, I can't quite, and then I finish and I'm like, I have no idea what's happening. You gotta speak up.

Yeah. I wish I had gone back and listened to every episode so I could have come with a list of things I disagree with you about Devoki. Because I do feel like sometimes they'll say stuff like that, I'll be like, says who? Yeah, but this is a universal truth. No, I agree. Brushing teeth is inconvenient. No, I love brushing my teeth. It's where I just get to, no one's bothering me when I'm brushing my teeth.

I feel like I've heard of people trying to develop the kind of instant pregnancy tests, COVID tests, blood tests, whatever to detect cancer. But given that there are so many different kinds of cancers, I don't know what you would detect exactly unless there was a common compound among all those things. And I don't know enough to know what that is possible. I have a hard time imagining that that would be, unless you're testing for a very specific kind of cancer.

Kleenex also bothers me because, boy, you don't want a Kleenex near the inside of someone's body. It's gonna rip, that's gonna get stuck in there. Goopy in there. That's more mucus than I'm used to. But what if it's like a surgery qualified Kleenex? Right, like a kit, like a, what's it called that they use in the lab? Oh, chem wipes. Chem wipes, yeah. Yeah, those are good wipes. They're great on glasses.

Toothbrush cancer camera, that's too many steps. Who's looking at it? Who's, is this a subscription service? What's going on here? You go to the doctor. You know that one about the butt, right, though? Where you, they put a camera in the toilet to take a picture of your butt. They identify you as a certain member of your household by your butt.

Wow. By your butthole footprint. Butthole footprint? No. Butthole fingerprint. Butt print. It's not a butt print. A butt print is a separate thing. It's a butthole fingerprint. Fingerprint better. That's not better.

Well, because that's actually what it is. A footprint is not used for identifying. Everybody's got a special footprint. A footprint is not used for identifying criminals. So they identify your bottle and then they like test how everything goes and then they keep track of your healthness. Well, you can't, sure you can do that, but you can't, you can't really. Can you sign up for that service now? I don't know. Probably not. Yeah, but everything's a proof of concept until it's in stores. That's right.

That's right. You're here to defend all your answers. That's what I'm here for. I've never had to do that. You're fighting. I've only had to do this like a handful of times. Sometimes Hank will just be like, I don't really know what the book he's talking about. The diaper scans, I just don't know.

Cells have water. Cells have water. Cells have water. Cells have water. Cells have water. And then there's hydrogels in diapers, I think that's what makes them all swell up. Diapers everywhere if you are looking for them. I mean, I like diapers.

That's a really easy solution to the problem. This makes sense to me. Yeah, I agree. That's what I'm going for too. I'm going to spice it up and maybe shoot myself in the foot and say the toothbrush. Toothbrush. Well, it is, in fact, the diapers. Yes.

Yeah. So usually when people are checking on the machines for CT imaging methods, they use things that are called phantoms, which are meant to stand in for real human tissue. And so to mimic tumors, scientists have used plastic phantoms in the past, but they're not always able to capture the complicated shapes that are found inside of tumors. So scientists at the National Institute of Standards and Technology, or NIST, they wanted to see if diapers could work. And so they just injected water into the diapers and they found that the lumps that they formed looked like tumors. And as an added bonus for using diapers in this way, they actually could make the tumors get bigger by just injecting more water. And so they were actually able to then use

this technique to track whether measuring the length or volume of a tumor was a better way to track tumor growth, just by like kind of constantly adding water to these diapers. And we found that volume was a better way to track the mass of a tumor as it grows compared to length. So I just thought that was a cool way to use diapers. The other stories were inspired by real things, but obviously there is no, or at least not that I know of, there's no toothbrush with a camera. Was it the butt camera Hank was talking about?

No, I was just, originally actually what I was inspired by was a different household object, which is the tampon. There's no cameras on that either, but. This is good to know. In 2004, researchers, they published a study that used tampons to look for signs of endometrial cancer just by looking at the fluid on them. And so more scientists have followed up on that work.

And so I thought that was really cool because it gives a way to detect cancer that doesn't necessarily involve having to do a biopsy. Like it's something that's convenient, involves tampons, which are like, they just use normal unscented tampons. So that's something that could also allow for more comfortable testing.

I did wanna find out if there's any kind of at-home testing with toothbrushes for cancer, and I found a story of a high school student named James Chow Nguyen who has this idea for a toothbrush with a chip in it to detect cancer, but I don't know that he has made it. So if you have, let us know because I think that's pretty neat too. The Kleenexes are not real, but there are a lot of different tools out there that people are coming up with to help surgeons actually identify cancerous tissues in the operating room.

And so one of- That's tricky. Yeah, it really is. And one of the tools that I found is something called a MassSpec pen. So obviously inspired by a pen, it's just like a little handheld device. And so it takes up molecules from the cells into these tiny little volumes of water

and then sends them through an instrument that I think on the pen, or maybe the pen is attached to it, that I'm not quite sure, because it does have a big plastic tube. It sends them through an instrument called a mass spectrometer to kind of characterize those molecules and figure out whether or not the cells are cancerous.

Wild. Yeah. I would not have imagined you could use a mass spec to figure out not the cells are cancerous. Wild. Yeah. I would not have imagined you could use a mass spec to figure out if a cell is cancerous. Yeah, so I don't know, I don't remember which, they are- If you'd hit me with that, I would have been like, nah. Yeah.

It's all just cells. Yeah, I mean, I was debating. Cause I was like, that is pretty neat. And there's another device I found called an eye knife that I think, so what I read is it uses surgical smoke, but I don't know that much about what surgical smoke is, but I think there are just like a lot of these different tools that people are working on to help surgeons figure out,

is this a cancerous tissue? That's important because when you're in there, especially if you're trying to cut cancer out, you wanna make sure that you're getting all of it. And the body is a mess in there. It is not like how it is in the books. With all the pretty little, everything's in its place. Things are different colors.

Yeah, and so, you know, surgeons can turn to pathologists. They do have ways to figure this out, but having like a tool that can help them. It just takes a long time. Pathology can take a long time. Yep, figuring out faster would be great. The score is now with Sam with one and me with one and Sheri with nothing.

And Sheri has no chances to get more points. So I don't think she's gonna make it. Next up, we're gonna take another short break and then it's time for our second game. ["Sherry's World"] Welcome back, everybody. Get ready for game number two. It's This or That with Sari. So today we're going to play a slightly modified game of This or That where the rules are very

simple. I'm going to present you with the name of a cancer related medical eponym. In other words, a term with someone's name in it. And you have to guess whether that name is a researcher, so the person studying the phenomenon. So for example, how Hodgkin lymphoma is named after the British physician Thomas Hodgkin. A patient, which is the person who experienced the phenomenon in a case study, for example, how HeLa cells are named after Henrietta Lacks, a patient who had cervical cancer in the 1950s, or both.

Because after starting to write this game, I found that sometimes researchers study themselves. Wow. I'm trying really hard to find something that would tickle Hank's brain because he knows everything about cancer. Yeah, that was what was really hard about writing a game for them.

Yeah, I didn't know about any of that stuff. So you're doing great. There are a lot of medical eponyms I left out, but these ones seem spicy. So a sister Mary Joseph nodule is the medical term for small painful lumps around the belly button area, which can be a sign that some form of gastrointestinal cancer or a cancer

anywhere in the abdomen really, has metastasized. They're named after the Catholic nun Sister Mary Joseph, an American woman who died in 1939. Was she a researcher, a patient, or both? They're called Sister Mary Joseph nodules. Nodules. Yeah, right.

MJ nodules. They just call them SMJ. And they're like, what does SMJ stand for? Is some kind of like bizarre physiological? No, no, it's for Sister Mary Joseph. That's my gal, Sister Mary Joseph. How strict is the definition of researcher in this? Is it definitely all scientists or?

No, that's why I did researcher. Because we're going back in history where people were not necessarily credentialed in the same way or publishing in the same way. I think Sister Mary Joseph was seeing some belly buttons and going, oh my, there's nodules there. And then, so she discovered these nodules. So thus being a researcher. I'm going to go with both. Like an absolute mad lad. Just starting off with both.

I forgot that was an option, but that's great. like an absolute mad lad, just starting off with... I forgot that was an option, but that's great. I just think that Sister Mary Joseph probably wasn't a doctor, but there's lots of nuns who've done and members of the Corgi generally who've done important research. And maybe she also found these things and told somebody about them. Maybe on herself, maybe on somebody else. But I guess on herself because I said both. In fact, on herself. I think I'm also leaning towards both.

Just because I feel like, well, I mean, my logic is also, I feel like she saw a lot of Pelly buttons. I agree. You know, nuns and Pelly buttons. There's something about nuns that makes me think they were seeing bellies. I don't know what it is. So the answer is a researcher. Ah, dang it.

So Sister Mary Joseph was a nurse and first surgical assistant to William James Mayo, who was one of the founders of the family dynasty that created the Mayo Clinic. There's a family dynasty. I thought it was named after the sauce. They were pasty white, but they were just a bunch of guys. And she worked at St. Mary's Hospital in Rochester, Minnesota. And she was responsible for preparing patients' abdomens for surgery. And at the time, like as she was prepping patients over many years of work, she noted that a group of patients who had some sort of gastrointestinal cancer

also had these nodules. And then William James Mayo was like, interesting observation, let me publish about this as the pants button umbilicus is what he called it. What? I don't know why he called it a pants button, but maybe because that's where you got irritated.

Yeah, that's where your pants button was. Or used to go. Now these days it's lower. Yeah. These days it's low rise, but the term sister Mary Joseph Nodule was coined after her death to honor her contributions

to this research. And she was the one who actually noticed it. She died of some other thing though, unfortunately. She died of some other thing. I don't know. She lived a long life. 1856 to 1939. Pretty good.

So round two, a trousseau sign of malignancy, T-R-O-U-S-S-E-A-U, is, as the name would imply, an indicator that a cancer is spreading or malignant. Specifically, it's either moving or repeatedly felt blood clots that cause blood vessel inflammation that can feel tender or lumpy under your skin. They typically appear in the lower legs and feet, but could be anywhere throughout your body. This Trousseau sign of malignancy is named after Armand Trousseau, a French man who died in 1867. Was he a researcher, a patient, or both?

Sorry, did he die of cancer? I can't tell you that. I can give you a death date for your vibes. I almost gave lifespans, and then I was like, you might be able to estimate too much from that. I think patient. I think he was a guy with some legs that had some problems and then then they found another guy with some one of like problems And his name was also true. So and they're like boy I'm gonna go with researcher. I'm also gonna go with researcher. No points for any of you cuz he was

gonna go with researcher? No points for any of you, cause he was born. Oh, baby. His own legs, very own legs. It feels like we're doubly failing him when he's both of them. I like this because this guy's feeling these bumps and he's like, do I have cancer here too? And then he's like, no, I'm a doctor, I must investigate.

Yeah, so he was a well-known French physician, Armand Trousseau, and he completed his medical education and investigated a lot of infectious disease to start his career, yellow fever, tuberculosis, diphtheria, whatnot. But one of his most well-known contributions to the field of medicine was describing this thrombosis or the sign of malignancy, these swollen veins, these blood clots. And he delivered a series of lectures in 1865 to describe this phenomenon of cancer-related thrombosis. And then he realized that through those lectures, he diagnosed the condition within himself and died of gastric cancer two years later in 1867.

So he noticed this pattern, noticed it in himself, and then passed away. So he noticed it in other people first? Yeah. Holy cow. And then studied it more because it was in his own body. Oh, shit. But he just had two years to study it in his own body. He was doing it for a while before

that. And that you have nothing to go off of, so you're all doing a great job. I just have to say this. Do you mean by that we're doing a great job. I just have to say this. Do you mean by we're doing a great job and that we have zero points so far? Yeah. I have one. Sam has one, yeah.

I have one. Yeah. I thought, okay. Sam is destroying all of us. Next round. Some cancer drugs try and mess up anything chemically that cancer cells need to thrive. For example, AOH-1996 is an experimental medication

designed to inhibit what's called the proliferating cell nuclear antigen, or PCNA protein complex. Basically, all you need to know is that it's important in DNA replication and repair and helps make more cancer cells. The AOH in that name comes from Anna Olivia Healy, an American woman who died in 2006. Was she a researcher, a patient, or both?

I must abstain. Oh, you know. You know. Patient. I haven't, I don't have, I've just taken a wild guess here. I think I'm also going to go patient because it feels a little Healy. I will also go patient. Well, you're... If we're all going to get points, you're going to get a point too. because it feels a little Heela-y. I will also go patient. ALL LAUGHING

If we're all gonna get points, you're gonna get a point too. ALL LAUGHING You're all correct. So, it's named after her, uh, 1996 is when she was born, 1996. And she died in 2006, um, just before her 10th birthday. And her dad basically gave a chunk of money to cancer researcher Dr. Linda Malkus, who was a breast cancer researcher, but he was like, could you research this neuroblastoma that my daughter has functionally? So she switched

her career path. And for the last, I guess, 17-ish years now, more than 17, she has worked on a treatment to neuroblastomas and has come up with this AOH-1996 that is now in an early phase clinical trial. It is a pill that's given twice a day and aims to destroy the cancer cells while leaving healthy cells alone as with many cancer treatments. That's like the whole goal of it all. It's like broadly good at attacking almost all solid tumors and broadly bad at attacking healthy cells, which is the thing you really want. That's the big goal of cancer treatment is to have something that works on all of these guys, because they're all pretty different.

Okay, the last one. I'm curious if any of you know this, because I didn't, but I don't know anything. So you've probably all heard of a PAP test or PAP smear, which is a method of swabbing and screening cervical cells for anything precancerous or cancerous, but did you know it is named after a person? So much like Chuck E. Cheese is Charles Entertainment Cheese, the PAP test is actually the Papinikalu test. Papinikalau?

Papinikalau test. It's named after a couple, Georgios and Andromache, or Mary, who died in 1962 and 1982 respectively. Were they researchers, patients, or both? How? Is that like Charles Entertainment Cheese? Chuck E. Cheese! You know! Do you know about Charles Entertainment Cheese? Of course I do. I just... Of course you do. The PAP test is all... You never hear his full name out loud. Okay. Okay. You only hear the PAP test, just like Charles.

Should I call him PAP? I don't think so. I think people just didn't wanna say Papanikolaou. They were like, we gotta stop this. Wait, they both died in the same year? No, they died 20 years apart. Oh, okay. What were the years they died again?

Georgios died in 1962 and Andromache died in 1982. That's a kick-ass name, Andromache Papanikolaou? Yeah. The fact that you're talking about both of them makes me feel like they are perhaps both. Like a... Interesting saying. Yeah. The both of them seems important. I'm gonna go with both,

but I think it's either both or researcher. This, I agree with your assessment that it is either both a researcher. I'm gonna go with researcher because I need to catch up to Sam. I think, I mean, yeah, again, I feel like, I think because it's two, it feels like one person was developing it on the other. So I'm gonna go with both. Well, Hank is right.

They were both researchers. That was my little mind game. So, Georgios is actually the one who is credited with the test. And basically, the Pap smear is this really broadly used cancer test for cervical cancer. But the way that he developed it, they immigrated to the United States from Greece, and he didn't have a bunch of credentials at this point. But he was a trained physician and not licensed in New York. He was curious about these sort of like epithelial cell mutations. I think it was a continuation of his research.

And his wife allowed him to swab her cervix for 21 years, which is insane, like the the amount of dedication But like how often like once a year or the the paper did not specify but took regular vaginal fluid samples And cellular material for 21 years and she helped process stain and organize her own samples for ongoing analysis Oh, that sounds like both to me doesn't it? Yeah, and That sounds like both, huh? Well, she never had cervical cancer. So she wasn't a patient. Oh, my. She was not a patient.

She never had cancer. Mind games. This was like, yeah, mind games. It was all for developing the technique to sample the cells, developing which things you needed to swab, how much you needed to collect, all these things, what a normal population looked like over the course of 21 years as you're going from being able to get pregnant

to going to like menopausal women, like having all these consistent tissue samples. And I think she would organize, like help organize other patients too, including some who were diagnosed with cervical cancer based on these pap smears. But she herself never was diagnosed and she lived a long and happy life without cancer. But very interesting. Presumably happy.

Presumably, yes, I guess presumably happy. She and her husband did have a little bit of a weird relationship when it came to the cervix, but other than that. And so again, he is credited a lot, but there is a really great 2014 paper that credits her for not only donating her skills, she was his research assistant through all these years even though she wasn't credited as formally, but also her body. She wasn't a cancer patient, but she was a patient. She was a subject more than a patient.

She was researching herself. It's like if you collect your own poop in a stool sample and look at it, are you a patient? But even if you get a negative test, aren't you still a patient? She was being very patient. That is true. That is accurate.

That is a really exceptional love right there. But, or just love for humanity, you know? Everybody's giving in their own way. That's my game. Congratulations. So you chose to come both. Great game. I learned so much. Sam, do you know what that means? That means me and you are exactly as smart as each other, Hank.

That's right. We should get three tattooed on each of our biceps because we both got three points. I'd have to get a bicep before I did that. You have bicep. I'll be back here in a few months. Oh god, what a good game of tangents. Thank you everybody.

And that means it's time to ask the science couch where we've got a listener question for our couch of finely honed scientific minds. You're gonna nail it the last episode. You're gonna just really say it perfectly. Fuck you! I think H8858 on Twitter asked, according to the state of California, it sounds like everything will give you cancer, but how likely is it that you will actually get cancer from those kinds of things?

Yeah, so there's this California law that if something contains a thing that could be a carcinogen, that it has to be labeled, which results in weird situations like the Disneyland parks having signs that are like, Disneyland contains things that might give you cancer. Right, but also like every label that you see has that because they might as well just print it once. Yes, I think that there is a certain amount of that. This is very tricky when it comes to kersenogens. When you're trying to tease out small effects

on diseases that don't happen that often, it's just that the science is hard. And so you will often end up with really a lot of just a huge amount of uncertainty about whether something is actually a carcinogen. And I think that's kind of what this boils down to. That is how I was going to frame it, too. The ballot initiative is called Proposition 65.

It became the Safe Drinking Water and Toxic Enforcement Act of 1986 and just has continued to update. The list has over 900 items on it and there are a number of different ways to be added to the list. If the World Health Organization has studied something, thinks it has some sort of carcinogenic effect, it ends on it. If an authoritative body like the FDA, EPA, things like that have it on the list, it gets added. If there's committees of science and health experts in the state

of California that agree that based on the literature review, something maybe carcinogenic, it's added. And it's kind of like the more you know, the better it probably is. In the way that it is helpful for us to have the ingredients listed on all food items, just so you know, so you can look it up so you can understand the chemicals. This is similar, where you can go online. Like I looked up as of January 3rd, 2025, there's like a list of all the chemicals that have ever been on it, including the ones that have been delisted and what dates they were added or delisted. And to be added, you just have to have some sort of like scientific literature that's saying that it might cause cancer in some capacity or a developmental disorder in some

way. But it has things like aloe vera on it, which there is a study from 2019 that says there might be a link between aloe vera and cancer. There's wood dust because inhaling sawdust is not necessarily good for you. There's alcohol and nicotine and things that we know are toxic to us, but people still imbibe anyway. Alcohol is not good for you, but the other effects of it, people still use to drink it. Yeah. For some folks. Yeah, for some folks.

I don't like, I feel like this was ultimately a mistake because it's just like not specific enough and the difference between a cigarette and aloe vera is so vast, but it's saying that they're basically equivalent things. And it's so vast that like, it's likely that aloe vera indeed does not cause, has never caused a cancer. And even if it has caused like one, you know, that's very different from cigarettes that are sort of responsible for like the majority, not the majority, but like for, you know, certainly the majority of lung cancers and lung cancers are the most deadly cancer.

So I find it a little bit like I understand the intent, but it feels like a miss ultimately because it doesn't tell you the actual proportional risk. And also, you know, science takes time and with small effects, you can detect things that are not significant. Also, it doesn't tell you the circumstance under which it is carcinogenic. So I can like be around wood dust and that's fine. I just can't have it like aerosolized

and breathing it in all the time. And like you can, you know, just like you can cook with wine and that's fine. And you could have a glass of wine a week and that's fine. But, you know, but if you are a binge drinker, you are definitely increasing your risk of cancer substantially. It doesn't tell you that information.

Where it might be that there's a chemical in the plastic of your toaster that if you heated it up and breathed it in, well, that's a bad example because that actually is happening with a toaster. There might be a chemical in printer ink that causes cancer, but only if you like vaporize it and breathe it through an asthma inhaler, you know? Yeah, that's a really good point.

It is decontextualized completely from anything else. It is just a list of chemicals. With outlinks to the research, yeah. So what are they trying to do with it? Keep people educated as to the risks that they're experiencing? I mean, I think it's like, I think a lot of us probably, we think, oh, if I just know that this thing causes cancer, I'll know to avoid it. But then when you see this long list of things, you realize how complicated that decision

actually is. It's like any risk it has, or any decision we make has a lot of different, you know, different contexts, different actual risks associated with them, different decision factors. And so I can see why this seemed like a good idea, maybe at the time, and then the execution of it has become something that's actually made it harder,

probably, for a lot of people to make decisions. Maybe it's helpful for some people as a starting point, I could see that, but otherwise it's still, for all the reasons you guys have said, it's like really tough to actually kind of use the information as presented. I feel like it would be harder to take it seriously. Like there's so much of that.

Yeah, that you're not, that's the problem. Eventually you're like, well, I do have to own a toaster and all of them cause cancer apparently. Right. Right. Yeah. Yeah. It might be something that people ignore more than look into at this point because it's so prolific, which is the opposite of what a safety thing is supposed to help with.

And you could avoid all that stuff forever and still get cancer, right? Like you don't just get cancer from carcinogens. Indeed. Okay. And now for our listeners on Patreon, we're going to answer a bonus science couch question. Sam, what do we got? Will Russell 6223 on YouTube asked, why does it seem like we've been searching for a cure for forever?

Is there ever, is there even such a thing as a cure? And if there is, how close to it are we? If you want to hear the answer to that question, as well as enjoy our episodes ad free, you can head over to Patreon. That's patreon.com slash SciShow tangents at our $8 a month tier. You can get our episodes ad free and some extended shenanigans as we answer a bonus science couch question every episode. The Tangents Patreon and all of its perks are going to be up through the end of the

show, at which point the patreon will close We will not charge you anymore So if you want to join for just one one little month, then you could do that If you want exactly eight dollars that cost eight dollars and look we're gonna take that money We're gonna put it toward doing other cool stuff a complexity a promise and then you can you can get in there and you can Gobble up that piss minion stuff But also we have an update I did I don't even know about this never fear after the show ends all of our bonus episodes crew chats and movie commentaries will live on in

In perpetuity for everyone to access starting on April 8th We'll be posting our backlog of Patreon bonus episodes to our main podcast feed and to our YouTube channel when there's bonus video content to post. The bonus episodes will come out twice a week in the same order they were originally posted to Patreon. Wow, so eventually the whole world can have the piss minion. Yeah, everybody's gonna get piss minions.

I released the first like five minutes on Hank's channel and people were like, what the hell is going on? What the hell? What the hell? It's good, I enjoyed it. Along with bonus episodes, we'll also be posting some special compilations to the YouTube channel and the podcast feed for those times when you just need

a giant mega dose of tangents. Our patrons are the best. We are very grateful for their support and we could not have done this show without them. If you wanna ask the Science Couch your question, you can follow us on Twitter at SciShowTangents or check out our YouTube community tab where we've got one more topic we're going to send out. Or you can join the SciShow Tangents Patreon. Thank you to Europa Easterbrook on Patreon at gray0730 on YouTube

and everybody else who asked us your questions for this episode. If you like this show and you want to help us out, you can go to patreon.com slash SciShow Tangents to become a patron, just one last time, get access to everything and also give us $8 that we're going to do good stuff with. Shout out to a patron, let's acre for their support. Second, you can leave us a review wherever you listen. That helps us know what you like about the show. And finally, if you want to show your love for SciShow Tangents, just tell people about us. And then they'll be like, oh my gosh, I have a whole feed of this that I can go through. Yeah, tell people about us even after we're gone.

Remember us. We're still alive. Please. Witness me. We only exist in the box. Thank you for joining us. I've been Hank Green. I've been Sari Reilly.

I've been Sam Schultz. I've been Deboki Cheper-Brighty. SciShow Tangents is created by all of us and produced by Jess Dempter. Our associate producer, and director of the SciShow Tangents, is the director of the SciShow Tangents. We're so excited to be here. We're so excited to be here. We're so excited to be here. We're been Sari Reilly. I've been Sam Schultz. I've been Deboki Chakrabarti. Starship Tangents is created by all of us and produced by Jess Dempert. Our associate producer is Eve Schmidt. Our editor is Seth Glicksman. Our social media organizer is Julia Buzbazayo. Our editorial assistant Deboki Chakrabarti is here with us

right now. Our sound design is by Joseph Tuna-Medish. Our executive producers are Nicole Sweeney and me, Hank Green. And of course, we couldn't make any of this without our patrons on Patreon. Thank you and remember, the mind is not a vessel to be filled, but a fire to be lightened. But one more thing. In 2011, a paper published in the British Medical Journal investigated whether a trained Labrador retriever could sniff out colorectal cancer from patients' breath or poop. Since this very good dog successfully identified a cancer patient sample in 70 of the 74 sniff tests, the study suggested there must be some kind of scent chemical that can be used for diagnosis. That being said, the researchers also concluded that it's difficult and expensive to train dogs

for this specific task, especially when we have or could develop other screening methods. So that's probably why cancer sniffing dogs are only in research studies rather than hospitals. I don't know, man, there's a lot of dogs. I don't have a job. There's a lot of dogs out there who want a job. What if I could have a dog? It's like the like Eon Musk cyber cab promise where I just like get a dog and then it's just like,

I can loan it out to the hospital and they can pay me for every colon cancer at Diagos. Will you train it or would you be training it? I think it's just like I can loan it out to the hospital and they can pay me for every every colon cancer at Diagos. Will you train it or would you be training it? You know I think it's born this way. I think it's just good at it from birth. Dogs already have the urge to sniff poop. Yeah you have a dog and you're like hey you want a job and he'd be like and then he'd be like you get to sniff poop all day.

He'd be like okay. You don't need to pay me, I pay you.