The Oprah Podcast - The Conversation About Cancer Everyone Needs to Hear

Episode Date: July 23, 2026

Why is cancer on the rise amongst the younger generation? Oprah sits down with world-renowned oncologist, New York Times best-selling author and Pulitzer Prize winner Dr. Siddhartha Mukherjee to find out. In this powerful and deeply personal discussion about the new edition of his groundbreaking book The Emperor of All Maladies: A Biography of Cancer Dr. Mukherjee shares why it was important for him to update his seminal book with four new chapters and what has changed in the science of cancer in the last fifteen years. He explores possible reasons behind the rise of cancer in younger people today including genetic factors, environmental triggers, chronic inflammation and the “sleeper” cells that may lie dormant in the body until activated. Joining the conversation is actress and breast cancer survivor Olivia Munn, wife of the late Chadwick Boseman, Simone Ledward Boseman and a 28-year-old woman from Texas who battled stage 4 endometrial cancer after years of dismissed symptoms. She passed away just weeks after her conversation with Oprah. 

I'm joined by world-renowned oncologist, Dr. Siddhartha Mukherjee. So we're seeing younger and younger people diagnosed with cancer. So you're getting a spike in cases and you're getting a spike in deaths. Spike in deaths. So that is real. You cannot really, you can't turn your eyes away from that. That is a real number. Joining us now is actress Olivia Munn.

You learned you had breast cancer at what age? 42. 42. I was then diagnosed with multifocal, multi-quadrant bilateral breast cancer. When Chadwick-Bosman died after colon cancer, the world was stunned. Yeah, Chad was 38 when he was diagnosed with stage 3 colon cancer. He was at an age where normally he wouldn't have even been getting a colonoscopy. You can live a healthy lifestyle.

You can eat well. You can exercise. What is going on? that it turns out there are lots and lots of sleeper cancer cells in everyone's body. The new theory, or one new theory, is that they need to be woken up. And the sleeping beauty wake-up potion is, at least one of them, is chronic inflammation. This is very new research. Hi, everybody.

It's great to be with you here in the Oprah podcast, and I am really glad that you joined us for this episode because we're talking about a health issue that I do. know has impacted every single family in the United States in some way or another and all over the world. It's the word that makes your blood run cold if you ever hear a doctor say it to you or to anyone you love. It's the big C. It's cancer. And now doctors and researchers are seeing an alarming rise in the rates of cancer in younger adults in their 20s, in their in their 30s, in their 40s, I have experienced that within my own family and circle of loved ones. The question is why?

Why is this happening? And what does this mean now for how we live and at what age should people start paying attention? So I'm joined by world-renowned oncologist. He's world-famous, an author of the seminal Pulitzer Prize-winning book on cancer, The Emperor of All Malady's. Dr. Siddhartha Mukherjee. And I just welcome you and so really, really, really excited that you would be willing to sit with us and talk about it.

It's my pleasure. Yeah, I first want to talk about your book because, as we were just talking before, it's an astonishing work. And the Emperor of All Maladies, you all, as I just said, won the Pulitzer Prize. It spans 4,000 years through the history of cancer. And in the author's note, you say,

this is a chronicle of an ancient disease once a clandestine whispered about illness that has metamorphosed into a lethal shape-shifting entity imbued with such penetrating metaphorical, medical, scientific, and political potency that cancer is often described as the defining plague of our generation. So that's what you say in the author's notes. But it helped me, and if you have read it or will read it, it will help you understand cancer, and particularly if you you have somebody who's going through it, help you understand it not just as a disease, but as a story, one that is deeply human,

deeply complex and still unfolding. So the idea for this book came from one of your patients. It came from one of my patients. Cancer is my Moby Dick. I will, I've hunted it for 20 years. I will spend my last breath hunting it. I have spent every waking moment of my life thinking about cancer and thinking about cancer patients.

But this book boils down, comes down. I sometimes say, Moby Dick began with a journey and a question. And this book begins with a journey and a question. And the question was a very simple one. I was a fellow in the hierarchy of cancer doctors. A fellow is pretty low down on the list. I was a fellow tending my patients.

And I had a patient that I had developed a very warm relationship with, a woman who was dying, who had, you know, gone from trial to trial to trial, extended out her life possibly by three or four years. And then she turned to me one day and she knew and I knew that the end had come. And she turned to me and she said to me, where did all of this come from and where am I going? Very simple question. And to my astonishment, I realized that there was no book or a show or a podcast or anything on the planet that would tell the full story.

What is this story? Yeah. Where did it come from? Where, where, where, how old is this disease? Where am I going and why am I here? And it would seem to be this book is almost a kind of dedicated to her because she sort of set me off on this. journey for yourself. That's right. And she, you know, that's how cancer became my Moby Dick. But you devoted the book to this, the little three-year-old boy, Robert Sandler.

Yeah. Yes. Tell us why, who died of leukemia in 1948. Stories don't live in abstractions. Stories live in real lives. They live in real people. And books on medical books, medical textbooks tend to be, you know, very abstract. They take away names of people. They remove all the human qualities of a book. So I was looking for a human being, a real thing. A real thing. A real thing. real person to begin the book would to pin the book down on. And I knew that there must have been a first child who received chemotherapy for, in this case, leukemia, children's leukemia. And I kept searching for that child.

I kept looking for that child. Ultimately, after a very long and circuitous journey, which took me actually from the Dana Farber Cancer Institute in Boston, back to India, back again, I ultimately found. the name of this child. The name was buried in a newspaper clipping, which was in microfiche. You know, there was not searchable. You couldn't have found it anyway. So I found the name of this child. And then, you know, I went to the home of this child. I learned about the child's family. And his name was Robert Sandler. And that's how the book came about. Wow. So last year you released a new edition with four new chapters title, The Emperor's New Journey. And you wrote that it felt urgent to

update this book. Why? Well, lots of things have happened since the book first came out in 2010. And so 15 years had passed. And it seemed to me that it needed an update. Now, it's a funny thing, as you know, people don't tend to evergreen their books. Right. You know, you don't go back and write your book again. Yeah.

But what's it, what was interesting is, you know, cancer, you couldn't do that because things were, history was being made as we live. So this was a lived history. And so I had to update it in order to capture what had happened. since 2010. And so much it happened in prevention, in detection, and in treatment that I had to almost write an addendum or a new set of chapters. Even in chemotherapies, because I'm going through this with a family member now. And one of the things I've learned is that what chemotherapy used to be compared to what it is now is so much more improved. Yeah. It's vastly different. People, you know,

take, you know, people have a visceral reaction to that word, to that word. Yeah. You know, I'll be caught in the wards. I'll be throwing up. I'll have a, you know, a, you know, a, you know, a, you know, a vomit basin next to me, my, I'll lose my hair, my body will shrink. That's not true today. I mean, of course, there's still some chemotherapies that we still use that are sort of chemotherapies of olden days. Yes. But there are lots more new therapies where you don't have all these side effects. You still have some, but you don't have these severe side effects. There's a whole new world of therapy that has emerged even in the last 15 years. So one of the things that I really appreciated about the impromality,

is, as I was saying to you before, is that it tells the story of cancer. But even in the very beginning, what it clarified for me, that cancer isn't just one thing. It's many diseases, and it really is an abhorrent cell. The cell's gone awry. So can you just give us the most basic definition of what cancer is? Because when we hear the word, everybody just goes, you know, fearful. Well, it's a disease in which the disease typically is a disease of a single-state. cell that is no longer able to respond to signals that tell it to stop growing.

So just to give you an example, when you cut your hand and you have a wound, the wound cells start growing back into the wound and then they stop growing. That's normal. In cancer, it is as if those wound cells never begin, never have the signal to stop growing. Why? Genetic mutations in the cancer cells, mutations in genes, tell the cells, normally tell cells when to start and stop growing. Genes make proteins.

Those proteins act as signals. Those signals tell a cell, now you're done. You should stop growing and go back to being a non-growing cell. In a cancer cells, genetic mutations make proteins that are no longer able to respond to these stop growth signals. Therefore, the cancer cell is unable to stop growing, and it keeps growing, and ultimately, it keeps making a large and larger masses.

It can take over your bones, take over your blood, take over other parts of your body. and even metastasize, it migrates, and starts growing in places where it should normally not be growing. I mean, why should a breast cell be growing, a breast cancer cell, be growing in the bone? It's because it's co-opted. It's co-opted, its environment,

and made it an environment where it can actually start growing again, in the case of a breast cancer cell inside bone. So it's a cell gone awry? It's a cell gone awry in multiple different ways, not just awry in the basic way that I'm, said, well, you know, it can't stop growing. It's also gone awry because it's hijacked other parts of other signals from the cell, which enable it to move, to metastasize, to colonize other organs, to live in other places. It's all of that, a cell that's gone awry with this massive hijacking.

Okay, so we're seeing younger and younger people diagnosed with cancer. The American Cancer Society found that I think I read the cancer incidence rates in women under 50 are now 82%. percent higher than males. And you've said that the incidence of collectual cancer in young men and women in the United States is nearly doubles since 1995. What is going on? So it's very important. You're asking a very important question. This is very particular to young men and women. So I'll give you three examples and there are three concrete examples. Okay. The first one is colorectal cancer cancer of the colon and rectum. So basically

in the lower bowels. Yeah. Colorectal cancer incidence has increased dramatically in young women and it's colorectal cancer mortality, which is a statistic that never lies. Colorectal cancer mortality in young men and women has increased dramatically as well. I'll come to the Y in a second. But that's a clear signal that that's not just early diagnosis or early detection.

Okay. That was going to be my question. Is it that we're just getting diagnosed and detecting it sooner? That's not true. So that's not true because if it was just, If it was just early detection or early diagnosis, then you wouldn't have the fact, usually, in statistical terms, you wouldn't have an increase in actual mortality. So it's a statistical, you know, when you have an early detection, you can get a spike in cases, but you don't necessarily get a spike in mortality.

Yeah. But in this case, you're getting, so for choleraic cancer, you're getting a spike in cases and you're getting a spike in deaths. spike in deaths. So that is real. You cannot really, you can't turn your eyes away from that. That is a real number. I'll give you a second example, breast cancer in young women. So breast cancer, mortality in young women was slowly coming down year after year after year. But for the past few years, it's being plateauing, which means that something is happening such that the kinds of breast cancer that we're getting in these young women is either causing more mortality

or is generally more aggressive. And we know both of these two, too. And once again, it's not because of early detection. Number one, because most of these women are not being caught by mammography. They're not. No, they're detecting it often themselves. And number two, as I said, statistics don't lie.

They're not being caught by mammography because they haven't even started the mammograms. That's right. They haven't been started the mammograms. So they are detecting by themselves, often coming to their doctors because of having detected it. And secondly, the statistics don't lie. And it's being reflected by this lowered curve

or slowing down of the gains that we've had in the past decades. I'll give you one last example, and that's also relevant, and that is endometrial cancer. So endometrial cancer, also in women and particularly young women, has been rising in cases. Endometrial cancer, we don't usually have a detection for, we don't have any test for. It's usually, you know, when people come with bleeding or pain.

Yeah. That has been rising, so that's not in an early detection problem. And thus far, usually mandonemical cancer, you know, early stages is quite curable. So it's not been reflected in increase in mortality, but it may soon be reflected at some point in time in increase in mortality. So you have three different cancers with three different patterns, colorectal cancer, increases in incidence, increase in mortality, breast cancer, increase in incidence, particularly of the aggressive kinds and a plateauing or slowing down of gains in mortality,

and endometrial cancer increase in incidence and no increase in mortality at what we'll see. So you can live a healthy lifestyle. You can eat well. You can exercise. You can get enough sleep. You can do all the things. I know people who have done this. They don't smoke and they don't drink excessively.

And then it feels like, you know, you're 38 and it comes out of nowhere. So how much of this early onset is driven by what is inherited or by something in the environment? Or do we know? So the sad story is that we don't know, but we're getting to know. Okay. So virtually all cancers have some component in which, as I said, they're all genetic diseases ultimately. But many cancers have a component of the environment in it. So it's a genes plus environment phenomenon.

So the problem is when we talk about the environment. environment, we talk relatively poorly about the environment. So you just said what you eat, what you do, what exercise and other things. But your real environment is much more complex. It is the things that you're exposed to as a child. It is things that are in your gut, the called microbiome that's in your gut. It is things that you eat, but you may not know that you are being exposed to because, you know, you may be thinking that you're eating a very healthy diet, but some aspect of your diet might be,

might be the problem. And finally, all the things that you're exposed to, the so-called exposome. So again, there is that, the external environment, there is your genes, and there's one piece that is critically missing here. And that is your internal

environment, the environment which actually bades your cells, your body, with whatever it blades it in. And one very major part of that that we've discovered is the inflammation in the internal environment. Oh, that's what I was going to ask. There's growing confidence.

conversation around chronic inflammation as a root of many diseases. What does that mean actually when you have inflammation? So how does it connect to cancer? So inflammation is a sort of a bucket word. It means many things, it means different things to different people. You come and say, oh my God, my left cheek is inflamed because it's burning. Other people might say, I have chronic inflammation. In fact, that's-

If you have chronic inflammation, do you even know you have chronic inflammation? No, often you don't know that you don't have chronic inflammation. So just a great example of that is asbestos workers. I'll give you a historical example. Asbestos workers were exposed to little particles of asbestos, and they started having inflammation in their lung. It wasn't until much later when they started having cough and all these other symptoms.

That's lung symptoms, that they realized that they had chronic inflammation in the lungs. The point that I'm trying to make is that there are many different kinds of inflammation, just like there are many different kinds of cancer. Inflammation means it's a chronic or something. or acute activation of the immune system. Okay.

And the immune system gets chronically or acutely activated and it starts sending signals. Some people describe it as, it's as if your immune system is saying your body's on fire. There's a kind of inflammation which we, which is brought on by certain kinds of immune cells. Not every immune cell is the same. There's another kind of inflammation

that's brought on by other kinds of immune cells. And so far, so far, we've been able to track down cancer risk to one kind of inflammation, not all kinds of inflammation, to one kind of inflammation. That's a very big advance, because you could now ask the question,

if I can track that inflammation in your body, if I can make a test for that particular kind of inflammation in your body, can I make a potential test for future cancer? Hmm. You're right. Research suggests that healthy people may have a cadre of potentially cancerous clones,

sleeping assassins. So I'm asking you. asking, is there a possibility that part of what we're seeing is simply that cancer, because it's rooted in our own cells, is going to always find a new way to show itself? So this was another surprise from work done by many people, but really recent work. The surprise was people thought, oh, you know, cancer cell grew up, got the mutations that required, you know, hijacked or commandeered. the uh it's it's uh it's jeans and off it went yeah it turns out that the it's a little bit more complicated than that and a little more chilling than that yeah which is that it turns out there are lots and lots of sleeper cancer cells in everyone's body i want to repeat that there are lots and lots

of sleeper cancer cells in everyone's body and they're just asleep they're just dormant okay so by the time the cancer shows up it's it's been sleeping there for how long we don't know but we don't know there for a while, but we think that it needs something to wake up. Wow. And inflammation, chronic inflammation, we're realizing more and more, is one of those sleeping beauty signals. So say that again, we all are carrying the sleeper cells. We're all carrying sleeper cells in various organs. But they're dormant, they're asleep, they'll probably do nothing to you for the rest of your life.

The new theory, or one new theory, is that they need to be woken up. and the sleeping beauty wake-up potion is, at least one of them, is chronic inflammation. This is very new research. It has to be validated over and over again, but it really changes the paradigm. It says, you know, it's not as if you had a, you know, one morning you woke up. I'm sorry, not you, someone woke up. I hope it's no one here, but someone woke up. And a cancer cell started having genetic mutations and off it went and became the tumor that

the nasty tumor became. That would be one theory. Another theory is, actually, the morning, the night that we were asleep, there were thousands of dormant cancer cells sitting in your body, and something happened, in this case, what I call the sleeping beauty kiss, something happened that woke them up. And in this case, we're realizing that that one-something is chronic inflammation. That's big.

It is very big. It is a new theory. It has to be tested, but it really changes the way we think about cancer. That's why I had to write a whole new chapter on it. Yeah. I see. I see now. Because it really switches around the way we think about cancer, how I thought about cancer.

As I said, new theory, lots to be tested in it, but it is a powerful theory. That that inflammation is the kiss that wakes it up. And that's why now there's so many people talking about reducing your inflammation. That is why. And if we could test the particular kind of inflammation, not again. All kinds of inflammation. There isn't just one kind. But if we could test that particular kind of inflammation,

we would have a biomarker, we would have a marker for future cancer and potentially even prevent it, potentially by stopping that inflammation. Do you think we will find a prevention in your lifetime? I think we will find a prevention in my lifetime. Yes, it may not work 100%. Yeah.

As I said, it is my Moby Dick. Bobbi Day. You and Moby are going to be out there. Me and Moby are going to be at it. At it. So breast cancer, as many of you know, is one of the most common cancers in women across the world. It's now rising faster in women under 50

than in older women. And younger patients are being diagnosed with more aggressive forms, as we've been talking about. So joining us now is actress and activist wife and mother of two Olivia Munn. Welcome, Olivia. Great to have you here. And thank you for zooming in.

You learned you had breast cancer at what age? 42. 42. What happened? So I had been doing everything I was supposed to do, the mammograms, the ultrasounds, I have dense breasts. And also, I think it's important for people to understand what dense breast means because we hear these terms a lot and don't really connect with it. So dense breast is when you like, it's like when you look at the sky and you see clouds and you see blue sky, well, when you do a mammogram and you have dense breast, your tissue and your tumors all look like clouds. But when you have dense breast, you get an MRI or an ultrasound. it's a blue sky and then there's like one cloud and that's your tumor.

So I was getting my mammograms done in my ultrasounds and I was cleared and I had genetic testing done as well just to be proactive. And my doctor said there's something called the lifetime risk assessment test and it gives you a score that tells you how likely you are to have breast cancer in your lifetime and anything above 20% is considered high risk. And it's like a few minutes, it's online, it's free. and I came back at 37.3%. So I went to get an MRI,

and after that MRI was off to the races, I was then diagnosed with multifocal, multi-quadrant bilateral breast cancer. Yeah. That's a touching story. Wow. And you've had multiple surgeries. Tell us about that and how you're doing today.

So along with the stuff that you do before delmastectomy, like a lymph no dissection and nipple delay, I had a double mastectomy, and I also had my over. and my phalopine tubes and my uterus removed as well. There is this, when you have a hormone positive breast cancer, like mine is ER positive, PR positive, her tumor. So why would you have ovaries removed?

Because I didn't have anything to do with your breasts. Exactly. So there is a medication called Lupron that I had to take. And that medication suppresses the estrogen production in my ovaries. And it was debilitating. It was a shot every month. and I had, my son had just turned one when I was diagnosed, and I couldn't get out of bed. It was actually debilitating.

I would get up, I would go get something to drink, and I would just come right back to bed. I was probably out of bed, maybe a total of 45 minutes for an entire day, and this went on for months, and I just had to figure out a solution, so I said, can I just get an ophrectomy and have them removed? And then when I was doing that, I said, you know what, I don't want to have to worry about cancer coming into other places. can we just go ahead and take out my fallopian tubes and my uterus? So we did that all just to be preventative and to help me get off of this medication. But there's also this other medication that I have to be on called an aromatase inhibitor. And that suppresses the testosterone in my body that turns into an estrogen that could feed my cancer.

And you asked how I'm doing today. And I've always really maintained a positive outlook when I was talking about this. I think it was so important for me when I was talking about it publicly to come with a lot of hope. Also be very realistic and honest about the tough times, but there's so much hope in this journey because people are doing all this research and I have the ability to fight. I've been given the chance to fight where so many women in my position were told to get their affairs in order. So I wanted to be really hopeful. In the middle of all of this, you stop the cancer treatment to do in vitro fertilization and egg retrieval?

So I had frozen my eggs in my 30s, and we wanted to have another child. And so I was diagnosed with breast cancer. And the next day, we had already planned to turn those eggs into embryos. And my husband was like, what do we do? What are we doing? I said, I don't know what's going to happen in me. So just go. I don't even know because when you freeze your eggs, you don't know until they're turning

into embryos if any of them work out. So I said, just go and like just try to make the embryos and we'll deal with it later. And we were able to get a small amount of embryos. But in order to ensure that we could have another baby, I said, I think I need to go and do more, do another round and get more eggs out. And so I spoke with my fertility doctor, and he said, we're going to put you onto a breast cancer protocol.

And that means that's a lot less hormones. And I was putting myself at risk. And my fertility doctor is like, you know, we're just going to get you like just a couple more. and then we're calling it. And it was just a calculated risk that I just felt I had to take. And my baby girl, May, May is 19 months, and she's in the world because of that risk I took.

And I would do it all over again just to have her. What do you want other women to know? Because 42s scary. I want other women to know, first and foremost, that the lifetime risk assessment test is something that is free, and it's online, and it saved my life. And I think that every woman should know, what it is, something that every doctor takes for their patients, that when you go in, they

ask for your blood pressure and your family history, but they don't ask what your lifetime risk assessment score is. So we're working on legislation that will help make the standard of care for every doctor to also know that information. I think you've already done such a great job. They saw an increase in people taking that task after you told your story. And I'm sure it's going to go up even more now that you're sharing your story. Thank you for helping to get out this message because that's the, I mean, as you know more than anyone, it's just like continuing conversation over and over, the awareness that just has to keep going, which is why we want the onus to come off of women some to know about this test

and put it onto doctors to be there in those offices and educate the patients about it. Yeah. So you sharing your story has already done so much for women. I thank you for that. Thank you. Thank you. Thank you. take good care. Thank you, Olivia. Thank you, so more and more women, 30s, 40s, are experiencing much of what she talked about. Absolutely.

And as you can imagine, I mean, these are often, you know, young women with families. They have children to think about. They have future fertility to think about as Ms. Mun did. And so the decision becomes not just, you know, about yourself, it becomes about your family. So what are the current recommendations for breast cancer? taking a mammogram now since I was 40 doing screenings. But if women in their 30s are big, I also

have a family member who at 36, you know, developed breast cancer and wasn't even through a mammogram, just through doing our own breast test. So what should be happening? Should we be screening earlier? Well, so the problem with mammograms is that the yield to discover real cancer is very low, especially in young women, and that's complicated, of course, by women who have young breasts. By yield, I mean there's a number, which is how many mammograms you need to need to take in order to save one breast cancer life. And you said complicated by women who have dense breasts. Dense breasts.

Olivia talked a little bit about that. But leaving aside the question of dense breasts, which is particularly the case with young women, the yield in the mammogram is very low, especially in that group. And so doing mammograms early or doing more mammograms will inevitably yield lots and lots of false positive, lots more biopsies, lots more anxiety. And, you know, it'll obviously yield a few real cases of breast cancer. So what I've been recommending is very much on the lines of what Olivia did, which is to say, first of all, if you're a young woman.

And if you have any history of breast cancer, of ovarian cancer, of pancreatic cancer, you should go and see a physician to potentially look at, to do some genetic counseling to see if you're at a genetic risk for breast cancer. Wow. And those are people who have, you know, will pick up people with so-called BRCA-1,

Braca 1, Bracca 2 mutations, among other things. Number two is that there is actually a genetic test. If you have a family history of breast cancer, cancer or of any of these cancers, there's a genetic test that even if you are not Bracca 1 or Bracca 2 positive, it will give you a score of the risk that you have genetic risk for breast cancer. It's a score. It's called a polygenic risk score. Again, it's not perfect, but if women who do have a polygenic risk scores, if they do have one, certainly if they have Bracca 1, Brac 2 and some of these other breast cancer genes, I'm recommending them to enroll

in a trial with intensive screening. There are many around. Some of them use them. a combination of MRI and mammograms, sort of alternatively, some of them are MRI only. What I'm really hoping for is that there's a test that will come along, which won't be as invasive and which will not have as many false positives as a mammogram that we can use that as a potential way to screen these younger women.

Okay. So when Chadwick Bozeman, the actor who played the Black Panther, died after private battle with colon cancer, the world was stunned. Chadwood was just 43. and his wife, Simone, Bozeman, was by his side until the end. Simone, thank you for joining us. We were all so stunned, and you all were able to manage to keep that private.

I read that his symptoms began just weeks before his diagnosis in 2016. What was going on? Yeah, well, first, thank you for having me. Thank you. Chad was 38 when he was diagnosed, and he was diagnosed at stage three. So just before that, he had already been to the doctor a few times before I even found out about it. And essentially, he was just having trouble going to the bathroom. And first the frequency changed, and then it really slowed down altogether and stopped altogether,

which just impacted his ability to move and operate and eat. He was on a really strict exercise regimen. So it was affecting him quite a bit. And there were maybe three or four weeks in between our first visit to the doctor together and him being diagnosed with stage three colon cancer. And so once you both found out, did he go into chemotherapy? What was the procedure for helping him? Yeah, there was chemo.

There were surgeries. a few different rounds of chemo and a few different types of chemotherapy to see what worked on his particular type of colon cancer. And there was also Eastern medicine that we involved. We were doing all the research we could and trying all of the avenues that we could

to get his immune system to fight his cancer and fight the effects of the chemo as well. By the time you're stage three, though, what does that actually mean, Dr. McCurgeon? So it means the cancer has spread beyond, certainly spread beyond the original local site. It's gone through the bowel wall. And in many cases, depending on what kind of cancer, has started invading the lymph nodes. So it's called advanced cancer in the case of colorectal cancer. Now, astonishingly, I mean, I'm so sorry that.

you had to go through all of this. And the world is very sorry for it, I think. Astonishingly, immunological therapy still works in stage three in some cases. I'm sorry it didn't work in this particular case, but it really works. I mean, this is an incredibly important conversation we're having because, you know, cases like this remind us that we have got to do better. We have just got to do better. And if we don't do better in diagnosis and in treatment,

then, you know, shame on us. Yeah. So. And he was at an age where normally, he wouldn't have even been getting a colonoscopy. No. I have a friend who's 42 who's going through this, also stage three,

and also had to make up a story about it being in his family in order to even allow them to test him. They weren't going to test him. The doctor said, you know, you're too young. You know, it's probably just stomachache or whatever. Big misconception, by the way. Big, big. What is the big misconception?

Misconception is that, you know, we're saying we know the rise of colorectal cancer incidents in death in young men. So no doctor, if you come with abdominal, lower abdominal pain or abdominal pain, should be saying to you, oh, it's just, you know, something you ate. Yeah. That's not the standard anymore. I know that caretaking is one of the most demanding jobs, and you were there by his side till the end. What is your advice to those who are supporting loved ones with cancer? Just love your way through it. It's going to be stressful. It's going to be overwhelming.

But let the good times be good and do as much research as you can. Try as many things as you can. Really leave no stone unturned because the guilt of grief is almost an impossible thing to deal with, even when you do try all of the things. If you have even an inkling that something might have any kind of effect on your loved one's situation, you should try it and you should push them to try things as well. That was interesting. You were talking about the guilt of grief. Are you still carrying that? Are you still thinking that there was something else you could have done or should have done or might have done? I think I will always wonder if there were things we could have should have done. I think that's a, yeah, that's a reality of losing someone. You'll always wonder whether it's from cancer or from anything else. Could I have talked to them?

Could I have, you know, kept them in the house for five more minutes? And they didn't get in that car accident. Anything is going to come into your mind. And I think it's also survivor's guilt. I think for the first several years, I could not make sense of why I was still here and he was not. when he was just such an incredible, extraordinary spirit and person. And it is, the edges are less sharp now,

but they are still here. Yeah, and you know what? I was just thinking too, and I don't know four people in my immediate family and friends who are going through one former, another of cancer right now, and we know about it. We, the family know about it,

other people know about it. I think it's even doubly hard when you have to keep it a secret or you have to not let other people know. So that adds to the stress because he was working and correctly so, if everybody knew he had cancer, there would have been a completely different reaction on set and all the other things. And so how absolutely courageous of him and of you

to go through that when you're getting cancer treatment. It's just unimaginable. I just wanted to add them incredibly brave. of you and to share this journey. You know, I think about the guilt of grief a lot. It really rests. The guilt of grief is something that resonates with many, many families. And I always return to the very famous quartet of things that patients want to do when they're facing death,

which is to say to someone that they love them, to be told that they're loved, to say to someone that they forgive them and to be told that they're forgiven. And I can tell you for sure the way you took care of him, Simone, I'm sure that you received all four. So I hope that helps with you with the guilt of grief. Thank you. Thank you.

And you say he was your greatest spiritual teacher. Tell us why. Oh, man. He was. You know, credit to my mother. She gave me my foundation for my own spirituality. but Chad, he was someone who did not just believe in spirituality, but he really lived it. And he showed me discernment,

and he showed me what the feeling of truth was, what it means, how to understand when I know something that is right or good, and when I know that it is not good, and when I know that I don't know, and then how to go to God and ask for, guidance and most importantly to be able to listen and wait for God to answer. And those are principles that I learned from him that I'll carry with me for the rest of my life. Well, sounds like he was truly the Black Panther.

He truly, truly, truly was. Sounds like he was truly the Black Panther. Really. Thank you. Thank you. Thank you. Thank you. So what can people do?

Is there anything, first of all, What you just said, if you are under 50 years old and you go to your doctor complaining of stomach pain, rectal pain, and the doctor says it's just a stomach ache, you should fight like hell to get the test. Well, you should get a different doctor. You should get a different doctor. You should get a different doctor. Yes. Yeah. So because you just said, doctors know that this is happening.

This is a well-known phenomenon. It is published in national statistics everywhere around the United States. That you don't have to wait until you're 50 anymore. There's no reason to wait if you have symptoms. If you have symptoms. Yes. There is absolutely no reason. It doesn't make sense.

It's like saying my car is broken. I'm going to wait until the next 10 years to fix your car. Yeah. This doesn't make any sense. So yes. So uterine cancer, I understand, is the most common cancer for female reproductive organs. And one young woman named Eve was recently diagnosed and shared her story on social media. Watch this.

My name's Eve. I'm 28 years old. In October of 2025, I was diagnosed with stage four endomete, neutral adenocercinoma that has metastasized to other parts of my body. And the reason for this video is because I am starting a series to kind of talk about the symptoms that I had leading into this diagnosis.

I've had tons and tons of women reach out to me via social media asking, how did you know, what did you do to find out, what are you doing now? I'm so scared and the last thing that I want is for this circumstance that I'm walking through to cause fear and anxiety and other people. I remember before this diagnosis came out to life, the anxiety and the fear that I had,

just leading up to this moment was absolutely crippling. And I would never wish that upon anybody. And Eve is joining us now from Texas. Hi, Eve. Hi. Hi, how are you? How are you? How are you?

I'm good. Thank you. Yeah. I heard you were dealing with symptoms for years, but you were dismissed by doctors. And what were those symptoms? Those symptoms were prolonged uterine bleeding. So I was having bleeding at that point for about three years now. Wow.

I also was having urinary incontinence. And then the other one was extreme pelvic pain, which all of these, when I did present them, to my gynaecologist at the time was dismissed and labeled as just PCOS, which is what I was diagnosed with over 10 years ago. And first of all, I apologize. Your doctor should have known. Your doctor should have known. You know, it's interesting that the three cases that I picked were colorectal cancer,

breast cancer and endometrial cancer because this is known. This is established. It's known. And so a young woman, particularly with PCOS, the syndrome that she has, who comes in with vaginal bleeding, pelvic pain, et cetera, needs to have a... So PCOS stands for what? Polyscystic ovarian syndrome. Well, you can tell us more about it than I can,

but this is well known. And, you know, the sad, sad story about all of this is that if you catch endometrial cancer early in its first stages, it is highly curable. It is very, very, very curable. And so the idea is that as soon as someone comes in, particularly with this kind of history. Yeah.

With pelvic pain, with, et cetera, et cetera, they need to be assessed to see if they have endometrial cancer. Yeah. I would say that the only piece of good news is that these cancers have become over time more and more, we've gotten more and more better therapies, chemotherapies, some of them. I can tell that you're probably on one of those chemotherapies already,

but also their second line and third line therapies. So there's a lot of progress in treatment, But this is a case that should not have happened. Eve, so what are the doctor saying is your prognosis right now? Right now, my prognosis is less than two years, and that changed over a spam of, I want to say, four months. Initially, when we first found out about the cancer, I was given about five years. And the reason why there was such a long delay was because insurance companies weren't wanting to cover for treatment. So that played a big role, and by that time, the cancer, which was already,

stage four, grade three, it had already metastasized even more. And we actually found out about this after four years of infertility. So that was really hard to hear. But the prognosis as I've been praying over myself is not a promise. And so even though I'm given less than two years, I'm going to live and believe that God still has more for me and that if I'm here right now, it's for a reason.

Absolutely. And one of those reasons is you wanted to share with other young women what you wanted them to know. And what is it you want them to know? I want them to know that it is extremely, extremely important to truly advocate for yourself. And like we just said, if one doctor is not listening to you, you have to push and find another one. Even if you go through 10 doctors, you have to find one until they finally sit down and hear what you have to say. because I didn't do that, and I do feel like had I spoke up earlier before I even knew that I had cancer, I wouldn't be in the situation today.

So tell me this, Eve, every time you were told that it wasn't the, you know, that you shouldn't be that concerned about it, was a part of you relieved? Because I think a lot of people, when their doctors say, let's keep an eye on it or let's watch it, which I don't believe in, let's keep an eye on it. I believe in, let's look at it right now. But when your doctors say that, there's a sort of a sense of relief that maybe it's not as bad as I thought,

and therefore you buy into that. Is that what you did? It was actually not relieving for me at all because I always kind of knew in my subconscious that something was wrong. I actually worked in women's health for a little over eight years, and so I talked to women who had these same symptoms,

and every time I would bring them up, my doctor actually said, you know, if you were a few years older, than I'd be concerned for cancer, but because at the time I was 24, 25 years old, it didn't cause any alarm. And so I do feel like, and it was always per ACOG guidelines, part ACOG guidelines. And I really would like for ACOG guidelines to be updated at this point because after posting about this on social media, it turns out that there are quite a lot of women younger than me that do have very advanced stages of uterine cancer. So your advice would be when you think something's wrong, as, you know, we've heard from Dr. McGurgy earlier, if the doctor says, no, you go find another doctor if you think something's really wrong.

It's listening to your body. Because do our bodies, our bodies tell us. Well, in this case, her body was telling her, the full story, actually. Her body was telling her that she had risk factors. Her body was telling her that, you know, she was having pelvic pain, that she was having vaginal bleeding, that she was having, uh, you know, I think you said you stopped your periods. You're having infertility. I mean, your body was telling you,

your body was not telling you something. Your body was screaming from the rooftops. So I'm sorry, as I said, it's hard for me to put myself in every physician's shoes. But these are known facts. These are just, you know, there's something very well known about all of this. Eve, thank you so much for being courageous enough

to share your journey with us. Thank you. Thank you. You know what? Someone is watching or listening right now who has had one or more of those symptoms who's looked the other way and because of you today, they won't. They will follow through. I believe that is true. Thank you so much. Thank you so much. Thank you. Thank you for sharing. So you talk in the book about all the various kinds of cancers. Is there one cancer when you hear that cancer that all doctors go on the alert?

Well, their typical answer to that question is pancreatic cancer. Yes. And doctors go on the alert. But as you know, as of very recently, for the first time in human history, there was one medicine that changed the, in a randomized controlled trial. So in other words, in a fair, statistically clean way, showed that it could increase the lifespan of patients with advanced pancreatic cancer. Now, the increase was from six months to 13 months, and you could say, who cares?

But that's not the way to think about it. The way I think about cancer, all cancer, is it's like climbing a mountain. And the first crampon you put into the mountain is very crucial, because it's going to hold up the whole journey upwards. And in this case, the first crampon has been planted. From here on, we'll know, you know, how does it become resistant? Can we make another medicine? Can we combine it with a third medicine?

and so forth. So that's that. And then, of course, my personal nemesis has been acute myeloid leukemia, AML, which I've treated for many years and still Tatiana Schlossberg, got this very moving since she died of AML, that same disease a few months ago. You write this on page 473. About the time you met with your book editor, you said, I sat in the editor's waiting room high above 6th Avenue looking outside. It was one of those magical New York afternoons when the balminess in the air becomes intoxicating, and crowds had gathered on the streets, but I was a trainee in oncology in Boston,

and all I could see was a landscape of future grief and anxiety. The woman laughing breezily by the bakery might be diagnosed with cancer, ovarian, or breast. In a few years, I imagined the man smoking a cigarette with evident pleasure in a hospital gown as he went for a lung CT scan. The lenses with which I saw the world had forever been changed, you wrote.

So my question is, how do you personally cope with, you know, the immersing of yourself with people fighting every day for their lives and you don't know if you can save them? How have you managed to do that? Well, people say that the way to manage to do that is by moving yourself away to distance yourself from the fight. I think it's just complete nonsense. I think the way you survive being an oncologist, the way you survive many of these intense professions

that make deep demands of you is to lean in instead of leaning out. And by leaning in, I mean, you make that person's grief your grief. You make that person's fight your fight. You make every fight your fight. And eventually, if that is that person, explodes, it explodes, but you can't, you can't survive it by leaning out, because that will always

come back to haunt you. Yeah. The only way you can survive is by leaning in. Well, what you described feels to me is the difference between having a good doctor and having a great doctor. Yeah. Yeah. And, you know, having people in my family going through it now, I mean, I see the difference between people who are really leaning in and the people who you're just another patient. Yeah. Yeah. Yeah. So what is, what, what is the future? It's like with that woman who started this whole book for you, what is the future? What do you see for where we're headed with cancer in the future?

Will it be eradicated or is that just a pipe dream we're all having for ourselves? Well, I can tell you what I'm doing. You know, in some ways, I think of myself in my own journey or fight against cancer as an opportunist. In other words, if new technology comes along and I can push it, to use in cancer, I'll bring it along and make it useful for cancer. Has AI been helpful? AI is the single most revolutionary technology of our generation. And if we're not using it for cancer, we're losing the plot.

So in other words, people have all sorts of paranoias and fears about AI. They're worried about, you know, job loss and, you know, fake news and so forth. But I think the one thing everybody agrees on is that I'm an AI optimist. And I think if there is one use case of AI that is optimistic, it's medicine. Medicine, yes. I started a new effort company called Manus AI. Manus comes from the Sanskrit word for brain or mind. So the idea is to turn the mind of AI to make new cancer medicines,

cheaply, better, more efficiently, and superior medicines. And the way we do that is by, you know, you can't go into Claude or, you know, Gemini and say, find me a medicine for breast cancer and out pops an answer. What you have to do is you have to go and go. teach it the basic rules of medicinal chemistry, physics, and to some extent, biology, but basic rules of medicinal chemistry, to teach it how to build a medicine, just like humans build medicines. Humans don't build medicines by going into Claude Code and writing a code for medicines. They make it molecule by molecule. They figure out what the targets are. They validate those

targets. And then they build a medicine by stitching together, literally stitching together a molecule in space that can either, you know, jam a lock in a key in a cancer relevant target. So that's what we're doing in Manus. We have taught the algorithm. The algorithm actually knows more medicinal chemistry than I do. And it speaks to us. It speaks back to us by producing, this is the funny thing about it, it speaks the language of medicinal chemistry.

So if you give it a potential target or a query, it will, start generating not one, not two, not three, but series of medicines that it's been built using the laws of chemistry and physics, these constraints. And then, of course, we could test them in real life and then feed that information back to AI and say, yes, you're wrong there, you're right there, you're wrong there, and that's called reinforcement learning. You learn. And I think that is the capacity to really change the game.

We used to build medicines one at a time using human medicinal chemists. that's not good enough. We need to do better. So we're making medicines many at a time using AI medicinal chemistry. One of our guests today spoke of leaning in and also keeping a positive attitude. I think Olivia was talking about that, keeping in a positive attitude through the whole process. Have you found that the way a patient approaches their cancer diagnosis affects the outcome or not? Not in the simple way you think.

I mean, I think the problem with, I mean, I applaud people who have incredibly positive attitudes through their cancers. I think it's wonderful. But it also, unfortunately, creates a kind of prison cell of optimism for patients who don't have a positive attitude. You may be suffering from terrible grief because, you know, you're worried about leaving your children behind. And should you be blamed for that? No. You should be, you know, I don't. do think that attitude makes a difference in terms of your capacity to cope with, you know,

with cancer. You know, it's something that brings you to the hospital day after day, night after night. I talk about Carla in my book. And I, at one point I wonder, you know, what, I was in traffic. I was going to her home one day. And I said, what is it that brought her night after day, night after night to the hospital in this boiling traffic, you know, sitting? So a positive attitude, I think, you know, can become its own stigma.

You have to have a positive attitude. You know, you've got to be, you've got to think positive. We've got to think better. I think that can become its own stigma. Some people are, you know, drenched with grief. But to them, I generally say, I understand. I understand you have full right to be drenched with grief. I would be too.

It would not be. But on the other hand, let me make sure that that you being immersed in sorrow and grief and anxiety does not prevent you from getting the medical care that you need. That's the difference in the question about positive attitude. And is there anything we should be doing or, you know, adapting the way we live and eat and move and exercise to improve the, you know, inevitability of those sleeper cells being awakened? Well, there are small ways.

I think I wish I could give you big ways. Yeah. But the small ways that are certainly, you know, I think that I'll give you a couple of associations that I think are alarming. I think there is a growing relationship between forever plastics and inflammation that I find alarming. So it's not been proven out yet, but there's enough, there's the beginning of a smoking gun there. Obviously, obesity has been now connected with many kinds of cancer, including most importantly endometrial cancer, a cancer related to obesity. So, you know.

Forever plastics. So, yeah, forever plastics. You know, the standard thing is bestest, of course. You know, same inflammatory pathway, obesity and diet. Appropriate risk assessment. So in other words, really think about, think through. If you are at high risk, you need to be seeing a different kind of doctor in terms of your risk for cancer. And, you know, in terms of diet, we've now known forever that diets that are diets that are

diverse and that actually are rich in fiber. Yeah, the Mediterranean diet are much, much lower risk of colorectal cancer. So generally speaking, I always advise for all of this. On the end, if there's some cancer that are caused by viruses, human papillomavirus, for instance, causes cervical cancer. The incidence of cervical cancer in patients who get the HPV vaccine, women, who get the HIV vaccine is. zero. So in other words, it completely eliminates. There should be no cervical cancer left in the

world. So get the vaccines that are relevant. And those are the, you know, those are very broad recommendations. I think as we explore this whole issue of chronic inflammation, we'll find more things that potentially cause chronic inflammation. We'll find things that are markers of chronic inflammation. That would be a big day because that will mean that we can start. It's just, it'll be, it'll be like finding a cholesterol for cancer, as in cholesterol for heart disease and chronic inflammation for cancer. That'll be a big day because we will then be able to say, I think that you have a heightened risk for cancer because there's chronic inflammation going on in their body. Let me try to see how I can help and figure out, you know, how to balance that, how to decrease that and potentially look for

cancers. So all these things we see on the market for anti-inflammatory causing anti, none of that means anything. No, they're usually not even attacking the right kind of inflammation. You know, the that's just commercial marketing. That's just commercial marketing. Yeah, that's that's the low fat of this era. Yeah, low fat of this era. Yeah. So what keeps you up at night? What keeps me up at night is hope. I'm a born optimist. I live, I eat off. My morning breakfast is optimism. My, my morning breakfast is optimism. evening dinner is optimism. I'm an optimist. I think that we will make a difference and we will make a difference in this disease before I die. Thank you. Thank you. Thank you. Thank you, Dr. Mukherjee. The book is the emperor of all maladies. It's a biography of cancer and the new edition is available

everywhere books are so. Thank you, Olivia Munn. Simone, thank you, Simone Bozeman for sharing and Eve for sharing your stories with us. And thank you all for listening and watching. Take good care of yourself. Thank you. Dear listeners, it is with sadness that I share with you that my guest on this episode, the young woman named Eve, who was fighting stage four, endometrial cancer, passed away just a few weeks after our

conversation. It was an honor to have Eve on the Oprah podcast. She told us it was deeply important to her to share her story because she wanted to help other women facing similar medical challenges. We extend our sincerest condolences to Eve's husband,

family and friends. May her life continue to be a blessing to all who loved her. Dr. Mukerjee says we're on the cutting edge of AI advances and research for cancer. To read more about this work, check out his New York Times article, Can We Make AI Belong? The link is right there on your screen. If you want to dive deeper into the history and also the future of cancer treatment, the QR code for Dr. Sidhartha Mukerjee's updated Pulitzer Prize winning book, the emperor of all maladies is right there on your screen.

It offers a deeply research look into a disease that has touched nearly every person on earth in some way over the last 5,000 years. To order the book, just scan the QR code. It's that easy right now. Our listeners tell us that the podcast is resonating with you and is serving as a bright spot in your day. That means a lot to me. So here's the thing. I would really appreciate it if you like and subscribe to the Oprah podcast on YouTube or wherever you podcast. It's just a quick tap of the subscribe button.

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