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#267 ‒ The latest in cancer therapeutics, diagnostics, and early detection | Keith Flaherty, M.D.

The Peter Attia Drive

Release Date: 08/21/2023

The impact of gratitude, serving others, embracing mortality, and living intentionally | Walter Green (#288 rebroadcast) show art The impact of gratitude, serving others, embracing mortality, and living intentionally | Walter Green (#288 rebroadcast)

The Peter Attia Drive

Walter Green is a remarkable philanthropist, mentor, author of This Is the Moment!, and founder of the impactful “Say It Now” movement. In this episode, Walter delves into the unique insights gained from his challenging upbringing, discusses embracing mortality, and highlights the mindset of “finishing strong.” He shares insights on intentionality, thinking in reverse, saying “no,” prioritizing relationships, and the essence of focusing on others. The conversation focuses on the “Say It Now” movement, which stresses the importance of expressing sentiments to loved ones well...

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#373 – Thyroid function and hypothyroidism: why current diagnosis and treatment fall short for many, and how new approaches are transforming care | Antonio Bianco, M.D., Ph.D. show art #373 – Thyroid function and hypothyroidism: why current diagnosis and treatment fall short for many, and how new approaches are transforming care | Antonio Bianco, M.D., Ph.D.

The Peter Attia Drive

Antonio Bianco is a world-renowned physician-scientist and expert in thyroid physiology and metabolism. In this episode, Antonio explores the complex biology of thyroid hormone production, conversion, and regulation—highlighting how deiodinase enzymes modulate hormone activity at the tissue level and why that matters for interpreting lab results. He discusses the shortcomings of relying solely on TSH as a marker of thyroid function, the ongoing debate around combination therapy with T3 and T4 versus standard T4 treatment, and how genetics, tissue sensitivity, and individual variability...

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#372 - AMA #77: Dietary fiber and health outcomes: real benefits, overhyped claims, and practical applications show art #372 - AMA #77: Dietary fiber and health outcomes: real benefits, overhyped claims, and practical applications

The Peter Attia Drive

In this “Ask Me Anything” (AMA) episode, Peter breaks down the science of dietary fiber, moving beyond the blanket advice to “eat more fiber” to uncover what it actually does in the body and where its benefits are truly supported by evidence. He explains how different types of fiber—soluble, insoluble, viscous, and fermentable—affect digestion, satiety, weight management, and glycemic control, and compares their impact to other, more potent metabolic tools. Peter also examines how certain fibers influence lipid metabolism and cardiovascular risk, evaluates the strength of...

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#371 – Women’s sexual health: desire, arousal, and orgasms, navigating perimenopause, and enhancing satisfaction | Sally Greenwald, M.D., M.P.H. show art #371 – Women’s sexual health: desire, arousal, and orgasms, navigating perimenopause, and enhancing satisfaction | Sally Greenwald, M.D., M.P.H.

The Peter Attia Drive

Sally Greenwald is an OB-GYN who specializes in women’s sexual health from a hormonal and physiologic perspective, with expertise spanning desire, arousal, pelvic floor function, contraception, and menopause care. In this episode, she explains why sexual health is a vital component of overall well-being, exploring topics such as the drivers of desire, the anatomy of sexual function, myths and realities around orgasm, and the role of hormones in perimenopause and menopause. She also covers vaginal and pelvic health, pain with sex, evidence-based therapies for low desire and arousal, how...

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Longevity 101: a foundational guide to Peter’s frameworks for longevity, and understanding CVD, cancer, neurodegenerative disease, nutrition, exercise, sleep, and more (re-broadcast) show art Longevity 101: a foundational guide to Peter’s frameworks for longevity, and understanding CVD, cancer, neurodegenerative disease, nutrition, exercise, sleep, and more (re-broadcast)

The Peter Attia Drive

In this special episode, Peter provides a comprehensive introduction to longevity, perfect for newcomers or those looking to refresh their knowledge. He lays out the foundational concepts of lifespan, healthspan, and the marginal decade. Additionally, Peter discusses the four main causes of death and their prevention, as well as detailing the five key strategies in his longevity toolkit to improve lifespan and healthspan. Detailed show notes provide links for deeper exploration of these topics, making it an ideal starting point for anyone interested in understanding and improving their...

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#370 - AMA #76: Peter evaluates longevity drugs, aspirin for CVD, and strategies to improve muscle mass — proven, promising, fuzzy, noise, or nonsense? show art #370 - AMA #76: Peter evaluates longevity drugs, aspirin for CVD, and strategies to improve muscle mass — proven, promising, fuzzy, noise, or nonsense?

The Peter Attia Drive

In this “Ask Me Anything” (AMA) episode, Peter revisits the “proven, promising, fuzzy, noise, nonsense” scale and applies it to a variety of popular topics. He begins with a refresher on what each category represents before classifying a range of interventions based on the strength of their supporting evidence. The conversation spans three main areas: drugs for geroprotection (including GLP-1 receptor agonists, SGLT2 inhibitors, methylene blue, and telomere-lengthening supplements), the use of low-dose aspirin for cardiovascular disease prevention, and strategies to improve muscle...

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#369 ‒ Rethinking protein needs for performance, muscle preservation, and longevity, and the mental and physical benefits of creatine supplementation and sauna use | Rhonda Patrick, Ph.D. show art #369 ‒ Rethinking protein needs for performance, muscle preservation, and longevity, and the mental and physical benefits of creatine supplementation and sauna use | Rhonda Patrick, Ph.D.

The Peter Attia Drive

Rhonda Patrick is a scientist, health educator, and host of the FoundMyFitness podcast whose work explores the intersection of nutrition, aging, and disease prevention. In this episode, Rhonda joins Peter for part two of his deep dive on protein, continuing last week’s discussion with David Allison and expanding the conversation to include creatine supplementation and sauna use. She discusses why the current RDA for protein is insufficient, how much more is needed to maintain muscle mass and prevent frailty, how activity level and aging influence protein requirements through mechanisms...

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#368 ‒ The protein debate: optimal intake, limitations of the RDA, whether high-protein intake is harmful, and how to think about processed foods | David Allison, Ph.D. show art #368 ‒ The protein debate: optimal intake, limitations of the RDA, whether high-protein intake is harmful, and how to think about processed foods | David Allison, Ph.D.

The Peter Attia Drive

David Allison is a world-renowned scientist and award-winning scientific writer who has spent more than two decades at the forefront of obesity research. In this episode, David joins for his third appearance on The Drive to bring clarity to one of the most contentious topics in modern nutrition—protein. He explores the historical pattern of demonizing macronutrients, the origins and limitations of the RDA for protein, and what the evidence really says about higher protein intake, muscle protein synthesis, and whether concerns about harm are supported by actual data. He also discusses the...

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#367 - Tylenol, pregnancy, and autism: What recent studies show and how to interpret the data show art #367 - Tylenol, pregnancy, and autism: What recent studies show and how to interpret the data

The Peter Attia Drive

In this special episode of The Drive, Peter addresses the recent headlines linking acetaminophen (Tylenol) use during pregnancy to autism in exposed children. Recognizing the confusion these claims have sparked among patients, listeners, and the broader public, Peter uses this episode to provide a framework for thinking critically about complex conditions and the research related to them. He highlights the dramatic rise in autism diagnoses over recent decades, noting that multifactorial conditions rarely have a single cause, and emphasizes the importance of resisting oversimplified...

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#366 ‒ Transforming education with AI and an individualized, mastery-based education model | Joe Liemandt show art #366 ‒ Transforming education with AI and an individualized, mastery-based education model | Joe Liemandt

The Peter Attia Drive

Joe Liemandt is a software entrepreneur turned education reformer who left Stanford in 1989 to found Trilogy, a highly profitable private software company, before pivoting to transforming K-12 learning. In this episode, Joe shares how he transitioned from leading a global software enterprise to becoming principal of Alpha School, where his focus is building a mastery-based, individualized education model that leverages AI as the missing infrastructure for large-scale change. He details the shortcomings of traditional K-12 education, explains how Alpha replaces conventional seat time with...

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Keith Flaherty is the director of clinical research at the Massachusetts General Hospital Cancer Center and a previous guest on The Drive. In this episode, Keith first delves into the statistics on cancer's prevalence as we age, underscoring the significance of finding effective treatments and early detection methodologies. He touches on the history of cancer therapeutics and illuminates the notable enhancements in cancer therapy within the last decade that are setting the stage for a promising future. He goes into detail on the potential of immunotherapy and therapies that can combat cancer’s evasive tactics while explaining some of the existing challenges around specificity, cost, and scalability. Additionally, Keith highlights the significant leap in early detection methodologies, namely liquid biopsies, which have the potential not only to determine if a cancer is present in an early stage, but also identify the possible tissue of origin.

We discuss:

  • Keith’s interest and expertise in cancer [3:15];
  • Cancer deaths by decade of life, and how cancer compares to other top causes of death [7:00];
  • The relationship between hormones and cancer [12:00];
  • The link between obesity and cancer [18:45];
  • Current state of treatments for metastatic cancer and reasons for the lack of progress over the decades [22:30];
  • The interplay between the immune system and cancer cells [32:00];
  • Different ways cancer can suppress the immune response, and how immunotherapy can combat cancer’s evasive tactics [39:30];
  • Elimination of a substantial portion of cancers through immune cell engineering faces challenges of specificity, cost, and scalability [52:15];
  • Why TIL therapy isn’t always effective, and the necessity for multimodal therapy to address various aspects of the cancer microenvironment [1:01:00];
  • Potential developments in cancer therapy over the next five years: T-cell activation, metabolic interventions, targeting tumor microenvironments, and more [1:06:30];
  • The challenge of treating metastatic cancer underscores the importance of early detection to improve survivability [1:19:15];
  • Liquid biopsies for early detection of cancer and determining the possible tissue of origin [1:24:45];
  • Commercially available cancer screening tests [1:33:45];
  • How to address the disparity in cancer care, and the exciting pace of progress for cancer detection and treatment [1:40:15]; and
  • More.

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