[00:00:00] Carl Lanore: [00:00:00] you got to open my mic. Welcome back to another episode of super human radio. Today is September 21st, 2020. We're going to be talking about, uh, a new method, uh, potentially of early detection of cancer. You can beat cancer if it's detected early enough. We know that and really, uh, detection is where the magic.

[00:00:19] Uh, resides. We're going to be talking about some great information out of Exeter, uh, university of Exeter. Um, before we do that, we have to thank our title sponsor legendary foods. The website is eat legendary.com. The code is SHR 10 for 10% off your entire order. If you're low carb, low sugar type person, high protein type person, and you want to snack and stay in your lane, it all This email address is being protected from spambots. You need JavaScript enabled to view it..

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[00:01:06] And now we will bring my guests on and that, Oh, let's get rid of that. And that's dr. Sara Bailey from the university of exa. Hi, how are you? Uh, dr. Bailey.

[00:01:18] Dr. Sarah Bailey: [00:01:18] Hi, I'm very well. Thank you very well. Thank you for having me on the show.

[00:01:22] Carl Lanore: [00:01:22] Thanks for being here. This is exciting. As I said before, I'm really early detection is where the magic is when it comes to cancer.

[00:01:29] If we, if we know someone has cancer, the earlier we know the sooner we know it, it could be handled so quickly that the person may never have any of the symptoms, uh, of their cancer. So, uh, finding ways to detect, detect cancer. That are more efficient, less invasive is really where the magic is. Is it not?

[00:01:52] Dr. Sarah Bailey: [00:01:52] Yeah, absolutely. I mean, definitely the earlier, uh, in the disease progression that it's diagnosed, the more curative treatment options are available, [00:02:00] uh, and that will start with early detection.

[00:02:03] Carl Lanore: [00:02:03] So, uh, why this study, what work preceded this paper we'll get to talk about today that made you look in this direction at platelets.

[00:02:13] Dr. Sarah Bailey: [00:02:13] So back in 2005 in the UK, um, at the university of Exeter, a city was carried out to try to identify early markers of lung cancer. And lung cancer is one of the types of the poorest survival. Uh, and the most people diagnosed at a later stage where the curative options are limited. And in this study, Looked at a whole range of features that could have been markers of that cancer.

[00:02:42] Uh, I'm just going to distinguish between risk factors and risk markers. So when I say risk markers, I mean, things like coughing up blood or, um, in this case it's high platelet count, whereas a risk factor or something that means you're more likely to develop cancer in the first place like smoking obesity.

[00:02:59] So in this [00:03:00] early lung cancer study, um, the team at the university of exigent really cast the net wide and looked at a whole range of physical symptoms, but also blood tests results that could potentially be, um, pointing to a lung cancer and undetected lung cancer and platelet count was thrown into the mix.

[00:03:18] Um, not really because they believed. That it was going to be significant, but as I said, it was a as a casting, the net wide exercise to try and find some way to identify these cancers earlier to improve survival. So a platelet yeah. Counts is measured in a standard blood test. What we call a full let's count and that covers various counts of, um, Cell type red cells, white cells in the blood platelet count has largely been ignored up until this point, at least in primary care, because it's quite reactive to lots of things, any kind of inflammation can raise the blood count pale accounts, any kind of bleeding can cause raise platelet count.

[00:03:55] So, cause it's not particularly specific, it wasn't particularly [00:04:00] useful. But then this lung cancer study platelet count came up surprisingly in the model as something that did predict. Um, a future lung cancer diagnosis that was around 14% of people with lung cancer in that study, how to raise platelet counts in some time in the year before they were diagnosed.

[00:04:21] And this is particularly significant in. Uh, the UK comes to setting because 90% of people with cancer go to a general practitioner, what you call family doctor before they get diagnosis, like really crucial setting for that early diagnosis, because that's the point where we can hopefully intervene to pick up on these early signals.

[00:04:42] So a few years down the line from that point in 2005, Um, the research group where I currently work had decided that it was time for a bigger investigation of this race, platelet counts flag, um, to find out more about it. And that's the point that I joined grape with, um, a [00:05:00] study that looked at the, um, The stiff diagnostic, usefulness of platelet counts in identifying any types of cancer, because although the initial count was for lung cancer, we had a couple of other studies in the group that had it looked at platelet counts.

[00:05:15] So we thought, right, let's just start rather than with people with cancer. And looking back for markers, start with people who have this race, panic, like count, and then look forward in that diagnostic journey to see how useful that was at detecting a cancer. So that was phase one. Okay.

[00:05:32] Carl Lanore: [00:05:32] And so, so you had a cohort of how many people were in that database that you were able to examine.

[00:05:40] Dr. Sarah Bailey: [00:05:40] So when the, uh, in the. At the point that I came in, where we really started to examine the platelet counts in detail. That was an initial group of 50,000 patients. Who'd had a blood test in UK primary care setting. So we didn't know, um, at the time time of data collection, why they'd have the blood tests, it could be all number of [00:06:00] reasons.

[00:06:01] And actually they're done almost indiscriminately in the UK and. Oh, almost any reason, a non just sort of have an idea of what the various blood counts are doing. So that was a huge study with lots of data. Um, and we exclusively studied people with a range platelet counts and the normal range is 150 to 400, um, times 10 to the power of nine per liter floods.

[00:06:25] And we studied 40,000 to pay that count over 400. And we compared them to 10,000 with a platelet count in the 150 to 400 range because we needed a kind of baseline. So

[00:06:39] Carl Lanore: [00:06:39] you need, you need a control, a control, a control group, the control group, right

[00:06:44] Dr. Sarah Bailey: [00:06:44] last study to conclusively study platelet count as a risk marker of cancer.

[00:06:51] And the results were absolutely phenomenal. We found that, um, 12% of, uh, Oh, sorry. Now. [00:07:00] Just giving you the wrong 6% of women, an 8% of men with this race, platelet counts went on to be diagnosed with cancer within a year,

[00:07:11] Carl Lanore: [00:07:11] no

[00:07:11] Dr. Sarah Bailey: [00:07:11] numbers, but that's phenomenal.

[00:07:13] Carl Lanore: [00:07:13] Well, I was going to say, and that, and, and many of those.

[00:07:17] Their cancer was already advanced. So if someone was paying attention to their elevated platelet count, let's say two or three years earlier, then there may have been a chance to actually go in there and treat them. You are

[00:07:30] Dr. Sarah Bailey: [00:07:30] absolutely right. So we look to that in the study. And, um, a third of the patients with cancer didn't have any symptoms before they were diagnosed that would have alerted.

[00:07:41] The doctor to the possibility of cancer other than this raise platelet count. So if anything, it was even more exciting because we could say, okay, so potentially for a third of people, they could get diagnosed up to a year earlier based on this, and hopefully get into that curative early detection point in the disease.

[00:07:59] That's crucial for [00:08:00] survival.

[00:08:01] Carl Lanore: [00:08:01] Did you, did you use any, um, identifiers to stratify or potentially. Eliminate some of the people from being chosen in the cohort. The reason I say that is because there are people who have a primary, uh, uh, what is it called? The, um, w when you have high platelets is a name for it, uh, uh, poly from both side AMIA.

[00:08:30] Dr. Sarah Bailey: [00:08:30] So I'm just like, Oh, uh,

[00:08:33] Carl Lanore: [00:08:33] yes. Yeah. So, so there are people who have that as a primary disorder. Not secondary. You're looking for people who have a secondary condition. That's elevating, uh, the, the, uh, uh, platelets.

[00:08:47] Dr. Sarah Bailey: [00:08:47] Correct. Yes. We were looking for people with secondary or reactive thrombocytosis or something's going on in the body.

[00:08:53] So thrombocytosis is the name of the race platelet count condition. Uh, so we were looking for people at the reactive [00:09:00] type of race type accounts. We excluded patients who had already been diagnosed with cancer before they had the platelet count, because they would already be on the radar. But aside from that, we didn't exclude anybody.

[00:09:11] We really wanted a broad sort of population wide snapshot, uh, in, in that study. So once that kind of hit the news, that was, that was big news, that finding and the, um, the rates of cancer and the rates paid that count. People was so high that we thought, okay, are we setting the bar? Too high for investigation.

[00:09:32] Should we be looking at sort of lower platelet count levels? If the risk is as high as 400, what is it? Three 50? What does it three to five? So the study that we published recently, and it's the, um, the subjects that this means for you today is where we took a slightly different, um, group of faces, slightly different cohorts.

[00:09:51] You had a platelet count that was still in the normal range, but it was at that. And, and we wanted to know if we. They did in theory, [00:10:00] select a higher threshold. To be considered an abnormal platelet count. What would the implications be for cancer diagnosis, kids who identify cancer sooner. Uh, and so that's what we did.

[00:10:10] So in this one, we studied a much larger group, um, over 220,000 patients. We start to fight them by platelet counts. So we have the sorts of comparison group that was the controls, if you will. And the 150 to three to five range, and then a high, a normal group, which is the three to six to 400 range. And even in that group, we found the cancer risk of 2.7%.

[00:10:37] Carl Lanore: [00:10:37] Wow.

[00:10:38] Dr. Sarah Bailey: [00:10:38] And 1.4% for women. So it's always slightly less of a woman for reasons we may come and see later. Um, but this is still an exciting result. And instead of asking you a lot of questions really about whether we even have the right normal range for platelet counts, um,

[00:10:55] Carl Lanore: [00:10:55] that'd be quick because let's talk about that for a second.

[00:10:57] Right? All the ranges that [00:11:00] we see as part of an assay in a lab are developed by looking at the population. Well, what does that do when a large portion of the population are sick and we're using that as well? Here's the, we see that with testosterone in men. Um, the acceptable levels of tusks, Austrian and men are going down at labs.

[00:11:22] When I first started following testosterone, the bottom for hypogonadism was 429 of grams. Now it's down to 300. And 29 grams. Why? Because the population is sick. They have low testosterone and they going, Oh, well this is the average in the population. So this has to be the low and this has to be the high.

[00:11:42] No, the population is sick. That's not, that's the low of the population. That's not the target. And that's what happened to

[00:11:49] Dr. Sarah Bailey: [00:11:49] yeah. And the technology is improving as well.

[00:11:51] Carl Lanore: [00:11:51] Yeah.

[00:11:52] Dr. Sarah Bailey: [00:11:52] I mean, definitely in terms of like machines that analyze cell counts and bloods have really come a huge. Advancement [00:12:00] since the platelet count reference range was set 30 odd years ago.

[00:12:04] Uh, and as you say, the sicker, um, also we know a lot more now about. Um, the fact that men and women have different baseline platelet counts, but we just have one range for all, whereas that perhaps needs to be tailored, um, in that case by sex.

[00:12:21] Carl Lanore: [00:12:21] So why do you think platelets are responding to, to an environment where there is cancer, uh, platelets.

[00:12:28] So platelets serve a very important role, right? They, they, they are the primary clotting agent. Um, that allows blood to clot in the event of an injury or something like that. Right. That we need platelets. But what do you think is happening in the body when there is cancer present? That's making platelets go up.

[00:12:51] Dr. Sarah Bailey: [00:12:51] So this is hotly debated and there's two theories. One is that platelets are causing cancer. And the other is that cancer is causing [00:13:00] platelets. And I think it's likely to be a bit of both. So in the. Cancer causes platelets scenario. As the tumor develops, it's releasing all kinds of hormones and growth factors that are affecting other processes in the body, which in turn are causing an increase in the production of platelets or affecting other processes, which in turn are causing an increase in production of platelets and alternative hypothesis.

[00:13:24] Is that something in the body is causing underlying inflammation, which is another thing that causes a rise in platelets. And that background information or inflammatory state is making a cancer more likely to develop. So the people already have raised platelet counts for some other reason. And they're more likely to develop cancer.

[00:13:44] I think it's likely to be both of those working at the same time.

[00:13:49] Carl Lanore: [00:13:49] So dr. McKell blag is Saloni, who has been a frequent guest on my show over the years and published a paper in 2014. Uh, He [00:14:00] was an oncologist. He's the author, he's the, he's the editor of several prestigious journals. Um, he was an oncologist and he was working with rapid myosin and, and cancer.

[00:14:12] And he noticed distinct phenotypical changes and people that were getting rapid myosin. Uh, they were sick less, less often. They seem to be resistant to viruses. They, they looked like they were actually aging better. And so he shifted. His focus from rapid logs and cancer to wrap a logs and aging. And he was the first person to discuss this whole senescent cells theory.

[00:14:40] The bioaccumulation of senescent cells is what is aging. What we see as aging. He was just on the show a couple of weeks ago. And he said, now that I look back, we, we know that the older you get, the more likely you are to get cancer. That's that's a fact that everybody agrees on and he [00:15:00] said, now looking back, I realized that rapid myosin work to treat cancer tangentially because it made the body and the tissue younger by getting rid of senescent cells and the younger, the tissue, the less likely it is to develop cancer.

[00:15:20] So kind of staying with that idea for a second. Um, and talking, we know that senescent cells are the most inflammatory cells in the body. They're producing all sorts of cytokines and chemokine, and they literally make the cells around them sick and they become senescent. And this cascade of events occurs.

[00:15:43] Cook. Do you see any opportunity to look at. I know you can't go back with these people. And I don't know how much information that they gathered from these people. Like, do we know any of them that were already type two diabetic? Do we know any of them that had [00:16:00] been, uh, had any, uh, chronic inflammatory diseases that would link to this idea that the, there, the increase of platelets is, is, is secondary to the, the inflammation.

[00:16:13] And obviously back then, no one was paying attention to senescent cells would be fascinated to find out. What the senescent cell load is of these individuals as well.

[00:16:20] Dr. Sarah Bailey: [00:16:20] What do you think. Yeah, absolutely. So the study was carried out with a particular database that we have access to in the UK, which doesn't hold that kind of mention.

[00:16:30] But we have advances all the time in, um, data sets that are available to us. And, um, new data sets are being linked together all the time. So that's definitely something that we could pursue in the future. Um, in terms of what other conditions the patients had enough study. We would have data on things like, um, other diagnoses and type two diabetes.

[00:16:50] And I mean, we really need to look into this. Um, this is so much to be said for personalized cancer investigation, because, and then UK, um, [00:17:00] uh, um, doctors has a particular guidance published by the national Institute for health and care excellence. And sometimes some of these guidances are, um, Offer specific advice, depending on preexisting conditions, but in the counselor guidance, um, the recommendations are not personalized to do preexisting conditions.

[00:17:25] And this is something that we are going to be investigating in a huge new program grant that we've just been awarded at the university of Exeter. And we will be specifically looking at how we can diagnose cancer earlier in people with different preexisting conditions. Because as you've already alluded to in particular, people with type two diabetes are at much higher risk of being diagnosed with many different types of cancer, but our cancer risk profiles don't take that into account at all.

[00:17:52] So hopefully this new study we'll be able to address,

[00:17:56] Carl Lanore: [00:17:56] you know, I, I don't know how it is there in the UK, but most of us here in the [00:18:00] United States who are w are aware. Of disease States. And, and, and we know that, um, there is so many people out there today who have type two diabetes that are being treated with drugs, like Metformin and other, other, uh, ancillary drugs too.

[00:18:18] And even insulin, once you get on insulin, I mean, your, your, your lifespan is shortened dramatically. So we know that these people were not allowed to say cured. No, you can't say cured. Um, but you can say managed. We know that these people should be reducing carbohydrate consumption in their diet as a form of therapy, but doctors are so reluctant to discuss nutrition because here in the United States, doctors don't really know any, they get a couple hours of nutrition in med school and that's it.

[00:18:54] And so there's this attitude here in the United States that. What [00:19:00] you eat really doesn't matter. You know, it's not going to affect, I mean, even with cholesterol, well, you, you have the predisposition for high cholesterol. It's not your diet or, you know, it's, it's frustrating to me. Is it like that in the UK or, or doctors talking to their patients and going, look, you can re reduce.

[00:19:20] Your blood sugar levels, your insulin levels in six months, we just need to cut out the carbs. Let's focus on healthy proteins, lots of green vegetables that lets you know, a Mediterranean style diet. Do they have those discussions with their patients there?

[00:19:33] Dr. Sarah Bailey: [00:19:33] I think there's a greater awareness from what you said in the UK compared to, um, in the States about, um, You can't just eat anything and unexpected to have unexpected, be healthy as a matter what you eat.

[00:19:46] It really matters. Um, we have, uh, like dieticians on the NHS who specifically advise patients on the kind of diets. They should be eating and advising on what to cut out or to eat more of [00:20:00] that. There's really something to be said for everything you've just discovered in the Mediterranean diet, eat leafy green vegetables, Richie's Covestro intake.

[00:20:07] Um, I suppose the problem is that it sounds easy when you say, just reduce your cholesterol intake, but actually changing your diet when you're used to eating in assess and weight is really challenging and very difficult, but without increasing awareness of the problems coming from obesity is it's so important to, to improve our diets and eat more healthy.

[00:20:28] But I think there's a lot more to it than simply. Telling people what they should be eating. There's so much psychology involved in diets and eating and weight loss, and gain that. It's, it's a really difficult, um, a really difficult thing to achieve for anybody.

[00:20:44] Carl Lanore: [00:20:44] Our problem here is even worse because we have big ag that the government subsidizes, you know, the government subsidizes corn, for instance, and wheat.

[00:20:56] And so the government wants to get their money back, right? [00:21:00] They don't want people going out there and say, Hey, eating a lot of corn and eating a lot of wheat, probably not the best thing. The organizations that have authority to put together, the suggested diets for diabetics. Well, them 250 to 350 grams of carbohydrates a day are fine.

[00:21:17] Don't be worried about it, but then they just up their insulin or they up their dose of Glucophage or, and, you know, it's, it's, um, It's a big frustration to me because I see this as we wear this, this car pulling, uh, pulling, uh, a motor home up the Hill. And we're losing cylinders. And at some point in time, we're going to have less cylinders working than the ones that are sick.

[00:21:41] And the car's going to come back down the Hill and crash into a pile of, and I feel like that's where we're going in the United States. Every year, more people become obese every year. More people become sick productivity is, is interfered with, and the rest of the people who were still working a carrying that load.

[00:21:58] And it's going to get to a point where we [00:22:00] can't sustain illness anymore, but. That's another story. So let me get back on, on topic, because this is a very important discussion because going back and looking at your platelet count could tell, I mean, I keep every blood test. I get, I get the whole thing. I'm going to go back and look at my platelets and see where they are.

[00:22:17] What once, once platelets a high, how do we determine what type of character we have? Is there a protein that is able to identify this cancer versus that cancer? What do we do with that information?

[00:22:29] Dr. Sarah Bailey: [00:22:29] So the first step would be to discuss it with, with your doctor and see if you've got any other signs or symptoms that might point to a particular cancer.

[00:22:38] So it's worth remembering that actually. Although a reasonably high proportion of people with a high platelet count have cancer. Most of them don't have cancer. Um, so it's still an unlikely diagnosis in that respect. Um, so really kind of discussion of any of the clinical signs and symptoms you might have.

[00:22:58] Um, And that should [00:23:00] really be the starting point for any further investigations. And that will depend on that individual. And as repeatedly previously discussed any other conditions they might have that might explain the race platelet counts. So certain conditions, arthritis, for example, um, there's a higher baseline platelet count there.

[00:23:19] Um, it might even be that change in platelet counts. For that individual is more important than the actual threshold value or the actual result that they have. So if there's, if the platelet count increases in it in a short period of time, that might point to something. Yeah, I was going on. Um, some people just have higher, right.

[00:23:39] Platelet counts and definitely women baseline platelet counts are higher. So that's something that should be taken into account in any clinical assessment with them that long.

[00:23:50] Carl Lanore: [00:23:50] No, I was gonna, cause we have four minutes before you have to take this break. Do, does platelet count, uh, change depending on where a woman is in her, in her menstrual [00:24:00] cycle?

[00:24:01] Dr. Sarah Bailey: [00:24:01] I'm not sure, actually it definitely changes as they hit menopause and cancers drop after that time. And it also decreases with age in men. Okay.

[00:24:13] Carl Lanore: [00:24:13] All right. I want to take a quick commercial break when we come back. I've got lots more questions. We're talking with dr. Sarah Bailey about using platelet counts.

[00:24:19] Too, as an early warning sign that you may have. Some type of cancer, stay tuned. We'll be right back or brawn and brains.

[00:24:31] welcome back. Thank you. Uh, before we back into the show, I want to remind everybody that our live stream is back up again. If you have been one of the people who grew with superhuman radio, by listening to it on your own. IPhone or your computer while you're at work or you, uh, we have in the UK that listened, they used to listen to the screen.

[00:24:53] It was the first time I ever heard the word, the tubes referred to, I got an email from a guy saying, I'm listening [00:25:00] to your show in the tubes. I'm like, what are the tubes? Somebody said, Oh, that's the subway there. Yeah. But if you, um, if you go to superhuman, radio.net/live player in any browser on your computer, on your iPhone, You can listen to the show, live streaming, wherever you are.

[00:25:16] And you could email me at  dot net during the show. And if you have comments and questions, you want a, we'll do our best to answer those. So check that out. So, dr. Bailey, um, what about. Things like sleep apnea. We know that it elevates D dimer and increases the thrombotic index as do things like birth control pills, uh, any, well, let me rephrase that as do things that are methylated and cause some sort of hepatic stress, they can increase the thrombotic index or those things, having an effect on, um, play playlists or they doing it through some other mechanism.

[00:25:57] Dr. Sarah Bailey: [00:25:57] Sure a really [00:26:00] complicated question. I mean, this, one of the tricky things with council and also with platelets, is it so many things influence factors that can cause cancer. Um, and then they all interplay with one another as well. Then there are individual risk factors that might mean that you're more prone to exposed to cancer, given those conditions, um, then you would have been otherwise.

[00:26:21] So it's a really complicated situation, um, especially with the platelet campus is actually another factor in the body that's heavily influenced by many conditions. So picking that apart and the exact cancer. Kate that relationship from those other conditions is going to be a very difficult task. 

[00:26:41] Carl Lanore: [00:26:41] be a culprit in shifting the burden to men.

[00:26:45] We know that, um, a higher testosterone levels lead to higher blood red blood cell count is, does do the sex hormones play a role in the propensity of, [00:27:00] or the appearance of platelets in men versus women?

[00:27:05] Dr. Sarah Bailey: [00:27:05] So that's another interesting question. Men are more likely to be diagnosed with cancer than women. So that's one thing to consider when it comes to platelet count.

[00:27:14] We actually think that, um, female hormones and women's bodies are reacting differently, uh, in terms of platelet counts. Unless so much the testosterone, uh, so various hormones and particularly with bleeding, um, that women are more predisposed to, it was high platelet counts in the woman. Um, I, through that, but other indirect hormonal influences that are leading to a higher baseline plate accounts.

[00:27:43] So. Whether that in turn is making women more likely to be diagnosed with certain cancers than others. Um, which isn't usually the case, or actually, um, the link is less strong in woman. Because their baseline platelet counts is higher. So that's potentially [00:28:00] masking any effects that cancer is having on the platelet count.

[00:28:04] Interestingly, when we looked at exactly what kind of cancers are being diagnosed in people with raised platelet count, prostate cancer was much less likely to be diagnosed in platelets, 80 patients compared to those with a normal counts. So there's actually potentially a protective effect there. Um, conversing woman, breast cancer was much less likely to be diagnosed, but then again, for both of these cancers, well, at least for breast cancer, we have an extensive screening program in the UK.

[00:28:35] So potentially it's more likely to be diagnosed early before the platelet effects are seen. Um, Prostate cancer. That's a slightly different one. Um, well we found that the lung and colorectal cancer were more likely the lungs are sites of particular importance in platelet production. Um, and this is evidenced by if you sample blood before and after it [00:29:00] passes through the lungs, the blood.

[00:29:02] Post lungs has a high concentration of platelet count than it does for full. And so there's something going on that colorectal cancer is commonly, um, accompanied by bleeding within the guts.

[00:29:15] Carl Lanore: [00:29:15] I w I was just going to say, don't, don't all cancers have some. A component of bloodletting. When you think about it, like stomach cancer, people vomit a blood colorectal cancer.

[00:29:26] We detect blood in their stool. Uh, sometimes as an early warning, is it possible that all of this is a result of tumorigenesis causes microscopic bleeding and the body's going, Hey, we got something that's not stopped bleeding. We need to send some platelets over there. Yeah,

[00:29:44] Dr. Sarah Bailey: [00:29:44] you're absolutely right. That it's highly likely.

[00:29:47] Um, and because prostate cancer is quite a localized cancer that doesn't really result in much bleeding that would entirely fit with that hypothesis, that it's essentially a factor that accompanies [00:30:00] bleeding somewhere within the body.

[00:30:02] Carl Lanore: [00:30:02] That's interesting. So can you explain the difference between platelet volume and platelet count?

[00:30:10] So, so there's three in, in the research that I started to read about in preparation, there were three different studies. Um, one of them from China that looked at, um, uh, platelet, uh, volume and cancer. And I would imagine to me, volume means as a percentage of, of whole blood versus the actual number per liter.

[00:30:38] Dr. Sarah Bailey: [00:30:38] Yeah, I think this is essentially the difference. Um, another factor that is significant in measuring platelets is activation. Yes. So the numbers and the activation are two separate things. And this is another, it's another Avenue that I'm really keen for us to investigate in future studies because, um, uh, I think it might be mean [00:31:00] MCV in the UK is measured a slightly different way.

[00:31:03] Um, So, yeah, we've definitely got more avenues to explore, particularly with the activity. Um, and if I, um, Another, we were talking briefly before about athletes pay the accountant athletes and pay the activation is higher following exercise that they have a human body.

[00:31:25] Carl Lanore: [00:31:25] What does that mean? Does that mean that, uh, uh, regardless of platelet count it, they have to be activated to cause coagulation, right?

[00:31:35] Dr. Sarah Bailey: [00:31:35] Yes. Yes.

[00:31:36] Carl Lanore: [00:31:36] See, we see a higher thrombotic events in marathon runners. Two days after they've run a marathon because these, regardless of total number of platelets, they're more active. They're like getting stickier.

[00:31:48] Dr. Sarah Bailey: [00:31:48] Yes, precisely. So there's um, and so the bone marrow is mostly where. Plate as a produce. And the precast, the cells to the platelet is called a mega carrier site.

[00:31:58] And this lives within the [00:32:00] bone marrow, these cells, um, and they kind of send out protrusions into the bloodstream and from the protrusions, the platelets break off or pre platelets technically break off that then become platelets. And these later become activated. In a fairly complicated, um, cascade of activation with various, um, and hormones.

[00:32:24] Okay. So, um, this many opportunities within that process for different faxes to influence what's happening. So there's the influence of the production and then, and the metric material action of the mega carrier sites to begin with. Uh, the send the actual, um, protrusions production of the pre platelets and their conversion to which again is influenced by further cascades.

[00:32:51] And then as we talked about that, the actual activation of those platelets, which will prompt them to initiate that clotting [00:33:00] processes, um, at sites where they detect damage. In the blood vessels. So sometimes that's them in a correct way. If you've cut yourself to form a clot and sometimes that's in an inappropriate place, um, leading to, um, some basis in the, uh, DVD.

[00:33:16] She, for example, some place with damage inside that theme of the blood cell.

[00:33:22] Carl Lanore: [00:33:22] I had a DVT when I was 330 pounds, I attempted to ride a bicycle down a Hill and I fell and I had a DVT in my thigh that they had to watch and it dispersed on its own because it was from a trauma. Um, but yeah, no fun. It was very painful.

[00:33:38] So, um, everything that seems to be anti inflammatory thins, the blood. Fish oil, aspirin. I mean, you name it, anything that is seen as an antiinflammatory that's, uh, uh, has, has any type of antiinflammatory effects and sets. They have a blood thinning effect as [00:34:00] well. Is that blood thinning effect a result of how it's acting on platelets?

[00:34:08] Dr. Sarah Bailey: [00:34:08] Uh, love it. You know what? I really, I'm not sure. Um, definitely the platelets will play a part because they're so involved in inflammatory processes, um, that they, they can't fail to be affected by all of those things. Um, and systemic inflammation, uh, yeah. Affected by so many different things. As you said, the various, um, drugs and conditions, diet as well, highly influences it.

[00:34:37] Um, and platelet volume in the blood will affect, um, the. The thinness or otherwise it's the blood.

[00:34:45] Carl Lanore: [00:34:45] Yeah. I keep coming back to inflammation and then that brings me back to senescent cells. And the reason for that is that the FDA here in the United States has approved azithromycin for [00:35:00] use as a scent of LeDuc drug and anti-aging drug.

[00:35:04] I personally take a Z pack once every six months because the Z pack will eliminate. 95% when 97% of all senescent cells in the body in five days, this is dramatic. This is amazing. And my good friend, my personal physician, who was also my friend, dr. Matt, Andrea, and I, we were talking about this because we were talking about.

[00:35:29] A Z pack works for COVID like I have a, uh, sister-in-law who her husband was diagnosed with. COVID he suffered for six days with a very, very high fever. He's older, he's just quit smoking. And I, and we told him, get your diet and the doctor wouldn't prescribe it. Finally, a doctor prescribed the Z-Pak form two days later, his.

[00:35:50] His fever is gone and he's already up and around. So the reason I say this is because my buddy, uh, dr. Andrew said that in his [00:36:00] practice and he sees a lot of patients. He sees a Z pack being a very powerful antiinflammatory. He says, he gives us iPack to somebody for this reason, uh, let's say a sinus infection or something.

[00:36:11] And they say, Oh, you know, my achy joints don't ache anymore, doc. And they've had arthritis or something like that. And so. I keep coming back to senescent cells. I wonder what role senescent cells are creating this pro inflammatory and vital environment that leads to cancers and also stimulates the production of platelets.

[00:36:32] Dr. Sarah Bailey: [00:36:32] Yeah. I'm yes, I am. Can't speak for the anti aging pills. That's not something I've ever come across, but it sounds phenomenal. Right. Um, but there's definitely something to be said for the general body inflammation. Lots of things that cause inflammation, smoking, drinking, um, are also risk factors for cancer.

[00:36:52] Um, there's definitely something in it.

[00:36:55] Carl Lanore: [00:36:55] We're going to take our last commercial break. And when we come back, I want you to tell me what you hope clinicians take [00:37:00] away from your research. Okay. Stay tuned. We'll be right back with more superhuman radio. Fit that out right now. This is the superhuman channel.

[00:37:14] Welcome back. If you heard the commercial about the sauna, we're giving away a 57 $100 sauna. Right now it's a three person sauna. It fits in the corner of a room has a very, very small footprint. If you go to SHR network.biz, Slash free sauna. You can enter today. Once we get 300 entries, that's when the drawing will occur.

[00:37:40] So don't waste any time. It's a one in 300 is a good odds actually. So there you go. Check it out. So, uh, dr. Bailey, what do you hope clinicians take away from your research?

[00:37:53] Dr. Sarah Bailey: [00:37:53] The key message for clinicians from this research is to consider counselor when they [00:38:00] see a patient with unexpectedly high platelet counts.

[00:38:04] And this can act as a real clue, but there's an undiagnosed cancer somewhere in that patient we saw from the numbers that actually a good proportion of people with cancer have no other symptoms of their disease other than baseplate accounts around a set of patients with lung cancer. So, so my key message would be.

[00:38:26] When you see when you're wearing these blood test results cuss and I have to pay that count. And if in the absence of any existing explanation for that result, Recall the patient into your practice and have a discussion about what other signs and symptoms that patient may have been experiencing. Have they been coughing persistently for quite awhile?

[00:38:47] This is obviously pre COVID in the present day. If you've been coughing for a while, you've got another kind of problem. Um, have they been experiencing persistent stomachache? Have a lot of people are reluctant to talk about and more embarrassing [00:39:00] symptoms. Um, bludgeon that we flood in their stools is anything.

[00:39:05] Additional that they've been experiencing that they're worried about and talk through those concerns with that patient and have a conversation about what's due next. Um, often those conversations would lead to further clues about what other investigations might be appropriate. For that patient. Um, but, um, also, I mean, for the patients, I would also like to remind me, remind your listeners that most people with a slightly raised platelet count aren't harboring undiagnosed cancer.

[00:39:34] Right? And this can all sound quite alarming, I think initially, but it is still, um, quite a rare condition and, you know, trust your doctor. Particularly in general practice, um, doctors have quite a good instinct for what might be wrong with the patient. Um, and although I look at things on a population level with really large cohorts of patients at an individual level, the risk is quite different.

[00:39:59] Um, [00:40:00] and other things could explain the, restate the camp. So, uh, you, your choices about what to do next and what further investigations might be appropriate can be taken in discussion with that patient and what. What they want to do next with their results.

[00:40:15] Carl Lanore: [00:40:15] One of the discussions your doctor probably won't have with you, but you should know about it is a dietary interventions.

[00:40:21] I mean, there are literally a host of good studies out there that show specific types of dietary protocols that reduce wholescale inflammation in the body. Those diets generally eliminate grains, uh, starches. Potatoes and stuff like that. Rice nup forever. This isn't Oh, I can never eat. Right. It's just, well, you get, because what happens is when we talking about inflammation, we're talking about the army of the immune system.

[00:40:51] I know people right now going, we know Carl, we know, but I say it a lot because people forget this. The army of the immune system is. [00:41:00] Inflammation. That's what goes out and fights the Wars, suppresses the dangers, and then just go back home and sleep. But when you're chronically inflamed, your house is on fire all the time.

[00:41:08] And your immune system is turned on 24 seven, trying to put out. All of these different fires and problems, uh, reducing entirely their body inflammation can be  none and it doesn't have to be drugs. You have to studies out there. Don't take my word for it. Look for just Google, a low inflammation diets. And what you'll see is you've got to get rid of sugar and starches and grains for sure.

[00:41:33] Beans legumes, because they have anti-nutrients in them that are designed to keep bugs from eating them well in low levels, they cause inflammation. And diets high in things like salmon, high quality, animal protein, green, leafy vegetables. Those are the diets that are going to literally change your body and it's inflammation.

[00:41:56] And that may bring down your platelets. Maybe you don't have cancer yet, [00:42:00] you know, but something like as simple as that, then I guess, and I was going to ask you this question. If a doctor is still perplexed, the patient presents no real symptoms, I guess then maybe if, if, if for some reason the doctor is concerned, Could do like a radio type, a radio isotope, a glucose test where they put you in a CT scan machine, they give you sugar that has been, you know, the Warburg effect.

[00:42:27] You give you sugar that has been radio isotope. They watch where the sugar goes because cancer gobbles up glucose. Like it's going out of style and they can actually track that. Glucose right. To a site of a tumor or something like that. I guess that could be like, if you're really worried and you want to do, and you want to eliminate any possibilities.

[00:42:48] Dr. Sarah Bailey: [00:42:48] Yeah. So that the danger of, if it's something like that is potentially an incidental finding or over-diagnosis of something that may not have caused you any problems. Anyway, um, all data indicates that a lung cancer [00:43:00] is most common or it was most likely if you do in fact, have a cancer with a race platelet count.

[00:43:05] So a good Fest poster could be chest sex, right? Have a look and see if there's anything going on in the lungs, um, alternative, but we call a fecal immunochemical test or fit for short. Um, this is a test that involves taking a stool sample and having it processed in the lab to look for the presence of a human hemoglobin in the sample that might indicate, um, It's a tumor in the digestive system.

[00:43:29] And we're actually evaluating that test now in the UK for people with very low risk symptoms of colorectal cancer. So not the things like, um, visible blood in the stool or extreme, um, abdominal pain or, um, anemia, which are what we call red flag symptoms for colorectal cancer, but they're kind of low risk, uh, much more low risk symptoms.

[00:43:53] Um, And I mean, this is an absolutely phenomenal test. It's really good. So a [00:44:00] colonoscopies is quite an unpleasant procedure to go through, and there are a lot of associated risks aside from that in the UK, or maybe not so much of a problem for you over in the U S we've got a limited number of colonoscopies that can be done in any one time.

[00:44:14] The waiting lists are huge and they're getting longer by the minute. So we have to have a way of triaging people so that if you have a really low risk of cancer, we don't want to put you through that. Um, so this fecal immunochemical test is a really great way of identifying those people who really do need to have that code.

[00:44:33] And oscopy, if you have a negative, um, fecal immunochemical test, your chance of having an undiagnosed colorize of cancer is virtually no. You can relax. So it's an excellent test if there's a bit of real estate accounts, um, but no other obvious sign as to what might be going on. Um,

[00:44:55] Carl Lanore: [00:44:55] we, we ha we have that here.

[00:44:56] Now, the company is called colo guard, colo [00:45:00] guard, and, and, and I recommend them. So for years, I've been talking about, um, the inappropriateness of so many, um, Of these colonoscopies here in the United States and the United States physicians get together two or three physicians get together, they'll buy a facility and they'll do nothing but colonoscopies.

[00:45:23] And then they send their own patients to those facilities. So it's a moneymaking, uh, event. And the average colonoscopy in the United States cost about $2,500. And most of them are unnecessary. They really are. But more importantly, They carry a lot of risk. Number one, there's a high level of introducing a bacteria when they, when they don't a autoclave, you can't autoclave a colonoscopy, a device because it's got cameras and, and delicate equipment.

[00:45:55] And so they have alternate ways of, of sterilizing them. That's not always works. And [00:46:00] they've, I've heard of numerous cases of people going and getting a colonoscopy and then coming back with C diff or something like that, the other problem is. That they could perforate your colon and cause all sorts of problems for the rest of your life.

[00:46:14] Dr. Sarah Bailey: [00:46:14] And

[00:46:14] Carl Lanore: [00:46:14] so they're like, go get the stuff sample test first, you know, then, then if you see something now, okay, now we have no choice. We have to do a little, something more invasive and see what we can see the other problem with colonoscopies when they're unnecessary. As you pointed out a second ago, when I said this elaborate Warburg effect, and maybe we can do that.

[00:46:33] And you say, ah, a lot of times you'll catch something that you didn't even need to bother with polyps in the colon. I like mushrooms. They appear and disappear in days and weeks. They, they, they, once you have a polyp, it doesn't mean it's Oh, now I have that polyp. No, they grow it there. Their inflammatory response, they grow and sometimes they disappear.

[00:46:54] And if there is in fact the polyp that. Is problematic when they [00:47:00] snippet to do the, to do the, uh, uh, uh, biopsy on it. They can actually, it's called seeding cells when they snipped it blood, when they snipped it gets into the colon in other areas. Now, all of a sudden you got the polyps growing in that same area where you just had one just weeks later and that, and this is not a good thing.

[00:47:20] So I agree with you a thousand percent. And in the United States, colo guard was forced. Forced by the food and drug administration, because of pressure from physicians, that order all, you know, here in the United States say, Oh, if you're 50, you got to have a colonoscopy. Every four or five years, like just rudimentary, you got to do it.

[00:47:41] And coal, coal, God was forced to make any kind of claims that it was potentially early detection. Because the people were like, Oh, I won't go for colonoscopy anymore. Cause nobody wants to go, go for what? Anyway, let's be honest. They know we

[00:47:58] Dr. Sarah Bailey: [00:47:58] have it here. I mean, that's a very unpleasant [00:48:00] procedure. I don't see if you can have the, if you have symptoms, have the fit.

[00:48:04] Um, the fecal immunochemical tests with the, um, screening of the stool sample. Um, yeah. Don't, don't go through that unless you absolutely have to. I mean, that's the problem with that full body scans and all that kind of thing. Like more often than not, you find something that otherwise you would have happened.

[00:48:18] He died at 85 without having ever known it was the right. Um, but it's very difficult to understand that because you have the sense of just in case you wish to do things just in case, but. Um, yeah, they're all, they're all homes that diagnostic testing and definitely like that kind of incidental scanning for anything that could be wrong.

[00:48:38] Um, but yeah, well, we also need to consider the individual risk and individual people's perceptions of the kind of risk they're willing to take and, um, what they're willing to go through. For, for particular benefits or perceived benefits. Um, another good example is, um, PSA screening process specific antigen, which [00:49:00] is measured in the blood test.

[00:49:02] Um, and that is a really nonspecific test for prostate cancer. It has a very, very high. False positive rates, all things considered, um, particularly if the man is asymptomatic and yet the next step in investigation for that, um, is a prostate biopsy, which is, if anything more horrendous than the Komatsu,

[00:49:22] Carl Lanore: [00:49:22] there are men who end up with erectile dysfunction after one, a prostate biopsy.

[00:49:26] And, and the it's funny you say this, I did a show in 2009, maybe. Uh, with a scientist from Rutgers university, they found. Prostate specific antigen in breast cancer tissue, which means it's not prostate specific at all. Not at all like that. Whoever named that, they made a big mistake because PSA is found in other cancer tissue too.

[00:49:51] They, that, that was what he was, he was saying like, PSA is not indicative of prostate cancer could be indicative of some other cancer.

[00:49:59] Dr. Sarah Bailey: [00:49:59] Yeah. I mean, all [00:50:00] prostates produce PSA at a normal rate. There's so much variation in what a normal level is for an individual man. Um, and prostate cancer is also generally not an aggressive form.

[00:50:13] It's pretty slow growing. And you know, you could put yourself through the stress and anxiety if the rest of your life, knowing that you've got a prostate cancer and actually it wasn't going to do anything to you.

[00:50:21] Carl Lanore: [00:50:21] Anyway. You know what question most physicians fail to ask men before they, uh, evaluate prostate, uh, uh, PSOs.

[00:50:31] Did you have sex last night? If you have an orgasm, if you have an orgasm, your PSA go up 10 fold. They go because every time you a man has an orgasm, it, she creates a microtrauma in the prostate. But in reality, I've talked about this study so many times, if you want to avoid prostate cancer, have lots of sex.

[00:50:52] Men who have more orgasms have less prostate cancer and less aggressive prostate cancer, because the prostate is doing [00:51:00] its job. So it's not getting old and funky and broken down. But interestingly enough, if you, you have an orgasm and then go have a process, state test done a PSA test the next day, your doctor's going to go, Oh my God, your, your PSA is through the roof.

[00:51:15] They never say, Hey, did you have sex last night with your wife or your girlfriend or whoever? Because. That orgasm will raise prostate specific antigen because it causes a microtrauma. That's actually protective, protective against things like BPH and stuff. It's. It's lunacy. It really is.

[00:51:34] Dr. Sarah Bailey: [00:51:34] Men are actually advised to abstain from sex in advance of a PSA test, exact reason.

[00:51:40] Cause it will mess with the results.

[00:51:42] Carl Lanore: [00:51:42] Absolutely. Which means I'd never be able to take a PSA test in the UK. So I'm not gonna fit. I'm trying to get as much as I can before things don't work anymore. So there you go. Listen. Okay.

[00:51:54] Dr. Sarah Bailey: [00:51:54] Prostate biopsy. That's not going to end.

[00:51:57] Carl Lanore: [00:51:57] I'm not. No, I'm not doing that at all.

[00:52:00] [00:52:00] I want to thank you so much for coming on the show today. I know it's quite late there and I think this information is fascinating and anything that can help someone get on target if they do in fact have cancer sooner. That's that? I'm all for that. So thank you so much.

[00:52:14] Dr. Sarah Bailey: [00:52:14] Thank you so much for having me on.

[00:52:15] It's been great speaking to you. Take care.

[00:52:17] Carl Lanore: [00:52:17] Thank you very much. We're going to take a one last commercial break. And when we come back, I want to tell you about some things that are changing here at superhuman radio. And I need your support stay tuned. We'll be right back evolution just got kicked up a notch.

[00:52:36] are you wondering why I'm wearing this? So I am so freaking hot wearing this hoodie in the studio because the studio was hot anyway, with all the equipment. But you're wondering why I'm wearing this because I wore this blue quest shirt today. And for some reason, my green screen thinks it's green and whatever's behind me, ends up on my shirt.

[00:52:54] I looked like a frigging alien. I was like, Oh great. I got to wear this hoodie today. [00:53:00] So, um, couple things I am starting to promote our live stream. Again, the live stream is really what. Got me started in this business back when I used to do off topic, what made off topic famous was we had a live stream that people could interact with the show and the same thing with, with superhuman radio.

[00:53:22] When I started doing superhero radio with the live stream, that's when I got that email from a guy saying, I'm listening to your show in the tubes in the UK. I was like, what are the tubes? So I'm starting to promote the live stream again because I need to remove. The power that Facebook and Instagram, Facebook and YouTube have over the production of this show last week was a week from hell.

[00:53:46] I literally went home Friday night and drank wine because I was so freaking stressed out. Uh, from the, the week between YouTube clip. You mean, I made a post that I didn't, and I've messaged [00:54:00] them no less than a dozen times now and said, fix your mistake. And of course they're ignoring it because they don't give a damn.

[00:54:06] They don't care. There's nothing I can do to them. Um, they claim I made a post on September 11th, uh, about Osama bin Laden. I didn't September 11th. The only post I made was, um, I think that was the day I did the show with Dan Matha and I that's what I posted that was it. And they literally like right at the beginning of the show.

[00:54:28] They shut me down and all the Facebook videos, what they only were like a second long or 10 seconds long. And then YouTube did the same thing to me the other day, because some of the science, some of the reputable, legitimate science that I was talking about, uh, didn't fit there. Community standard, which is complete BS.

[00:54:49] Yes they're. They're not scientists. They're tech guys. So I am researching right now. I have a separate server. [00:55:00] In fact, upgrading it. We're putting a brand new server in. That delivers my stream. And it's real easy to listen to the live audio stream of this show. You just have to go take any browser and go to superhuman radio.net/live player.

[00:55:17] A player will appear you press the play button and you could listen while you're jogging while you're working while you're commuting, while you're on doing cardio. I wouldn't recommend listening while you lift, because music is better to listen to when you lift. Cause it's more motivating, but if my voice motivates you, hell listen to it while you lift.

[00:55:38] And I'm working on getting a video stream up as well. If I can get a video stream up, then I can't be shut down by these, uh, these, uh, groups, Facebook and YouTube at all. And people will just come to my website to watch the show instead of Facebook. So [00:56:00] I need your help. Those of you who are listening to the podcast right now, replay.

[00:56:11] If you're around at one o'clock in the afternoon, use the link superhuman radio.net/live player. Listen, live, um, And promote and help me promote the live stream. That's number one, excuse me. Those of you watching I'm coughing.

[00:56:34] I gotta drink some water. I get this every day at the end of my show.

[00:56:42] The other thing is you can send an audio clip.

[00:56:51] I've been asking for video, but I get the feeling that people are shy and they don't want their videos out there.

[00:57:02] [00:57:00] if you would record a brief SHR story, maybe that you hate when I start coughing and I have to mute my mic, I have horrible allergies. This course I was a C section, baby. Um, If you could do like a 32nd, 62nd audio clip of why you like, or don't like the show and then upload it to SHR network.biz/your story.

[00:57:34] I would really appreciate it. I got to believe more people are willing to do an audio recording, then a video for whatever reason, I don't know, but I need your help with these two things. The live stream is SHR network that biz slash the live player and to upload a video or audio clip of why you like or hate the show.

[00:57:59] And [00:58:00] me upload that to SHR network.biz/story, help a brother out. Okay. And we'll see you tomorrow with another yeah. Episode of superhuman radio. Thanks for watching and listening today.