In short
Whether particle beams can treat cancer, how they work biologically and physically, and how they compare to surgery, chemotherapy, and conventional radiation.
Guests/backgrounds
Kelly Wienersmith, studies parasites and space; Daniel, a particle physicist.
Key claims
- Cancer is uncontrolled cell growth plus broken apoptosis, often requiring multiple mutations; metastasis (spread via blood) is what makes it deadly.
- Particle therapy is a form of radiotherapy: narrow beams aimed at tumors to damage DNA in cells that are less resilient/repair poorly.
- Precision comes from using multiple angles so beams intersect at the tumor, plus better dose modeling and particle choice.
- Particle therapy can increase future cancer risk in normal tissue because beams pass through and deposit energy/damage DNA.
- Protons are highlighted as especially useful due to deep penetration and the Bragg peak (energy deposited near the end of their path).
Notable examples/examples mentioned
- Skin cancer from UV radiation; cervical cancer linked to HPV with vaccines.
- Brain tumor surgery examples (two friends recovered quickly).
- Bragg peak motivation vs rodent studies (particles may pass through smaller animals).
Written by AI. May contain mistakes. Listen to the episode to check what was said.
Chapters
Tap a time to open that second in VOIntroduction to Particle Beams and Cancer
2:35 to 3:26
Discussion on the potential use of particle beams in cancer treatment.
“The Large Hadron Collider in Switzerland costs more than$10 billion.”
Morality and Applications of Particle Physics
3:26 to 6:41
Exploration of the ethics and implications of using particle physics in medicine.
“Welcome to Daniel and Kelly's Extraordinary Practical Universe.”
Audience Reactions and Speculations
6:41 to 9:22
Sharing audience ideas on how particle beams can treat cancer.
“And so today on the podcast, we'll be talking about exactly that topic.”
Understanding Cancer and Particle Treatment
9:22 to 10:48
Discussion on how cancer occurs and how particle beams can be a treatment.
“And so it's sort of on the periphery of their knowledge, at least.”
Understanding Cancer Growth and Metastasis
14:03 to 17:50
Learn about how cancer cells grow, replicate, and spread throughout the body.
“So for a lot of people, they connect radiation with the cause of cancer instead of the cure of cancer.”
The Cancer Epidemic and Treatment Strategies
17:51 to 19:42
Explore the impact of cancer on society and various strategies for treatment.
“I'm not going to be sleeping well tonight.”
Living Longer and Cancer Incidences
19:43 to 20:54
Discuss how increased longevity contributes to higher cancer rates.
“so many of us are getting cancer and having cardiovascular problems these days is because a lot of us are living to be old enough for this kind of stuff to become a problem.”
Debunking Myths: Sharks and Cancer
24:33 to 28:05
Uncover the truth about sharks and their relationship with cancer and discuss cancer treatments like particle therapy.
“That was a trick setup because even though you hear over and over again that sharks don't get cancer, sharks do get cancer.”
Understanding Particle Therapy
28:05 to 29:15
Learn how particle therapy targets cancer cells by exploiting their vulnerabilities.
“And actually, we should get someone who knows what they're talking about, because I'm just vaguely remembering these facts and they could be wrong.”
Precision in Targeting Tumors
29:15 to 31:09
Discover how particle therapy can be precisely aimed at tumors while minimizing damage to healthy cells.
“It has all these broken repair mechanisms that makes it easier to take down.”
Show all 17 chapters
Future Risks and Treatment Accuracy
31:09 to 32:36
Explore the long-term risks associated with particle therapy and advancements in treatment accuracy.
“So the beam stays constantly on the tumor, but is spread around on the normal cells.”
The Role of Photons in Radiotherapy
32:36 to 34:56
Understand the function of photons, especially X-rays, in cancer treatment and how they interact with the body.
“Okay, so let's talk about what our options are for particles.”
X-ray Generation and Safety
34:56 to 37:29
Learn how X-rays are generated and the safety improvements in modern radiological practices.
“we're not normally shooting just like light bulbs at people, right?”
Narration Challenges in Audiobooks
42:44 to 43:45
Ray Porter shares his emotional experiences narrating 'Project Hail Mary'.
“frog in my throat and starting to get teary as I'm narrating some of these sections and it's like, okay, yo, yo, yo, is this indulgent?”
Proton Therapy for Cancer Treatment
43:52 to 56:00
Exploring the advantages and mechanics of using proton beams in cancer treatment.
“But the best method is one we haven't talked about yet.”
The Role of Particle Beams in Cancer Treatment
56:00 to 56:51
Learn how particle beams can be used to treat cancer effectively.
“But particle beams can also deposit energy in those cancerous cells in a very defined and very calibrated way to help treat your cancer.”
The Role of Particle Beams in Cancer Treatment
58:44 to 59:07
Learn how particle beams can be used to treat cancer effectively.
“and neither should you with vital proteins, collagen, and protein shakes.”
Transcript
Automatic transcript. May contain errors.0:00This is an iHeart Podcast. Guaranteed human. Hey everyone, it's Cal Penn. I'm inviting you to join the best sounding book club you've ever heard with my podcast, Earsay, the Audible and iHeart Audiobook Club. Every episode, I nerd out with amazing guests and dive into the best new audiobooks available on Audible. It's the book club for your ears. Listen to Earsay, the Audible and iHeart Audiobook Club on the iHeartRadio app or wherever you get your podcasts.
0:54on the bottle. You've probably seen it at the grocery store. And this mayo is different. Most mayonnaise uses whole eggs. Kewpie only uses egg yolks, which gives it this rich umami flavor. It's smoother, deeper, almost buttery. Once people try it, they start putting it on everything. Egg sandwiches, fries, burgers. Chefs use it. Restaurants use it. People who really care about flavor use it. Put it on just about anything. Then you'll understand. Kewpie, the original Japanese mayonnaise. This is Jacob Goldstein from What's Your Problem? Running a business is hard enough. Don't make it harder with a dozen apps that don't talk to each other.
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2:34Particle physicists love playing with big, expensive toys. The Large Hadron Collider in Switzerland costs more than$10 billion. And hey, what is it good for? Well, you know, understanding the nature of the universe and revealing the fundamental properties of matter, energy, space, and time. It's a pretty good deal if you ask me. But it's not just that. Basic research has also created lots of technology that improves our lives, including all of the electronics you're currently using to listen to me on this podcast. But particle physics has more directly saved lives as well. Usually we think of particles as dangerous, of radiation as a cause of cancer.
3:15But what if particle physicists could do something useful for once? Today on the pod, we'll be asking, what if particle beams could be used to treat cancer? Welcome to Daniel and Kelly's Extraordinary Practical Universe.
3:43Hello, I'm Kelly Wienersmith. I study parasites and space, and I'm excited to be talking about newer-ish treatments for cancer today. Hi, I'm Daniel. I'm a particle physicist, and I didn't get into it to save anybody's life, but I'm happy if it does. Yeah. Today we're talking about a practical application of your work. Amazing. Amazing. And so I know that for some kinds of mathematicians, if it turns out that their basic research has applications, they're like almost bummed out because it makes it less pure. How does the particle physics community feel about this amazing application of their work?
4:22The broader community, I think, is positive because they're always looking for ways to sell fundamental science to politicians and to the general public that don't understand that any investment in basic science is a good idea because it's going to yield something in the long term. And they're looking for something in the short term to use as an example. For me personally, it's a bit more mixed. I got into particle physics because it has almost no immediate applications. because as you know, my parents worked in the weapons program and I was like, it's a little morally complicated to be building weapons of mass destruction pointed at civilian populations, which is basically what they were doing.
4:59And so I was glad that there were no immediate applications. So the idea that you're now building particle beams and pointing them at people, I'm glad that that's a positive thing. I can imagine how there might be other uses for high intensity particle beams pointed at people's heads. So yeah, I think I would just prefer if the applications were more downstream, so I didn't have to think about it. Oh, you feel like at some point they're downstream enough that you don't have to worry? Like, what if somebody tomorrow did say, okay, this particle beam stuff results in, you know, weapons of mass destruction, but it's 20 steps away.
5:32Does that absolve you? As long as it's like, you know, 20 generations and I'm dead when they build the torment nexus from all of my particle physics work, then I think it's not really my fault. What can I do about it? All right, fair enough. Yeah, I guess you can't see the implications generations down the line in some cases. But I do in general think it's a really interesting philosophical and moral quandary because the only way to prevent people from using ideas to build things to torture people is to have no ideas and to make no advances. And I think that's ridiculous. And so I think we have to take leaps forward into the future and understand the universe knowing that it's going to change society.
6:09We just hope for the better. Yeah, I totally agree. And so trying to think about how we unroll these new technologies without having too many negative implications, soonish got me thinking about this topic a lot. And I feel like we need to be having a lot more conversations about how these technologies could be used. But on the plus side, we don't have to dig into too much of that today because this is an unmitigated good. Yes, exactly. All of those taxpayer dollars spent on building particle colliders have resulted in saving people's lives by curing their cancers. And so today on the podcast, we'll be talking about exactly that topic.
6:46How exactly can you use Daniel's ridiculously abstract research with his 10 ,000 friends to cure cancer? I love that you have so many friends, Daniel. That's fantastic. You're very likable, though. I'm not surprised. Well, I'm rounding them all up to friends. I'm sure there's some haters in that community. Oh, I see. Yeah, I've got that too. So I went out there and asked our audience if they had an idea for how particle beams could be used to treat cancer. And we're very delighted to have their extemporaneous speculation here on the podcast for you to enjoy. If you would like to contribute for future episodes, please don't be shy.
7:21Write to us to questions at danielandkelly.org. Here's what people had to say. Particle beams are shot into the cancer at high speeds and just shake it up from the inside out until there's nothing left. Directed with magnets would focus on the cancer. Target the specific cancer cells. Radiation treatments, which basically killed the cancerous cells. Through very finely targeted obliteration. Using a high energy particle beam, you can destroy the cells in a very targeted way. It just deteriorates the cell growth. Particle beams disrupting the DNA of the particular cancer cells. Zapping a location, a cancer, with particle beam.
8:10The beams heat the cancer and stops it from metastasizing. So picking up on context clues here, it's got beam in the name, and I'm pretty sure the main way cancer is treated is by destroying cancer cells. So my answer is via destruction of some kind. From all different directions so that those beams all intersect in the exact shape of the tumor. Fry the area. The particles in the beam are specifically targeted at the areas in which the cancer is. My energy protons emitted from a cyclotron go through a lens that is shaped like the patient's tumor so that it goes no deeper than the tumor. Focused on the cancer cells directly so that they'll form a constructive interference.
9:00Concentrated focused therapeutic particle beams directed at solid tumors reduce their viability. The particles damage the malignant cell's DNA. The high energy in the gamma range damages their DNA so they can't replicate themselves anymore. I would think by killing everything in their way and thereby also killing the cancer. These are super fantastic answers. It sounds like a lot of people have heard of this before. And so it's sort of on the periphery of their knowledge, at least. I hadn't heard about this until there was a case of cancer in my family where we were thinking about this as a treatment.
9:36Everything turned out OK. My sense is that this isn't in the public consciousness aside from people who have to think about this sort of treatment. But maybe I'm wrong because it does seem like almost everybody had an answer that was like kind of on target. I think I knew roughly how this works. You know, I knew that when you get cancer, your options are like chemotherapy, drinking poison, basically, or radiation shooting particles at it, or surgery trying to cut it out. In all cases, they're like versions of localized suicide, like let's try to kill this part of my body before it kills the rest of me.
10:10Yeah. But until a couple of friends had weird growths in their brains recently, and it really had to make this decision, radiation or surgery, I never really dug into the details, the physics of like, how does a particle beam hurt a tumor? How do you aim it? How do you make sure you get it to the right spot? What kind of particle should you use? So I thought it'd be really valuable for people to have some sort of understanding of this so that in the moment when they're faced with these decisions, maybe they have some understanding of these options and what's really going on and the risks. And so when the doctor says, this is going to swell your brain, or this is going to do that, or this is going to damage the other tissue, it makes sense to you and helps you make those decisions.
10:49So radiation is different than the particle beams. It's the same, yes. It is the same? By radiation, I just mean shooting particles. And we'll get into that in a minute. But yeah, radiation particle beams, to me, it's the same deal. Excellent. All right. So let's start with probably the most interesting part, the biology. That's why this is another fun topic, because I was like, ooh, physics curing biological issues. Yeah. Yeah. Although I think at the top of my list of fun is not cancer, but cures for cancer is pretty awesome. So go ahead. Let's hear the physicist's explanation for what is cancer.
11:25Wait, I'm explaining it? I was hoping. Oh, you thought I was going to do it? Well, I'm going to give it a start and you chime in with your informed details. Okay. My understanding is it's a whole collection of things. They have something in common, but you can't really say cancer is like one thing. In general, it's cells growing out of control, but the causes for that can be manifold, right? Yeah. I have a friend who studies cancer and he was telling me that even just one kind of cancer can be caused by so many different mutations that that makes it pretty difficult to treat because often you want to know exactly what kind of mutation it is that causes it.
12:01And so now we genotype people's cancers to try to figure out exactly which of the many mutations is causing it to target our treatment. So yes, it's a lot of stuff that can cause cancer, but don't let that keep you from sleeping at night. But in general, it's when something goes wrong with the cell's growth function, right? So cells are constantly replicating, called this mitosis. And the nucleus splits the DNA and copies itself. And there's a whole bunch of genes that control that copying, but errors can creep in, of course. And then cells keep doing this, duplicating themselves, copying themselves for a while, and then they stop.
12:37And this apoptosis is when a cell is like, I'm done, disassembles itself and gets reabsorbed into the body. And there's a huge variation. Some cells only live for very short periods, like a day. Bone cells can live for like 30 years. Neurons can live forever. So you have this whole mechanism where cells are splitting and making copies of themselves and eventually retiring. In order to get cancer, a bunch of things have to go wrong in just the right way. So it's kind of amazing that cancer happens as often as it does because it requires like multiple mutations, multiple ways for this whole process to go wrong.
13:11Yeah. I'm going to go ahead and give you a POD in biology. Congratulations.
13:18So the first thing that has to go wrong is that the gene that controls how often you're going to replicate, right? These oncogenes, the genes that control replication have to go crazy. So maybe there's like a mutation or maybe you just got a bad gene from your parent or something. And this gene that controls how often you're splitting can go crazy. So you just get like uncontrolled replication instead of like doing it at a reasonable rate. Yeah, it could be because you got a gene from your parents. It could be because you were exposed to something that caused a bad change in your genetic code.
13:49Now, for example, that's what happens with skin cancer is you acquire a lot of mutations from the sun, which I know well. And where are your sunscreen, kids? Fascinatingly, that's an example of radiation causing cancer, right? There what's happening are like ultraviolet photons are penetrating into your body and causing damage to your DNA, which triggers cancer. So for a lot of people, they connect radiation with the cause of cancer instead of the cure of cancer. And actually radiation could end up on both sides of that equation. Yeah, yeah. But I think instead of fascinatingly, I would have said something like suckily.
14:24Tragically. Tragically. Yeah, I have a big scar on my forehead, which my daughter will sometimes be like, oh, it's hard to look at, mom. And I'm like, kiss my butt, kid. You don't have to live with it. Anyway. Is that a scar from a cancer removal? Yeah. Yeah. Glad they caught it. Yeah, me too. So we were talking about how cancer cells grow uncontrollably. But that's not enough to be a cancer cell, right? Just because you change the gene that controls replication doesn't make you already cancerous because the cell can just die, right? So in order to have cancer, you need to have uncontrolled replication and you need to break this apoptosis.
15:01This thing that tells the cell to turn itself off because you're done, buddy, needs to also break. And so you have to have uncontrolled replication and the cell has to be immortal. This is what I meant earlier when I said you require multiple mistakes in the cell. From happy cell that's growing nicely and playing kindly with everybody to cancer cell that's going to grow uncontrollably, making more of itself and refusing to die off. Yeah. And feeding itself, managing to get more blood vessels to be made to feed those cells and stuff. And then it starts choking off other things. And yeah, thinking about all the different ways our bodies can break down, it's amazing they ever do anything right.
15:38But Kelly's catastrophizing today. That is a terrifying rabbit hole to dig into. And I've done that sometimes, especially, you know, when under the influence of various substances. But I'm like, wow, I am this pulsing, throbbing meat machine. And it's incredible that it just keeps working. And for most people, just works for decades without lots of issues. It's amazing that it survives this long. On the other hand, of course, if it didn't, we wouldn't be here. And so obviously evolution has done its job. That's right. Well, we all made the wake-up list today. So hurrah for all of us. All right.
16:14What's the wake-up list? The people who didn't die in their sleep? That's dark. Well. Oh, my gosh. Yeah, that is what it means. So anyway. Wow. Do you wake up every morning and you're like, ah, I was on today's wake up list? No, but I do wake up in the mornings and think, you know, you don't know how many days you've got. So you should try to make sure you're doing good by you and your family and your kids. But anyway. All right. So cancer is uncontrolled, constant growth. It builds these blood vessels. It saps the resources. and you might think, why do I care if I have a little blob of cells that are growing out of control?
16:51Well, you know, they're growing out of control, so they get bigger and bigger, right? And if it's like that's in your brain, it's going to press on important stuff, like the things that control your balance or your memory or your speech patterns, and that's going to be an issue. Or if it's in your pancreas or if it's in your liver, right, you can impede the function of the normal cells. And also it can spread, right? That's the real danger. If you have cancer and it's just in one spot and you're like, okay, I got to get this blob out. Then they can just do surgery and cut it out, or they can do radiation like we're going to talk about.
17:20But the time the cancer really becomes deadly is when it spreads to the rest of your body. And this is what metastasis is. Usually it spreads into the bloodstream and then the blood carries it all around the body and it lodges somewhere and then it keeps doing its cancer thing. And now instead of having one blob that's growing out of control that you can maybe deal with, you have lots of them, uncountable number and they're also spreading. And so very quickly it goes out of control. So often it's crucial to catch cancer early before it metastasizes. Future casting here. I'm not going to be sleeping well tonight.
17:55We're just doing a lot of ironic foreshadowing because we're going to get to the bit where we're curing it. We just need to set it up. All right. Okay. All right. Great. But this is not a small issue, right? Cancer is a real killer. Yeah. 3 % of people in the United States are cancer survivors. Wow. It's a huge number. Cancer hits about 100 million people a year. And there's like 10 million deaths a year. Wow. So like this is a real issue. You know, a huge fraction of our healthcare budget is focused on cancer as it should be. This is what motivated like Joe Biden's cancer moonshot. Like, hey, can we crack this thing?
18:29But as you were saying earlier, one of the big struggles with dealing with cancer is it's not just cancer, it's cancers. There's like more than 100 different types of cancer. And they come in all kinds of varieties. Like a huge fraction of them are just caused by tobacco use. Like 20 % of all cancer is like from smoking or some kind of like snorting or sniffing or sucking on those leaves. But there's another chunk, like 20%, that are due to infection. Like some virus comes in and injects its DNA into your cells. And now those cells are cancerous because they've changed your cells in exactly the right way to trigger that cancer.
19:07Jerks. Jerks. But the good news is, like, we know how to deal with viruses. So now we have, like, vaccines against cancer. That's amazing, right? Yes, incredibly cool. Like, cervical cancer caused by the human papillomavirus. Like, we have really treated that. And really, the rates of that cancer have dropped tremendously. So there are real wins here. Even though it's lots of different kinds of cancers, which require lots of different kinds of approaches, people are working hard on this and really making progress. So, you know, go big pharma. Go MDs. Like, thank you to all those folks working on the front line of saving those lives.
19:41Amen. And also, you know, to focus a little bit more on silver lining, you know, the reason so many of us are getting cancer and having cardiovascular problems these days is because a lot of us are living to be old enough for this kind of stuff to become a problem. You know, before there was a pretty good chance you wouldn't survive to be five. But now a lot of us, you know, live a lot longer. And cancer doesn't just strike humans. You know, one of the main reasons that rats die, for example, is that they live long enough if they're well-fed to get cancer. We had pet rats. And after a couple of years, they each got these big tumors.
20:12They were dragging these things around, like these big blobs hanging off their bellies. And Katrina has a good friend who does cancer studies on rats. And she knows how to operate to remove tumors. And so she offered to operate on our rats. And I was like, yeah, I don't know if we need to bring our rats into your special expensive facilities. At some point, you're just fighting a losing battle. You cut these tumors out, you know there are more coming. But it was sad. Rats are wonderful little critters, and they don't live very long, and we bonded with them. But on the flip side, that's when we decided we needed a longer-living critter, and now we have a dog.
20:51Oh, that's fantastic. Yeah. But you're right. The bigger picture is as we live longer, as we tackle these things, we just discover new things that are going to kill us, right? The front just moves, and we have a new battle to fight. That's right. And it's time to take a break. And when we get back, we're going to talk about why sharks don't get cancer.
21:17This is Matt Rogers from Las Culture East. That's with Matt Rogers and Bowen Yang. This is Bowen Yang from Las Culture East. That's with Matt Rogers and Bowen Yang. You know when people try on new food and suddenly it's like, wait. That's the reaction a lot of people are having when they first try Kewpie mayo. It's the one with the red cap and the little baby on the bottle. You've probably seen it in the grocery store before. And if you've ever just walked past it, some people would say that's a huge mistake. Because this mayo is different. Most mayonnaise uses whole eggs. Kewpie only uses egg yolks, which gives it this rich umami flavor.
21:51It's smoother, deeper, and almost buttery. Once people try it, they start putting it on everything. Egg sandwiches, fries, burgers. Some fans even swear by dipping pizza crust in it. And once you notice it, you start seeing it everywhere. Chefs use it. Restaurants use it. People who really care about flavor use it. Never tried it? Grab the bottle with the red cap next time you're at the store. Put it on just about anything. Then you'll understand. Kupi, the original Japanese mayonnaise. How's the new place? Get your Wi-Fi figured out? I got T-Mobile 5G home internet and I'm loving it. It's the fastest 5G home internet.
22:23My old provider was so slow. Mine is slow. And only$35 a month. Do I need to try this? Try it for 15 days. Love it or get your money back. I love it already. There are over 250 reasons to join T-Mobile. Find yours and check availability at t-mobile.com slash home internet. This is according to Ooglu Speed Test Intelligence. Date a second half of 2025. All rights reserved. Redeemed money back guarantee within 30 days of cancellation. Hey everyone, it's Cal Penn. I'm the host of Ear Say, the Audible and iHeart Audiobook Club. This week on the podcast, I'm sitting down with Ray Porter, the narrator of Andy Weir's audiobook Project Hail Mary.
23:03Massive sci-fi adventure about survival and science and what happens when you wake up alone very far from Earth. I really had to make a decision because I caught myself getting that frog in my throat and starting to get teary as I'm narrating some of these sections. And it's like, OK, yo, yo, yo, is this indulgent? And I really thought about it. I was like, no, at this point, it would kind of be betraying the trust the author and the listener have in telling this story if I don't go through it. But there's places in this book that deeply emotionally affected me. And I left it on the mic. That's great.
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23:38Because it served the story. People will say like, oh, my God, I cried at the end. It's like, yeah, dude, me too. Listen to Earsay, the Audible and iHeart Audiobook Club on the iHeartRadio app or wherever you get your podcasts. Aging is real. And so are the benefits of adding Vital Proteins Collagen Peptides to your daily routine. Because around the age of 30, your body needs backup to keep your collagen up. To help support healthy hair, skin, nails, bones, and joints. Available in the classic collagen peptides. Collagen and protein shakes. And new Vital Proteins Collagen Sparkling Waters. So you can stay vital, stay you.
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24:32And we're back. That was a trick setup because even though you hear over and over again that sharks don't get cancer, sharks do get cancer. Gotcha! What, Kelly? Are you dispelling another pop sign myth? Yeah, sorry. So why was it so commonly said that sharks don't get cancer? Was that just purely invented? Or was it like a crab study, a misunderstanding of real science? I don't know. It could be both. I mean, I imagine that a lot of times when animals in the wild get cancer, it debilitates them to the point where something else gets them, you know, a predator eats them, for example. And so it just could be that we didn't encounter many sharks that had tumors or people who did noted it but didn't publish on it or something.
25:13And so, I don't know, somehow this misconception entered its way into the Twittersphere or the exosphere, whatever we call it now. But anyway, yes, sharks get cancer. The exosphere is actually a science word already. It's like when you don't have an atmosphere, you have particles that are just flying around, not interacting with each other. Like the moon has no atmosphere, but it does have an exosphere, even though there's nobody on the moon posting on X. But that's spelled E-X-O, right? Yeah. So this would be like the X-osphere or something. You can't have two words that sound exactly the same.
25:50I mean, you know, the English language is the worst in terms of spelling of stuff. So particle beams can't cure the problem of the English language, but maybe they can help with cancer. So let's lower our sights and think about that instead. So let's overview some of the ways that we can deal with cancer. So if you have cancer, your options are often surgery. Like if it's localized, it hasn't spread, and it's not next to something else really, really delicate, then often you can cut it out. Like if you have skin cancer, they can just clip that thing off because you don't need to go inside the body.
26:20It's not next to anything else dangerous. And it probably hopefully hasn't spread yet. And so they can just cut it off. Whereas if you have, for example, something growing inside your brain, surgery is more complicated because they got to go into your brain and maybe it's touching something else really delicate. And it's hard for the surgeon to cut out the whole thing without touching that delicate nerve and maybe impacting your brain function, right? That was the great fear for my two friends who recently had brain surgery because of growth. You have two friends who had brain surgery? Are they both doing okay?
26:52Both of them are fine. Both of them are scientists and both of them were back to work amazingly. just like a month after brain surgery. So it's incredible what modern medicine can do. 10-hour surgery to cut out these lumps. And yeah, they're back to work and making the same terrible dad jokes over email that they were before surgery. So I can't even blame it on the cancer. My daughter is really into puppeteering and her hero, Adam Crutinger, passed away from a brain tumor recently. And so these are difficult things to tackle. Yeah, it's scary. But there's a lot of people working hard and dedicating their lives to making this better.
27:27So surgery is a great option if it's still localized and it's not close to anything else that you're risking. Another option, of course, is chemotherapy. And we can have a whole episode on that if you like. But essentially, you're just drinking poison. Yeah. And you're hoping the poison kills the cancer. The poison is designed by clever chemists to kill the cancer faster than it kills you. And so it's a race of attrition there. Yeah. As I understand it, cancer cells tend to replicate faster than other things. And so it's targeting very quickly replicating cells. And that's partly why you lose your hair, because you've got like very fast replication happening in those follicles.
28:04And they kind of get shut down for a little while. So your hair falls out. And actually, we should get someone who knows what they're talking about, because I'm just vaguely remembering these facts and they could be wrong. But you're right. In each case, what we're trying to do is highlight a particular sensitivity to cancer and then take advantage of that in our attack. And the same thing is going to be true for radiotherapy, which is particle therapy. We're shooting beams at the cancer. The idea is that these cancer cells have a mutation in the place where they're doing their DNA replication, right?
28:38When they're replicating, instead of doing it at a normal rate, they're doing it at an uncontrolled rate. And so these cells are actually pretty bad at repairing damage, right? They're already damaged, and they're worse than normal cells at repairing damage. And so if you attack them and try to break up their DNA, they are more sensitive to those kind of attacks than normal cells. Ah, okay. But so you told us that they're also resistant to apoptosis, so resistant to breaking apart. Is the idea just that if you mess up the DNA enough, they just kind of like die and wither away? Yeah. Okay. Exactly.
29:14I asked Katrina about this actually, and she said another way to look at a crazy cancer cell is that it's less resilient. It has all these broken repair mechanisms that makes it easier to take down. And so if you can shatter its DNA or attack its DNA, it's less likely to be able to survive. So they're more fragile in that sense. They're more susceptible to radiation than the normal cell. Okay, but chemotherapy often acts throughout your body, and it would be really nice to be able to target so you don't get negative impacts spread throughout the body. And so particle therapy, I'm guessing, can give us that?
29:47Yes, exactly. particle therapy is not just like broadly shooting radiation at your whole body. We're shooting particles in a very narrow beam so we can aim where it goes. If you have a tumor in your brain, we're not shooting particle beams into your toes. And we can get very, very precise with it. And you can think about it in three dimensions as well. Because imagine you have a tumor in your brain somewhere, right? The goal is to have the particles hit the tumor and nothing else. That would be ideal, right? Now, we can't do that perfectly. We have to shoot it through some normal tissue to get it to the tumor.
30:21So we have a few ways to avoid damaging the normal cells along the way. And we're going to talk about one of them being particle choice. But the other one is very simple, which is that you just shoot from a few different angles. And those beams intersect at the tumor. So the beams are going to hit some normal cells. But the normal cells all just get like one beam. But the tumor gets like four beams. or the generalization of this is that you have a single beam that sweeps around you and as it rotates, it's consistently on the tumor, but the normal cells are only getting it part of the time. So the tumor gets it constantly and it spreads out the beam across a bunch of other normal cells.
30:59So the idea is to deposit more energy to do more damage on the tumor cells than on the normal cells. And so the way you do that is by shooting from multiple angles or by scanning around. So the beam stays constantly on the tumor, but is spread around on the normal cells. Does that make sense? That does. Yeah. So I've talked to a few friends who have had cancer and the treatment that they got saved their lives, but increased their future risk of getting cancer because it damaged the DNA of some of their other cells. Do we know for this treatment when you get, I don't think I would love the idea of having particles go through all of my brain, even if I knew they were still focused on one spot, but you know, it still sounds better than the alternative of letting the tumor grow.
31:39But do we know with this method 40 years down the road, does it increase your probability of getting a tumor somewhere else? It definitely increases your probability of getting a tumor in that otherwise normal tissue because you're shooting beams through it and you're depositing energy and you're damaging DNA. And so, yeah, you're setting yourself up for cancer in those cells. But people are trying to make this more and more accurate by controlling the dose, by doing really thin scans, by making sure that the dose is like the minimal necessary. People used to have really high doses to make sure they got the tumor.
32:12And now they can scale that down. They have better models for calculating the dose. They just used to assume like the human body is water. Now they're like, okay, well, there's other tissues in there. And we need to take that into account. Think about the scattering, you know, and now they think more about the angles. What is it going to go through? As time goes on, we get better and better at this. And also, crucially, we're choosing the particles we shoot because that can determine where the energy lands. Okay, so let's talk about what our options are for particles. Yeah, so number one is photons, right?
32:42We all get radiation when we go to the doctor for a broken bone. They use x-rays to take a picture of your insides. And x-rays pass through the body, but they're absorbed differently by bones and by soft tissue. And that's why you can see through the body, right? And this is a whole fascinating topic here about transparency. Like, why can visible light not go through the body, but X-rays can? And the answer is that for photons, how far they go through and where they deposit their energy, or if they do deposit their energy, depends on the wavelength of light. Today, we're just going to talk about that interchangeably, right?
33:17Radiation is made of particles. One example is a photon. We'll also talk about electrons and protons. But we'll start with photons, mostly X-rays. I feel like I'm still not really understanding how X-rays work. Can you give me some more detail? Let's think about what happens when a photon hits your body, right? And let's say, for example, it's a normal visual light photon, like a red photon that's just flying around. Well, what happens when it hits your body is it finds a bunch of atoms. And those atoms all have energy levels, right? There are electrons whizzing around those atoms, and they can absorb some photons.
33:49If an electron has an energy level that matches the energy of the photon that's coming in, it can eat it. Like if the electron is in energy level five and it needs a certain amount of energy to go up to six or to seven and a photon comes along with just that much energy, boom, it can gobble it up. So this is atomic absorption and also atomic emission. Like we talked about recently in our episodes about what color is the sun, that same atom, if the electron is in the higher energy level, it can release that energy shooting off that photon. So atoms can absorb photons of specific energy levels, right?
34:22This is why red paint is red, because it absorbs everything but the red. It reflects the red. The red doesn't get absorbed by those materials. This is why glass is transparent, because there are no atoms in the glass that can drink light in the visible spectrum. So it just passes through. So for very low energy light, like the kind that's in the visible spectrum, whether or not it goes through or whether or not it's absorbed and deposited its energy, and that's the crucial thing for curing cancer or treating cancer, you want to deposit your energy depends precisely on what energy you have. But for treating cancer, we're not normally shooting just like light bulbs at people, right?
34:59We're shooting higher energy stuff. And so at higher energy, what happens is the photoelectric effect. Instead of the electron just going up an energy level, you kick the electron off of the atom, right? You completely ionize it. So if you have high enough energy, like x-rays, for example, they can kick electrons out of the atom. This is the photoelectric effect that Einstein used to like discover quantum mechanics and all of that kind of stuff. And then at even higher energy levels, what happens to a photon is that it pair produces, it turns into an electron and a positron because of the nuclear electric field.
35:34And so what happens to a photon depends a lot on its energy relative to the matter. And so x-rays are a typical thing that we use in radiotherapy and they do penetrate, right? And so they have high energy so they can get pretty deep into your body. Like if you just shoot red light at somebody, it's absorbed at the skin, but x-rays can penetrate. They can go further in. The downside of x-rays for treatment is that they leave a lot of energy in the first few layers. Like they deposit energy and then they sort of peter out. And so a lot of the energy is deposited near the top. So if you want to get like deeper in, you have like a tumor, like three centimeters under the skin, you have to shoot a lot of x-rays at it.
36:12And the normal cells, the cells you don't want to treat that are between the skin and the tumor are also getting a lot of x-ray energy. So that's why for x-rays, it's crucial to like rotate it around the body. And so when you go to get an x-ray and you wear a lead, oh, that lead is not covering the spot where you're getting the x-ray. It's covering everything else. Got it. Okay. Yeah, exactly. It's covering your critical bits. Yeah. Because x-ray penetration also depends on the atomic nucleus, right? If the atom has high Z, a lot of protons and neutrons in the nucleus, then it's likely to absorb the x-rays rather than let them through.
36:46And so the lead is like a shield for you. Got it. I really messed up my ankle when I was pregnant and I was so worried to get an x-ray. I didn't want to hurt little Ada, but anyway, she was fine, thanks to the lead blanket. Or maybe she's weird because something went wrong, but she's weird in the best way possible. So anyway. Well, they used to take x-rays with incredibly bright sources, And now they've reduced those x-rays as far as they can. And they can still see inside your body, but with much, much lower luminosity. They've improved the detectors they put on the other side. So x-rays are much safer than they used to be.
37:21If you were going to get an x-ray in the 50s or 60s, it would be really dangerous. But now it's much, much safer. The x-rays you get do not deliver a dangerous amount of radiation. And there are other things we do in our lives, like flying an airplane, that do increase our radiation dose. but people don't really think about it that way very much. No, I don't. But I'm about to go on a long plane ride. Thanks for ruining it for me. One more thing to worry about. That's right. Oh, man, I'm going to sleep so good tonight. Okay, so how do we make these x-ray beams, Daniel? Yeah, exactly. If you want to make a beam of red light, you just like heat up a tungsten filament and it glows in the white and you can have like a prism and filter out the red light.
38:01But if you want x-ray beams, we don't have stuff that glows in the x-ray. you need like super duper crazy hot gas, like sources of x-rays astrophysically come from like gas near black holes and stuff. And so we don't have that here. It's not easy to generate. So instead, what you just do is you just heat up the electrons, right? Take a bunch of electrons, speed them up using an electric field. Electrons respond to electric fields. They're going really, really fast. This is a lot like what we do in particle physics. And then bend them with a magnet. So you have an electron, super high velocity, going in some direction.
38:34It encounters is a magnetic field, what does it do? It bends, right? And when an electron bends, the only way it can do it is by emitting a photon, right? That's how electrons bend. And in a sense, it's interacting with the electromagnetic field. And so photons are a natural way for that to do it. And so when it's going at high speed and bends through a magnet, it tends to emit a high energy photon. And that's our source of x-rays, which is why you often have like x-ray crystallography facilities at places with particle beams, like at Argonne National Lab, they have like a world-class x-ray crystallography setup because they're also good at particles.
39:09Cool. Okay. So this sounds like a really great method for creating x-rays and finding where tumors are, but this is not something you'd ever use to treat a tumor, right? Well, you can use these to treat tumor. They're not great because they, as we said before, they pass through the body and they deliver energy in many layers, but you can use x-rays. You can use high energy photons to treat a tumor. But these days we have more advanced techniques that are superior. Yeah. Okay. So we were just talking about electrons. Can you skip the phase where you use a magnet to get x-rays and just use those electrons directly?
39:41You can use electrons and shoot them at people, right? And they will deliver their energy. But electrons are not very penetrating, right? Your skin mostly stops electrons. At very low energy, the electron will just like ionize atoms and be absorbed. At very high energy, the electrons will emit a bunch of radiation and slow down. It's called bremsstrahlung, which is German for like breaking radiation. And so electrons are not very penetrating, mostly because they're very, very low mass. And so like any interaction basically stops them. Because even at high energy, they don't have a lot of momentum because their mass is so low.
40:16And so they're not a great choice for penetrating. The gold standard, the thing you really want is some kind of radiation, which takes a while to stop, which like flies through your body and then deposits its energy all in one go somewhere deep in your body in a way that you can tune. And so we've talked about photons and electrons. And let's let the listeners guess what kind of particle it is that does that. And we'll get back to it after the break.
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42:43I really had to make a decision because I caught myself getting that frog in my throat and starting to get teary as I'm narrating some of these sections and it's like, okay, yo, yo, yo, is this indulgent? And I really thought about it. I was like, no, at this point it would kind of be betraying the trust the author and the listener have in telling this story if I don't go through it. But there's places in this book that deeply emotionally affected me, and I left it on the mic. That's great. Because it served the story. People will say like, oh my God, I cried at the end. It's like, yeah, dude, me too.
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44:04All right. So we've already talked about photons. We've already talked about electrons. But the best method is one we haven't talked about yet. And by process of elimination, I'm going to guess it's protons. Because you only have three particles in your mind. Is that why? Well, you know, you told me particles are complicated. But yes, I guess those are the first three that come to mind. Well, that's fair because the universe is mostly made of protons, electrons and photons. So that's a good set to have in your mind. Good choice, Kelly. I also have this outline in front of me that says protons next.
44:38That makes you sound smart. That's right. That's my trick. Protons are a great choice for treating cancer. And protons are also one of the favorite toys of particle physicists because we can accelerate them to really high energies and bend them around. They have a lot of mass compared to an electron. So you can get them going really fast. and when they go around curves, they don't emit as much radiation because they're heavier. And protons, because of the way they interact with matter, can penetrate deeply and deposit their energy deep under the skin without harming as much the tissue in between.
45:12Oh, that's fantastic. Yeah. Why does it work that way? Yeah, it's fascinating. Protons can interact with the electrons in matter, right, or with the nucleus. And which one they do depends on their velocity. So when they're going really fast, they basically can't see the nucleus and they just interact with the electrons. But it's like glancing collisions. It's too big and heavy to really get slowed down by these electrons. It's like a bulldozer going through a field of snowmen, right? It's just like plows right through them, hardly gets slowed down. I was just reading Calvin and Hobbes. And so like each snowman that the bulldozer hits slows down a tiny little bit, but it really doesn't deposit a lot of energy.
45:53It doesn't get slowed down. But this interaction is dependent on the velocity squared. And so at some point, it reaches some threshold where it does get slowed down enough. Now it's going to interact with the atomic nucleus, and that's going to rapidly sap it of energy. And so there's like a threshold there, above which it can mostly ignore what's going on inside the nucleus and just plow on forward. But when it gets too slow, then all of a sudden it's a very strong interaction with the nucleus, and it deposits a lot of its energy right there. And so that's why it's excellent, of course, for treatment.
46:23And this is called the Bragg Peak. I remember reading about the Bragg Peak because when I was reading about space radiation, one of the problems with trying to understand how radiation impacts people is that you often study it in rodents. Yeah. And rodents are just smaller than humans. There's less mass that the proton needs to go through. And if the particles in some cases are just like shooting through the rats, then you don't really understand the impact of the radiation because the particle didn't stop and release all of its energy inside of the body of the organism. And so there's some concern that like studying rodents doesn't tell you exactly what you need to know because humans are just bigger and we're more likely to stop a particle because it's running into more stuff.
47:06Does that make sense? Yeah, that makes perfect sense. Can't you solve that problem just by like, you know, gluing a bunch of rats together into like a huge sphere of rat and then you could have enough rat to stop the protons? Daniel, you missed your calling in biology. I'm sure we could get that past the IRB, right? I don't see any problems with that. That sounds totally ethical. I'm sure they'd have high quality of life. I wonder if you need to have the mouths all pointed out, but then, you know, what's going on in the inside? Yeah, anyway, this problem is not a great idea. This gets messy, Daniel.
47:37So the Bragg peak is a great way to understand where the energy is deposited by these various particles. So if you imagine like we're talking about as a function of the depth, how deep into the tissue, start out with electrons, mostly deposit energy at the very surface. Photons deposit a lot of their energy at the surface, then it fades gradually. But protons like deposit almost no energy. And then all of a sudden, boom, you're like 10 centimeters in, they deposit almost all of their energy there. That's the peak that they're referring to when they say the Bragg peak. And this is excellent, right?
48:07Because if you could tune this, if you could say, oh, I wanted 10 centimeters in or 15 centimeters in, then you could basically just shoot a beam and have it deposit most of its energy deep within the tissue and spare the normal tissue where the protons are passing through. They're still plowing through those electronic snowmen, but they're not really doing a lot of damage. That's amazing. All right. So tell me in a practical sense, how would you do this? Yeah. So by changing the energy of the protons, you can change the depth. And so where it deposits energy depends on the velocity, right? So if you start out with a lot of velocity, then you're going to go much deeper and then all of a sudden deposit your energy.
48:42If you're very close to that threshold already, then you're not going to go very far and then cross over that threshold where you're depositing your energy. So you can tune the depth where the protons are depositing their energy, which means doing damage to those cells, breaking up the cancer DNA by tuning the energy of the protons. So you already have like two dimensional pointing just by pointing the beam at something, right? Now you have the third dimension of control by tuning the energy of the beam. You can go deeper, you can go less deep. And so you can do this 3D, they call it pencil beam scanning, where you're changing the direction of it and you're changing its energy simultaneously.
49:20So you can trace out the three dimensional shape of the tumor, right? You're probably imagining a tumor as a sphere and that's what a physicist would do. And that's probably what they did 20 years ago. Like let's assume a spherical tumor. What accent was that? That was clueless physicist accent. I don't know. Was it German? It sounded vaguely German, but I'm not. It was a rough average of all the accents I've heard at CERN. There you go. Okay, perfect. All right, move on. There's a little Russian in there, a little German, maybe some Italian and a smattering of Japanese. No. All right. I'm equally offending the whole world right now.
49:54But imagine if you can do a 3D scan with like an MRI and you can see exactly where the tumor is. And tumors are never simply shaped. They're like long and thin. They got a blob over here. And what you ideally want to do is deposit energy everywhere in the tumor and nowhere else. Well, with a proton beam, you can do that because you can aim the beam and then you can change the energy, go back and forth and back and forth over the tumor. And then when you change the angle, now you're intersecting a different part of the tumor with a different shape and different depth. Now you change the energy of the protons back and forth, back and forth.
50:24You can scan in 3D. You can trace out the whole tumor. Use the Bragg Peak to deposit energy there and almost nowhere else. That's amazing. So do we have like complicated models that sort of figure that out ahead of time and you just press a button and then it automatically gets the whole tumor? Or is somebody like going, you know, step by step and like moving the beam around to get every little part of the tumor? It's all computerized, absolutely. And controlled. So nobody's like, oops, I slipped and I fried your eyeball or whatever. The disadvantage is that proton beams are harder. Like electron beams are easy to make.
51:00Electrons are light. You can accelerate them easily. X-ray beams, there's lots of ways to make that. Proton beams are complicated. And the magnets that bend them and point them are huge. We're talking like hundreds of tons of magnets usually. Wow. And so these facilities are much more specialized. They sound fantastic. And if you get cancer, I hope you have access to one. But there are not that many of these facilities yet in the world because they are big and complicated. Is this also a kind of new treatment for cancer? How long has this been around? It's an idea that's been around since the 40s.
51:34Like Robert Wilson, the guy who designed Fermilab and did all sorts of crazy architecture and was a huge, important particle physicist, predicted this in the 1940s in a paper. And it was first used in the 50s. It was pretty expensive until around 25 years ago when people made some improvements in magnet technologies. Now, instead of there being like one center at Fermilab, for example, there are a few dozen centers worldwide. And as of like 10 years ago, like 100 ,000 people had received this treatment. So it's still not the overwhelming treatment for cancer, mostly because there aren't that many centers and they're expensive.
52:12But it's definitely the best treatment you can get. Hmm. So we're not medical doctors. So I want to clarify a little bit for the best treatment we can get. That probably depends on what kind of tumor you have. Yes. Yeah. Okay. So from a particle physicist's point of view, thinking about maximizing the control of the energy dose, proton beams are, from a physics point of view, the best way to optimize the energy dose delivered. But please speak to your doctor about your treatment needs. Don't listen to me. That's right. You're welcome, I heart. We had all the right caveats there. But for a particle physics nerd, it's very similar to what we do with the Large Hadron Collider, like how you make a proton beam.
52:53Well, that's what we have with the Large Hadron Collider is a proton beam. And so the steps are very similar. Like you start with hydrogen, right? Protons are everywhere. They're the most common thing in the universe. The universe, mostly hydrogen, which is a proton and an electron, take some hydrogen, heat it up so the electron goes away and you have protons, right? And then you just need to accelerate them, which means put them in an electric field. We used to just use flat electric fields to accelerate particles. Now we use these cool things called RF cavities. These things have oscillating electromagnetic waves.
53:25So the particles like surf on them, which is really cool and get accelerated more easily over shorter distances to higher energies. And then you have magnets to keep them going in a loop. And that's exactly how the Large Hadron Collider works. And so these are lower energy than the Large Hadron Collider. You don't need crazy energies in order to deposit a dose in your brain, but it's the same technology. And so because it's more similar to the LHC than to like your standard technology, it is more specialized and it is more rare. All right, so let me tie this back to parasites. All right, so when you have a parasite in your body and then it dies, that can often be worse than having a live parasite in your body because now there's all this dead tissue and your immune system like responds to it.
54:06Does this process have to get done in stages? Because if you kill too many of your cells all at once, your brain now has all of this dead stuff that it needs to sort of process and deal with? Or do you not know because we're way outside of physics now? I don't know in great detail. And maybe some cancer doctors can write in and let us all know. But I do know that the immune system will respond to this. And, for example, if you get radiation treatment on a tumor, it can make the tumor swell. Even if it dies, like the immune response there can make the tumor swell, which can also be dangerous. because if it's next to something delicate, you don't want it to swell.
54:42And so again, talk to your doctor about what the best treatment is for you and all those side effects. But we actually do have some data about what would happen if you shot a super duper high energy particle beam into your head because it happened once. What? Yeah. There was a Russian guy, Burgoski, and he basically was looking down the particle beam. He was doing some repairs on the beam and they turned it on. Oops. and so it went right through his head and amazingly, the guy survived. Wow. He ended up with epilepsy and some hearing loss and some people say his personality changed a little bit but he lived his life otherwise.
55:20So I wouldn't recommend it but it is possible to survive LHC level energy proton beam through the brain. Oh my gosh, this happened at the LHC? No, this was definitely not at CERN or the Large Hadron Collider. This is in 1978 at the Institute for High Energy Physics in Prodvino, back behind the Iron Curtain. And it was Anatoly Burgosky. Poor guy. Well, I'm glad he made it. We're all glad that he survived. And we're sorry that that happened. And we hope that it doesn't happen to you. But, you know, the bigger picture is that particles interacting with matter is complicated. Particles from the sun and from the atmosphere can mutate your DNA and cause cancer.
56:00But particle beams can also deposit energy in those cancerous cells in a very defined and very calibrated way to help treat your cancer. And so particles are on both sides of the coin of life. That's right. And I'm guessing that most of the folks who are working on these particle related questions did not have in mind that this would end up being a treatment for cancer. So, you know, we're going to go ahead and bang that drum that we've been banging so much lately. Fund basic research. This stuff results in amazing life-saving technologies. Yeah. And you don't know if that study into like how ducks mate or how to synthesize this random chemical or whether this parasitoid wasp does this or that is going to yield the next great bit of technology that's going to save your life or a loved one or transform our lives into some way we can never imagine.
56:50Amen. All right, everybody. Thanks for listening. And we'll see you on the next show.
57:02Daniel and Kelly's Extraordinary Universe is produced by iHeartRadio. We would love to hear from you. We really would. We want to know what questions you have about this extraordinary universe. We want to know your thoughts on recent shows, suggestions for future shows. If you contact us, we will get back to you. We really mean it. We answer every message. Email us at questions at danielandkelly.org. Or you can find us on social media. We have accounts on X, Instagram, Blue Sky, and on all of those platforms, you can find us at D &K Universe. Don't be shy. Write to us. When you're a maintenance engineer in a beverage manufacturing plant, you keep production lines moving and quality on track because there is no room for slowdowns.
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