Doctor turned founder: How entrepreneurship can cure cancer | Dr. Padman Vamadevan, Founder of Astron Health

0:00When we talk about problems to solve in entrepreneurship, there are few problems better to solve than cancer. that's my next guest's mission padman vamadevan is the co-founder and chief medical officer of astron health a platform for personalized cancer treatments they use molecular insights and advanced research to develop a unique algorithmic approach to give cancer patients more targeted treatment options this tool which is orders of magnitudes faster and lower cost than conventional methods of new drug development, helps cancer patients and care teams to not only get proactive long-term cancer care, but to also extend remission and stay ahead of recurrence.

0:45Padman, congratulations. I want to give you a pat on the back straight away, like kudos for doing this. So obviously your background is in the medical field. What triggered you to explore entrepreneurship? And why did you think that this huge problem would be better solved as an entrepreneur versus as a medical professional? Well, look, firstly, thanks, Steph, for having me on. So great to be on. And hello to all your listeners. It's a great question to start off with. I think that from my side, what I realised in being a doctor, that we are incredibly good on the front line of solving problems that are non-complex.

1:25We're brilliant. If someone's got a pneumonia, someone's got a heart attack, if someone's got an urgent problem where there is a simple guideline and there is a formula that works there is nothing better than the healthcare system globally I think for that I think where I got to and I'm my background is that I am a traditional doctor that sort of works at the nexus of oncology and something called clinical pharmacology which is really understanding what drugs really do in the body okay beyond just what they're licensed to do can they do other things and so working in a healthcare setting for about 16 17 years treating some patients successfully and not doing so well on other patients what I really realized was that the current healthcare system isn't geared towards dealing with complexity and that's not an intelligent problem we've got some of the best minds the best scientific minds in the world we've got some of the best doctors people that really care the problem is really that they're not getting the right data they're not getting the connectedness between their intelligence globally everyone's working in silos and that doesn't enable us to deal with personalized care or deliver personalized care I should say what we end up doing is sticking to guidelines that are kind of for the many not the few and some of those guidelines will work and some of them won't work so much and so that was really the problem that we were trying to solve at astron which is to say look in cancer this is an incredibly complex disease and there is a massive technological overhang we can now tell you in incredible detail what is likely to have caused your cancer how your cancer is behaving what pathways is it using what might happen next but the problem is that the tools that we have to address that complexity are really really limited um you know drug development takes years and costs billions and we we deal with cancer at a sort of node level you know we find a gene or a biomarker and we try to deal with that one at a time and that's not really how cancer works you know it evolves um the rest of the network doesn't really get hit um and the disease adapts really quickly and so that's why at the moment i don't think we treat it as well as we possibly could and that's really why we built Astron to try to fully understand what the triggers what the drivers what's enabling your particular disease to grow to thrive to behave in the way it is what's going to enable it to thrive in the next five years and try and get ahead of it by being just smart incredible such a noble mission Padman I'm so impressed if you're tuning into this right now then first of all a big heartfelt thank you I really appreciate it and secondly there's a very high chance that you're on your own entrepreneurial journey right now.

4:15So whether you're a first-time founder and you're figuring things out and you feel like you're on your own or if you've done it before and realize that actually this whole entrepreneurship business is a lot easier said than done then I might be able to help you. If you feel like you vibe with my energy and feel like you need some of that professional big sister direction support and advice then I'm opening up a few select spots for that one-to-one coaching mentorship and growth strategy for ambitious founders there's a link in the show notes so check it out and I would love to hear from you all right let's get back to the episode what was the trigger for you to explore solving this problem through entrepreneurship and like what why did this motivate you so much to explore another path in solving this I think because I realized I'm looking you know I was on a path to becoming an academic clinician probably within the NHS and with a university as well and I realized when looking at you know some eminent professors who were above me really wonderful people actually and just having really honest conversations with them and talking to some at the end of their careers about what they felt they'd achieved and when I talked to them what they achieved was publications and you know education educating the next generation of doctors and when I actually got really deep into it and said look how many patients did you actually you know did your research translate into benefit for?

5:38Often the answer was very few. And I'm going to be honest, slightly controversially, I hope they're not listening here. But the main trigger for this, I think, was I was very happy working as a clinician. I loved it. I love seeing patients. It's one of the things I really miss now. But actually, I went for dinner not too far from here with two of my very good friends from university from my time at Cambridge and both economists. um one works um very high up in the kind of food marketing um sector and one is a ceo of a an ipo company in the uk um and i spent an hour listening to them talking about everything that they'd achieved um and after that they looked at me um and they were asking me about what i was doing and the change i was making and we had published a paper recently showing that we had sort of doubled survival in a particular type of brain cancer and that paper was about 96 patients and I expected them to sort of be really wowed and dumbstruck yeah and the question they looked to me I said well has that changed any guidelines and I said well no we would need to run a trial and that's going to take billions and decades and it might not ever be possible they said okay and how many patients do you see every week so you know 30 40 50 whatever it was and they said well look that's great but how is that scalable like you're one person you're a smart person there are lots of smart people how do you scale that into population level change because clearly you've got something but how do we move the needle for people around the world and i was really annoyed i was sitting there thinking come on look i'm trying to deal with cancer patients here and you guys are like you know you're building yeah you're building food umpires and selling cards and whatever else it is um absolutely brilliant guys and i didn't speak to either of them for a few months afterwards um but it was the shift i needed in a mindset and i actually went back and spoke to my wife who's a physio um in the nhs as well and and she thought it was hilarious and she was like i think they're smarter than you give them credit for here bad um and what ended up happening was that was one of my triggers to join one day um which obviously you know well um and it was the movement to say okay well look i don't feel that i can achieve or we can achieve the change the systemic change in the system that we need to in terms of building you know um a framework that's going to help people at a population level scale the nhs isn't built to do that it's it's built to help one patient at a time do an amazing job it's got fantastic people in it but to build systemic change I firmly believe that you need companies that are geared just to doing that to collecting the data to being completely focused radically focused on just that aim to getting the right data connecting the right team together connecting those silos together working with the NHS working with all those people but with one singular goal hey gang super quick interruption but I promise it's worth it I want to tell you really quickly about one day it's an 18 month MBA program.

8:45But get this, you literally start and scale your business for real alongside it. I am a mentor on the program. If you've been following this show for a while, then you may have picked up on the fact that I work there as well. That's one of my other jobs. And I absolutely love it. I've been with the business now for two years, probably a little bit more by the time you're listening to this. And that's why I can say with utmost conviction from being on the inside track, how good this program is. So you've got the curriculum, the content, the learnings, the resources, the frameworks that add the structure to the chaos and the mess and give you that much needed direction, how you can move the needle week on week on week and get closer to your entrepreneurial goals.

9:21Beyond the actual content and curriculum, you've got one to one mentorship. So with myself, for example, and then best of all, I would argue the community, you get access to other entrepreneurs that are on the same journey that you are because entrepreneurship is tough. And so being surrounded by other people that are on the same journey, who can pick you up when you're down. It can also be helpful in terms of sharing other learnings, resources. Honestly, I cannot talk any more highly about this program. I'm going to drop the link in the show notes. Check it out if you're a first time founder, if you're considering making that leap into entrepreneurship, or maybe if you tried something before and it didn't quite work out, you realize actually this whole entrepreneurship game is a lot harder than you expected.

9:58One day is the place for you. The frameworks, the guidance, the support, both practically, emotionally is just second to none so check it out let me know what you think now let's get back into the episode you've got to be playing a completely different game haven't you like one of the foundational ingredients for any type of success which i talk about is first and foremost is play games you can win select the game that you want to be playing first and so you recognize the advantage that you've had is like being on the inside you've got that knowledge you've got that firsthand experience you've observed everything that's happening you've then you've come to that realization that okay we're not going to solve this problem in this way or in this timeline through this existing systemic structure and there's a reason for that and we get that so we're not bashing how that works um really interesting about that dinner and i love hearing about those specific trigger moments it's really funny how that bruised your ego as well i'd be the same i need a few months to like lick the wounds and then come back again um but that was exactly the sort of thing that was crossing my mind as i was listening to the early part of your story right like i was wondering like were your parents entrepreneurs what was that sort of exposure that you had because you mentioned that okay maybe they're smarter than you I doubt that but it's more the fact that these two friends of yours they just come from a completely different world right they're in the private sector they're both economists as you said it's much more commercial capital it's like that completely different viewpoint and that's where it's really healthy when we talk about diversity it's not just the color of our skin or our genitalia it's that diversity of thinking as well absolutely so your next step so you kind of came to this realization I can imagine in terms of like your self-identity you've had many many years as a medical practitioner it must have been such a shift for you to move into being an entrepreneur I think even like now would you call yourself an entrepreneur no I actually call myself still a medic but I'm just practicing medicine in a slightly different way is the way I think about it and it's interesting So my background is that both my parents are doctors.

11:54My mum is a psychiatrist. My father, an ENT surgeon back in Sri Lanka, but when he moved here, became a GP, a family doctor. And when I said that my wife said that they were smarter, what she actually meant, they are smarter, but what she actually meant was that they had an ulterior motive. And actually, it's quite funny because after Astron was set up and, you know, we started doing what we were doing, I went and spoke to one and he said to me, he had a twinkle in his eye. He said, it worked. No, not quite that. But it did work then, didn't it, Pad? Because it's taken you five years to kind of take the hint that you could be building something here.

12:30We just thought now's the time to be harsh. Give you that push. Yeah, so it was actually, they'd actually curated a plan, I think, beforehand without really between the lines. So I kind of owe their, what can I say, their sort of robust fronting up to a really good mate. But it worked. Fantastic, David. So those first steps. So first of all, you've got that kind of like, OK, having these outside perspectives and opening your mind to these other ways of solving this problem. What are those first steps that you take on that part of entrepreneurship? You mentioned one day. So as context to our listeners, one day is an ed tech scale up.

13:09It is an MBA program built by founders for founders. I'm a mentor on the program. Very proud to be one. And the best thing about it is that fully academically certified, you get an MBA at the end of it. But the best thing is, is that you start and scale a business for real alongside it. So that's how Padman and I are connected. He went through the program. I was very, very impressed with his final capstone assessment. So that's just a bit of context for the listeners. Was that the first step for you into entrepreneurship? And if so, why did you choose one day? Yeah, it's again, a great question.

13:45I think it took a lot. I think when you're when you're comfortable in a profession that you love and you can rationalize everything that you do every day by the fact that I took an immense amount of just pride in helping patients. You know, my they all have my mobile number. I, you know, spent as much time, you know, in the evenings on the phone to people, you know, reassuring them, talking them through things as I did in clinic. So it's just kind of one of the professional duties is the wrong word, but responsibilities that I took on. And as I said, I really miss that. But I think for me, I've always been someone who has had lots of ideas across loads of different things, actually.

14:24And the difficulty was always knowing how to translate those. And I'm always someone that tries to build the perfect product before standing up or letting anyone else see it. And actually, one of the first things that I that I learned, the reason I chose one day really was it was about building a product. not just learning the theory because I thought I'm great at exams I can you know I can learn the theory and I can pass that and I'll have another you know MBA and then I'll go on for another 10 years doing exactly what I'm doing now. Electing like certificate. Exactly I was like this is the safe thing to do yeah um but it's not the right thing to do and it was actually my my dad that said to me look you know take the risks that I never did you know he was a GP and loved it.

15:05That's so great. But I think he looks back on his career now and thinks he wished he'd done other things um with his time as well as being a doctor um and that's what attracted me to wonder i think i think it wasn't really about the mba the certification although that's obviously nice it was really about the exposure to people who had been there done it um you know really simple things i was fantastic at being able to tell my stories you can probably hear in a thousand words um in a really complex way where everyone would fall asleep by the time i got halfway way um and one of the first things i got from one day was that you have to simplify things and if you can't tell your story to everyone and they aren't interested within the first three sentences you've lost them and that was it um the other thing that was a really early learning actually and i think one of the things that i have really taken to heart and it's changed me most in just my personal life and my interactions with people is all about that perfection goal you know um and i think it was uh ben who's now my ceo who was my mentor at one day um who came up with the whole i didn't come up with it but he told us about the whole boys law of iteration where um speed of iteration beats quality of iteration every single time um and i don't know if you know the kind of story behind that um i'm sure oh okay that's a cool story actually um it's stuck in my mind where um there was essentially um two particular type of fighter jets so mig 16s and f86s i think they were um and essentially the migs were better than the f86s in every single way they were more maneuverable they were faster they climbed faster and higher more quickly um they were built better etc um and the f86 were older um they had two advantages and that was it they had i think side windows so you had slightly better visibility from the side and they had hydraulic um you know controls and that was it and every single person in this field predicted that in a dog fight the migs would win every single time and actually what happened was that the f86 has won i think nine out of ten times um and it was super interesting because boyd went back and looked today and he said well look the MiGs are higher in quality in almost every single metric but the F-86 win so why is that and it turned out that he thought that actually maybe it's the speed of iteration and the speed of iteration being that that hydraulic control that the F-86 has had meant that the pilots even though you know the MiGs couldn't get sorry the F-86s couldn't climb as fast or weren't as easy to turn or whatever the actual control to turn them was a lot easier for the pilots to use it required less muscle or less time and so they were able to just move much more easily and so over time in a dog fight when you have to do that same movement loads of times you could iterate really really quickly because the lever was easier to turn than the manual one and that's why they won the dog fight every single time and that's kind of where that learning comes from so from my point of view in medicine you get rewarded for staying within guidelines and not making mistakes yeah exactly and it's really hard the opposite yeah exactly yeah in entrepreneurship you kind of you get rewarded for making mistakes quickly enough so that you've still got some runway left in completely different world isn't it and again with like safety and you know putting patient first like it's it's the complete opposite like you know rightly and very understandably so right like you can't take risks move fast and break things all of these like startup truisms so you shared the Boyd's law as a story that really stuck with you that helped to kind of better sort of I guess appreciate the importance of the speed of iteration was there anything else for you that helped that sort of mindset shift because you've been living eating breathing this whole other world for many many years and so I'm I understand that like it's not as easy but okay I'm going to be an entrepreneur I'm going to like just learn how to work in this completely different way so was there anything else that I guess helped you overcome that sense of perfectionism doing dotting the i's cross crossing the t's I think it was that there's so many cases in medicine where I thought I'd done everything right and I didn't achieve the outcome that I wanted for the patient that was sat in front of me and I was sitting there thinking I've done everything I've done every test I've read every book and paper there was nothing within the confines of the system that I could have done differently and yet this person in front of me hasn't had you know the report the results that I would have thought and yet there's someone else over there who's done all the things that maybe they shouldn't have done and they've done really well and I can't explain it and and I think that's why I think the problem that we're trying to solve really i mean fundamentally and this might be a bit controversial i see this all over my timeline that ai is going to cure cancer and the thing is from my side it might well help and i hate using that word cure but it might help turn cancer into a chronic disease which is what we're trying to do really into something that is manageable long term but the main problem is that it's a data problem not an intelligence one we aren't collecting the right data you know we're not collecting enough data we're not collecting broad enough data we're not collecting it frequently enough and we're not sharing it with the world um and i'm not you know our team is wonderful but we haven't got all the answers we haven't got all of the expertise and so one of the things that we are really focused on is we've got a use case scenario for collecting broad deep molecular data across cancer types but we want to make that accessible so that other people who are asking slightly different questions can interrogate it and use it and move this forward yeah and it's a really it's a public health you know decision yeah um you mentioned the buzziest word of 2025 obviously AI how much of AI are you incorporating in to Astron a fair bit and I think where we are with Astron at the moment so essentially what we are is a bioinformatics platform so the way I think about um cancer management at the moment is that we we talk about precision or personalized medicine but the main problem is I mentioned there's a big technological overhang so we know that there are over 750 different cancer driver genes okay at the sort of dna level and that's one level at which you can look at cancer there are many other levels you can look at how those genes are expressed or what proteins they're creating or what metabolism of the person is or um i don't know the immune system etc so just looking at dna is one bit but there are 750 potential cancer driver genes and at the moment precision oncology can only hit about 50 of them okay and in any one cancer type we're looking at kind of two or three drugs hitting two or three genes and that's it so precision oncology is for the few not the many at the moment and the problem that we are trying to solve is that drug development is absolutely vital don't get me wrong it's the cornerstone of the next frontiers in oncology um but drug development is costly um you know we're talking two to four billion dollars to create a new drug or vaccine and um and it's also really time consuming it takes 10 to 12 to 15 years to develop a new drug and there's a lot of risk for a drug company you know you're finding now because the costs are so high um the cost of developing a new drug double every nine years or so it's ridiculous um only drug companies can afford to do it really universities can't charities can't it's really hard can i just say on this point on cost what you make um come up in my mind for me is the extortionate unbelievable eye-watering amount of investment that is going into ai to bring that back up again yeah into like the technological development the the servers the all of all of everything in this whole kind of ai industry is so like incomprehensible the scale of it how does that make you because it's like you can like anything in like you can find the salute you can you can find the money you know if it's if there's like enough of like uh a capitalist need enough of like a political you know look i think it's i think fundamentally we're in a system where we're trying to create one drug for one alteration and that's a problem yeah because you're dealing with one node of a really complex disease yeah you deal with one node and if you're lucky it works for a while and then the disease evolves anyway yeah but the problem is if you think if you're thinking about a drug company and they've identified that there is already a drug out there for a particular molecular alteration and that drug works really well and it's worth I don't know$50 ,000 per month to the drug company per patient okay that's an incredibly you know rewarding target to hit and they think well okay there's a drug out there that works and that company's doing really well how about I hit the same target but I use a drug that doesn't have to be injected it's a tablet or it's got better side effect profile or whatever it might be.

24:13Just like optimizations and improvements on something that already works. Exactly. So that's hugely de-risking it. So when we're talking about hitting more targets, that's not how drug companies are incentivized. They're incentivized to hit targets that they know are going to work. And so our approach at Astron is we can't solve that problem with new drug development. That's absolutely vital. It will continue apace. And the AI bit that you mentioned, actually in drug development, the hard bit is even if you expedite the bit at the start, where ai is really useful identifying better biomarkers etc that's just the kind of first 20 of the process you still have to go through phase one two three clinical trials and that takes time because you're looking at outcomes and safety and all that kind of thing so we're still talking about an eight ten year process yeah ultimately so from our point of view where we use ai we say okay well look there are hundreds of thousands of papers out there that talk about drugs oncology drugs non-oncology drugs supplements lifestyle interventions anything that can have an effect in your body and there are papers in the peer-reviewed literature that talk about how those interventions affect different pathways proteins dna and what we're doing as astron really is we've created an engine which is llm i suppose which is incredibly effective and specific at drawing out interactions between an intervention and a target we then score that intervention using our expertise um on multiple different criteria so how good is the literature what kind of studies were there who published it how many patients were there were they just in animals were they in cell lines etc how good is the actual binding data so how well does that drug actually bind that target in real life um how safe is the intervention um is it relevant to your particular cancer how important is the gene and all of that is really important because patients often ask me, how is this different from like Gemini or GPT?

26:05And the thing is, we're not just trying to find any pattern because you can literally go to GPT or Gemini and put in any drug or any supplement and any disease and it will find you a way that they're connected and it might be useful. That's not science. That's not useful at all. That's just finding trends that might be completely wrong. Yeah. And the thing with patients and this is the hard bit is that they explore this journey once. They do it once. It's really difficult for them to be experts because you're kind of constantly learning from what's going wrong or right. But they have one chance to get it right.

26:42Yeah. Is there a more personal driver for you with this? The surprising answer is actually not, which is, I think for me, I like challenges and cancer has a really special place from a psychological viewpoint. You think of someone with a diagnosis of cancer and you compare them with someone with a diagnosis of, I don't know, heart failure or dementia or diabetes even. And people think the worst about cancer. And the reality is that there are lots of cancers that people do really well from and live long, healthy lives. but I think for me I actually trained initially in cardiovascular medicine and we became really good at treating heart attacks and strokes and that was kind of like the reason that I thought okay well they've achieved a lot there what they did in cardiovascular disease kind of mirrors what we're trying to do in cancer which is if someone has a heart attack the acute problem is you've got a blockage in a blood vessel and you need to put a stent in or a bypass and restore the blood flow and that's great and that really helped but actually most of the research dollars that were spent in cardiovascular medicine was on the secondary prevention like how do you prevent that person from having another heart attack or a stroke well you identify the risk factors have they got high blood pressure high cholesterol diabetes do they smoke are they taking cocaine at the weekends they're not doing enough exercise whatever it might be and you really aggressively optimize that and you measure you know what you're doing and what impact that's making and failure for a cardiologist is that person ever having a heart attack or a stroke again okay and in cancer what we do is typically most of the tools and there are some newer tools which do different things you know in the case of say immunotherapy but typically or historically most of the tools in cancer surgery radiotherapy and chemotherapy are designed to kill cancer cells okay so eliminate as many cancer cells as you like and then hope it doesn't come back right We're not really hitting those secondary prevention factors that affect how likely it is to come back.

28:38And that's where I thought there was a real job to be done. And obviously, cancer is much more heterogeneous, much more complex. We're not talking about five or six risk factors. We're talking about, you know, 750 to the power of three or four. Right. So the combinations are infinite. Wow. Which is why the toolkit has to be massive. We're not just talking about five or six different drug types. We're talking about potentially thousands. and that's why conventional drug development can't solve this problem and so the first bit is collecting the right data on the right patients at the right time the second bit is being really practical with how we hit this but for me i think i just established that i wanted to big challenges of what i feel like i'm here for if i'm completely honest i'm very happy i just yeah i just i and i just I thought that cancer was although I wasn't directly affected by it actually for me that means that I can slightly depersonalize it and don't get me wrong this is exactly what I was about to say yeah yeah sorry carry on no please no I was just thinking exactly that you know with your opening answer on like it might be surprising like actually it's not surprising to me and I was just thinking that I was like it enables you to be perhaps more level-headed like less emotionally affected and just eyes on the prize like focused on the problem you're solving leveraging your experience your expertise the the the kind of technological age that we're in as well and how you can apply ai and data to to just solving the problem so almost more effective in that sense i think it makes it it certainly helps with that it also takes the ego out of the game yeah when you haven't got like i mean and don't get me wrong every patient is a horse in the race for me and i want to do everything yeah of course yeah absolutely as long as it's safe and proportionate etc but it does actually mean i don't have a particular philosophy that i yeah exactly we're trying to kind of find the truth for every patient exactly and then deal with that truth in the best possible way or give their doctors the best information yeah to deliver the you know the interventions in the right way for that person's version of the truth yeah yeah and that i think is actually a bit of a superpower exactly and it also kind of leads into the decisions we've made around you know who's the team and and how we're growing as a company amazing well you've had it on a platter the perfect segue because the other thing I wanted to ask you about is you mentioned that your mentor on the one day program which we touched on is now your CEO yeah so I'd love to hear about that like what was the decision making process with that how did it feel bringing in an external person to come in as a CEO to run the business that you founded do you know what it was the easiest hard decision I think I've ever made really really really really easy Ben is like yourself Steph just an incredibly humble chap um he is I am a humble chap sorry my apologies I love it I love it I've got the masculine energy not at all um he is yeah he is he's obviously as you know an incredibly successful entrepreneur he has the scars um the things that have gone really right the things that have gone really wrong and if I'm honest I think one of the things that one day taught me was to really double down on the things that I'm good at already amazing and to be quite frank um I haven't got the time um not me personally but patients and science hasn't got the time for me to learn how to be a good CEO love that you know I'm you know a middle-aged man I've been a doctor for a long time I've been a scientist for a long time my expertise lies there that's what I think I can deliver for patients that's what I want to deliver do you know what I'm just observing but the uh the lovely compliment that I will take about being a humble chap and that that what's really funny is like that humility that you recognize in Ben is something that you just have in buckets pad man and this comes out here as well even with this decision to bring in a CEO like we mentioned before about not having any ego in the game whatsoever like there is the ego has like left the building with you right and I just I really wish you know everyone could do with having you know greater self-awareness but especially founders especially entrepreneurs where I get how difficult it is when like it feels like it's your baby it's your mission you're so dedicated to it you've got that conviction you've got the vision I totally get that but sometimes when you're able to put some of that ego aside and really truthfully objectively ask yourself I think with you here again with the huge problem that you're solving I think that's I think you're already incredibly humble and knowledgeable and lovely and super high self awareness anyway but when you combine that with this life or death problem that you guys are solving it just means that that ego is now in a whole other postcode do you know what I mean And so obviously not everyone is solving these life and death issues, but you'd be so much better for it because to your point is like, I just know so many people who are doing it for their own egos to prove to prove it to either themselves or somebody else.

33:45But there may be like this other battle tested CEO that might be better at leading the come and taking it to that next direction. I think especially when you're past maybe a certain level with the business as well. I see that sometimes too when like your post-product market fit and you're on that scale up journey being a founder a zero to one leader is very different to like a one to ten so I really commend you for that Padman but you know what I think part of it is actually being a doctor because um it's really difficult people might disagree with me here but on the inside when they're really honest with themselves most doctors have quite a lot of self-awareness and not that much ego maybe on the outside there's a lot of bluster because there's this paternalistic view of doctor knows best yeah you have to kind of portray that image but in the individual moments where you're there at the end of the day and every doctor does think about what's happened that day it has a funny way of smacking you in the face just when you think you you know it's a commitment to lifelong learning and it you know there is your ego gets bashed every single day when it does absolutely i'm so sorry to jump in here again but like on the uh earlier conversation around how completely different these worlds are actually this is something that it does have in common with the world of entrepreneurship right like we're getting like not back down keeps us humble absolutely and to your point about you know bringing ben in and that being humble i think there was a bit of selfishness in there if i'm honest because ultimately my skill set maybe i could be good at being a ceo managing a team and growing the business and fundraising and all that and i love doing all of that of course i do um but i'm not as good as ben is and i'll never be as good as him because he's been doing for 20 years to be quite frank with you and that is his skill set and I'd like to think that probably he would say the same about me scientifically um but I but you know I think from my point of view I think being a founder um is not about being a hero it's about bringing in a team of people that resonate with your core mission and have the same values as you do for your business so that you don't need heroes ultimately um and and and look in terms of there's a lot of founders who have run their own companies and done incredibly well so don't get me wrong that can happen but for me I always felt this was too important a project for it not to work because of the wrong CEO and I thought you know look if you're if you're the founder of your business maybe you haven't dreamt big enough and and I think all of us in our team are humble we're all searching for the truth we're all searching for the right way of doing things so that you know we're being really practical we're driving change but we're not doing it in a really difficult to tolerate way for the establishment you know and that's part of it as well just being smart about how you approach conventional science and conventional oncology to be part of the solution not to be a thorn inside renegade exactly like fully like disrupting you've got it you've got to play the game as well right um it's important for anyone to bring in a but especially again solving this problem other than ben's experience track where like being a battle tested ceo was there anything else for you that made you confident that ben would be the right ceo for your business so he's got some really complementary skills so um he's been working on neural networks since he was about 12 i think um he's also one of the best stories if anyone has a chance to sit down with ben ben waitley he's one of the best storytellers ever we were actually a team Christmas drinks a couple of days ago and we just sat there listening to him he's incredible but he's a fantastically intelligent guy, he is a wonderful communicator and he gets people really rooting for him I think those are his superpowers to be quite frank, he also is incredibly good at bringing everyone into the conversation so in terms of our core values he's really collaborative no decision gets made just by him or just by the senior leadership team, everyone's involved.

37:45And we are a small team because we're a software team and an R &D team. But he just really manifests everything that I wanted for Astron. Incredible. I love it when you know, you know, right? That's incredible. I love that. You mentioned fundraising earlier as well. Like this was one of the benefits of bringing in another CEO who's kind of been around the block. They've been there. They've done that. They've got the T-shirt. So on that note, congratulations on raising 700K in your fundraising. That's incredible. what were your lessons learned from that I know fundraising is always a top topic for entrepreneurial listeners everyone wants to know like how do they bag the loot so any top lessons you can share from that fundraising yeah I think this was a really interesting one is that I often concentrated on the science and how exciting it was and what I realized was that a lot of investors are really busy they're super smart and if you gave them long enough they would absolutely understand the the core and the essence of our science and be super excited by it in the same way but they just didn't have the time and what they really wanted was the inevitability of our solution working and that's really difficult to give them of course especially as a doctor and as a scientist and you could never be sure about these things there's always risk of course you can't blag it no of course you can't but i think that was that was the thing there was there was there was you know you were they were buying in i think firstly we were super lucky that um the funding groups that we have eventually worked with were people who had identified and cared about the same problems that we cared about we weren't trying to show them what the problem was and this is one of the benefits of working in science and cancer in particular as you mentioned earlier everyone's got a relative or a friend or someone that's been through that it resonates with people psychologically and i think that's been helpful yeah for us yeah um i think a lot of people now in our generation sorry steph i know you're not younger than me but uh in my in my generation i suppose um have you know we're getting cancer younger you know and and talking about five-year survivals isn't enough right we need to be talking about 35-year survivals and getting this to be a chronic disease and i think what our mission is all about not just talking about cure um but giving people great quality of life for as close to normal length of time as possible um without making it this horrible noose around your neck yeah um that's what we're about and i think a lot of people resonate with that so i think those are my my two main points yeah how do you go about finding them i guess did you just kind of really lean into ben and his networks and his contacts or any other practical tips yeah there was quite a bit of that ben's got and that was the other thing i didn't mention ben ben no ben seems to know everyone that's how that's helpful it really is helpful so there was there was there was a fair bit of that but then you know going to health tech conferences meeting people honing your elevator pitch really telling them what you're trying to achieve um and actually what's really exciting is that you know one of the things about astron is that yes we have we think an amazing solution for how to deal with personalizing cancer and doing that at scale really rapidly without having to wait 30 years for the next batch of you know new drugs to come about yeah but also we're building this incredible database which is really if i'm honest like a public health service so much value in and of itself right with the database exactly and i think that brings a huge amount of interest to lots of people that you wouldn't associate you know pharmaceutical companies have been really interested in what we're doing yeah biotechs um healthcare systems etc because the kind of joining up of that data is a massive yeah yeah yeah what i'm taking away from this as well is like it's really easy to overlook the magical convalescence of these various factors that are both inside and outside of your control so the fact that you know the selection of the problem to solve you know which has obviously been drilled into you through the one day program right we spend a lot of time like what we call like running into the spike and really sort of like we're actually kind of proving you wrong at every step right we want to actually like pull it apart rip it apart see if there's any holes in it and so that's where first and foremost is absolutely vital to choose the right place kind of what i said right at the very beginning it's play games you can win we all get so every we get these ideas like you said you're very much an ideas person we can all imagine what this thing would look like We can even like, you know, the branding, the website, all this other stuff.

42:12But we leapfrog too far all the time. You need to spend time in that discomfort of choosing the right problem, because now where we're at in your story is that fundraising and how much that has helped kind of those tailwinds of, you know, it's a huge factor, right? It's a huge problem that you're solving. So many people relate to that. And then on top of that, you've got kind of the tailwinds with AI at the moment. You know, I feel like every single VC is just, hey, that's like the buzz at the moment. You've got Ben that you've brought in as your CEO. You've got all of these like various factors, your expertise, of course.

42:50But again, a lot of that has been inside of your control, but other things haven't as well. Right. And so it's that's where I think, again, entrepreneurship is so humbling. And I think people need to also remember to not take it so personally, because as much as you try, as much as you do the right things, like you say, even like a doctor, there are still things that it just might not be the right timing. Right. Absolutely. And I think, again, just as a doctor, we never think about things in this country, in the UK. We never think about things commercially. And so one of the things that's really hard is the incentive structure.

43:24yeah it's one of the really difficult things for me especially in certain unnamed countries is that patient outcomes aren't always the bottom line yeah you know health care cost yeah is a massive issue yeah and so reframing the problem sometimes is a bit of a wrench yeah but it's not always about we can do this to survivals it's about well we can do exactly what we're doing now but at a much lower cost for much exactly um and that's been a bit of an unlock as well yeah to be honest Padman my traditional closing question on the show I know what's coming next here we go locked and loaded this is called strategy and tragedy because often the best lessons come from the biggest mistakes what's one tragedy that's taught you an unforgettable lesson it's a great question if I'm honest you asked me earlier about whether there was a personal story as to why I got into cancer specifically and it It's not something that got me into cancer, but it is something that got me into medicine.

44:26And when I think back to it is that my mum was diagnosed with Parkinson's disease when I was three. Wow. So she's had it for nigh on 40 years now. And I really wanted to be part of the system that could help her specifically. And my mum is, you know, a really active person. She was an athlete. she her life is outside you know gardening running jumping being sociable you know whatever amazing um and it was also a disease that affected her brain and she's a psychiatrist which is really really tough and i think for me the tragedy is that over the last i don't know 40 years 35 years maybe of my life i've tried loads of things to kind of help her and part of that has shaped why I work and where I am you know I I used to see that one day she'd eat certain foods and she'd be a lot better I remember one day she she had a she had a knee injury she'd had a fall somewhere when her she was only about 45 my dad gave her some ibuprofen and her Parkinson's symptoms got incredibly much better for that week and I was like what was going on here so that has shaped a lot of my interests in medicine but fundamentally it has been treating her through or helping to treat her and optimize her through the tools that are available in the system by drugs that treat parkinson's disease by prescribed by neurologists and that has kept her alive for 40 years you know she's 80 now um and i think the tragedy for me one of the reasons you know you asked the question about why entrepreneurship why one day etc was that i realized probably seven or eight years ago that we've done a really good job of keeping her alive but not really keeping her alive and there is a difference between living and quality of life and that was one of the reasons that I realised that we kind of owed this to people like her treatment within a system, especially the healthcare system as it is now, doesn't always afford the quality and depth of life to people suffering from chronic disease padman thank you thank you for coming on this show for doing what you're doing again i mentioned in the intro around problems to solve in entrepreneurship and you know what i actually share with like my founder students on one day is like you know don't sort of you know we call it a problem or a pain point but you know it could be um how how can i get like a healthier snack more quickly you know it's kind of like it's not always what we would think necessarily like as a problem to solve but what you are doing here really again is like one of the world's very few very pressing urgent life or death problems that need solving so again kudos to you padman ben your team i'm so impressed i'm so glad that that you guys are doing what you're doing so well done and more power to you oh thank you so much thanks for having us thank you for curating one day and doing all that you do i don't i don't i genuinely would not be here without that yeah how crazy we're very grateful well done you amazing thanks for having me thank you so much thank you for listening as well i really hope that you've enjoyed this episode if you have please hit that follow subscribe like button wherever you're listening to this it really really helps us out and it means i can bring more incredible guests on the show for you to hear from thank you episodes are weekly so hopefully see you next time take care bye

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