The Alarming New Risks of Cancer Everyone Needs to Hear

26:47And I think that every woman should know what it is. Something that every doctor takes for their patients, that when you go in, they ask for your blood pressure and your family history, but they don't ask what your lifetime risk assessment score is. So we're working on legislation that will help make the standard of care for every doctor to also know that information. I think you've already done such a great job. They saw an increase in people taking that test after you told your story. And I'm sure it's going to go up even more now that you're sharing your story. Thank you for helping to get out this message because that's the...

27:22I mean, as you know, more than anyone, is just like continuing conversation over and over, the awareness that just has to keep going, which is why we want the onus to come off of women some to know about this test and put it onto doctors to be there in those offices and educate the patients about it. Yeah. So you sharing your story has already done so much for women. I thank you for that. Thank you. Thank you. Take good care. Thank you, Olivia. Thank you, sir. Good luck. So more and more women, 30s, 40s, are experiencing much of what you talked about. Absolutely. And as you can imagine, I mean, these are often, you know, young women with families.

28:02They have children to think about. They have future fertility to think about, as Ms. Munn did. And so the decision becomes not just, you know, about yourself. It becomes about your family. So what are the current recommendations for breast cancer? I've been taking a mammogram now since I was 40 doing screenings. But if women in their 30s are big, I also have a family member who at 36, you know, developed breast cancer and wasn't even through a mammogram, just through doing her own breast test. So what should be happening? Should we be screening earlier? Well, so the problem with mammograms is that the yield to discover a real cancer is very low, especially in young women.

28:47And that's complicated, of course, by women who have young breasts. By yield, I mean there's a number, which is how many mammograms you need to take in order to save one breast cancer life. And you said complicated by women who have? Dense breasts. Dense breasts. Okay. Olivia talked a little bit about that. But leaving aside the question of dense breasts, which is particularly the case with young women, the yield in the mammogram is very low, especially in that group. And so doing mammograms early or doing more mammograms will inevitably yield lots and lots of false positive, lots more biopsies, lots more anxiety.

29:31And, you know, it will obviously yield a few real cases of breast cancer. So what I've been recommending is very much on the lines of what Olivia did, which is to say, first of all, if you're a young woman and if you have any history of breast cancer, of ovarian cancer, of pancreatic cancer, you should go and see a physician to potentially look at, to do some genetic counseling to see if you're at a genetic risk for breast cancer. and those are people who have you know will pick up people with so-called brca1 brca1 brca2 mutations among other things number two is that there is actually a genetic test if you have a family history of breast cancer or of any of these cancers there's a genetic test that even if you are not brca1 or brca2 positive it will give you a score of the risk that you have genetic risk for breast cancer it's a score it's called a polygenic risk score again it's not perfect but if women who do have apologetic risk scores, if they do have one, certainly if they have BRCA1, BRCA2 and some of these other breast cancer genes, I'm recommending them to enroll in a trial with intensive screening.

30:42There are many around. Some of them use a combination of MRI and mammograms sort of alternatively. Some of them are MRI only. What I'm really hoping for is that there's a test that will come along which won't be as invasive and which will not have as many false positives as a mammogram that we can use that as a potential way to screen these younger women. Okay. So when Chadwick Boseman, the actor who played the Black Panther, died after a private battle with colon cancer, the world was stunned. Chadwick was just 43 and his wife, Simone Boseman, was by his side until the end. Simone, thank you for joining us.

31:21We were all so stunned and you all were able to manage to keep that private. I read that his symptoms began just weeks before his diagnosis in 2016. What was going on? Yeah, well, first, thank you for having me. Thank you. Chad was 38 when he was diagnosed, and he was diagnosed at stage three. So just before that, he had already been to the doctor a few times before I even found out about it. And essentially, he was just having trouble going to the bathroom. And first the frequency changed and then it really slowed down altogether and stopped altogether, which just impacted his ability to move and operate and eat.

32:08He was on a really strict exercise regimen, so it was affecting him quite a bit. and there were maybe three or four weeks in between our first visit to the doctor together and him being diagnosed with stage three colon cancer. And so once you both found out, did he go into chemotherapy? What was the procedure for helping him? Yeah, there was chemo, there were surgeries, a few different rounds of chemo and a few different types of chemotherapy to, you know, see what worked on his particular type of colon cancer. And we also, you know, there was also Eastern medicine that we involved. We were doing all the research we could and trying all of the avenues that we could to get his immune system to fight this cancer and fight the, um, fight the effects of the chemo as well.

33:09By the time you're stage three, though, what does that actually mean, Dr. Mukherjee? So it means the cancer has spread beyond, certainly spread beyond the original local site. It's gone through the bowel wall. And in many cases, depending on what kind of cancer, has started invading the lymph nodes. So it's called advanced cancer in the case of colorectal cancer. Now, astonishingly, I mean, I'm so sorry that you had to go through all of this. And the world is very sorry for it, I think. Astonishingly, immunological therapy still works in stage three in some cases. I'm sorry it didn't work in this particular case, but it really works.

33:53I mean, this is an incredibly important conversation we're having. Because, you know, cases like this remind us that we have got to do better. We have just got to do better. And if we don't do better in diagnosis and in treatment, then, you know, shame on us. Yeah. And he was at an age where normally he wouldn't have even been getting a colonoscopy. I have a friend who's 42 who's going through this, also stage three, and also had to make up a story about it being in his family in order to even allow them to test him. They weren't going to test him. The doctor said, you know, you're too young. You know, it's probably just stomach ache or whatever.

34:37Big misconception, by the way. What is the big misconception? Misconception is that, you know, we know the rise of colorectal cancer incidence and death in young men. So no doctor, if you come with lower abdominal pain or abdominal pain, should be saying to you, oh, it's just, you know, something you ate. That's not the standard anymore. I know that caretaking is one of the most demanding jobs, and you were there by his side till the end. What is your advice to those who are supporting loved ones with cancer, Simone? Just love your way through it. It's going to be stressful. It's going to be overwhelming.

35:16But let the good times be good. And do as much research as you can. Try as many things as you can. really leave no stone unturned because the guilt of grief is almost an impossible thing to deal with even when you do try all of the things. If you have even an inkling that something might have any kind of effect on your loved one's situation, you should try it and you should push them to try things as well. It was interesting you were talking about the guilt of grief. Are you still carrying that? Are you still thinking that there was something else you could have done or or should have done or might have done?

35:54I think I will always wonder if there were things we could have, should have done. I think that's a, yeah, that's a reality of losing someone. You'll always wonder whether it's from cancer or from anything else. Could I have talked to them? Could I have kept them in the house for five more minutes and they didn't get in that car accident? Anything is gonna come into your mind. And I think it's also survivor's guilt. I think for the first several years, I could not make sense of why I was still here and he was not, when he was just such an incredible, extraordinary spirit and person. And it is, the edges are less sharp now, but they are still here.

36:42Yeah. And you know what? I was just thinking too, and I don't know four people in my immediate family and friends who are going through one form or another of cancer right now. And we know about it. We, the family know about it. Other people know about it. I think it's even doubly hard when you have to keep it a secret or you have to not let other people know. So that adds to the stress because he was working and correctly so. If everybody knew he had cancer, there would have been a completely different reaction on set and all the other things. And so how absolutely courageous of him and of you to go through that when you're getting cancer treatment.

37:24It's just unimaginable. I just wanted to add I'm incredibly brave of you and to share this journey. You know, I think about the guilt of grief a lot. It really rests. The guilt of grief is something that resonates with many, many families. And I always return to the very famous quartet of things that patients want to do when they're facing death, which is to say to someone that they love them, to be told that they're loved, to say to someone that they forgive them, and to be told that they're forgiven. And I can tell you for sure the way you took care of him, Simone, I'm sure that you received all four.

38:07So I hope that helps with you with the guilt of grief. Thank you. Thank you. And you say he was your greatest spiritual teacher. Tell us why. Oh, man, he was. You know, credit to my mother. She gave me my foundation for my own spirituality. But Chad, he was someone who did not just believe in spirituality, but he really lived it. And he showed me discernment. And he showed me what the feeling of truth was, what it means, how to understand when I know something that is right or good, and when I know that it is not good and when I know that I don't know. And then how to go to God and ask for guidance and most importantly to be able to listen and wait for God to answer.

39:03And those are principles that I learned from him that I'll carry with me for the rest of my life. Well, it sounds like he was truly the Black Panther. He truly, truly, truly was. Sounds like he was truly the Black Panther, really. Thank you. Thank you so much. Thank you. Thank you. So what can people do? Is there anything, first of all, what you just said, if you are under 50 years old and you go to your doctor complaining of stomach pain, rectal pain, and the doctor says it's just a stomach ache, you should fight like hell to get the test. Well, you should get a different doctor. You should get a different doctor.

39:39You should get a different doctor. Yes. Yeah. So because you just said doctors know that this is happening. This is a well-known phenomenon. It is published in national statistics everywhere around the United States. That you don't have to wait till you're 50 anymore. There's no reason to wait if you have symptoms. If you have symptoms. Yes. There is absolutely no reason. It doesn't make sense. It's like saying my car is broken. I'm going to wait until the next 10 years to fix your car. Yeah. It just doesn't make any sense. Yeah. So yes. So uterine cancer, I understand, is the most common cancer for female reproductive organs.

40:11And one young woman named Eve was recently diagnosed and shared her story on social media. Watch this. My name's Eve. I'm 28 years old. And in October of 2025, I was diagnosed with stage 4 endometrial adenocarcinoma that has metastasized to other parts of my body. And the reason for this video is because I am starting a series to kind of talk about the symptoms that I had leading into this diagnosis. I've had tons and tons of women reach out to me via social media asking, how did you know? What did you do to find out? What are you doing now? I'm so scared. And the last thing that I want is for this circumstance that I'm walking through to cause fear and anxiety in other people.

41:02I remember before this diagnosis came out to light, the anxiety and the fear that I had just leading up to this moment was absolutely crippling. And I would never wish that upon anybody. And Eve is joining us now from Texas. Hi, Eve. Hi. Hi. How are you? How are you? How are you? I'm good. Thank you. I heard you were dealing with symptoms for years, but you were dismissed by doctors. And what were those symptoms? Those symptoms were prolonged uterine bleeding. So I was having bleeding at that point for about three years now. I also was having urinary incontinence. And then the other one was extreme pelvic pain, which all of these, when I did present them to my gynecologist at the time, was dismissed and labeled as just PCOS, which is what I was diagnosed with over 10 years ago.

42:03First of all, I apologize. Your doctor should have known. Your doctor should have known. It's interesting that the three cases that I picked were colorectal cancer, breast cancer, and endometrial cancer, because this is known. This is established. It's known. And so a young woman, particularly with PCOS, the syndrome that she has, who comes in with vaginal bleeding, pelvic pain, et cetera, needs to have a... PCOS stands for what? Polycystic ovarian syndrome. Well, you can tell us more about it than I can, but this is well known. And, you know, the sad, sad story about all of this is that if you catch endometrial cancer early in its first stages, it is highly curable.

42:47It is very, very, very curable. And so the idea is that as soon as someone comes in, particularly with this kind of history, with pelvic pain, with et cetera, et cetera, they need to be assessed to see if they have endometrial cancer. Yeah. I would say that the only piece of good news is that these cancers have become, over time, more and more, we've gotten more and more better and better therapies, chemotherapies, some of them. I can tell that you're probably on one of those chemotherapies already. But also, there are second-line and third-line therapies. So there's a lot of progress in treatment, but this is a case that should not have happened.

43:26Eve, so what the doctor's saying is your prognosis right now? Right now, my prognosis is less than two years, and that changed over a span of, I want to say, four months. Initially, when we first found out about the cancer, I was given about five years. And the reason why there was such a long delay was because insurance companies weren't wanting to cover for treatment. So that played a big role. And by that time, the cancer, which was already stage four, grade three, it had already metastasized even more. And we actually found out about this after four years of infertility. So that was really hard to hear.

44:06But the prognosis as I've been praying over myself is not a promise. And so even though I'm given less than two years, I'm going to live and believe that God still has more for me and that if I'm here right now, it's for a reason. Absolutely. And one of those reasons is you wanted to share with other young women what you wanted them to know and what is it you want them to know? I want them to know that it is extremely, extremely important to truly advocate for yourself. And like we just said, if one doctor is not listening to you, you have to push and find another one. Even if you go through 10 doctors, you have to find one until they finally sit down and hear what you have to say because I didn't do that.

44:50And I do feel like had I spoke up earlier before I even knew that I had cancer, I wouldn't be in this situation today. So tell me this, Eve. Every time you were told that it wasn't the, you know, that you shouldn't be that concerned about it, was a part of you relieved? Because I think a lot of people, when their doctors say, let's keep an eye on it or let's watch it, which I don't believe in. Let's keep an eye on it. I believe in let's look at it right now. But when your doctors say that, there's a sort of a sense of relief that maybe it's not as bad as I thought. And therefore you buy into that.

45:27Is that what you did? It was actually not relieving for me at all because I always kind of knew in my subconscious that something was wrong. I actually worked in women's health for a little over eight years. And so I talked to women who had these same symptoms and every time I would bring them up, my doctor actually said, you know, if you were a few years older, then I'd be concerned for cancer. But because you, at the time I was 24, 25 years old, it didn't cause any alarm. And so I do feel like, and it was always per ACOG guidelines, per ACOG guidelines. And I really would like for ACOG guidelines to be updated at this point, because after posting about this on social media, it turns out that there are quite a lot of women younger than me that do have very advanced stages of uterine cancer.

46:16So your advice would be when you think something's wrong, as, you know, we've heard from Dr. McGurgy earlier, if the doctor says, no, you go find another doctor if you think something's really wrong. Absolutely. Because do our bodies tell us? Well, in this case, her body was telling her the full story, actually. Her body was telling her that she had risk factors. Her body was telling her that, you know, she was having pelvic pain, that she was having vaginal bleedings, that she was having... I think you said you stopped your periods. You were having infertility. I mean, your body was telling you...

46:51Your body was not telling you something. Your body was screaming from the rooftops. So I'm sorry. as I said, it's hard for me to put myself in every physician's shoes, but these are known facts. These are just, you know, there's something very well known about all of this. Eve, thank you so much for being courageous enough to share your journey with us. Thank you. Thank you. You know what? Someone is watching or listening right now who has had one or more of those symptoms, who's looked the other way, and because of you today, they won't. They will follow through. I believe that is true. Thank you so much.

47:30Thank you so much. Thank you. Thank you for sharing. So you talk in the book about all the various kinds of cancers. Is there one cancer when you hear that cancer that all doctors go on the alert? Well, the typical answer to that question is pancreatic cancer. Yes. And doctors go on the alert. But as you know, as of very recently, for the first time in human history, there was one medicine that changed the, that in a randomized controlled trial, so in other words, in a fair, statistically clean way, showed that it could increase the lifespan of patients with advanced pancreatic cancer. Now, the increase was from six months to 13 months, and you could say, who cares?

48:17But that's not the way you think about it. The way I think about cancer, all cancer, is it's like climbing a mountain. And the first crampon you put into the mountain is very crucial because it's going to hold up the whole journey upwards. And in this case, the first crampon has been planted. From here on, we'll know, you know, how does it become resistant? Can we make another medicine? Can we combine it with a third medicine? And so forth. So that's that. And then, of course, my personal nemesis has been acute myeloid leukemia, AML, which I've treated for many years. And still, Tatiana Schlossberg got this very moving piece, and she died of AML, that same disease, a few months ago.

48:57You write this on page 473. About the time you met with your book editor, you said, I sat in the editor's waiting room high above 6th Avenue looking outside. It was one of those magical New York afternoons when the balminess in the air becomes intoxicating. and crowds had gathered on the streets, but I was a trainee in oncology in Boston and all I could see was a landscape of future grief and anxiety. The woman laughing breezily by the bakery might be diagnosed with cancer, ovarian or breast. In a few years, I imagined the man smoking a cigarette with evident pleasure in a hospital gown as he went for a lung CT scan.

49:35The lenses with which I saw the world had forever been changed, you wrote. So my question is, how do you personally cope with, you know, the immersing of yourself with people fighting every day for their lives and you don't know if you can save them? How have you managed to do that? Well, people say that the way to manage to do that is by moving yourself away, to distance yourself from the fight. I think it's just complete nonsense. I think the way you survive being an oncologist, the way you survive many of these intense professions that make deep demands of you is to lean in instead of leaning out.

50:23And by leaning in, I mean you make that person's grief your grief. You make that person's fight your fight. You make every fight your fight. And eventually if that explodes, it explodes. but you can't survive it by leaning out because that will always come back to haunt you. The only way you can survive is by leaning in. Well, what you described feels to me is the difference between having a good doctor and having a great doctor. Yeah. Yeah. And, you know, having people in my family going through it now, I mean, I see the difference between people who are really leaning in and the people who you're just another patient.

51:03Yeah. Yeah, yeah. So what is the future? It's like with that woman who started this whole book for you. What is the future? What do you see for where we're headed with cancer in the future? Will it be eradicated or is that just a pipe dream we're all having for ourselves? Well, I can tell you what I'm doing. You know, in some ways I think of myself in my own journey or fight against cancer as an opportunist. In other words, if new technology comes along and I can push it to use in cancer, I'll bring it along and make it useful for cancer. Has AI been helpful? AI is the single most revolutionary technology of our generation.

51:45And if we're not using it for cancer, we're losing the plot. So in other words, people have all sorts of paranoias and fears about AI. They're worried about job loss and fake news and so forth. But I think the one thing everybody agrees on is that... I'm an AI optimist. And I think if there is one use case of AI that is optimistic, it's medicine. Medicine, yes. I started a new effort company called Manus AI. Manus comes from the Sanskrit word for brain or mind. So the idea is to turn the mind of AI to make new cancer medicines. Cheaply, better, more efficiently, and superior medicines. And the way we do that is by, you know, you can't go into Claude or, you know, Gemini and say, find me a medicine for breast cancer, and out pops an answer.

52:33What you have to do is you have to go and teach it the basic rules of medicinal chemistry, physics, and to some extent biology, but basic rules of medicinal chemistry to teach it how to build a medicine, just like humans build medicines. Humans don't build medicines by going into cloud code and writing a code for medicines. They make it molecule by molecule. They figure out what the targets are. They validate those targets, and then they build a medicine by stitching together, literally stitching together a molecule in space that can either, you know, jam a lock in a key in a cancer-relevant target.

53:12So that's what we're doing at Manus. We have taught the algorithm. The algorithm actually knows more medicinal chemistry than I do. And it speaks to us. It speaks back to us by producing. This is the funny thing about it. It speaks the language of medicinal chemistry. So if you give it a potential target or a query, it will start generating not one, not two, not three, but series of medicines that has been built using the laws of chemistry and physics, these constraints. And then, of course, we have to test them in real life and then feed that information back to AI and say, yes, you're wrong there, you're right there, you're wrong there.

53:51And that's called reinforcement learning. You learn. And I think that is the capacity to really change the game. We used to build medicines one at a time using human medicinal chemists. That's not good enough. We need to do better. So we're making medicines many at a time using AI medicinal chemistry. One of our guests today spoke of, you know, leaning in and also keeping a positive attitude. I think Olivia was talking about that. Keeping a positive attitude through the whole process. Have you found that the way a patient approaches their cancer diagnosis affects the outcome or not? Not in the simple way you think.

54:34I mean, I think the problem with, I mean, I applaud people who have incredibly positive attitudes through their cancers. I think it's wonderful. But it also, unfortunately, creates a kind of prison cell of optimism for patients who don't have a positive attitude. That's right. You may be suffering from terrible grief because, you know, you're worried about leaving your children behind. And should you be blamed for that? No, you should be, you know, I do think that attitude makes a difference in terms of your capacity to cope with, you know, with cancer. You know, it's something that brings you to the hospital day after day, night after night.

55:16I talk about Carla in my book. And at one point I wonder, you know, I was in traffic. I was going to her home one day and I said, what is it that brought her day after day, night after night to the hospital in this boiling traffic, you know, sitting? So a positive attitude, I think, you know, can become its own stigma. You have to have a positive attitude. You know, you've got to be, you've got to think positively. You've got to think better. I think that can become its own stigma. Some people are, you know, drenched with grief. But to them, I generally say, I understand. I understand you have full right to be drenched with grief.

55:50I would be too. Who would not be? But on the other hand, let me make sure that you being immersed in sorrow and grief and anxiety does not prevent you from getting the medical care that you need. Right. That's the difference in the question about positive attitude. And is there anything we should be doing or, you know, adapting the way we live and eat and move and exercise to improve the inevitability of those sleeper cells being awakened. Well, there are small ways. I wish I could give you big ways. But the small ways that are certainly, you know, I think that I'll give you a couple of associations that I think are alarming.

56:33I think there is a growing relationship between forever plastics and inflammation that I find alarming. So it's not been proven out yet, but there's enough, there's the beginning of a smoking gun there. Obviously, obesity has been now connected with many kinds of cancer, including most importantly, endometrial cancer, a cancer related to obesity. So, you know. Forever plastics. So yeah, forever plastics. You know, the standard thing, there's bestest, of course, you know, same inflammatory pathway, obesity and diet, appropriate risk assessment. So in other words, really think about, think through, if you are at high risk, you need to be seeing a different kind of doctor in terms of your risk for cancer.

57:19And, you know, in terms of diet, we've now known forever that diets that are diverse and that actually are rich in fiber. Yeah, the Mediterranean diet. Are much, much lower risk of colorectal cancer. So, you know, generally speaking, I always advise for all of this. On the end, if there's some cancer that are caused by viruses, human papillomavirus, for instance, causes cervical cancer. The incidence of cervical cancer in patients who get the HPV vaccine, women who get the HPV vaccine, is zero. So in other words, it completely eliminates. There should be no cervical cancer left in the world. So get the vaccines that are relevant.

58:08And those are the very broad recommendations. I think as we explore this whole issue of chronic inflammation, we'll find more things that potentially cause chronic inflammation. We'll find things that are markers of chronic inflammation. That will be a big day because that will mean that we can start. It'll be like finding a cholesterol for cancer, as in cholesterol for heart disease and chronic inflammation for cancer. That'll be a big day because we will then be able to say, I think that you have a heightened risk for cancer because there's chronic inflammation going on in the body. Let me try to see how I can help and figure out how to balance that, how to decrease that, and potentially look for cancer.

58:50So all these things we see on the market for anti-inflammatory, causing, none of that means anything. No, they're usually not even attacking the right kind of inflammation.

59:04That's just commercial marketing. That's just commercial marketing. Yeah, that's the low fat of this era. That is the low fat of this era. Yeah, low fat of this era. Yeah. So what keeps you up at night? What keeps me up at night is hope. I'm a born optimist. I live, I eat off. My morning breakfast is optimism. my evening dinner is optimism. I'm an optimist. I think that we will make a difference and we will make a difference in this disease before I die. Thank you. Thank you. Thank you. Thank you, Dr. Mukherjee. The book is The Emperor of All Maladies. It's a biography of cancer and the new edition is available everywhere books are sold.

59:46Thank you, Olivia Munn. Simone, thank you, Simone Bozeman for sharing and Eve for sharing your stories with us. And thank you all for listening and watching. Take good care of yourself. Thank you. Dear listeners, it is with sadness that I share with you that my guest on this episode, the young woman named Eve, who was fighting stage four endometrial cancer, passed away just a few weeks after our conversation. It was an honor to have Eve on the Oprah podcast. She told us it was deeply important to her to share her story because she wanted to help other women facing similar medical challenges. We extend our sincerest condolences to Eve's husband, family, and friends.

1:00:25May her life continue to be a blessing to all who loved her. Dr. Mukherjee says we're on the cutting edge of AI advances and research for cancer. To read more about this work, check out his New York Times article, Can We Make AI Belong? The link is right there on your screen. If you want to dive deeper into the history and also the future of cancer treatment, The QR code for Dr. Siddhartha Mukherjee's updated Pulitzer Prize-winning book, The Emperor of All Maladies, is right there on your screen. It offers a deeply researched look into a disease that has touched nearly every person on earth in some way over the last 5 ,000 years.

1:01:11To order the book, just scan the QR code. It's that easy right now. our listeners tell us that the podcast is resonating with you and is serving as a bright spot in your day. That means a lot to me. So here's the thing. I would really appreciate it if you like and subscribe to the Oprah podcast on YouTube or wherever you podcast. It's just a quick tap of the subscribe button. And that way you won't miss an episode in your queue. You don't have to pay anything. I know subscribe usually means you're paying something, but this time it means you just are notified when there's something new. There are many more to come that we're excited about, so thank you for watching and listening.