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Back to #412 ‒ The evolving science of cancer: emerging approaches to prevention and early detection, and the advances reshaping treatment | Siddhartha Mukherjee, M.D., Ph.D., with Siddhartha Mukherjee.

Is Osteoarthritis an Obesity Disease?

Siddhartha Mukherjee says he has never believed osteoarthritis is an obesity disease. People who are not obese get osteoarthritis, and the disease can appear in joints that do not carry body weight.

His laboratory discovered the first osteoarthritic stem cells and published the finding in Cell, then in Nature and Nature Medicine. Knees and hips, the weight-bearing limbs, do get osteoarthritis, and people have hips and knees replaced. The pattern is usually women who are obese. Mukherjee says the explanation seems backwards, in the way much of medicine has treated women: obesity, therefore a weight-bearing problem, therefore a weight disease. A woman with no obesity can still have massive inflamed nodes in her hands. The hand is not a weight-bearing joint. Some patients have degeneration of the upper neck joints and come in with upper neck pain and shoulder pain, and they are not obese.

Mukherjee says osteoarthritis is almost certainly a combination of two problems. One, which his lab has been a big proponent of, is a balance in the stem cells that grow cartilage in the joints over time.

Grokipedia·Siddhartha Mukherjee·Nature Medicine

Transcript

#412 ‒ The evolving science of cancer: emerging approaches to prevention and early detection, and the advances reshaping treatment | Siddhartha Mukherjee, M.D., Ph.D. ·

The Peter Attia Drive

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  1. Why Is There No Cholesterol Test for Cancer?Siddhartha Mukherjee says medicine has no simple screening biomarker for cancer the way blood pressure and cholesterol work for heart disease: hypertension…
  2. Should Everyone Get a Blood Test for Cancer?Siddhartha Mukherjee says blood tests that can find some cancers early are probably not going to work if they are used on everyone, with no selection for…
  3. Does Immune Therapy Help Smokers With Lung Cancer?Siddhartha Mukherjee says immune therapy is now known to extend the lifespan of smokers with lung cancer if it is given to the right population of people.
  4. What Percent of Cancer Mutations Are Random?Peter Attia says about two-thirds of cancer mutations, 66-ish percent, are purely random.
  5. How Much Does BRCA1 Raise Breast Cancer Risk?Siddhartha Mukherjee says a BRCA1 mutation is a shove mutation: it puts a person at a ninefold or tenfold risk, above the normal population, of hereditary…
  6. What Are Cancer Sleeper Cells?Siddhartha Mukherjee calls dormant cells that already carry cancer mutations sleeper cells. A person can have them and still not have cancer.
  7. Does High Insulin Make Cancer Resist Treatment?Siddhartha Mukherjee says chronic insulinemic tone has the capacity to make cancers grow and to leave them resistant to some forms of therapy.
  8. Why Can't T Cells Finish Off Cancer?Peter Attia says T cells rarely mount a response strong enough to finish the job on their own, even when they already know a lethal tumor is not self.
  9. Why Do Immune Cells Leave Cancer Alone?Siddhartha Mukherjee says immune cells leave cancer alone because the cancer cells that survive display dozens of surface flags telling T cells and B cells…
  10. What Does the Thymus Have to Do With Cancer?Siddhartha Mukherjee says a talk from someone at Harvard used AI to read CAT scans and found one correlate of disease: whether the thymus was still there.
  11. How Does CAR T Cell Therapy Work?Siddhartha Mukherjee says a CAR T cell is made by taking cells from the body, using a virus to insert a gene, growing those T cells, and putting them back so…
  12. Can a Person Live Without B Cells?Siddhartha Mukherjee says human beings can live with their B cells killed.
  13. Do Most Pancreatic Cancers Have a KRAS Mutation?Siddhartha Mukherjee says most pancreatic cancers have KRAS mutations.
  14. Can Surgery Cure Cancer in the Tail of the Pancreas?Siddhartha Mukherjee says surgery can cure some pancreatic cancers that start in the tail.
  15. Why Does a Lower Tumor Burden Improve Cancer Treatment?Siddhartha Mukherjee says a lower tumor burden raises the chance treatment works because fewer cancer cells are left that can resist the therapy.
  16. Why Is Colorectal Cancer Going Up?Siddhartha Mukherjee says he does not know why colorectal cancer is going up.
  17. Will There Be a Drug That Prevents Cancer?Siddhartha Mukherjee says yes, there will be chemoprevention. Asked where the gains that save lives will come from, he says the answer is always prevention.
  18. Do People Over 110 Die of Cancer?Siddhartha Mukherjee says people more than 110 years old do not die of cancer. They die of regenerative failure. Skin stops regenerating and falls off.
  19. What Is Dream Time Before Writing a Book?Siddhartha Mukherjee calls the first part of writing a book dream time.

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