Detecting Cancer at Stage 0 - Sumit Rai

What happens when a hedge fund veteran loses his sister to cancer and dedicates the rest of his life to stopping the disease in its tracks?

On this powerful episode of the Crackin’ Backs Podcast, we sit down with Sumit Rai, founder and CEO of Cancer Check Labs—a revolutionary company on the forefront of early cancer detection. After two decades in venture capital and hedge funds, Sumit’s life took a personal and urgent turn in 2012 when he lost his only sibling to cancer. That loss sparked a mission that now spans cutting-edge diagnostics, bold technological innovation, and a commitment to public health that’s as personal as it is professional.

We explore:

• How Cancer Check Labs is changing the cancer conversation with blood tests capable of detecting cancer at Stage 0—before a tumor even forms.
• The psychological challenges of early detection: When is early too early? And how do we avoid panic and instead inspire action?
• The emerging concept of “dialysis for cancer”—a mind-blowing technology in development that could filter cancer cells directly from the bloodstream.
• Why Sumit’s approach outpaces earlier tools like Cologuard in both precision and peace of mind.
• How the post-pandemic world views health tech, and what it takes to earn the trust of both patients and physicians.
• The “Save a Firefighter” initiative, a nonprofit offering free cancer screenings to our front-line heroes—where 72% of line-of-duty deaths are cancer-related.

And most importantly, we look ahead to a future where routine, multi-cancer blood screening could become as normal as checking your cholesterol—a future where knowledge saves lives, and where fear gives way to empowerment.

 Learn more about Cancer Check Labs and schedule your screening: https://cancerchecklabs.com

Special Offer for Our Listeners:
Save $200 on your test by using code: Crackin200 at checkout.
Offer valid until July 10, 2025.
Claim your discount here: https://cancerchecklabs.com

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Transcript

Unknown: 0:00

Today on the cracking backs podcast, we sit down with a man on a mission, Sumit Rai the founder of cancer check labs. After losing his only sibling to cancer, Sumit didn't just grieve. He transformed from Wall Street to the front lines of medical innovation. He is now the leading charge on a groundbreaking blood test that can detect cancer at stage zero, before a tumor even really develops. We're talking about the future of cancer care. This is a screening that could become as routine as a cholesterol check and a sci fi sounding device that may one day filter cancer cells from the bloodstream. But how do we balance knowledge with fear, trust with technology? And what does it mean to truly catch cancer early enough to save lives? Stay tuned, because you won't want to miss this one. Well, Mr. Summit, Ry, it is very good to have you on the show. I look forward to some of our conversation, and I would love to start with asking you about your history of over 20 years and as a venture capital and a hedge fund, but I know this life journey became deeply personal for you back in 2012 so with that said, I understand you lost an only sibling to cancer and essentially dedicated your life to finding out a cure. How did losing that that sister change your perspective on life and set you on a path of founding the cancer check labs?

Sumit Rai: 1:37

Sure? I mean, you know, the first kind of half of my career that you alluded to, when you go into venture capital and, you know, private equity, hedge funds, those sorts of things, you're really in there to make money largely. I mean, that's really what your focus is. And, you know, despite what people talk about, even with ESG, which is, you know, sort of environmental, social good investing, the reality is those funds are there to make money for their fund investors, and that's what you're focused on. I think when you have an experience like I did, unfortunately, and you suffer these types of unbearable losses, you change. You start to think that you don't want anyone else to ever go through that type of pain, that type of trauma, and that type of an unbearable loss. And you become much more mission oriented, much more impact oriented, you start thinking a lot more about humanitarian things, philanthropy, and that's what triggered me to go forward and learn so much about cancer to try to come up with a solution that could really move the needle for other people's outcomes so no one has to go through what I went through, what my family went

Unknown: 2:41

through. Go ahead. Now we understand, I mean, we look at a little bit of recent history and how the pandemic changed, how we view healthcare and technology as an issue of trust, and understanding about how science has changed, especially with rapid vaccine development, the rise of telehealth, but also a lot of the public skepticism on a lot of the infodemic issues that came up from your perspective, though, how has that impacted the way people view Health Tech like early cancer screening? I'm sure there's some skepticism out there. And you know, this post pandemic mindset made it easier or harder for you to build trust in that high tech blood test for cancer.

Sumit Rai: 3:31

Well, I think the healthcare industry in general is very slow, right? It just takes a long time. And I think what that's resulted in in healthcare specifically, the sort of two factions and a rising faction, and you have sort of traditional healthcare today. And traditional healthcare, you're talking about normal primary care, sometimes concierge medicine, which is effectively glorified primary care, where you end up paying some type of large subscription fee, $10,000 a year, so the practitioner will spend 40 minutes with you instead of four. But all of that is traditional allopathic medicine. And what that means is it's reactive. You have to have a disease, a condition or a symptom, until then, they're really not going to do anything. And so what that's resulted in is the rise of sort of this area called Functional Medicine, sometimes longevity, sometimes anti aging, sometimes regenerative. But this whole group of sort of functional medicine practitioners today are very much about preventative, preemptive medicine. So it ends up becoming largely a cash pay market, because insurance doesn't really do anything until you have a disease, condition or symptom again in traditional allopathic care. But the reality is, you should be trying to prevent disease, not trying to always cure it. I mean, if you have something, obviously cure it. But the reality is, you don't want to get to that point. You want to try to prevent it as much as possible. And that's why you're seeing the rise of functional medicine. People that do clinics that do health optimization, blood panels that are more extensive, looking for different markers and signals that something may be wrong. Bronze, weighted. Coming along so you can intervene earlier, and it's growing rapidly. I mean, just to put in perspective, if you were to think about these are again, high income demographics, because they're cash pay, generally speaking. But if you think about concierge medicine in the United States, you have 13,000 practices in the US. If you think about functional medicine in the US, which is maybe 1015 years old, you have 40,000 practices. It outsizes it by three times, and is growing rapidly around the globe as well. It's not just a US thing.

Unknown: 5:27

So I think I got a quick question for you. I'm gonna go back to something you mentioned, hedge fund. It's all about making money. And now you got into more of the heart, right? Well, cancer has always been about making money. It seems like all the research, all the treatment, it's all been about making money. And it never seems like there's a I don't know they've been. Never seems like it's been a cure. There's been, there's billions and trillions of dollars that have been dumped into cancer research. Yet. Why we still, I feel like we're in the same boat we were 20 years ago. How is that wave hard to navigate.

Sumit Rai: 6:02

So, you know, look, I mean, a lot of cancer, historically has been about and still is about making money. I mean, you know, chemo is about making money. Surgeries are about making money. Radiation, ablation is about making money. You know, hospitalizations are about making money. And so imaging is about making money. I mean, all of this stuff is about making money in their businesses. I think what it really comes down to is, who are the innovators, and so, you know, the businesses? I mean, even our, you know, even our company, ultimately will make money. I mean, but it's What's your motive? Is your motive to get into it, to become, you know, financially wealthy and make a bunch of money, or is your motive to try to have an impact and move the needle and change outcomes. I mean, to that end, you know, in the cancer world, and I'll just speak personally, my motive is impact. My motive is not financial. You know, I didn't decide from my history where I was a technology, venture capital, private equity guy and a tech entrepreneur in Silicon Valley that built, you know, one of the largest marketplaces for mobile advertising and iPhone Android apps, that suddenly I have this great idea where I'm going to make a lot of money and I'm going to go figure out, you know, a cure to cancer. Like it's just such a dramatic shift. You would never make that shift naturally. If your motive was to make money, you go down the path that you know, and you go down the path where you already have a lot of domain expertise, you would never even try something like this. And so it has to be driven by something very personal and into that end for me specifically, you know, I run two nonprofits as well in cancer. You try to give back that money. I run 250 1c threes, you know, the first of which I founded 13 years ago, in 2012 when or now? Yes, yeah, when my sister passed away. And that's called cure Sonia. That's a federal 501, c3, my sister's name was Sonia, and in that one, we fund cancer research to look for better therapies and better solutions. We fund cancer research at Stanford, MD, Anderson, USC, City of Hope. We do financial assistance for underprivileged families that cannot pay for their cancer care because it is so expensive, because it's a money making business. I am one of the largest registers of bone marrow donors in the world. I registered over 10,000 people in 300 drives across 60 cities. I know for a fact that several of those registrations have resulted in bone marrow transplants that have saved several lives. And so, you know, I was nominated for the National Board of LS and chemo Lymphoma Society for my contributions to combating cancer. So yes, while these things will ultimately make money, because that's how the system is set up, I think a lot of it also comes back, if you want to give it back to that end, we started our second nonprofit last year. I started another 501, c3 called Save a firefighter. Because where we're looking to essentially screen all the firefighters in the country, because, unfortunately, they have up to three times the incidence of cancer as the general population due to the hazardous exposure that they endure as first responders. Firefighters don't die from fires and collapsing buildings. Generally, they die from cancer. It's 74% line of duty death. It's three out of four, staggering number. And so you know, when you start thinking about those things, yes, these businesses are going to make money at the end of the day. But a, why are you doing it? What's your purpose? Why did you get into it? Are you doing it for impact? Are you doing it to help? Are you doing it to make money? And B, if you do make a lot of money, how can you give that back to help people

Unknown: 9:17

love it? Do you have a strategy that helps doctors in public more become more comfortable with such new innovation,

Sumit Rai: 9:27

yes, but complex strategy, because it depends which doctor, what channel, you know, the way that a functional medicine practitioner, for example, will look at things. Who is looking for things that are early preventative you know, early signals is different than how perhaps a traditional practitioner will look at it. You know, one of the issues in sort of traditional medicine is it's very programmed today, like if you walk into a primary care practice today, the doctors don't do a lot of medicine anymore. They listen to you. Take your symptoms, they take your name, your body weight, they punch it into a computer that's got all kinds of algorithms which punches out what may be wrong with you and punches out what prescription they should probably give you. The thought is kind of gone largely in much of primary care. It's become very automated, and to that end, in medicine, and this is necessary to some extent. There are protocols. You need protocols because you need things that work, but they get so programmed into those boxes. In those protocols, they can't get outside of it. They're too accustomed and too programmed just following this rule set that they've been taught. And the thing is, when you have new technologies and new solutions come in. Sometimes you need them to kind of get outside of that a little bit and start to think about it, so they can have a little bit of thought leadership and start to, you know, expand the tools available to them as medical practitioners. There's also this concept that, you know, look, there's a gap between science and medicine. Science is always ahead of medicine. And so what ends up happening is you figure things out in science, and you figure things out that look promising and potentially work, but until you go and run very, very large trials, present them to the right regulatory bodies present them to the right, you know, bodies and associations the right thought leaders in the medical community. Adoption of that takes time. And so there are many things out there that are understood to be helpful in the scientific world that just take years, unfortunately, to make it into mainstream medicine, because of how these pathways are set up, which have a lot of friction, a lot of hurdles and a lot of barriers, some of which are financial, some which are political, and there's all kinds of issues there.

Unknown: 11:44

You know, we probably should have mentioned in the very beginning, could you describe this early cancer detection protocol that you are introducing to the world?

Sumit Rai: 11:56

Sure, so you know to understand it. Well, just a little background on cancer. If you have a solid tumor, and a solid tumor means lung cancer, breast, colorectal, pancreatic, ovarian, uterine, cervical, esophageal, gastric, stomach, brain, skin, thyroid, adrenaline, all the organ tumors from which 100 million people a year suffer across the globe annually, the primary tumor itself, that lump generally does not kill you. This is what a lot of people don't understand. What kills you is that tumor sheds tumor cells that circulate through your bloodstream that are known as circulating tumor cells, or CTCs, the acronym for short and the CTCs, the circulating tumor cells, spread the cancer in your body in a process known as metastasis, and the metastatic effects make your other biological organs dysfunctional, shut down, and you die. That's really how you die from cancer. You generally don't die from this alone. Now, a lot is known about CTCs, right? They have been extensively and exhaustively studied over the past 30 years, and then we can talk more about that. But very basic things are CTCs are known to be the drivers of metastasis, the spread of cancer in the body. So when cancer is staged, when it goes from stage zero to stage one to stage two to stage three to stage four, the process by which cancer progresses is spread, is metastasis, which is driven by these CTCs being shed from the tumor. And so you can't go from stage zero to stage one, one to two, two to three, three to four without CTCs being shed out into the bloodstream, which means they begin shedding. And they're known to begin shedding very early in a tumor's life, as early as stage zero, because that's what they need to do to get to stage 1234, so there are millions and millions of CTCs floating around your blood when a tumor is born. And so what we do, and what we did over the last 15 years, was develop a technology that allows us to extract these CTCs from a blood sample, whole and intact, such that we could take them and physically place them on a glass slide, like tissue, like cellular tissue, because that's what it is. You could stain it just like tissue, because it is tissue, you could put it in the palm of a pathologist to examine under a microscope, just like a tissue biopsy because, again, it is cellular tissue. It's whole intact tissue, and output a tissue biopsy report, a Board Certified pathology report. So what we do is we take a blood sample, we process it in our lab, we leverage this technology to extract these whole circulating tumor cells, and then we put them on slides and stain them like tissue and have a human pathologist look at it just like they would a tissue biopsy to render a result. Now, when you do that and you have whole intact cells, the accuracy of the test becomes very high, because tumor cells look very, very different than healthy cells. Tumor cells are often much larger, 3040, microns, instead of eight or 10. They are multinucleated, multi headed. They have five six nuclei, instead of one or two. They have what is known as a high NC ratio, which is a nuclear to cytoplasmic ratio. All that means is, because they're so heavily nucleated, the nuclei can comprise 85% of the cell, instead of 15 or 20. They are hyperchromatic, which means they have too much DNA, because they have so many nuclei with so many different genomes, with so many different DNA sequences. I mean, these features are so pronounced that my 70 year old daughter could look at that and tell you, that's weird. A board certified pathologist that spends their life is learning how to examine cells and tissues is not going to mistake a tumor cell for a healthy white blood cell. You're comparing elephants and rabbits.

Unknown: 15:45

So you basically, you could detect cancer as early as what they refer to as stage zero. Is that correct?

Sumit Rai: 15:54

We can and we have, yeah,

Unknown: 15:57

I'm just trying to familiarize, familiarize myself with the nomenclature. So stage zero would be that that is the earliest possible stage, but then that's pretty incredible. I mean, right off the start. But if I'm still curious about, like, the flip side, if someone finds out that they have stage zero and that, you know, just that C word freaks people out to begin with, and could create a lot of anxiety, but especially if there's, like, if there's not an obvious treatment, or is there for stage zero?

Sumit Rai: 16:26

Well, so survival rates at stage zero are 99% okay, okay, so, so the problem with cancer is they don't catch it early enough. Generally, yeah, that's the problem. And the way you solve that is screening with a test that can, yeah, and so, you know, let's take an example, like someone like Angelina Jolie. You know, she had some genetic mutations. They're called Braco one, braca two, which increase your risk for cancer. Now, here's the thing, Braco one, braca two, positive doesn't mean that you have cancer. It doesn't even mean you'll ever get cancer. It just means your risk is higher, that's all. So you can be Angelina Jolie, and you can take an extreme intervention, like she did, you can get a double mastectomy, and I don't fault her for that, because, again, cancer is a scary thing, like you just pointed out, and so she's afraid that she won't find it till stage three, stage four, at which point it could be fatal, so she wants to preempt it. But if you had a test, as we do, that can detect as early as stage zero, you wouldn't where survival is 99% you would never take such an extreme intervention. You would just screen regularly to make sure you caught it early.

Unknown: 17:41

Well, I got a question for you. So if you So, have the treatment caught up with this detection, because a lot of treatments based off of stage four and stage three as a treatment caught up to stage zero,

Sumit Rai: 17:55

yes. So treatments are not based necessarily off. There are certain things you might do they're more aggressive at stage three stage four, which you may not do at an earlier stage cancer, because you don't need to be as aggressive all the time with an earlier stage cancer, you know so. So for example, let's assume you have a stage zero tumor in your breast or your lung, a very small mass that has not spread regionally, locally into your lymph, regionally, into these areas, or certainly not distantly. And so you can treat that locally. You could take focal radiation, you could treat that spot. You could take lower dose of chemo, potentially, and you could treat that right. But when you end up with, you know, a stage three, stage four cancer, and it's spread all over your body. That's not going to work anymore. Now you end up with full body radiation. Now you end up with lots of heavy systemic chemo. And oftentimes, if the cancer doesn't kill you, the chemo will, right? Chemo is highly, highly toxic, right? Chemo is nephrotoxic to your kidneys, hepatoxic to your liver, and immunocompromising, so infections can take over your body and kill you. That's why chemo is so dangerous. But you know right now, that's what that's what the protocol shows. So these things, the solutions do exist for stage zero, stage one, stage two, certainly stage zero, types of cancers, and that's why survival rates when they catch it that early are so high. But again, the issue becomes, catching it early. How do you do that consistently and reliably? And how do you do that for all cancers today, we only screen for five types of cancer, right? The only screens you have today really are mammogram for breast, pap smear for cervical, colonoscopy for colorectal, PSA for prostate and lung, CT for lung. Now, lung CTs are not generally ordered unless you have 20 years of smoking history, you have a family history, so most people are not getting lung CTS to screen for lung cancer that's gone generally Now, depending on your gender, you're not going. To do all four. If you're male, you're not going to do a mammogram and a pap smear. You're just going to do a PSA and colonoscopy. And if you're female, you're not doing a PSA, you're just doing a mammogram for breast, pap smear for cervical and colonoscopy with colorectal. You're doing nothing for pancreatic, liver, bladder, stomach, gastric, brain, skin, thyroid, adrenal, gallbladder, blah, blah, blah, blah, blah, on and on and on. Most cancers are not even screened for, and that's a problem. Now, one of the things about, you know, a good example of that is pancreatic, by the way, like pancreatic is, a presumed death sentence. Pancreatic cancer is not a death sentence. Stage four, pancreatic cancer is probably a death sentence. Stage one, pancreatic cancer is curable. You'll just never find it. There's no symptoms, there's no screen, there's no easy diagnostic. The only way they really find it at stage one for pancreatic is accidentally. They're doing a procedure in some adjacent organ, like your liver. They notice an abnormality. They biopsy it, you come out and oh my gosh, we found pancreatic cancer. It doesn't happen often, but when that happens, stage one is broken into one A and 1b survival at 1b even on pancreatic, is 85% survival at one A is 92% survival at state zero is 99% so if you could reliably find them, early, survival rates invert entirely, right? And so one of the things that's important to understand about our testing cancer check Labs is that because we are leveraging these CTCs, all tumors must shed to spread fundamentally period they have to that is the fundamental mechanism. And so whether it is coming from your stomach, your liver, your breast, your lungs, your prostate, your colon, whatever the case might be, that tumor is going to shed in order to go from stage zero to stage one to two to three to four, so on and so forth. So when we extract CTCs, those CTCs, interestingly, share certain physical and mechanical characteristics, size, structure, rigidity, lack of malleability, lack of deformability. They're big, they're hard, they're stiff, they don't bend. Those parameters enable us to selectively extract them during our process. And it turns out that those physical and mechanical characteristics of CTCs are uniform and homogeneous across all solid tumors in their subtypes. As a result, we will capture them indiscriminately, irrespective of source organ, which is what makes our test at cancer check labs a broad spectrum pan cancer screening. We will catch them whether they're coming from your breast, your lungs, your colon, your brain, your stomach, your pancreas, so on and so forth, because the CTC characteristics from all of them, physically and mechanically, are similar.

Unknown: 23:02

This is fascinating because you brought up pancreatic cancer, which is usually found way too late, and the patient unfortunately dies within a couple months. This could be revolutionary for such a that type of cancer that there is no early detection those people that have had certain cancers in their family or in their, you know, genetic history. Do you advise them to get, you know, once a once a year testing or what? What does it depend on the type of history or cancer that they have? Sure?

Sumit Rai: 23:46

So you're asking about frequency of testing with cancer check labs. So, so at cancer check labs, you know, generally, I think people are going to try to do it annually, but I don't you know, there's no magical reason for that other than behavioral training. Yeah, people are trained to get annual physicals. People are behaviorally trained and do annual checkups like there's nothing biologically magical about 365, days versus 282, or 417, training. So because of behavior and because of behavioral training, I think people will generally do it every year. Now, with that said, if you have risk factors, to your point, yeah, right, if you're a smoker, if you have lifestyle factors, you know, comorbidities, obesity, diabetes, if you have family history or genetic risk, if you have occupational hazard, you're a firefighter, you work in a nuclear power plant, you know, then I think every six months, right? You should be more aggressive about screening, because your risk is higher.

Unknown: 24:48

Let me ask you about I got something special. Yeah, just yesterday, I had a patient come in who had some tests come back somewhat abnormal, and the advice he got from his doctor is what. Going to watch it, and that's like the hose is going and we're just going to let flood, and until it gets to stage four, when I know what to do with it, you know? So what's your that's why I was asking the treatment protocols. I told immediately, well, we need to change and look at like, functional medicine, stuff like that, to try to rid it. But your lab is almost like we're going to define it even more. So we have a plan of knowing what to do with it at an early stage. Am I grasping that correctly?

Sumit Rai: 25:29

Yeah. So, I mean, there's two parts to this, right? Part A is, you have to find it early. Let's start there. You have to find it early for all solid Supers, not just, you know, the three or four that you're going to strain for right today. Part two is, once you find it, you need to do something like this concept of, we're gonna watch it and we're gonna see what happens. I just think is absurd. Like, you know you have cancer, you know it's going to spread. In fact, the practitioner in this in this context, is saying, we know it's going to get worse, and then we'll just wait till it gets worse to treat it. And you know, that doesn't make any sense to me, like it's just irrational in my mind. But so I think, like, you need to intervene. I think that's also where you're seeing the rise of things like functional medicine, where they're like, You know what? We're not going to wait until this gets, you know, to stage three, stage four. It's metastasized through your body. We're going to intervene. Now, there are many physicians and oncologists that will intervene at state 012, so I don't know who this particular patient is speaking with, and they want to get another opinion, because they probably should. But generally speaking, if you have cancer, you want to start making changes, right? Whatever those changes are, and there, there are things you can do just for your health optimization that can help. Like, you know, one of the things about cancer that a lot of people don't really understand this, you know, I get asked this question once in a while of, well, you're looking for these tumor cells in the blood, you know, doesn't everybody have tumor cells? And so, wouldn't, wouldn't everybody be positive? Yeah, well, not exactly interesting. So it's a very subtle nuance, but it's an important nuance. And so we are living biological organisms. As living biological organisms, we constantly have cellular turnover, old cells die, new cells are formed. Old cells die, new cells are formed. And this cycle continues throughout our life, and so during this cycle, unfortunately, our body makes mistakes sometimes, and it creates erroneous replications of cells, ie mutated pre cancerous cells. Now the good news is our immune system is very intelligent. Our immune system goes and recognizes those cells and destroys them. And that is why everyone in the world is not dead from cancer right now, or we all would be. And so our immune system is constantly killing these little erroneous replications so that we don't get cancer. Unfortunately, once in a while, for a whole variety of reasons, we can discuss your that little erroneous replication will either evade the immune system or the immune system will fail to kill it. And when that happens, that erroneous replication gets a chance to multiply and grow in a tumor is born. Once that tumor is born, it's basically base camp that tumor. It's, you know, this is an alien type being. It's a, literally, a mutant. It is a mutated cell that is in your body that wants to now take over more territory. And so it's got its little camp. It's been formed, and now the next thing it does once it's formed. After it's formed, they say, I'm going to find more territory to take over. And it sends out its soldiers, which are little cells from the tumor. Think of them like Vikings going out to sea. And the sea is your bloodstream, and those Vikings are traversing your bloodstream, looking for more land and territory to take over, to raid, pillage and plunder. And so in that territory are your other organs. Look, we found pancreas, look, we found a liver. Look, we found stomach, we found a brain, and they start expanding, right? They start conquering they start setting up camp. And those are metastases, secondary and tertiary, metastatic lesions. And so what's happening is these cells don't start floating through your blood until that tumor is born, which is why, with our tests, you're not going to detect those CTCs, those circulating tumor cells, unless it's already formed a stage zero tumor. But, you know, everyone has these sort of things, and so it's important to understand that, because it's the second part of this is our immune system, again, as I just explained, knows how to kill these cells. And so even if you did have an extremely early stage tumor, there are changes you can make in your health to optimize your immune system, right to immuno potentiate it upwards, perhaps your immune system was copper. Myosin to fail to kill it, perhaps your immune system needs a boost, right? There are things you can do that will help it try to even self resolve the tumor, and that may or may not work, but it may and so there are ways you can intervene, even without getting into the standard protocols right early on. But the notion of just, hey, you have a tumor, and we're going to do nothing about it at all. We're just going to hang tight until it gets bigger and it spreads like that's just nuts. I'm glad

Unknown: 30:30

you're you're elaborating on that perspective, because it is when you when you mention it to sound so asinine that a doctor would say, hey, let's just wait and watch. Meanwhile, the person has been diagnosed, you know, even with the earliest forms, and they're probably in shock and they want to do something, they want to take action. I think a nice paradigm shift would be to consider, instead of treatment, maybe we should expand on prevention, because people's habits tend to cause, you know, inflammation and immune system compromise and things like that that would typically fight those cells, those cancer cells, or any other forms of disease. So I love that we're bringing this up, because this is something that we've, you know, we're shifting the tides and the perspectives of of especially in America. Well, let's wait till I'm in pain and agony before I take action

Sumit Rai: 31:29

again. This notion. I mean, imagine an analogy. Imagine that you had a skin infection on your finger, right? And the doctor said, you don't we see it. We diagnosed it. We know it's there, but let's wait until it gets to your head, your arm, and then once your whole arm is affected, we're gonna intervene. We're gonna chop it off.

Unknown: 31:52

I love this. I love that we brought that to light because, you know, we, Dr Terry and I stand strong on on preventative measures, instead of waiting for, you know, these things to happen and manifest. Now

Sumit Rai: 32:10

with prevention, you know that that gets into why is there so much cancer? Yeah, I mean, cancer is a huge problem, right? Like, look, 40% of the population will be diagnosed with cancer in their lifetime. Okay, it actually just went up from 39 and a half percent to 40.5 for the National Cancer Institute. And so you're talking about, you know, four out of 10 people. And what that represents is one in two men and one in three women. Half of men and a third of women will be diagnosed with cancer in their lifetime, and it's going up. And so it is a huge problem in high income developed countries, several of them, cancer has overtaken heart disease as the number one cause of mortality. That data came out in the Lancet in 2019 and so this is a massive problem. Last year alone, there were 10 million recorded deaths in cancer, and obviously there are more unrecorded. More unrecorded. So this is a problem of great scale. It is going to become, in some places, has already become, the number one cause of mortality. It continues to increase. Cancer rates in the younger population are rising dramatically. Colorectal cancer rates in people under 55 have doubled in the last 30 years. So, so what's what's going on, right? Like, why is this happening? And what can we do to try to prevent it from happening, slow it down and hopefully stop it. So there's many things that cause this right? Number one, our lifestyles. We are far too sedentary. You know, yes, like, historically, we were hunters and gatherers. We moved. We don't move anymore. Sedentary lifestyles lend themselves to metabolic disease, diabetes, obesity, all of which causes inflammation in the body. And inflammation is a breeding ground for that erroneous cellular replication to occur, ie, precancerous, mutated cell. And so because we have become so sedentary in the last 100, 200 years, and we don't sort of move around the way we used to. We develop more cancer because we develop more erroneous replications. Second we're living longer, it's generally a good thing, but age is a risk factor, because the longer you live, the more cellular turnover you have, the more chances you have to develop in error. And so that's kind of fundamental. Third, we eat too much and we eat too frequently, right? You know, our bodies were not designed to eat breakfast, lunch and dinner, right? That is a commercial construct that actually started about 100 years ago, in 1916 with the advent of grocery stores, the first one being Piggly Wiggly in Tennessee. And so that was created so we could sell a cereal box. We could sell later on snack bars, later on microwave meals, packaged foods, you know. But if you look at human history, for the vast, vast majority. Of human history, we didn't eat breakfast, lunch and dinner, right? We lived in periods of feast and famine. Yeah, you hunted, you caught a buffalo, you ate, you gathered, you ate. You didn't. You didn't. And those periods of famine were very, very important, because during those periods of famine, ie fasting, your body triggers certain processes, one of which is critical, which is known as autophagy, and that's auto self and fadgy, which is Greek for eating self eating and autophagy is critical because that is your body's cleansing process. Essentially, when autophagy is triggered, which is triggered in periods of fasting, periods of famine, your body goes out and starts to clean up cells, right? It actually looks for and contrary to popular belief, you know, opinion, and contrary to what you know, supplement companies and protein powder companies want to sell you, if you don't have a protein shake every three hours, your body is not going to go out and start eating up healthy cardiac tissue. That is not what happens, right? That is nonsense. And so, so what will actually happen is your body is a highly sophisticated biological machine, which crank frankly, we know very little. I would say we understand less than 1% of our biochemistry today, like there's so much more to learn that we're just naive in our overall understanding. But we are very sophisticated biological machines. And so when we are in periods of fasting, we're still having that cellular turnover. And as we're having that cellular turnover, we still need to make new cells. In order to make new cells, you need the building blocks of cells, which are amino acids, which come from proteins. And that's why these myths exist, that if you don't eat protein all the time, every two, three hours that your body will start eating up healthy cells. No, your body will actually do the opposite. Your body, being a very sophisticated, intelligent machine, will go out and look for two types of cells. Generally, it will go out and look for cells or three, two or three. It'll look for cells that are dysfunctional. Let's say you have bad liver cells from drinking. It'll go that's not performing. I'm going to destroy that cell, and I'm going to break it down into its base amino acids and reuse those, recycle them, literally into building healthy cells. One two, your body will look for mutated cells, pre cancerous cells, and it will go to destroy them more aggressively, thereby reducing the volume of those cells in our body, thereby reducing the risk of developing cancer, which is why fasting is one of the ways you can try to prevent cancer. Three, your body will look for cells that have short telomeres. A telomere is a little strand on a cell that has basically the DNA footprint of that cell. That's the blueprint by which the cell replicates. And what happens as we age is telomeres start to shrink, which is the equivalent of the blueprint fading. And so over time, you know, as they replicate and the blueprint is more faded, the chances of an error increase because you have a faded blueprint, a short telomere. So your body will actually go out during periods of fasting and destroy the cells with shorter telomeres to again, take those base amino acids, recycle them into healthy cells, which leaves the longer telomere cells, which increases the weighted average of your telomere length, ie the fidelity of your blueprint for DNA replication. And when the fidelity of your blueprint for DNA replication is higher, the probability of a correct replication is also higher. The probability of an erroneous replication, ie, cancer cell, is lower. And so your body does all these things. But again, if you sit there and stuff your mouth, you know, breakfast, lunch, dinner, we need a snack between breakfast and lunch, we need our afternoon snack as well. And then I'm gonna have a bedtime snack, you know, six times a day. You're gonna inhibit all these autophagic processes, autophagy in your body, and you're not gonna get all these benefits. And so, you know, I think the so one is that we gotta be less sedentary. We gotta move around. Two, you know, you gotta, we can't do much about the aging thing, but it's there three, try to stay healthy. Basically three, we gotta fast, you know, we can't keep stuffing ourselves at the frequency that we do. But this doesn't work. And then the fourth thing is getting into sort of, you know, toxicity. We live in a very toxic environment, like a highly, highly toxic environment, and from everything from the foods that we eat to the products that we use, to the air that we breathe, you know, all kinds of stuff everywhere. I mean, you know, in the US, for example, I think something like 30 years ago, there were 600 food additives that were approved. Today, there's over 10,000 in Europe. There's still 600 Yeah, if you go to Europe, and I was just in Zurich last year, and it was interesting, I was, I was having breakfast at a hotel, and all the fruit was really small,

Unknown: 39:49

right? But tasting your apples

Sumit Rai: 39:52

are like this big over here, like this big, yeah, because they're stuffed with chemicals, hormones, you know, there's stuff for production. There's stuff there. They're sprayed with all kinds of reagents in order to kill pests and this and that, we ingest all of that, right? We ingest those hormones, we ingest those pesticides, we eat those 10,000 food additives, even though we know they're harmful. There was one that was banned a couple months ago, a few months ago, you know red, red additive. And you know that additive and that food coloring we have known for 30 years is carcinogenic and causes cancer. In fact, it was banned in the US 30 years ago in cosmetics like lipstick because it causes cancer. Yeah, but it's allowed as a food additive in Skittles or Starbucks or whatever candy needs it to be red, so like, so, you know, we allow things here, unfortunately that we know are dangerous. We allow things to get by acne. I was commenting on story last year where there were acne products, household things you know. Estee Lauder, Clinique, Target, up and up. Clarosil, these are active products. These are products for acting now, the active ingredient in them is benzoyl peroxide. Benzoyl peroxide, fine, except one problem, benzoyl peroxide is not heat stable. Benzoyl peroxide turns into benzene. Benzene is a highly toxic known carcinogen. In fact, it is so dangerous that the environmental limits, depending on what standard you're talking about for benzene, are one to four parts per million. These products, when tested in independent labs, were kicking off several 100 to several 1000 parts per million of benzene because of the heat instability. That's a problem. When you take that product and you apply it on your skin and you absorb it into your body, you have benzene running through your blood. That is a very toxic chemical that causes cellular damage, causes erroneous precancerous cells, causes cancer, and with something like that, you know, to make matters worse, who's using it? The people that are using it are people that are experiencing a lot of acne, which is basically teenagers going through puberty. What happens during puberty? Well, during puberty, your body surges with growth hormone. What does growth hormone do? It makes stuff grow. Good cells, bad cells, cancer cells, non cancer cells. It doesn't care. It just makes stuff grow. And so you're going to take this product that has this highly toxic, known carcinogen, you're going to stick it into your body at 1000s of times the concentration that you should you're going to create precancerous, mutated cells, while these kids have growth hormones surging through their blood. What do you think is going to happen? You're going to see increases in cancer rates in the younger populations, which is what's happening. And so there's all these factors, you know, from just kind of our lifestyles, being too sedentary, causing inflammation, breeding ground for cancer, to eating too frequently, no autophagy, to environmental toxicity for products and foods and air and such. And when you put these things together, especially in a compounding fashion, cancer rates are increasing, and that's why cancer is becoming the number one cause of mortality in the world. You

Unknown: 43:14

know, I'm sorry, go ahead. Go ahead. I was just going to mention because in retrospect, some of the things that you said are not only important and valid, and I'm so glad that you are discussing this. You know, we've we've had several guests in the past that have talked about prevention and doing deep dives into nutrition with testing that most doctors have never heard of before or even bother doing, except your regular comprehensive metabolic test. There's so much more to identify to help with prevention. Your comment about autophagy is absolutely crucial to understanding like when the pandemic of concussion started becoming more evident and pervasive, especially in the NFL, there was one researcher out of UCLA, mayomi Prins, who did us, who would do studies on Alzheimer's and dementia, and found that eating a a ketogenic or even fasting would help accelerate autophagy or prevent it from being interrupted. But what do most parents do when, when your kid concusses? Oh, little Johnny, let's go to McDonald's, drive through and get you something to eat. And those are like poor fats and proteins and carbs, whereas a ketogenic diet with good solid fats and protein will help autophagy. So thank you for bringing that up, because I feel it's so valuable to understand, you know, the mechanisms behind it.

Sumit Rai: 44:44

I think the other thing that happens is a lot of people confuse. Really brought concussions, but correlation and causation, yeah, like with with concussions, for the, you know, the assumption. And it was an assumption, because, of course. Relation was that these hard hits that football players have caused concussions and cause brain damage, right? That's where the brain damage comes from. Yes, that is actually not true. What ends up happening is it is all the small, little concussive is where the brain rattles, right? It is not those large hits that are causing them a long term brain damage is the small hits. And the way they figured that out was they did a study on soccer players, yeah, and soccer players had the same rates of brain damage as football players, because they're constantly heading the ball, and so, you know, you just have to be careful. Like a lot of people, you know, even with cancer, like there's, there's assumptions that, oh, you know, I know people that do this and they don't get cancer. I know people that do this. That do this and they do get cancer, just there's a lot of caution to making sure that the things are actually positive and not just correlative.

Unknown: 45:51

Yeah, all right, I got a question, you know, let's go back to your cancer check lab and the screen process and how you develop that. A lot of people out there when they think of screening, when are the tests that they think of? And I know it's kind of a burden. Your side is cologuard, and the cola guard goes out there and they talk about pre screening, yet it only is catching maybe 40 to 45% of the pre cancerous cells, and there's a huge false negative or false positive. How does Can you walk us through your screen? Because it's almost like a cancer dialysis. But can you watch us through your your screen process and and talk about the pitfalls and how you approach this pre screen? Different?

Sumit Rai: 46:34

Sure. So, so, you know, in my opinion, COVID is not a good test. Start there. You know something, first of all, that's only catching. You know, 40x percent of cancer is missing. You know, more than half that's a problem. The reason COVID already exists, fundamentally, is because people, lot of people, don't comply with colonoscopies. That's it. But it's not because it's a good test. The bar is really low for them to clear in order to get their approvals. And so now tests like colivard, and there's, there's a whole, you know, in the world of cancer screening, there are categories of tests, right? So first of all, you mentioned cologuard, you know, isn't catching enough of the cells. Cologuard isn't catching any of the cells. Zero. Cologuard is not a cell based test, right. Cologuard is a what's known as a CtDNA, which stands for circulating tumor DNA, sometimes known as cell free CF, DNA based test. So let me explain what that is. So let's say we talked about how we have tumors, and the tumors shed whole cells, right that are kind of going through little and those whole cells are little MINI MES that are micro models from the tumor that are moving around right now, a circulating tumor cell is a biological cell. It's a messed up, mutated, dangerous, aberrant, malignant, cancerous, atypical cell, but it's a cell. It has the components of a cell. It has a nucleus. It has a genome with the DNA sequence. It has cytoplasm, membrane, blah, blah, blah, blah, blah. When that circulating tumor cell is dislodged from the primary tumor, essentially one of three things is going to occur in the bloodstream. A it's going to go through cell apoptosis, which is programmed cell death, where the cell and all its components will break into little bits and pieces be dispersed into the bloodstream. B, it will get eaten by your white blood cells, like your macrophages that look like a Pac Man that comes in and crunches it and will literally fracture it and break into little bits and pieces again. Or C will traverse your capillaries, where the shear forces, the physical stresses will blow up that cell and fracture when any of those events occur, the cell and its components, including the genome, which has the DNA sequence, break into little bits and scraps so incomplete, little scripts and scraps of DNA from that genome start floating around your blood and those little incomplete scripts and scraps are what are known as circulating tumor DNA, CtDNA. Sometimes they call it cell free DNA, because the cell is gone, so it's freed from the cell. But those scraps are highly incomplete, and they are very, very minimal in their quantity, what tests like cologuard, garden, shield, Grail, if you're familiar, what these tests are trying to do is take these little incomplete scripts and scraps, bits and pieces of DNA and put them in a black box, and in that black box Apply a set of mystical algorithms, AI, artificial intelligence, ml, machine learning, NGS, next gen sequencing, computational processing, and then extrapolate and guess whether or not we have a tumor cell. The problem is, that's a guess. We don't guess at cancer check labs, we take out. The whole cell. So we look at it, we actually know it's a tumor cell now that guess that they do is highly erroneous for a whole bunch of reasons. Number one, they don't have enough signal. They only have little bits and scripts and scraps of this DNA. This is like trying to identify a car with tire scraps. It doesn't work well. Number two, because, which is why you end up with false false negatives. Right sensitivity is not there. There's not enough signal. So because there's not enough signal, because they know there's not enough signal, they try to amplify the signal, and they use a technique kind of like PCR. Now, PCR is something that's used to amplify viral organisms. So let's say you get pricked in a hospital and you need a rapid HIV test. Well, there isn't enough viral load. There's enough HIV yet, so they got to amplify it so they can detect it. That's what they use PCR for. That's fine with whole intact viral organisms. DNA scraps are highly, highly unstable. When you try to amplify highly unstable DNA scraps, you will mutate them. So what happens is they have a healthy sample come in, they know they don't have enough signal, they try to amplify the signal, and in that amplification, they mutate the DNA and outcomes a false positive. And that's why some of these tests, like Grail, have false positive rates of 56.9% at which point you are literally better off flipping a coin. You will only be wrong 50% of the time, not 57 so it's just they suck, like in that regard, right? Like they just, they cannot detect appropriately and properly, in my opinion, because they don't have enough signal, they mutate in their amplification, and there's just a guessing game. You know, the reason that surgical tissue biopsy has always been the gold standard for diagnosis is because they're not guessing. It's an actual tissue. It's physical, tangible tissue that they put on a slide. The beauty of what we do at cancer check Labs is we figured out how to essentially extract similar, homologous cellular tissue from that blood sample. Those cells are the same cells that are dislodged from the tumor. This is actual tissue you need to follow gold standard methodologies and not guess. Guessing is dangerous. I mean, you know, there are cases and I can see you asked my folder, I can speak to Braille. There's cases that was published last year. You know, where the false positive? I mean, in May of last year, they published data at AACR, annual American Cancer Research Conference that they did not want to publish because it was so bad, they were forced to publish it because they recruited participants publicly their stage zero detection rate. This example of no signal is zero. Stage One, 3% stage two, 5% stage three, 15% they are missing 85 to 100% of stage zero to stage three cancer that is useless for an early cancer detection test, and then you crank out false positive rates of 56.9% that is dangerous. False positives result in unnecessary, costly and dangerous intervention, surgical tissue biopsies, you know, potentially even treatment at times, and so you have to be cautious. You know, there was a case published in The Atlantic last year with Grail gallery, this test where they got a false positive on testicular cancer and they castrate it, because that's how you biopsy a testicle. Like false positives are very, very dangerous. You cannot have false positives, and that is why we extract these tumor cells, right? I want to see the cell. I want to make sure that that cell is actually a tumor cell before we return a positive on our screen.

Unknown: 53:57

So let me ask, are there any I want to ask you about the next 10 to 20 years and what? And what you see your you know, your company like in the future, cancer check labs. But I also want to ask you, are there any pitfalls that you're constantly trying to avoid, because no test is obviously perfect, but is there anything that you're still working on to make it even more infallible?

Sumit Rai: 54:18

Well, everyone's always trying to optimize the test, right for sure. I mean, I think one of the things that we want to look at is, you know, right now we we talk about screening for 200 plus tumor types, because there's 200 major kind of solid tumor types and subtypes, and again, they all follow the same common denominator with the CTCs and physical and mechanical characteristics. But I think we want to start looking even beyond that, into more esoteric and rare cancer types. And we actually have had some recent success with that that we'll talk about in the future, but we're seeing that we're actually able to detect some extremely rare cancer types as well. And so that's that's really exciting. That's something to look at, I think, more than trying to you know beyond the. Test. We have a good test. But you know, beyond you always want to optimize, we have a very good test, an excellent test, and so, so that's that's solid. But I think the next step is also, what other applications can we do? What's the what are the next phases to this? More so than just trying to continually optimize an already outstanding test, I think the next phase is starting to look at other applications. So for example, we talked a little bit about chemo, chemo today. One of the reasons that chemo is so toxic is because it's largely blind. If you get diagnosed with cancer, they will put you through six to eight rounds of chemo, often several drugs at a time. That is why it's so toxic, you know, because they don't know what'll work. So they're throwing spaghetti on a wall, hoping it'll stick. And that's why the oftentimes the Chemo kills you if the cancer doesn't, because it's just so toxic, it's too much. And so one of the things that is known in CTCs that has been studied in the past is that, because this makes sense, because they are cells of the tumor, they have the same response to drugs as the tumor. So if you have the ability to extract them like we do, then before we start chemo, Let's inject them with 1020, 3040, chemo drugs and see what works before you start injecting poison into a human being. That's precision medicine that's starting to look at now let's get this down to two rounds with a couple drugs, as opposed to eight rounds with 30 or whatever the case might be, right? So there are ways to make these therapies more effective and less toxic, but they require precision. They require insight. And so, you know, thinking about things like that, these same tumor cells that are dislodged from the primary tumor share the same DNA as the primary tumor because they are tumor cells, literally. And so why not take those tumor cells and run a genomic analysis to understand the mutations that mutational data will guide the design of the most efficacious therapeutic protocol is this, her two positive breast cancer use Herceptin and immunotherapy? Is this triple negative breast cancer? Different protocol is this high up cam lung, low up cam lung? Different protocols is this MCR, PC, metastatic, castrate resistant prostate cancer, where the v7 you know, receptor is mutated that will not respond to hormone therapy. Different protocol. Those types of insights based on the genetic alterations are very valuable. One of the problems today is the only way to get that is to cut. You have to do a surgical biopsy. That's fine. They do it the beginning. They get their data. But here's the thing, cancer is evolution on steroids. That data is only good for a few months. The tumors evolve, and you can't update it today without going in for another surgical tissue biopsy, which is typically not indicated. Number one, many of these patients are older. They can't sustain so many surgeries. They will have a cardiac event. They will die on the table. Number two, a lot of these patients at that point of time have gone through chemo, radiation, all this stuff. Their bodies are weak, and so you can't just keep cutting them over and over again. So they end up relying on outdated data. If you could extract that data from simply a blood draw by taking the CTCs that are homologous to the tumor, because they're cells of the tumor. You could update it every day. You could update every week, whatever you want. It's a minimally invasive issue, and so looking at those types of things to kind of further and optimize how therapy should be done.

Unknown: 58:29

I love the way you think now we're gonna we're nearing the end, and we have the most fun with something we refer to as the rapid fire questions. Hey Spencer, hold on a second. I want I'm like, so hooked on this because my dad died cancer, and I have a lot of cancer. My mother had cancer for we have a lot of functional doctors listening. That's a huge group we have. I'm hooked right now. How did these doctors find your test? How do they use your test, and and is it rapidly available for everybody?

Sumit Rai: 59:03

Yes. So they go to go to our website, cancer check labs.com, just there's a form there, if functional practices want to sign up. We work with lots of functional doctors across the country, as you know, and we will onboard them. And the functional doctors will be given a portal, and in that portal, they'll have two options. Option A, if they have a physical clinic location, they'll be able to order kits directly to their location. Option B, if they have telehealth and remote patients, which many functional doctors do, we will drop ship it directly to the patient of theirs in whatever location we are available today in 47 of 48 continental United States. We're not doing Alaska and Hawaii right now. Logistics are complicated. The only state continentally where we're not there's six states where you need state licenses, California, New Jersey, Maryland, Pennsylvania, Rhode Island, we have all five. The last one we're working on right now, where we're close to final steps, is New York, but that's. That's 47 to 48 we are also available in Canada. We are about to launch the UK. We just signed a deal with 140 clinics in the UK that are going to pull blood for us, both fixed phlebotomy, as well as mobile phlebotomy. And we're expanding internationally. And so if you want to work with us, if you're anywhere on the globe, we will try to work with you. Just come to the site again, cancer, check labs.com, sign up that kit, by the way, that gets drop ship to our customer, your patient, essentially has everything you need. In that kit are the vials that you need to pull in the blood. It is a proper blood draw. It's 40 milliliters of blood. And so I'll get to that in a second, once the blood is drawn. There's a cooling engine in there, which is very simple. It's a box. The vials go in the box, you put a lid, you hit a button. That button causes a chemical reaction that keeps the sample between two to eight degrees Celsius cold for transport, so that it doesn't get spoiled. There Is No Dry Ice handling, there is no refrigeration, there is no centrifugation. There is no ice packs the night before that people forget to do is simply a button once that's done in there is also a prepaid FedEx overnight priority label that will overnight it to our lab in medical district in Dallas the next morning, at which point it will be processed now for blood draw. There's three options. Option A we have a partner. We have partnerships with 4000 mobile phlebotomists across the country. They will come to your doorstep. They will pull the blood, they will pack it up. They will take the kit. They will drop it off at FedEx. It takes you five minutes. It's white club option B. We have partnership across the country with any lab test now. They have 230 locations across the country. You can walk into one of their locations. They will pull the blood, they will pack it up, they will FedEx it to us. And option three is, of course, your your practitioner can pull your blood, or your nurse, doctor, whatever you'd like.

Unknown: 1:01:52

That's awesome, fairly serious. Thank you. All right, fantastic. We are out of time that we had a informative, very informative show. Thank you so so much. We probably would have you on again in the future, because it seems that there's, you know, constant progress and evolution going on. This is such an important feature and facet, especially with the new progressive government that we have now. So thank you so much for all your your information. Yes, very obvious that your sister would be so proud of you. It's so obvious that your passion is being led by her and so thank you for Sonia, for having a brother like yourself to to do this path, because I think a lot of people are going to be saved by both of you.

Sumit Rai: 1:02:46

Thank you. Thank you. Yeah, if you want to quantify that for you, but sure, if you think about, you know, look, I told you earlier, last year alone, there were 10 million lives lost in cancer right over the course of 100 years, 100 times 10 million, that's 1 billion lives lost. There are not many things on the planet that's double digit percentages of global population. There's not many things on the planet that actively threaten double digit percentages of global population. If you can detect at state zero, as early as we can survival is 99% you're talking about potentially eradicating that 1 billion lives, potentially saved in 100 years, a short century. I mean, to put that in perspective, if you were to add up all fatalities from all wars in human history, the total is 350 million. It's, you know, you're talking about an impact that's three times of that in just 100 years, potentially. And so it's just a massive, massive thing for the world of humanity, and it's important that we get it out there.

Unknown: 1:03:54

Well, we're gonna do our part. So thank you so much for your time. Thank you appreciate you guys. Have got it. Thank you for listening to today's episode of The cracking backs podcast. We hope you enjoyed it. Make sure you follow us on Instagram at cracking backs podcast. Catch new episodes every Monday. See you next time you.