Why Early-Onset Cancer Is Rising In The United States

On this episode of Going Under: Anesthesia Answered with Dr. Brian Schmutzler, why Early-Onset Cancer Is Rising In The United States.

Colon cancer at 40 should stop you in your tracks, and it’s becoming less of a rarity. We’re seeing more aggressive cancers diagnosed in younger adults across the US, and we wanted to talk about what’s changing, what we actually know, and what you can do before symptoms ever show up.

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Transcript

Handheld Ultrasound Sponsor Message

SPEAKER_01 0:16

This is going under Anesthesia Answer with Dr. Brian Schmutzer. I'm Bahid Saderzani. We are brought to you by the Butterfly Network.

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Why Cancers Are Showing Up Younger

SPEAKER_01 1:35

Uh coming off the heels of a great podcast where we talked about diabetes. Now we're kind of switching our focus to young, younger patients and why we're seeing so many cancer diagnoses uh in the population, especially in the United States. Yeah, it's crazy over the recent uh last couple of years.

SPEAKER_00 1:57

It's crazy. So traditionally, cancer, you know, obviously there are some childhood cancers and some people who rarely get cancer in their 20s, 30s, 40s, 50s. But usually cancers are are diseases of the elderly, the older people, 60s, 70s, 80s, 90s, even. And it's weird because really in the last probably 15 or 20 years, and really in the last five to ten, there's been a huge increase in cancers, aggressive cancers in young folks. Um so I mean one of the biggest ones and one the ones that get the biggest press is uh is colon cancer. Um and so we'll talk a little bit more about that later. But there's increases in breast cancer for sure. Uh pancreatic cancer, which is which is odd because pancreatic cancer used to be an incredibly rare disease. And when when I was a resident, um our surgery department did a lot of pancreatic cancer patient surgeries, and they were almost all in their 60s, 70s, right?

SPEAKER_01 2:56

So why do you think this I mean do you think we can go down a few rabbit holes? Yeah, yeah, we'll get there. We'll get there. But you know, cancer. What is the you know, I want to say what is the research behind it now that the research is kind of getting better. Um technology, yeah. What role is it playing in cancers of young patients? And is maybe is that why we're seeing so many of these?

Defining Cancer And Metastasis

SPEAKER_00 3:28

Yeah, it could be. So so let's go back and just explain what cancer is, because cancer is not really accurate, it's cancers, right? So most cancer, like a lung cancer is different than a pancreatic cancer, is different than uh uh a GI cancer, colon cancer is different than a breast cancer. So cancer just means that cells grow out of control um in a in a negative way, right? So um, you know, like probably one of the most common things you can think of that you can actually see is let's say melanoma, right? So you get a little what looks like a mole, and then all of a sudden it grows and it grows and it grows and it grows and it grows uncontrollably. So that that's like a local cancer, and then that can metastasize, go through the blood, and get to other parts of the body. So let's let's just define what cancers are. But you know, um, so so technology. So do we think technology has something to do with it? I you know, I don't know, maybe. Um probably probably not colon cancer. I can't see a way that technology is causing colon cancer. Um but there's there's probably some connection to modern society uh and brain cancers, um, and and maybe you know, skin cancers as well. Like there's there there may be some pharmaceuticals or some you know things like that that may be causing some of that stuff. But I mean, if you talk about colon cancer, I I you would have to assume, whether the data says it or not, that there's something related to diet.

SPEAKER_01 4:58

Right. Well, okay, so right. These are the two biggest things that I think people are young people are doing differently than our ancestors. Yep, yep, yep. Now they didn't live as long because they didn't have the medical technologies that we do, right?

SPEAKER_00 5:11

So a lot of people died of infection or um heart disease, stuff that we stuff that we treat very well now. Cell phones?

SPEAKER_01 5:19

Cell phones, yeah, cell phones, watches, yeah, yeah, yeah, metaglasses, yeah, right? Headphones, computers, laptops. That's all part of the technology, right? And now they're saying, have you seen the new thing where like if you put don't directly put the laptop on your lap because it can cause Oh, there's heat on it.

SPEAKER_00 5:38

Yeah, they've been talking about that for years. Like there's probably so so there is probably some um detrimental effects of putting heat, uh consistently putting heat on your groin area, whether you're male, male or female. But I mean that has doesn't have anything to do with uh electronics, it's just heat. Yeah, that'd be like sitting in a sauna, just putting your groin in a sauna for six hours a day.

SPEAKER_01 6:03

I just don't know if there's enough research on cell phone. I mean, we know that remember this whole thing in the 90s and early 2000s with telephone lines and living under power lines and stuff like that, right? Yeah. Causing cancer. Well, do we know enough research about cell phone data and what it does to not yet, probably not.

SPEAKER_00 6:27

And then how do you study that, right? Like it you're gonna have to do some goofy retrospective, like this guy got cancer. Tell me how often you used your cell phone, it's self-report. It's gonna be really hard to do, right? So I mean the electromagnetic fields that are by you. Yeah, so there's there's you know, there's a lot of discussion about that going back and forth on both sides, but let's like you know, I'm gonna take my personal opinion out of it. Let's let's talk about what the what is actually potentially happening.

Colon Cancer And Screening Age Drops

SPEAKER_00 6:55

So so I think colon cancer is probably the best place to start. So they used to recommend long time ago getting uh colonoscopies at like 55, and then it came down to 50, and now they say 45, and even that they're talking about reducing.

SPEAKER_01 7:12

So um my doctor the other day, yeah, I literally turned 45 a few months ago, yeah, and he's like, so what do you think? Yeah, yeah, you're gonna get it.

SPEAKER_00 7:22

There's different ways to do it now, though. Well, you can do the cola guard. Colagaard is a it it picks up in your colon, uh in your in your stool, whether or not there's the DNA. But isn't there blood work now that you can do instead of? It just came out, yeah. It just came out. I just saw a commercial for that. I'll just wait until that's so so here's the problem, and that's fine. It's a it's an okay screening test if you're low risk. Yeah. The problem is that it misses a lot. And it overdo so it's got a high false positive rate, meaning that it overdiagnoses it, and a high false negative rate, meaning that it underdiagnoses of certain types. So I mean, I'll I'll make the PSA right now. You need to get your colon, your uh colonoscopy at 45. Really? Maybe sooner, if you have any family history. You've got to get of col of colon cancer. Colon cancer. So so it this is a screening test that used to be in older people. So now we're finding more and more people at at age 45 or even younger who have colon cancer. And the the problem with uh colon cancer is that it's so advanced by the time it causes symptoms. So that's why we have screenings, that's why, even though you're healthy, you don't feel like you have any issue with anything in your colon, you get that screening done early. So, I mean, you know, I I would even push, depending on what your family history is and depending on you know what your risk aversion is, to get it as soon as 40. Uh I mean, look at like like the the poster child of um of uh uh like famous people who had colon cancer was that Chadwick Bozeman. Yeah. He like it was 44 when he died. Right. He was diagnosed in 42 and it was metastatic when it got diagnosed. So um a lot of them are advanced. Yeah, they're catching him at much more advanced uh advanced stages.

SPEAKER_01 9:15

What does James Vanderbeek have? Did he have colonies?

SPEAKER_00 9:17

I think it was colon cancer too, yeah. Yeah, and he was forty-eight, I think.

SPEAKER_01 9:21

Yeah. So And you don't have to have a family history, right? Or is this and and why do you think the numbers are increasing in colon cancer among younger patients?

SPEAKER_00 9:31

So there's a couple of things. So I think diet is a huge part of it, right? So we're not This was the other thing, right?

SPEAKER_01 9:36

You had like electronics, diet.

SPEAKER_00 9:38

Yeah, so so I think you can really make the connection with it's hard to make the connection with the cell phones and EMFs and that stuff.

Stool And Blood Tests Versus Scope

SPEAKER_00 9:45

Not not dismissing that that's a possibility. It's hard to make that connection. You can definitely make the connection with diet. We went from eating like meat directly from the cow and mashed potatoes, like a potato mashed up to eating all these ultra-processed foods. Like you, there has to be something in these ultra-processed foods, including like refined sugars, preservatives, emulsifiers, artificial additives. So, like that I don't know that the data is fully caught up to it yet, but I think most scientists agree that all those things do a couple of things. One, they change your gut microbiome, which you know, even though there's not direct evidence of it, probably contributes to colon cancer. The other thing is they cause inflammation, right? So chronic inflammation, like if I take my hand and I do this all the time and I cause chronic inflammation, that's going to cause an overgrowth of cells. If you hit the wrong cell that overgrows, that's a cancer, right? So the fact that you're that you're, you know, tearing up the gut over and over again with these inflammatory foods and things that we put in foods, I think that is a that is a huge part of it. Um the other thing is obesity and metabolic disease. Same thing, right? These are inflammatory states. You know, diabetes is inflammatory, obesity is inflammatory in your body in general. That's part of the reason you get heart disease with diabetes, is because of the inflammatory part portion. Well, which is crazy though to me, because Chadwick Bozeman.

SPEAKER_01 11:10

Yeah, young guy in shape. I I didn't Family Hist. I didn't go over his diet, I don't I don't know his eating patterns. James Vanderbeek seemed like a pretty healthy guy.

SPEAKER_00 11:22

Yeah, I don't know as much about Vanderbeek as I do about at the end. But Bozeman was family history. Yeah, and and there actually is a um a higher incidence of colon cancer, especially advanced colon cancer in the African American community. So, like there's probably at some point gonna be a recommendation that and there are for other things too, like that African Americans get a um get their colonoscopy earlier than Caucasians. Like that's probably gonna happen at some point because of like the epidemiology of it. Um and then sedentary lifestyle is big, right? So again, you create this insulin resistance and you create chronic inflammation by not getting up and walking around and not you know not having an active lifestyle.

SPEAKER_01 12:06

So what can we do? I mean, I I think the preventative other than right, I mean, diet, yeah, huge part of it. Yep. Anti-inflammatory diet. And is there like a diet that's like an anti-inflammatory diet or like what are the best foods for that?

SPEAKER_00 12:21

Yeah, so I think the key is to just eat whole foods, to eat eat, you know, unprocessed foods or or mildly processed foods, not alter processed foods. That's the biggest thing.

Diet, Microbiome, Inflammation, Obesity

SPEAKER_00 12:31

I I don't think it's in general, it's not the food itself. Um, at least not not with the data. Now, like some people talk about FODMAP and all that kind of stuff. Like, I get it, those are those are real things. But um if you look at the data, the the foods, if you eat whole foods, if you eat salads and meat, sure, you're not likely to cause inflammation in your gut and you're not likely to have an issue with with colon cancer. Uh or I mean you're not likely to increase your risk of an issue with colon cancer.

SPEAKER_01 13:00

It's tough because you know, friends of mine and I used to have these discussions all the time. How can you slow down genetics? Yeah. How can you s how can you reverse genetics or like let's say my dad had diabetes?

SPEAKER_00 13:16

Like we talked about medic medicine, uh I mean uh uh diet and food as medicine, basically. My dad has diabetes. The likelihood of me getting diabetes Well, when did he have when did he when did he uh develop 45, 50 and heart disease? Yeah, a little bit. Well, the heart disease is probably from the diabetes, but the diabetes may or may not is he the only one in your family who has it? Everybody, okay. So you probably do have a family history.

SPEAKER_01 13:41

I mean, he's the only like the kids don't have it yet.

SPEAKER_00 13:45

Yeah, but like does his brother or cousin or all that other people. Correct.

SPEAKER_01 13:49

And then my other grandparents had it. Yeah, okay. Yeah. So so you've got a family history, so you you're higher risk. Right. So like the likelihood that I get it pretty higher. Higher. Yeah. Likelihood that Ari gets it. Slightly higher, yep. I mean, each generation you go. So how do you break that cycle? How do you break the cycle of genetics to say, like, you know what? Like Well, you can't.

SPEAKER_00 14:12

You can't. You can't break the genetics, but you can you can do everything to mitigate the chances. So healthy weight, healthy diet, exercise. Again, we talked last time about diabetes. Exercise is the biggest way, best way to prevent uh serious diabetes and then complications from diabetes once you get it, because every time you move those muscles, lift weights, run, that sugar goes into your muscles. It also increases the effectiveness of insulin. So exercise is key, right? And diet is key too, right? Because that keeps a healthy weight, but exercise is key for diabetes.

SPEAKER_01 14:50

I do think, and the conversations we've had on this podcast, in particular, about uh some of the processed foods that companies are putting in these days that we don't even know about. I think those that is why you're seeing this.

SPEAKER_00 15:08

Probably. So so

Genetics, Risk, And Breaking The Cycle

SPEAKER_00 15:10

let's talk about so there's like three like controversial theories, although I don't think they're as controversial as people say right now. So um, so I think we can all agree there's a huge shift in the age of when cancer is diagnosed. So so theory one, ultra-processed foods, we've talked about this already. So it changes gut biology for sure. I think intestinal inflammation is probably the biggest the biggest reason why. I I don't know that this is all that controversial, but I don't think that there's big, large-scale randomized control trials that show this. So that that's probably the least controversial one. All right, microplastics, right? So this is a controversial one. Environmental chemicals, microplastics, PFA, PFAS, right, all that sort of stuff. So at least in the lab, these cause a lot of inflammation and cell changes and caught can cause cells to change from normal cells to fast growing or cancer cells. But that's technology, right? That's that's environment. Okay, it's environmental. I just I I don't think there, I don't think there is any I don't think there's any data out there to show that the EMFs or the cell phones or any of that sort of stuff are contributing to these types of cancers. So there there is data that comes out from time to time with like brain cancer and and and glaucoma and all that kind of stuff, but but not not colon cancer.

SPEAKER_01 16:28

Back in the day, we're talking about this too, not you and I, but I was talking about this to a group of friends. Back in the day in the 90s, guess what? You and I carry Nalgine bottles around. Remember those clear plastic water bottles that everybody was carrying around. Those PFAS, those were 100% PFAS, right? Yeah, yeah. 100%. And now they're like, okay, we're getting away from the metal.

SPEAKER_00 16:56

Yeah, yeah, yeah. Okay, metal's probably a little better. Glass is probably the best, honestly. Glasses? Yeah, because the the um there's the chemicals in the glass, which are few anyway, don't leach into the water. So like it's inconvenient, but glass is probably the the if you're worried about chemicals getting into the drinks that you're drinking, glass is probably the best thing that you can drink from. But that's like we're running around doing a thousand different things, you're carrying a glass bottle around. Oops, I dropped it. It's like it's not like a can that just explodes, like your glass ends up all over the place. So is that practical? No. Although I, you know, I I try as much as I can, although they're so expensive, to buy like Voss water. Sure. Just because I I I love Voss water. Honestly, I think it tastes better to do that as a glass bottle, but hundred percent. Damn. So, okay, so um the environmental chemicals we're talking about. I think the plastics are probably contributory. Um, and then we've talked about this in a few different ways before. Are pesticides contributing? Like the pesticides not only that are being sprayed for those of us out in rural Indiana, but also like, are we eating that pesticide and is it causing an issue? Now, there is no data, but I think you know, a lot of these pesticides are hormone signaling blockers or activators. So like they could change some hormones in your body that could potentially increase your risk of cancer.

SPEAKER_01 18:19

It's interesting because we we get, let's say we go to the shelf at Whole Foods and get a bag of mixed nuts. You have you hold on, you you have to say what's on the label. Uh you have to say what foods and what chemicals are in there, but not what pesticides. Correct. Yeah. And and that's also true for the fruit that we pick out, right? If you go to the, you're like, oh, I'm being super healthy and I'm picking out this fruit. No.

SPEAKER_00 18:43

No idea, yeah. Yeah.

SPEAKER_01 18:45

There could be more chemicals on that than there is in the mixed nut bag. You know what I mean?

SPEAKER_00 18:49

The thing you can do though is with fruits that aren't porous, like a strawberry is harder to do it with, but like an apple, yeah. If you wash it off real well with soap and water, you can get most of that stuff off the top of an apple. A porous thing like a strawberry, it's leached in there. But so I mean, I would highly recommend cleaning off your fruits. Like definitely wash your fruits,

Microplastics, PFAS, Pesticides Theories

SPEAKER_00 19:08

but anything that's non-porous, like clean it off, let it sit, that sort of stuff. Better with skin off. I mean, if you wash it right, it probably doesn't matter. It doesn't matter. Yeah. Okay. Yeah. Um but okay, so here's the super controversial one, right? Yeah. And I I'm not saying I I ascribe to this at all, but early life exposure to things like antibiotics, like uh environmental exposures, even stuff like in there's ideas of you know, like baby formula. So again, I'm not I'm not espousing all these, I'm just telling you what some of the theories are out there. There is there is very little, if any, research on on any of these. Um, so I think the likelihood of of any of these um panning out is probably 50-50. Um, but again, I go back to just like Tylenol, right? Like use the lowest dose possible, as little as possible. So don't take an antibiotic for every cold that you have, right? Only use an antibiotic, right? So and again, child childhood obesity. So trying to make your kids go out and run around, good diet, good exercise, um, and then the exposures to things like formula. I mean, like you know, we've seen that there have been some issues with formula production and people getting formula that's not got in it what they think's in it. So just just be careful with uh with when you go out and buy foods like that for your kids. Like I'm I'm you know, I've got two kids. I'm exceedingly cautious with my kids, as opposed to myself. Like, I'll go out and you know, drink a plastic bottle and not think twice about it. But my kids, my kids, I'm like, yeah, you probably shouldn't eat that. You probably shouldn't have by the way, my younger kid, this is cool. So I gotta tell this story before we finish off this. We got a couple other little things. So uh my younger kid um has been allergic to peanuts since he was like one and a half. Yeah. And um he got there's all this testing you can do now for like all the different um all the different um antibodies and like uh IgE and IgA and all this stuff that they can kind of tell you how allergic you are. Well, about six months ago he had one that showed he was like way less allergic. So this past week he goes in and has uh the basically a challenge

Early-Life Exposures And A Family Story

SPEAKER_00 21:22

where he eats peanut butter and sits there in the doctor's office and they wait for him to react. So he did that I don't know how many times I wasn't there, but um, so when when he left, they're like, Yeah, you're not really allergic to peanuts anymore. Giddy up. That's awesome. Yeah, so that was cool. So we had like uh we had like uh a Reese's together and like a spoon of peanut butter and stuff. So that was cool. That's cool. Anyway, so back to that that's actually something we we should do a whole episode on like uh allergies. Well, on peanut allergies, but yeah, childhood allergies in general.

SPEAKER_01 21:50

Yeah, we'll talk about that because my kid has a cat issue.

SPEAKER_00 21:53

Yeah, yeah, yeah. His is much more his is yeah, his is projectile vomiting.

unknown 21:59

I've got to

SPEAKER_00 22:03

So, okay. So, what are physicians seeing? Um what are you seeing? Well, so I do mostly orthopedics, uh anesthesia for orthopedics, so I don't see a ton of this. But overall, basically every area of medicine is seeing more patients with colon cancer. And I guess I do see that, you know, when I'm looking at a patient history, I might have somebody coming in for like a shoulder uh rotator cuff repair who's 40 and already has had colon cancer.

SPEAKER_01 22:32

Is that more men?

SPEAKER_00 22:35

So I think it's slightly skewed towards men, but it's both. Um I think colon in women, colon cancer in women. Yeah, colon cancer in women as well. Yeah. So um not the number one in women, though.

SPEAKER_01 22:46

That's still breast cancer. So so breast and prostate are still number one.

SPEAKER_00 22:50

Uh, colon may be catching up, though.

SPEAKER_01 22:52

I'd have to look through the data. I mean, in recent years, yeah, there has definitely been an uptick in colon cancer.

SPEAKER_00 22:57

And it's interesting because colon cancer doesn't get like uh its own month, breast cancer awareness month, and like, you know, prostate month is colorectal.

SPEAKER_01 23:05

Colorectal cancer month.

SPEAKER_00 23:07

Yeah, there is one, but it's just not as popular, right? Um, and so I a part of that's marketing. Right. Um, you know, I think colon cancer is catching up. It used to be prostate for men, and um, and that's a whole nother issue. We we should do a we should do an issue or uh do uh an episode about prostate cancer because that's an interesting one. Most men die with prostate cancer, not from it. So it's a very slow-growing, usually not aggressive cancer. And so there's a lot of discussions that happen with that. But anyway, yeah, so um, so I think it's a little bit more in men than women, but it is in both. Um and then so the the other problem is that a high percentage of these, and I say high percentage, 30

What Clinicians See And Who Gets It

SPEAKER_00 23:46

to 40 percent, don't have any genetic history of it, don't have any any family history of it. Like I it we don't understand what's going on. So if it's if it's not family history, it's gotta be some sort of exposure. So anyway, yeah. Um, all right, so what's this mean for the future? So I think screening guidelines are gonna change again. They're probably gonna drop it to 40, would be my guess. Now, you gotta balance that if you're the if you're the um payer, meaning the government, you gotta balance that with how much it's gonna cost to to take all those additional people and screen them sooner against what isn't that why they haven't done it because of so I mean why is that the official reason why they haven't done it? No, is do I think that contributes, yes. So the the reason you don't screen sure like uh why don't we why don't we do uh colonoscopies on 25-year-olds? Right. You're gonna have there's risk to it, right? Because it's a procedure just like anything else, and you're gonna have a decent amount of false positives with that. So you're gonna go in, you're gonna find a polyp, you're gonna biopsy

Future Guidelines And False Positives

SPEAKER_00 24:46

that polyp and it's gonna be nothing, but then you're gonna have to continue to watch it and then have colonoscopies every couple of years and all that sort of stuff. So you you've got to find uh the you've got to find a place, an age, uh, uh risk factor profile that makes sense for catching it, but not so much that you're gonna have a ton of of risk to false positives and doing procedures on people who don't need it. So my guess is it drops to 40. And that's that may be more that may be more political pressure or like advertisement pressure than it is actual data. But like you look again, you look at all these all these people, celebrities who are showing up with colon cancer 40, 41, 39.

SPEAKER_01 25:29

So um well, and again, it it is having the uh understanding that you can be 45 and get colon cancer. I mean, we've seen uh the celebrities, you know, most recently James Vanderbeek who went through it and it's quick. Oh, yeah. I mean it's it's you're looking at six to twelve months.

SPEAKER_00 25:49

Once you have metastat metastatic colon cancer, metastatic colon cancer is is very, very lethal. Yeah, you're you're it's that's not not good. Um now, if you catch almost all colon cancer, if you catch it early enough, you can either have uh you know a uh a polypectomy where they just go in with the scope and pull it out and you're okay, or even like small segments of your colon uh removed, uh, you know, partial or hemicolectomy or partial colectomy or whatever. So like there's a lot of ways that you can prevent colon cancer if you catch it soon enough, just like um, you know, there's a bunch of other cancers you can do that with. So um prevention strategies are gonna be key. What do we mean prevention strategies? Well, screening colonoscopies, but also diet, exercise, that sort of stuff. And then um making this uh again kind of a public health priority, meaning that we're talking about it instead of just talking about, oh, you know, do your self-exams for breast cancer and you know, get your PSA checked and have a prostate exam. We're gonna have to start saying, like, look for these signs of colon cancer. Are your bowels changing? Do you have blood in your stool? Like there are a lot of things that maybe show up kind of in that early to middle phase that you could catch at you know, 35 or 36 that maybe is gonna prevent you from waiting that nine years and then end up with a big colon cancer. So

Prevention, Warning Signs, Closing Plugs

SPEAKER_00 27:10

um, all right.

SPEAKER_01 27:12

Uh, and then and then obviously there's the the cola guard, which is the which is the test of the stool, and now the blood test, and I can't remember what it's called, it's brand new, but it is brand new because yeah, as recently as three months ago, my physician was like, Hey, you need a colon, you need a colonoscopy. You're 45, now you can get it done, but the easiest way is it's not foolproof, it's gonna be the blood work. Yeah, um, if you don't want to do all the other rigging revolt, but you could do the cola guard that's available, uh stuff like that.

SPEAKER_00 27:42

And so those tests, the technology will get better. And so 10-15 years from now, we may be saying, you know, only 5% of people actually get a colonoscopy because our technology caught up. Right now, though, it's still the gold standard to get a colonoscopy. So a cola guard, if a cola guard pops positive, that is a good indication that you need to get a colonoscopy. If it pops negative, it means that you don't have advanced disease currently. So it really doesn't tell you a whole lot. I don't know enough about the blood test to tell you exactly what that what that says. So uh, but I think as technology improves, I think I think this is gonna be a huge area of research. And I think there's gonna be a lot of medical device companies who are gonna come out with new ways to do this because now it's a huge population that has a risk for colon cancer. So, but I still, still the biggest thing prevention, right? Diet, exercise, you know, those two things are gonna prevent more than anything. And then I I will make my plug that I always make anytime we talk about health stuff, don't smoke. Smoking increases your risk of every single kind of cancer, including colon cancer. So number one preventable risk factor for basically everything heart disease, lung disease, but also cancer. So um, all right.

SPEAKER_01 28:59

Questions before we close it? I don't I don't think so. I mean, that was pretty thorough. I yeah, I think so. And again, if you want to listen to any of our podcasts from previous seasons where we do talk about these things, prevention, um, all leading all the way up to the diabetes episode last week. You can go on uh Dr. Brian Schmutzer's YouTube page, check it out, Instagram, Facebook, give it a follow, give it a like. Uh like and subscribe.

SPEAKER_00 29:24

Like and subscribe. Like, like uh wait, click like I can't remember what the phrase is.

SPEAKER_01 29:29

Take the three things that click, like, and subscribe, I think.

SPEAKER_00 29:32

Um so that'll do it for this episode. So we got two, we got two more, we got two more podcasts we got to do now. We got to do the allergy one, peanut allergy one. Yep, and we've got to do the prostate cancer one. Let's do allergies next week. All right, yeah, yeah, perfect. And we'll do we'll come circle back. We'll circle back. Circle back. Let's circle back to that. What was uh uh Jensaki, right? She the press secretary was like, let me circle back to that. I'll circle back to that.

SPEAKER_01 29:57

We're gonna circle back the same time next week. Thanks for listening for Dr. Brian Schmutzler on Vahit Sadrasadi. We're brought to you by the Butterfly Network. This is going under anesthesia. Answered with Dr. Brian Schmutzler. See you next time. Beat me too. Beat you to it.