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David B. Agus M.D.

lines on the record: 30
first: 2025-03-27
most recent: 2025-03-27
sittings or episodes: 1
sources: podcast

Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections

“First of all, I would never get into medical school today. I look at what they do in the tests and whatever. It is hard. Back when I did it, it seemed easier. I probably would still go into medicine. I love it. I pinched myself every day. I get to do what I do.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“When people come to see me, I mean, most of the time they have advanced cancers, so they fail conventional treatment. So I get to think out of the box, look at all of the data, and come up before AI with something that I think can work for them and try it. I get to watch evolution happen. When I give a drug to a patient, that cancer evolves. I'm watching evolution happen in weeks to months in my patient and learning the biology of cancer from perturbing it. Believe it or not, I'm a weird species in that I work in the lab and I see patients. There aren't many of us left in the world. And to be able to do both, I do autopsies on my patients who pass away. So I see what I missed, where I was right, where I was wrong, and I learned to get better.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“On back in the hip, and elderly people who broke their hip after repair, in the heart, in the eye, in the hair, other places. And it's going to be very exciting. It's still early days, and we have to perfect that science, but this is something in the future to turn on the regenerative capacity of our body is something that will enable us to have, you alluded to before, is quality years in our 80s, 90s, and 100 with stem cell technologies we're going to be able to reverse that.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“So, first of all, when you go to any mall now and you go to a mini mall in California or a mall here, you see a stem cell center, a nutritional center selling NAD and vitamins and supplements, all of them promising you the fountain of youth. Every single one of them is a fraud. And I think it's important to say that. There is no data behind them. And so it's difficult because they have great marketing. It makes intuitive sense. Well, STEM cell, I read the New York Times. STEM cells were good. This says stem cells, therefore I want them. And that's the reductionist approach many people take when they see these buzzwords. So these are the future, but they're not here today is the important message. There's no question we will at some point get to them. There now are ways of turning the stem cells back on. And so there are clinical trials now doing things to turn them.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“I consider it a privilege to talk to them. It doesn't bother me. It bothers my wife, believe me, but it doesn't bother me and I'm happy to try to help them. I mean, the ability to help someone, you know, I look at it as that takes two seconds of my brain time to help them and the benefit to them can be very significant. So there's an asymmetric part of the relationship here.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“100% we can, and I think we will. I can't see a reason why all of us can't live in a healthy, quality way till that point. In the early 1960s was the last time in the United States you can die with the cause of death being old age on a death certificate. Now you need Alzheimer's heart disease cancer. I want to go back to people dying of old age.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“No, I think it's a reasonable thing. I think it's an important thing. There's nothing wrong with it. I'm not saying it is an alarmist thing. I just believe in it.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“So it's interesting. A study came out earlier last year or later, the end of last year that was looked at biologic age and said the biggest change in health happens at age 43 and age 60. So that's when medical issues change the most. 43 and 60. And both of those time points, when things happen is when you start to kind of realize that you're not immortal. And so I see that very commonly in patients. You know, most of my patients, the first thing I have is, listen, you have a cancer. I'm going to be able to control it. I don't think you'll die from it. But I would recommend getting your fares in order. There's nothing wrong with being prepared. Hope for the best, but plan for the worst. There's a very reasonable thing. I've seen too many, and I'm sure you have too, people who weren't prepared in horrible fights within family because they weren't prepared. And that's not a good thing.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“And consider hard imaging Figure out where we are, where we're starting from. Look at all, be up to date with all your vaccines, which is critical. Make sure that regular blood values are on good order, and then consider genetic testing if you have a family history of anything.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“Not necessarily. Again, the warnings on alcohol showed there's an association small with alcohol and cancer, particularly women in breast cancer. There's also an association of things like toast and coffee with cancer. When you burn the coffee bean or toast, that brownness is acrylamide, which has carcinogenic properties just like alcohol does. But it's a very, very minor contributor despite all the hullabaloo that was made over the last couple of months.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“In a large study in Europe, they showed that three servings a week had no health detriment. There is a health benefit in several studies with grass-fed beef. So the key is moderation. Don't eat processed meat. People who had processed meat every day for 20 years had about a 20% increase in colon cancer. So yeah, if you have a hot dog a day for 20 years, it can increase colon cancer. So I probably wouldn't do that. But in moderation, it's fine.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“One of them went to medical school, the youngest. I didn't convince him. You know, he wasn't going to go. He went to MIT was a total techie, totally into programming, AI and data. And then COVID happened. And he was privileged to work for a group analyzing data on COVID and trying to help with some of the COVID software for some of the clinical trials. And he kind of learned, you know, I want to do things to help people. I want to do things that matter.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“You have to set priorities and you have to learn to say no. So I've been home every day of the week for dinner. I don't go out. I say no to a lot of things. My business, it's easy to say no, oh, I have a patient emergency. I can't go to this. I can't go to that. It makes it very easy to say no. I really try to make my schedule regular. You know, it turns out if you snack in between a meal, the next day your body expects that snack and insulin, cortisol, the stress hormones go up, you lose productivity, your metabolism goes down, you gain weight. It's really tough on the body. So I'm very regular with when I get up, when I eat, when I go to bed. And that makes an enormous impact on your overall health.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“I was a geek as a kid. You know, it was about 10 years after Sputnik, and I did this little competition where you had to do this test, and we were one of four kids chosen, and we went lab to lab across the country where we kind of got to tinker in the labs. And I loved being in the lab. And so as I got older, I kind of realized that I wanted to apply the lab to patients. I couldn't just be in the lab. Oncology, cancer was an amazing place because something in the lab could be translated right away to patients. Patients were willing to take the risk. I was willing to take the risk. So that got me into cancer.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“I went to school in Philadelphia. My father had moved as a professor. He was initially drafted from Baltimore to the Air Force. We went to San Antonio, Texas, and I went to St. Mary's Hall. I was the first, one of the first two boys that went into a school that went from nursery all the way through college. And I still remember first grade. I was one of two boys in the school. Then we went to Philadelphia. And then I went undergraduate to Princeton in med school at University of Pennsylvania, and then internship and residency at Johns Hopkins, fellowship at Sloan Kettering, and then to the NIH for a few years.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“All different. I mean, you know, there are people I take care of who are amazing. Jack Kemp was a remarkable individual and when I first started to take care of him, he goes, you need to do me a favor and I want you to come to my house. And I go, okay, thinking we're going to discuss his case and what's going on. And what he did was he had his whole family sitting on a long table and he had his church come and serve them dinner. He wanted me to see who he was. And he said, listen, you make all the decisions. I trust you. But I want you to understand my values system. And it really was a beautiful way of approaching things. And it's a privilege to take care of anybody that they put their health, their future into my hands.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“So, one of the largest studies ever done in Europe, what they showed is every year you delay retirement, you reduce the incidence of Alzheimer's by 3%. So it's the old adage you don't use it, you lose it. So keeping your brain engaged, making yourself uncomfortable, which you are good at doing with your myriad of activities is fantastic, and I love that.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“We are a technology application institute, so we develop drugs. We now have a large AI group that can design molecules targeting areas of cancer. So we're designing a molecule that hits part of the prostate cancer signaling cascade. To block it, that'll go into the clinic next year. We have a breast cancer molecule that we made with AI. So with AI, we can actually use AI to what is the structure of the target and then what is the structure of the molecule and what would have taken many years, we literally can do it in months is design a molecule to go into the clinic. So that's been a tremendous advance for us and enabled us to have a whole pipeline of drugs to treat cancer.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“Patrick Walsh was a rock star. Patrick Walsh was a young urologist at Hopkins, who at the time, people took out the whole Protestant. And the problem is the nerve looked like the prostate tissue. So they were taking out the nerve and they had continence problems and potency problems in all the men. So Patrick looked in kids who had basically died during childbirth, young kids, and was able in those kids to know where the nerve was and develop what's called the nerve-sparing prostatectectectectectectectectectectomy and started to pioneer that approach. Now with a robot, we can go in through a small incision, blow up the abdomen so there's a high pressure, so there's almost no bleeding. And instead of looking down a cave where the prostate is deep in the abdomen, you blow it up at a big Sony screen. Great visualization. You could take out that prostate and have better outcomes in terms of side effects. And the patient literally could go home the same.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“So there's no question that indulgent prostate cancers are very common. If I walk through the streets of New York City and biopseet everybody over 60, I'd find 35 or so prostate cancers. But again, most of them won't cause a problem. What we know is we can grade the aggressivity of the cancer and know which are the ones that are going to cause a problem. We have a blood test called PSA that is very good based on the slope of the curve, the change in the number. Doing a biopsy is not a horrible procedure, and under the microscope, we can say, hey, this is going to be bad or don't worry about this one. So we're getting a lot better about dealing with them.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“You can look at all the cancer risk genes for about $100 in today's world. And I think it's important knowledge is power The generation before us, if they had cancer, it was considered a sign of weakness, and many never talked about it. So getting a real accurate family history sometimes is really hard.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“I think there's a cadre of blood test you should get on a regular cadence. I think that you need to talk to your doctor about potential medicines that can lower risk. Things like aspirin, statins, and other things can lower cancer risk in the right individuals if you have a family history or others. And it's know your family history. Figure out what Aunt Marge died from and really understand because many of those family histories carry down from person to person important to know. In today's world, I can sequence your genome literally overnight and know if you inherited the gene that gave you higher risk for those diseases. And then we can have a targeted prevention based on that gene that you have.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“So it's interesting. All of the regimens we have, surgery, chemotherapy, were designed around people who were older with cancer. I do think the biology of younger cancer is very different. So first of all, we need to develop regimens meant for younger people. That being said, we also have to start screening younger people for cancer. The age of colon cancer screening dropped from 50 to 45 recently, and it probably should drop even further. So if you have any family history of cancer, we probably should start screening earlier.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“We assume it's either something in the environment, we assume its diet, it's ultra processed foods, it's microplastics, it's changes in the microbiome, we really don't know. Until we start to collect data, we can. And we don't really have a data collection system, unfortunately, in the United States.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“All right, so the dirty secret is we have no idea. We don't collect data well in the United States. What we do know is that there's not a dramatic rise in cancer in the United States, but what we are seeing is a troubling trend is younger people are getting more cancers. That's real. We have no idea why, but we are seeing younger people, more colon cancer, more breast cancer, and other cancers in younger individuals, 20, 30, 40-year-olds, that we never used to see.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“Why not? I mean, so there's an argument that, well, if you find a PSA test and PSA is high, we're doing overnumber too many biopsies, too many prostate surgeries, and too many radiation. And that's true. So finding a cancer doesn't necessarily mean you need to treat it, which I know which is a weird statement, but there are many cancers, some indolent prostate cancer, indolent thyroid cancer, some indolent breast cancer that don't necessarily need aggressive treatments, but can be followed. So we call that active surveillance. So we need to develop better guidelines, better ways of framing or talking about them. I say cancer, you panic. I want treatment, but in many of them there's no benefit to doing treatment and lots of side effects.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“They're all a little bit different depending on the type of the cancer. Stage four means it's all over the body. It's metastasized to different parts of the body. Stage one means it's confined. Stage two normally means it's spread, but in a local area. And stage three means it's spread a little bit more than local, but it's still in half of the body. And again, the stage four is all over. So as you go up in stages, survival goes down and outcome goes down.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“So there are MRIs now which don't have radiation to do full body scans. So certainly looking on a scan can be helpful many times. One centimeter of cancer is still many hundred million cells. So it has yet to be proven that using a technology like that, with the exception of lung cancer, where it clearly works in smokers. So smokers every year should get a scan. You catch it early. You can cure the lung cancer. But in other cancers, it really hasn't been shown to make a dramatic difference. Breast cancer, it does. Lung cancer it does, but many of the others it hasn't yet. We need better imaging technology. We need better blood tests. But most of our resources are spent on treating and figuring out new ways to understand the biology of cancer, very little on the diagnosis and the identifying early of cancer.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“The answer is we've made tremendous progress, but it's not enough. So we now have immunotherapy, right? Your own immune system can attack the cancer. We now have molecularly targeted therapy with every single patient in the country. It's covered by Medicare can have their cancer DNA sequenced, and we can potentially use a pill to target a molecular alteration or an on-switch in his cancer and turn it off. All of those buy time, but we haven't cured the disease.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source
“Yes, yes, and yes. So there certainly are what we call genetic predispositions. There's several dozen genes that if you inherit a faulty copy of it, your risk of cancer is dramatically higher than the average population. But cancer is a change in the genome. Sometimes behavior, sometimes things you smoke, things you do can cause or induce changes in DNA so you don't get it from your parents. You can cause them through what you do, but there has to be a change in DNA to get cancer.”
2025-03-27 · The David Rubenstein Show · David B. Agus M.D. · IDENTIFIED FROM THE TRANSCRIPT · source