Dr. David B. Agus is an optimist. “I’m a cancer doctor. I see pain and suffering from cancer on a daily basis. So I have to be optimistic. And I am.”
Agus, a renowned American physician and New York Times best-selling author, took the stage at Rakuten Optimism 2019 earlier this month in Yokohama, Japan, where he chatted with Rakuten CEO Mickey Mikitani before joining two pioneers of cancer research, Dr Hisataka Kobayashi of the U.S. National Cancer Institute’s Center for Cancer Research and Nobel Laureate Dr. Shinya Yamanaka, for a panel discussion moderated by Rakuten executive officer Hiroto Furuhashi. Rakuten Today sat down with Agus for an exclusive interview following his onstage appearance.
Optimism in an age of misinformation
“The internet is remarkable in that it democratizes information,” Agus says. “At the same time, there is a tendency for people to abuse it and take advantage of it.”
“All too often, in the medical world, we find something that we want to see, not something that is real,” Agus explains. “If you pull up the internet you can find anything — cures for every disease, everybody’s selling something in the hope of making a dollar off of somebody who’s sick. The hard part is to curate that so that the information matters.”
So how does the public separate the good information from the bad? “If something isn’t in a well-known scientific journal, it probably isn’t accurate,” Agus says, advising: “The key is to go where there is data.”
Agus points to data as another big factor in advances in treatments such as immunotherapy. “Immunotherapy is an amazing technology, in that it started in the late 1800s, and it’s been talked about since then. But until the last decade, it never worked. So 100 years of talking with no data, then all of a sudden, it’s starting to work.”
A future of self-collected data
In the future, Agus predicts patients will use 5G-connected devices to record and transmit their own health data before even setting foot in the doctor’s office, driving medical costs down and enabling a new age of medical research through big data.
“The answers are there in the data,” he says. “Yet that data has been hidden away, historically, in a paper doctor’s chart. Now it’s being transferred to a computer. The next stage is that it has to go into a database where we can actually learn from it.”
“True optimism is something you can’t teach. It’s not something we’re necessarily born with, it’s something that you cultivate. And my hope is that through science, we can actually understand it better and even optimize it.”Dr. David Agus
The road to data nirvana still has some twists and bends: The lack of common data standards remains a challenge. “When one person calls it a broken leg and another calls it a fractured leg, the databases just don’t talk. If we all used the same terms and collected data in the same way, I shudder to think just how much progress we could make. Hopefully we can put people like me out of business.”
“It takes on average 12 years to convince 50% of doctors to adapt to a new technology. We are pig-headed and we are stubborn,” Agus remarks. “I think that the way to do it is from the ground up and not the top down — to actually educate the patient.”
It’s not just about finding a cure
As Agus notes, prevention is much easier than treatment when it comes to cancer. “60% of cancers are preventable. So we have to get more aggressive on prevention. We have to get more mandated towards things like vaccines, preventive medicines — more aggressive on anti-smoking campaigns.”
“I do think we’re going to be able to control it.” Agus says. “To me, cancer is a verb, not a noun. ‘You’re cancering.’ It’s not something the body gets, it’s something the body does. My goal as a doctor is to change you from a cancer state to a health state.”
But advances in cancer research are worthless if new treatments or preventative measures aren’t made available to the world. “All too often we only focus on the cure, we don’t always focus on how to administer the cure. How are we going to do this in a sustainable way so that everyone has access? To me, that’s critical.”
“The costs of new medicines are getting prohibitive,” Agus warns. “The toxicity of the drug? The side effects? Well, the economic toxicity of most of these new drugs is unbearable.”
An optimistic prognosis
Despite the challenges of tackling cancer, Agus remains confident. “The things we can do today would be considered science fiction just a few years ago,” Agus exclaims. “It’s an amazing time. For the first time in my career, I can walk into the room of a patient with cancer with real optimism. Optimism is there on the patient’s side and my side.”
The optimism Agus talks about is much more than just an abstract concept. “If you look at medical trials — people with diseases, cancer, heart disease, Alzheimer’s, you name it. People who are optimistic do 30% better than everyone else,” he explains. “It’s a physical state in the body. When we’re optimistic, our whole body feels better. We have energy. Our body works differently.”
“True optimism is something you can’t teach. It’s not something we’re necessarily born with, it’s something that you cultivate. And my hope is that through science, we can actually understand it better and even optimize it. Because I see it and I want everybody to be optimistic. We’re going to have a better world, and each of us are going to have a better life.”
Learn more about the Rakuten Optimism event held in Japan from July 31-August 3 here.
For more information about the upcoming Rakuten Optimism event in San Francisco on October 23, please visit this site.