Latest news with #ShirleyLeung
Boston Globe
31-05-2025
- Health
- Boston Globe
Cancer patients are getting younger. Doctors don't know why.
The following is a lightly edited transcript of the May 29 episode of the 'Say More' podcast. Shirley Leung: Welcome to 'Say More' from Boston Globe Opinion. I'm Shirley Leung. This is the fifth, and final, episode of our series, 'The C Word: Stories of Cancer.' When we think about being young, we picture a time of exploration, discovering who we are. What we don't picture? Cancer. Cancer is supposed to be a disease of aging, not the concern of someone in their twenties or thirties. But there's a worrying trend in the cancer world where young adults are getting cancer at higher rates, and scientists don't know why. Kelly Spill was 28 years old when she was diagnosed with colorectal cancer. She was pregnant when she first noticed symptoms – constipation and blood in her stool. Her doctor told her not to worry – lots of things change in your body when you're pregnant. But the symptoms didn't go away after giving birth. She saw a series of doctors. No one seemed too concerned, but Kelly, who spoke to me from her home in New Jersey, says she knew something was wrong. Kelly Spill: I was waking up every day and I was like, 'I just don't feel good.' But I couldn't really pinpoint why. I would just say to my husband a lot every day, 'I just don't feel right. I just don't feel right.' And then one morning we both were getting ready for work and I went to the bathroom and I looked down and there was just so much blood. I called my mom right away and she said, 'I think our best bet is to go to the emergency room.' And I said, 'Okay.' So during this time, my health insurance wasn't great. It was very hard for me to see a primary doctor. So that was our choice to go to the emergency room. I had explained to him what was going on and he said it's most likely internal hemorrhoids, 'Lay off the spicy foods.' That's when I really started to feel defeated because now this is the third time someone is telling me this, it's gotten worse, and there was no extra that he was doing for me. At that time, he called a family clinic in order for me to get to the top of the list and get me in sooner rather than wait. At that appointment, I love telling this part because it sticks to me to this day, I had a nurse bring me back to the room. And she had told me, 'If you don't find your answers here, keep searching because you know your body best. Nobody knows your body like you do. You know your body best.' And I was like, 'Okay.' And that made me feel like I am feeling this. Leung: That nurse probably saved your life, right? You had her voice in your ear. Spill: Yeah. Leung: Trust your gut. Spill: Yep. Even to this day, having kids, I think about her. I wish I remembered her name, what she looked like, but I don't. If I did, I would go back and just say 'thank you' and tell her how much she's made a positive impact in my life. From there, I just kept talking to my family and friends about how I was feeling instead of not talking about it at all. And I finally had one of my friend's moms say, 'I think I know someone who takes your health insurance. Let me get you their information.' Thankfully that doctor did. I went to that doctor's office right away. I showed her pictures of what was going on from when I was living in California to when I was living in New Jersey. I was taking pictures in the bathroom the whole entire way. And she said, 'You need a colonoscopy, don't you?' And I was like, 'Yeah, like big time.' And I was able to go that next week and that's when I found out I had a tumor. Kelly Spill has had three children since she froze her embryos after being diagnosed with colorectal cancer. Kelly Spill Leung: Wow. So how much time had passed since the first time you saw blood in your stool to the tumor? Spill: At that point, my son was eight months old, so it's easy to track. It was about eight months. Leung: So how did it feel to finally get an answer of what was wrong with you? Spill: It felt scary, but it felt good to finally hear that there's a reason for what I've been feeling. Now it was, 'Okay, now what's next?' And at that appointment, I wasn't told that it was cancerous. They did a biopsy and I had to wait two weeks to hear if it was cancerous or not. I knew during that time that it was, you just know. The way I looked in the mirror, I was just very skinny. I didn't look like myself. I didn't feel like myself. I knew the news wasn't going to be good. During that time, I kind of prepped myself for that. My mom and I were in Walmart. We were baby shopping, and that's when we got the call. My first thought was 'How?' No one in my family has colorectal cancer, and I haven't even heard of it. So that was an extreme surprise. Leung: So what happened next? Did you have a treatment plan? Spill: Thankfully, I have a very supportive mom, and together we made a plan of going to three different cancer hospitals. We basically had a small checklist. We had it on comfort level, what the response was with treatment. We had it on how far it was going to be from our house and their reputation. However, our first stop was Memorial Sloan Kettering Cancer Center, and it ended up being our first, and our last stop. My appointment was in New York City, and at that appointment, that's when I learned that it was stage three. That means chemotherapy, oral chemotherapy radiation, and then surgery. Leung: How did you take in all of that? You were 28, you had your whole life ahead of you. Spill: My fiancé and I had just gotten engaged. We had a baby very quickly. We just moved back to the East Coast. He doesn't have his immediate family here. I dragged him to New Jersey with me and my first thought was, 'How am I going to tell him this?' I was thinking about him most of the time. We had plans to elope in Switzerland and I asked the doctor, 'Can I at least elope in Switzerland this summer?' He was like, 'Oh, absolutely not.' I think that's when reality hit for me. This was changing my whole entire life at this point, and that's when I lost it. Leung: In doing this cancer series, I'm always struck by the young people getting cancer because a lot of times you're not just thinking about, 'How do I live? How do I survive this cancer?' You're thinking about the life after cancer, which is actually very hopeful. You're thinking about planning for your future still, and I know one of the things that was very important to you was you wanted to have more children, right? Can you talk about how you talk to your doctor about that? You have stage three cancer, and yet, you also want to plan on having more children. Spill: Yeah, so at that appointment he had told me that I had time to either freeze eggs or embryos, whatever one I chose. I was very thankful because I know some people don't have the time for that. We chose to freeze embryos, and I will say that was one of the hardest processes during this journey. It was the most painful for me. I had a tumor that was sitting a centimeter away from my anal canal, and then I was growing these eggs. Any woman that goes through IVF once, twice, three times, four times, I cannot imagine doing it more than once because it's just so painful. So going through that experience was very humbling. After that, I got the call that we had four embryos. I said, 'Okay, that's great, right?' She's like, 'Yeah, do you want to know the gender?' So I was like, 'Oh, that's cool.' So actually hearing the genders of those embryos, it made me feel good again. It made me feel like I was able to do something for myself and my husband. It was like a little bit of a rainbow in the sky that I was able to see. After that, it was game on. It's time to think about chemotherapy. It's time to make that appointment, and it's time to get through the first part of my treatment journey. Leung: How long did it take you to get to being cancer free? Spill: I started treatment in March and I was done in August. In March, I was setting an appointment for chemotherapy with my doctor and I had a research nurse come in. She said to me, 'We had some tests comes back about your tumor. It came back with some positive tests that may allow you to go on a clinical trial. Are you open to hearing a different option?' And I said, 'Absolutely.' There was only three other people that had went on this trial, so the information was extremely limited. However, what I was hearing from her was that this treatment journey with this clinical trial would be a lot less harsh on my body than chemotherapy, radiation, and surgery. So, I chose to go on this clinical trial. I was the fourth one in the country to go on it, and I had no idea what my future was with this drug. I had no clue what it could do for me besides the fact of, 'Let's see.' Leung: What year was this and what was the drug? Was it a matter of taking of pills or injections or did you have to go to the hospital? What did it entail? Spill: It was in 2020. I had a port inserted, so it was through the port. It took 30 minutes for the medicine to get to me. I know chemotherapy is around two hours, so that's a big one in itself. By second treatment, I was already starting to feel a little bit better. By my fourth treatment, after my checkup, I was told that my tumor was halfway gone, and by my ninth treatment, the tumor had completely disappeared. Leung: Was that during the period from March to August? Wait, in 2020, meaning during the pandemic? Spill: Yes. Leung: Wow, you had a lot going on. I wanna just go back for one moment. Early on in your story, when you and your mom just learned that you have a tumor and it's cancerous, what was it like telling your fiancé and how did he react? Kelly: He's a very calm guy, thankfully. When I found out that I had the tumor, it was actually on his birthday, so I will always remember that date. He took the news very, very good. I remember going up the stairs. He opened the door. He had a big smile on his face, not knowing what the news was going to be, and I just hugged him and started crying and my mom looked at him and she was like, 'not good.' Between my mom, my husband, my dad, the people that are immediate around me, everyone kind of just jumped into action of, 'Okay, what are we going to do? What's next?' Leung: So once you have cancer, and I know this from firsthand having breast cancer eight years ago, other people with cancer, they find you. And so I was just wondering, did you run across other people your age getting cancer, and what are the stories that have stuck with you? Spill: I actually did. At that time, I had a really good friend who I grew up with. She went to graduate school with somebody who had just become a survivor of colorectal cancer, and she was diagnosed at, I believe around, 27 or 28 years old. Thankfully, in my case, I had her to bounce off of. So she gave me her phone number and she got me through my journey single handedly. I had a great support system, but when you have someone that you can chat about that has the same exact cancer as you, and you can text them saying, 'Oh my goodness, I have to get a sigmoidoscopy. What do I do?' There's just things during that journey that are very vulnerable that you talk about. It's very hard for anyone else to truly, truly get what you're going through physically, mentally, emotionally, and financially. Having her during that whole journey, for me, it was a blessing. Leung: I had two cancer buddies, too. I had two women. They were other women I know in my circle, and we had breast cancer the same year, within months of each other. It was the same treatment and same prognosis. So, I get it. When I had breast cancer I was 45, and I think the average age is someone in their early sixties. And I think with colorectal cancer, it's the same way. You're not supposed to find patients in their twenties and thirties and forties with colorectal cancer. They're supposed to be in their fifties and sixties and older. Spill: Yeah, I have thought about this a lot, not even just thinking about just colorectal cancer, but cancers in general. In your twenties, it's so hard because everything is the beginning of what you've been looking forward to from when you were a kid. When you throw colorectal cancer or colon cancer in the mix, now we're also talking about losing your fertility, whether you're a man or a woman, which is also scary at that age where you're starting to think about, 'Do I want to have kids? How many kids do I want to have? I can't wait to have them. Maybe I don't want to have kids, but I can't wait to travel to all these places.' It's just so hard because when I came out of cancer, and when I went to survivorship, I thought it was gonna be rainbows and butterflies, but it was so far from that. I didn't know who I was. I didn't know what I wanted to do. I was still a new mom. When you're a mom, new mom or not, you lose yourself anyway at that point. You're trying to figure yourself out again. So, it was very difficult for me to really figure out my future. Sometimes it still is. Leung: Kelly, so you're five years past your initial cancer diagnosis? Spill: Almost. Leung: Almost, yeah. That's a big graduation moment in the world of cancer. One of the things I've unearthed in my podcast series is this idea that a lot of times when we think of cancer, we equate it with death. But now through modern medicine, there are a lot of us who are living and surviving. But, that idea of being cured, it's also complicated. For me at least, it's almost like a ticking time bomb. I worry the cancer will come back or it'll pop up somewhere else because my body knows how to make cancer. How are you processing being 'cancer free?' Spill: So, before I started treatment, it did go through my head, 'How long do I have to live?' And looking at my son, it really broke me thinking that. But being a survivor at this point, I try not to think about it. I think about how my doctors did an amazing job with this trial. I'm on a great path, so when I go through that in my head, I don't think about this cancer coming back. Leung: Kelly Spill is a cancer survivor and patient advocate living in Tinton Falls, New Jersey. When we spoke to Kelly, she was pregnant with her third child. She has since given birth to a healthy baby boy named Nash. They're both doing well. Congratulations, Kelly. After this short break, we talked with oncologist, Andrea Cercek of Memorial Sloan Kettering Cancer Center in New York, the same hospital where Kelly got her treatment. Kelly's thriving now, but her cancer story is a troubling reminder of a broader trend. Of all the people diagnosed with colorectal cancer in 2019, 20 percent were under 55 years old. That rate has doubled in the last two decades. This increase in younger patients is pushing doctors to think differently. Andrea Cercek is an oncologist at Memorial Sloan Kettering in New York. She leads the first clinic in the world to specialize in young people with colorectal cancers. She told me she started the clinic after she realized that younger patients required her to take a more holistic approach to treatment. Andrea Cercek: It was really in response to these young adults that we were starting to take care of where we realized that. The treatment process was the same, but everything else surrounding it was very different in terms of their needs, their ability to kind of handle treatment, whether that was from a financial perspective or from support. Many of them were single and so we really wanted to focus on all the support that we could provide at the time of diagnosis through treatment and then also in survivorship. When, as an oncologist, you meet an individual, and particularly in the colorectal cancer world, many of them had advanced diseases, so you wanted to start treatment right away. So a lot of these support services or these ancillary services kind of fell by the wayside and we realized that really that was not okay for our patients or for our caregivers. Leung: What do you mean by those ancillary needs? What do these kinds of patients need? Cercek: That's a great question. I think the most important thing is when you are diagnosed with cancer, obviously there's a lot that goes into that from just wanting to fight, but then needing support, your caregiver support, providing caregivers with support. And especially young adults, many of them were just starting families, so fertility was incredibly important. I think the most important intervention actually has been social work. So, what we established was a meeting with our social worker who's dedicated to just seeing our young adults. After that first conversation, some find her incredibly helpful, so they continue the conversation on a personal level. She's done couples counseling, caregiver alone counseling, and then most of our patients just really wanna know, 'How do I talk to my kids?' Leung: I want to go back to this question of fertility, but before we go on, you're the doctor. I think a lot of our listeners might be thinking, 'What is colorectal cancer? What are some of the symptoms and how common is it?' Cercek: So colorectal cancer involves the large bowel, and then it goes all the way to the end of the gastrointestinal tract and the pelvis. The signs and symptoms are really associated with where the tumor is in the gastrointestinal tract. Oftentimes, if the tumor is at the end of the gastrointestinal tract in the rectum, the stool is already formed so the person can have blood in the stool, constipation, or a really hard time evacuating. If the tumor's on the other side, oftentimes they can present with just anemia. They don't really know. They're just feeling more and more tired. Then they are found to be anemic or unexplained weight loss. And then all of it can really cause a change in bowel habits, so looser stool or constipation and then unexplained abdominal pain. So I think the most important thing is if any of these symptoms come up and they last more than just a few days, it's important to seek medical attention. Leung: And I guess when you're younger, you don't immediately think, 'Oh, I've got colorectal cancer.' Right? Is that why it might take a little longer to diagnose these kinds of cancers? Cercek: Yeah, that's absolutely right. We initially thought when we first started to look at this, that this disease was just very different and much more aggressive. But what we actually later learned through very nice, large surveys is that most of these young adults actually have symptoms for more than six months. They are either too busy, they kind of dismiss the symptoms, or they actually have to see multiple doctors before they're diagnosed because nobody really thinks, 'oh, colorectal cancer' in a 35-year-old. Leung: What other cancers are we seeing more of in young people besides colorectal? Cercek: It's actually very scary. We're seeing a rise in a number of cancers. It's throughout the entire intestinal tract, so esophageal cancer, stomach, gastric, pancreas, appendix, and then as we talked about GI cancer. But then there's also an increase in breast cancer as well as certain gynecologic cancers, certain liquid tumors as well. There does seem to be this kind of general trend of an increase in young adults with cancer. Leung: What's your best guess? Why is this happening? Cercek: The honest short answer is we don't know. We assume that it is an exposure, so an environmental factor or most likely something multifactorial that's occurring. I think the reason that we think this is because it truly is occurring all over the world. It's not just in countries of high socioeconomic status where you might think, 'Okay, there's something that is different in behavior or in exposure,' but even countries of lower socioeconomic status that are starting to have registries, they're seeing this exact same trend. But what is it, we just don't know. Thankfully, now everything is under investigation. This includes lifestyle changes being more sedentary, like watching tv, things that we're ingesting from foods to just exposures in the environment. Medications, as well as things like microplastics that are just kind of everywhere in the environment that might be changing our bodies. Leung: That's just as scary, if it's everything. Cercek : No, that's absolutely right. It is. We may not be able to identify exactly what it is, but I think the goal of research is to see not necessarily what it is, but what are the changes that are occurring and who are those individuals in which these changes occur, and then lead to cancer. Maybe there's some other unifying factor that we could find. And then the goal, of course, would be to find these individuals and then screen them early to prevent this from happening. Leung: So is it kind of like breast cancer where if there's early detection through a mammogram, and I guess in the case of colorectal cancer, a colonoscopy, you might have a better chance of detecting the cancer? But I think in the United States, doctors recommend colonoscopy only starting at 50, right? Cercek: It's actually been lowered to 45. This was in response actually to this early onset colorectal cancer rise. However, the steepest rise in young adults is actually in 20 to 30-year-olds, and we still see a lot of individuals in that 40 to 45-year-old age group that are not recommended for screening. It's complicated because screening is expensive and it's still relatively rare in terms of incidents in young adults, despite the fact that it's rising. So, 45 was kind of the best that we could do. I think the goal is, though, exactly as you said, this cancer is preventable. If you do a colonoscopy early enough, you could remove that polyp and prevent the cancer from occurring. So what's going to happen, and where there's a lot of great research ongoing now in progress, is other ways of detecting colorectal cancer. That would be through early detection, either through blood tests or stool tests. I think that is going to be the future that will hopefully change outcomes drastically for colorectal cancer. Leung: I want to get back to patient care here. Can you share some anecdotes about some interactions you've had with younger patients that have changed the way you think about how you treat cancer for young people? Cercek: One patient who really struck me and really kind of inspired this clinic and this early introduction of support services, in particular social work, was a young woman with rectal cancer. So again, rectal cancer is located in the pelvis and so treatment is quite toxic with chemotherapy, radiation, and surgery. She went into early menopause and then needed the very morbid surgery, which in her case was a permanent colostomy and a very extensive surgery that left her with significant sexual dysfunction and early menopause and infertility. But the cancer was gone and there were no signs of cancer and she was cured. I remember I went in to tell her, 'Your scans look great and you're cancer free. This is amazing.' I had this huge grin on my face and she just looked at me and she said, 'You know, this is not living. That's great, but it doesn't matter because if I knew that this is what my life would be like in survivorship, I wouldn't have chosen it.' I was just completely floored because we live for that cure. That's what we want. We work for the goal of all of our interventions and obviously it's a hugely important goal, but then you realize there's so much more to curing the cancer. There's that whole part of survivorship and leaving our patients as equipped as possible to deal with life after cancer. They're never gonna forget that they have cancer. They're always going to be a cancer patient and we can't get rid of that. We can't minimize that. But if we could have supported her better from the beginning, prepared her better, maybe it wouldn't have been as difficult for her as it was. So this was the idea. Do we have these support services: social work, psychology, psychiatry early on? It's not for everybody, but I do think that for certain people that would make a big difference. And, that's kind of what really inspired me and I think about her all the time. Leung: While reporting the series, I was struck by how much progress has been made in the world of cancer treatment. Survivorship is higher, deaths are lower, but the main exception is this trend of young people. How scary is it for you to work in this somewhat dire, little understood corner of oncology? Cercek: I think it's scary in that the trend is alarming and when you keep seeing that you're aging and your patients keep getting younger, that's very, very difficult. As I mentioned, I'm an optimist, I am a researcher. I believe in progress and I think we're already making progress. So to me, it just inspires me to try to do better by my current patients and my future patients, not only in supporting them through this, but in actually doing the research to make treatments better for them. Then also in the preventative space, try to figure out why this is happening and how we can prevent and stop this trend. Leung: So with that said, is there one thing that gives you hope in this space? Cercek: I think we've seen a lot of progress. Even though it's challenging to see more young patients in the clinic, I would say each year, I think we've definitely made a lot of progress in terms of treatment of early stage disease with less toxicity. I think there's going to be a lot of progress in treatment of colorectal cancer, not just early stage, but also metastatic in the next few years. Leung: Dr. Andrea Cercek is a cancer doctor at Memorial Sloan Kettering in New York. She's the founder and director of the Center for Young Onset Colorectal and Gastrointestinal Cancer. Listen to more 'Say More' episodes at We want to hear how cancer has changed you. Email us at saymore@ If you like the show, please follow us and leave us a review. Kara Mihm of the Globe staff contributed to this report. Shirley Leung is a Business columnist. She can be reached at
Boston Globe
23-05-2025
- Health
- Boston Globe
He lost his mother, sisters, and brother to cancer. It was in their genes.
Later in life, he understood it was no coincidence: threaded throughout his family's DNA was a hereditary cancer gene, vastly increasing their risk of the deadly disease. In this episode of 'The C-Word' series, 'Say More' host Shirley Leung talks to Ingrassia about the moment he discovered the cause, the difficult choice of getting himself tested, and how greater knowledge of family history can lead to monitoring that saves lives. The following is a lightly edited transcript of the May 22 episode of the 'Say More' podcast. Shirley Leung: Welcome to 'Say More' from Boston Globe Opinion. I'm Shirley Leung. This is episode four of our five-part series 'The C-Word: Stories of Cancer.' For years, His mom died of cancer in her 40s, followed by his two sisters who also died young. And it didn't stop there. Cancer kept popping up in the family, like a horrible game of whack-a-mole. When he got older, he learned it was no coincidence. Threaded through his family tree was a deadly cancer gene. Science on the genetic roots of cancer has come a long way, and a better understanding can help save lives. Larry's recent book is called ' Larry Ingrassia: I was very young when my mother had cancer. She died when I was 15. She was 42 years old. But my memory is that she had breast cancer for eight to 10 years. She survived it initially before she died. My memory is a bit fuzzy, but I do remember these enduring memories of visiting her in the hospital with my three siblings. I'm the second of four with an older brother and two younger sisters. That was always hovering over us, that she was sick. But then, she would be fine. Then it seemed like a couple years later something else would happen and she would go back. It was in the spring of 1968, when I was 15 years old, she was in the hospital and I didn't think much about it because she'd been in and out of the hospital for any number of years. I was a bus boy at a breakfast restaurant not far from our house in suburban Chicago. I was on a shift. It was kind of late in the morning and I remember my father came to the restaurant. One of the workers said, 'Your father's out back, he wants to see you.' And I was like, 'Oh my God. What's that about?' I went out back and he said, 'Mom's dead.' And so I was really shocked. Even though she had been ill, I just didn't have any inkling. Back then, in the 1960s, people didn't talk a lot about cancer, a lot about illness. So it was a real surprise. A family portrait of Larry Ingrassia (third from left) and his siblings in the 1950s. Three would die of cancer. Handout courtesy of Ingrassia family Leung: Your mom gets cancer and then your sisters. One of your sisters first, then another. Ingrassia: It was another decade before there was another cancer in our family, and my youngest sister, Angela, was 23, and she developed abdominal cancer. She died within about six months. She was 24. And again, it was really a shock. About a year later, one of my brother's sons, Charlie, who was two years old, developed a soft tissue cancer in his cheek. Now he survived. Again, it was a totally different kind of cancer. The prognosis was not good, but we were lucky he survived. Another five years after that, in 1987, my sister, Gina, got lung cancer and died about six or seven months later. By that time, we were wondering, 'What is going on?' We weren't sure what was going on. Again, no oncologist said to us, 'Oh, we think that there is something hereditary going on.' Leung: You had theories, right? Ingrassia: Yes, and I think there were some reasons for this. Our father was a research chemist. We thought maybe he brought home chemicals, tiny particles on his clothing after work. He would pick up the kids when he got home, especially when we were young. We thought that maybe we would ingest it, our mom would ingest it, and then years later, you don't know how many years later because cancer can take very long to develop, it would manifest itself in cancers over different parts of the body. And it's a plausible thing because there was this growing understanding of environmental carcinogens and particularly chemicals that could cause cancer. We were puzzling over all the cancers in our family. Doctors were puzzling over, not my family because we weren't studied, but similar families and they were also swimming against the tide because there was not a belief that heredity was a major factor in cancers. And this is where my book begins. In the late 1960s, again my mother died in 1968, which was around the same time, two young doctors at the National Cancer Institute were examining causes of cancer. They were young, they weren't experts at the time. They were looking for interesting cases and they came across a very unusual case. There was a father who was 23 years old and had leukemia, and shortly thereafter, his 10-month-old son developed a soft tissue cancer in his arm. Both of these are rare, especially at those ages. The combination and the odds are considered astronomical. So these doctors said, 'Wow, maybe we should study this family to find out what's going on.' And indeed, when they started looking at that family, they found cancers going back generations. They found many cancers throughout the family, and a lot of young cancers, as well. They found women in their twenties and thirties, but also children having cancers, too. They didn't know exactly what was going on, but they did write a paper published in 1969. They raised the question of whether there was familial syndrome. This was a seminal paper that turned out to be very important. Interestingly, the paper was published and the experts in the field, who of course were mostly focusing their research on viruses, were highly skeptical. They said, 'These cancers that you're talking about, they're all different kinds of cancers. What could they have to do with each other? How could that be hereditary if they're all different kinds of cancers?' To their credit, these doctors, Frederick Li and Joseph Fraumeni, both children of immigrants, persisted. They said, 'Let's keep studying this family and other families.' A 1991 photo of Frederick Li (l.) of Dana-Farber Cancer Institute and Joseph Fraumeni of the National Cancer Institute discovered how some cancers can be inherited in what is known as Li-Fraumeni Syndrome. Handout from National Cancer Institute Leung: And that's what's known as Li-Fraumeni syndrome, right? And how did you learn that your family had Li-Fraumeni? Ingrassia: Okay, so my brother in 1997, when he was 46 years old, developed lung cancer. Again, he was given a low chance of survival. He had a lung removed and he survived. We were again lucky. But then he had another cancer around 2005. He had prostate cancer. Finally, in 2014, one of his doctors said to him, 'Given all the cancers in your family, maybe you should undergo a genetic test, because I think that the history indicates that you may have Leung: This is p53, right? Ingrassia: P53 is the specific gene. The p53 cancer suppressor gene protects cancers from occurring anywhere in the body. It's actually called, since it was discovered, the That's why people who have the inherited p53 mutation can get cancer anywhere in the body. It's not site specific. So the types of cancers are myriad. There are a handful of major cancers in p53. One of them is breast cancer. Leukemia, soft tissue cancer, skin cancer, colon cancer, brain cancer are a huge variety of cancers that can be linked to the p53 mutation. Leung: Going back to 2014, when your brother Paul calls you and says, 'I have this gene. I think I have Li-Fraumeni syndrome.' Did knowing that he had that genetic mutation help with his treatment of his cancer? Ingrassia: Yeah. So, what do you do if you have this inherited mutation? First of all, the inherited mutation, like any inherited mutation, cannot yet be fixed. But if you have the inherited mutation, you know that the odds of you getting cancer are very high. And, also that the odds are pretty high at a fairly young age. So by age 40, if you have the inherited p53 mutation, 50 percent of people with the mutation have cancer. That's versus 5 percent in the overall population. It's 10 times as high. Often, as I mentioned earlier, it's children. It's really sad. And in a lifetime, if you have the p53 mutation, it's like 95%. So, some doctors who were involved in studying p53 said, 'Given that propensity, can we help people by giving them extensive, regular screening?' The advantage of knowing if you have the inherited mutation is that you can get annual full body MRI scans. You can get blood tests, you can get all sorts of tests. In my brother's case, I think it actually prolonged his life by a couple of years. After he had his testing, it was positive for the p53 mutation and he knew he had Li-Fraumeni syndrome, so he began regular scans. In 2017, the scan detected pancreatic cancer on the tip of the pancreas. Usually you don't find pancreatic cancer until you have symptoms, and it's too late. Pancreatic cancer is one of the deadliest cancers. In his case, it was found early. They were actually able to do an operation and get rid of the tumor on the tip of his pancreas. However, two and a half years after he had that surgery and survived pancreatic cancer, it came back in his lung. He died when he was 69, in 2019. Sadly, it was seven months after his son died of his third cancer. Newsweek cover of the p53 gene that would lead to a better understanding of cancer. Newsweek, 1996 Leung: And Charlie was only how old? Ingrassia: Charlie was 39. This is where I would argue for people who say they don't wanna know because they don't wanna have it over them. 'I know I have this mutation. My children have the mutation. I'm gonna be worried all the time.' Not knowing doesn't change whether you have it or not. I say knowledge is power. And this is why I wish that we had learned earlier in 2010 when Charlie had a second cancer, colorectal cancer. He started having problems at the beginning of the year. It wasn't until the summer that he was diagnosed. I think maybe his guard was down, he'd gone almost three decades after surviving his childhood with cancer. But it took quite some time before they finally said, 'Okay, let's do a colonoscopy.' And by then, he had a later stage of colorectal cancer. Again, he survived amazingly, but he survived in part because they gave him heavy doses of radiation to kill the cancer cells. The problem is, if you have Li-Fraumeni syndrome and you have p53 that can't fight against potentially cancerous cells the way that it normally would, radiation can plant the seeds for future cancers. Sure enough, in 2017, a month or two after my brother was diagnosed with pancreatic cancer, Charlie was diagnosed with his third, and final, cancer. It was bone cancer in his hip, right where he was getting all that radiation to kill the colorectal cancer. The odds of him living a long life given the family history were probably not good. But I do think that it might have made a difference. If he had known in 2010 and he'd been diagnosed right away, it wouldn't have changed whether he'd gotten the cancer, colorectal cancer or not. But the earlier diagnosis might've meant they would've had a lot less radiation to kill it. It might've meant that it wouldn't have come back in his hip. And that was one of the really sad things. It was so hard to watch for this young man. They had to amputate his leg, including his hip, in a desperate attempt to save his life. But the cancer kept spreading after that. About six months later, not long before my brother died, Charlie died. Leung: That was the hardest part of your book. Ingrassia: It was. It was incredibly hard to go through and it was incredibly hard to watch and to write about and talk to his friends. But, I feel more connected to my family because of the research that I did. Obviously I knew a lot about my sisters and their cancers, but I learned more about it in this process. My sister Gina began keeping a diary from the time that she learned that she had lung cancer until just before she died, six or seven months later. It was a combination of wonderful and painful to read about. One of the most painful things, if you go back in the eighties, was that it was a time when there was a lot of belief in mind over matter. If you just had the willpower, you could fight illnesses of all kinds. Of course, the corollary to that is if you're not getting cured, it's your fault because you don't have the right amount of willpower. I sensed that in reading her diary that she felt that it was on her and if she wasn't getting better, it was not her fault, but certainly that she contributed to it. All I could think of is, 'No, you don't know that you have this mutated gene inside you that basically has doomed you.' So, there were a lot of moments in writing it like that. My sister Angela, who was so young. I talked to a lot of her friends about her struggling with this and how difficult that was. If you could just put yourself in her mind: you're 23 years old and you're the youngest of the siblings. She learned she has cancer, and we learned pretty early on that the outlook is not gonna be great because the doctor said, 'Well, I operated. I did what I could, but it spread throughout her abdomen.' It was about a six month period and it was pretty much downhill. I wanted to talk to as many people who knew my sisters as I could. I wanted to talk to her oncologist and I wasn't sure of his name. My sister-in-law remembered a last name, so I started doing research. I'm a reporter and sure enough, there was a name that popped up. It looked like he had recently retired. I sent a note, and if I might, I'll just read a little bit from the book about this. (Excerpt from book): My eyes welled up the instant I saw the subject line on the email that had just appeared in my inbox. 'I have never forgotten your sister.' Only a few hours earlier, I had sent a LinkedIn message to a retired doctor wondering if by chance he happened to have treated my sister Angela, 40 years earlier. Was he Angela's doctor? And even if he was, what were the chances he might recall? One patient he treated many years earlier out of the thousands he had cared for. 'I realize you may not remember my sister Angela's case as this was decades ago' I wrote. 'But if you do, I'm hoping to speak with you.' I wasn't sure if I'd even hear back, so his quick response floored me. 'The day after your sister died, I received a beautiful flowering plant at home. Not only do I remember her, so does my wife.' I was in tears then and I am now. I just think about my sister, 23 years old for a young woman. Her whole life was ahead of her. This is about a life loss, a stolen life. There was a one word message that came with the flower to all of us: 'forward.' The fact that she was dying, but she wanted us to grasp life, it's pretty profound for a then 24-year-old. That was one of those many moments in writing the book. It stopped me. Leung: Larry, I don't know if you know, but one of the reasons why I'm so interested in cancer is So my entire life I'm like, 'Will breast cancer come from me?' This question of 'Will I get cancer?' My mom didn't get breast cancer, but I did. It was because of early detection, mammograms. I was detected early and so I'm cancer free. I had a mastectomy. I didn't have to go through chemo, so I'm one of the lucky ones. I think reading this book, you're always wondering, 'Why did I get cancer? And why no one else?' And for you, many other members of your family got cancer. That's why you wrote this book. So do you feel like you are satisfied with the answer on why cancer struck your family so many times? Ingrassia: I'm heartbroken and sad that I lost all my family to cancer, especially so many so young. But my brother and I often talked about how blessed we were in many ways. We were the children of poor Italian immigrants and we ended up doing things and achieving things that we never would've imagined growing up. I always say that it's not really right to say 'Why me?' about all the bad stuff in your life if you weren't also asking 'why me' about all the good stuff. I think I decided long ago to try to celebrate our good fortune in life and not dwell on or be angry. It's not a matter of being sad, of course I'm sad. I think often of my family and missing them and not being able to grow old with my siblings. But I try not to dwell on 'why me.' It's part of genetics. There's no control over it. Leung: Now it took you a year to get tested. Why did you wait so long? Ingrassia: I don't know. I was busy, but what happened was my daughter began pestering me. 'I want you to get tested.' It would be very rare, but it's possible to inherit the p53 mutation and not get cancer. There's that tiny 5 percent. Nobody knows why. There's still so much they don't know. They've learned a lot. They still don't know. If I had the mutation, there would've been a 50% chance that I passed it on. So it was really because that's what I wanted to know, if I passed it on to my children. It was only after I realized that, that I got tested. That's why she wanted me to get tested. But that was really the impetus for me. That was why I finally said, 'Okay, I'll do it.' Also, quite frankly back then, getting a genetic test was quite expensive. It was $3,000 to $5,000. So I was lucky my brother, through his oncologist, found a study that was being done at the University of Southern California. I was living in Los Angeles, and I was able to get it in, do it without any cost. Now you can get a genetic test for $250. Often if you have a history of cancer in your family, your insurance company will cover it. The cost is a lot lower. They have these multi-panel tests where they can find out if you have any number of cancer mutations. Some people have more than one. Leung: So in your book you mark the date July 10th, 2021. Tell me about the significance of that date. Ingrassia: When I was writing the book and researching the book, at some point you're thinking a lot about death and not necessarily in a sad way, sometimes in a sad way, but you're just thinking about life and death and the arc of life. At some point, I realized that the date was going to be the day that I would be one day older than my brother when he died, and that would make me the longest living member of my immediate family. I said, 'You know what? I wanna do something that day.' Celebrate is the wrong word, it's really commemorating that day. It's more of a memory of that day. So, I pondered a lot, 'Okay, what can I do that would be kind of a little bit interesting and a little bit fun? That says I'm glad to be alive. I'm lucky to be alive.' I pondered a bunch of things, maybe go for a long hike and go paragliding. Finally I found a place in Los Angeles that had something that's called a Leung: I had to Google that. I didn't even know what that was. Ingrassia: I had never heard of a gyrocopter either. A gyrocopter is like a tiny helicopter, about the size of a big motorcycle. You can fit two people in. The great thing about it is that you actually kind of almost see even more than a plane. You have this bubble in front of you. You can see everything. It was just like, 'Oh my God, I wanna do that.' So I told my wife. I said, 'Vicki, I'm gonna take this gyrocopter.' And she said, and of course she didn't know what it was, 'Okay, so on the day that you become the longest living member of your family, you're gonna put your life at risk?' And I said, 'You're right.' I thought it was a great line. I said, 'Yeah, but I'm gonna do that anyway.' I just felt that I wanted to do something where I felt really alive. I could be in awe of this kind of human experience. I got on that gyrocopter. It was about an hour. It's like this tiny thing that went up and down the California coast, which is pretty spectacular. I felt alive. Let me see if I have it here in the book. (Excerpt from book): I felt an exhilarating rush of adrenaline and yes, one or two stomach churning ones, too, as the gyrocopter dipped and spinned. I contemplated what my mom and dad and my brother and sisters would've made of my jaunt. I'm pretty sure they would've rolled their eyes and then smiled happy that I was doing something just a little bit wacky on this day for them and for me, for us. Because they couldn't. Regina and Angelo Ingrassia on their wedding day. Regina would pass on a hereditary cancer gene to three of four children. Regina died of breast cancer in her 40s. Three of her children got cancer as adults and died. Handout courtesy of Ingrassia family Leung: You say this book is a love letter to your family. So what do you mean by that? Ingrassia: It's a love letter because, especially my sisters and Charlie, their lives were cut short and I wanted to make sure that these lives that were cut short were never forgotten even though they were short lives. I think it's also a little bit of a love letter to other families like this. One of the things that's been most touching to me has been people who've reached out to me since I wrote this book, those who say 'thank you.' It's so rare when somebody says they have Li-Fraumeni syndrome. So for them to be able to say, 'You've given a little bit of a voice to us. You've helped us have an identity within this community,' I've been really touched by the number of people who have reached out to me. And again, some of these letters… Leung: You got letters from people? Ingrassia: Yeah. Leung: Yeah, that's great. Ingrassia: Yes, most of these kinds of messages I would say I printed out. I cried this week when this book came out, not because I wrote it or had anything to do with it, however, because it is part my story, too. I have Li-Fraumeni syndrome. I'm grateful for this book. Being a call for grace, hope, and continued investment in a fight against all cancers that steal those we love and that steal our own futures. Another message was, 'I just finished 'A Fatal Inheritance.' I don't think I've ever sent an email to an author before, but I wanted to thank you for sharing your family's story. As someone with an inherited mutation that has unknowingly passed it along to two thirds of my kids, I'm always seeking to learn more about my mutation in the latest surveillance and research.' Leung: Did you expect that? Ingrassia: No. This is one of the things I think that was especially moving and especially touching about the book, to hear from total strangers saying the commonality was like, 'Your family is my family.' Those were the moments in writing the book that touched me the most. Leung: Larry Ingrassia is a journalist who has worked with the Wall Street Journal and the New York Times and the Los Angeles Times. His latest book is called 'A Fatal Inheritance: How a Family Misfortune Revealed A Deadly Medical Mystery.' Listen to more 'Say More' episodes at We want to hear how cancer has changed you. Email us at saymore@ If you like the show, please follow us and leave us a review. Kara Mihm of the Globe staff contributed to this report. Shirley Leung is a Business columnist. She can be reached at
Boston Globe
08-05-2025
- Health
- Boston Globe
The C-Word: Dr. Siddhartha Mukherjee wrote the book on cancer
The book shows that if there's one constant in cancer research, it's that it's always changing. On this episode of 'The C-Word: Stories of Cancer,' host Shirley Leung talks to Mukherjee about how his time living and working in Boston changed him as a doctor. They discuss the hopeful progress we've made in curing cancer — and the challenges that persist. The following is a lightly edited transcript of the May 8 episode of the 'Say More' podcast. Shirley Leung: Welcome to 'Say More' from Boston Globe Opinion. I'm Shirley Leung. This is episode 2 of our series, 'The C-Word: Stories of Cancer.' Today we're talking to the man who wrote the book on cancer. Siddhartha Mukherjee is the author of 'The Emperor of All Maladies.' It covers the long history of this disease, why it haunts us, why it's so hard to beat, and why there's hope. Siddhartha, who goes by Sid, learned everything he knows about cancer while working in Boston as a young doctor. I traveled to New York to meet him at his lab at Columbia University Medical Center. I asked him about the title of his book and why, when it comes to disease, cancer is the emperor. Siddhartha Mukherjee: At the end of the book, I realized that this was a disease that had occupied our brains and minds and bodies for centuries in a way that really no disease had. This was the thing that we had battled for so many years and have continued to battle. In the 1950s, people would say, 'What do you wanna be when you grow up?' And people would say, 'I wanna be a rocket scientist.' In the 1960s and 1970s, if you asked the same question to a young man or woman, they would say, 'I want to be a cancer doctor.' There's a spirit in which this has reigned so large over our imagination that it seemed like of all illnesses, this was the emperor, the most important and perhaps the one that we need to defeat. Leung: It's been 15 years since your book has been out, and many of the meaty chapters in the book were about research breakthroughs and lifesaving treatments in the late 1990s and early 2000s. Are those chapters out of date now? Mukherjee: We'll be glad to know that in September we're publishing an evergreen update with five new chapters. I'm writing them as we speak, and directly after this interview, I'm going to my publisher to start putting them down on real paper, editing them and so forth. So the book will become evergreen again in September. There's a new release called 'The Emperor of Maladies: Part 2,' which is, of course, a release of the new chapters with all the updates from that. Leung: When we start to read those five chapters, will it show how fast moving the research is or what will it show? Mukherjee: It'll show a mix of things. It'll show the disappointments. 'The Emperor of All Maladies' was not written as a kind of a triumphalist history. It was written as a kind of process of science. And the process of science involves defeats, it involves disappointments, it involves griefs. It'll show all of that. Leung: When you finished your book 15 years ago, did you foresee laying out these five new chapters? Was that a surprise to you or did you see that coming? Mukherjee: Some of it is a surprise, some of it was in process. Immunological therapy for melanoma and other cancers was in its early infancy. Some of the new chapters on breast cancer are amazing. Some of the new chapters on other cancers are just really different. So it's a mix. Some of these were early in development, some of these were late in development, but all of these are great successes, great surprises, and I think there's no way to describe them aside from the fact that we are fortunate to have them. We are fortunate to have these researchers dedicate their lives, and we're fortunate to have patients enroll in trials to get these treatments into real life. Leung: There's been a lot written about younger people getting cancer. Usually you think of this as a disease of very old people, right? But now people are getting cancer in their 20s, 30s, and 40s. I know people in my own life who had cancer in their 40s that have passed away. At the same time, there are all these new treatments that you've just laid out. I'd never heard this term before, but I love it. This idea of the Red Queen hypothesis. It's this idea about an evolutionary arms race where science has to constantly keep up just to stay in the same place. Talk more about that. Mukherjee: The idea of the Red Queen is that we never conquer a disease. We are always in equilibrium with the disease. It's a kind of game of chess. The disease plays its game, we play a game, and we figure out how to resolve these two games. A lot of the young cancers that we're diagnosing are because of better diagnostic technologies. But that's not all, habits have changed, people have changed, carcinogens may have changed. Overall, if you look at the data, the rate of cancer deaths in the United States has been decreasing pretty consistently overall. The decrease is important and striking. Over the last 15 to 20 years, it's decreased almost from, I'll just give you a kind of rough number, 150 per a 100,000 to 110 per a 100,000. That's a big number. That's a big, big, big, big, big number Some cancers are changing, some are on the rise, some are on the fall. But overall, the effect has been positive, it's been enormous, and it's been underestimated and under-reported. Leung: So would you say we're winning this medical chess game then? Mukherjee: Winning is a complicated word. Your definition of winning might not be my definition of winning. But are we moving in the right direction? Yes, we are moving in the positive direction for many of the common cancers. Some we're still struggling with. Pancreatic cancer, we're struggling with. Some are increasing, and we don't know why. But overall, the direction is not negative, but positive. Leung: So one of the things you're really good at is explaining to non-doctors why cancer is so hard to treat, compared to other diseases. So what makes it so tricky? Mukherjee: One of the things that's very tricky about cancer is that cancer arises from your own cells. It's not an external invader. It's not like a bacterial infection. It's not like a viral infection. All the viruses can cause cancer, but really, ultimately, it's your own cell that's gone wrong. And the differences between a cancer cell and a normal growing cell are pretty subtle. One of the things that we struggled with is, 'How do we kill a cancer cell without killing a normal cell?' Because the differences are so subtle. So what are the distinctions? How do we find the particular vulnerabilities of a cancer cell that are not the same as the other cell? When you think about standard chemotherapy, not modern chemotherapy, it makes you think about killing all growing cells. You lose your hair, you lose your skin, you lose your immune system, things that grow. That's because we are targeting growth in general, but growth is important for every cell. Growth is important for our bodies to maintain ourselves. The real trick in cancer is to be exactly discriminating between the normal and the cancer cell. That's a very hard trick because they're very closely related to each other. One arises from the other because of mutations, but also one arises because of subtle mutations. It's not like the whole cell turns into a monster. It's very particular that cancer cells grow while normal cells don't grow. Leung: I'm so glad you brought that up, because I think that's one of the reasons why it makes cancer so scary is because it comes within ourselves. We are the enemy. So you made a distinction between modern chemotherapy and standard chemotherapy. What does that mean? Mukherjee: More and more standard chemotherapy was directed at saying, 'Let's kill all growing cells.' If there's collateral damage to normal growth, it's just collateral damage. That's why chemotherapy was so toxic. Modern chemotherapy is about trying to find out what is precisely different about cancerous growth versus malignant growth versus normal growth. We found that there are different cancer cells that use different metabolic pathways. They use different ways of growing. That's why with modern chemotherapy, we want to think it's less toxic, it's more directed, it's more targeted, it's more personalized, and has been, generally speaking, less poisonous than the chemotherapy devised in the 1950s and 1960s. Leung: It used to be you think of someone on chemotherapy, they lost their hair, they lost weight. But now people go through chemotherapy and they have their hair. Mukherjee: Hair is just the beginning of it. People with myeloma are living tens of years, twenties of years and surviving. They're going to work, they're being members of society, and they're enjoying their children and grandchildren in a way that they weren't before. And that's, again, because we found these Achilles' heels, and these Achilles' heels are very important because they're exactly that. They are ways in which cancer cells resist the normal controls of growth. They are able to grow despite those normal controls. Leung: It seems like it's huge for quality of life, for patients. Mukherjee: Quality of life, but ultimately survival. Leung: I want to bring our conversation to Boston. You went to Harvard Medical School, you did your residency at Massachusetts General Hospital. I think you did a fellowship at Dana-Farber Cancer Institute, as well. You really spent your formative years in Boston before heading to Columbia. So what do you think about your time back in Boston? And what did you learn about cancer being there? Mukherjee: I learned everything about cancer being there. It was my formative years. Those were the years in which I learned to understand cancer. I learned to understand the mutations. I learned to understand the effects that cancer has on cells. But I think most importantly, I learned to understand the effect that cancers have on people's lives, through the patients I saw. I saw hundreds of patients. I saw patients from every ilk of life. They shared this same drive to live, the same drive to want to live, but they shared a kind of dignity that was very important. My time in Boston taught me that the dignity of a patient is just as important as a patient's life, and the dignity of a patient is something that's negotiated. I often teach my students that cancer therapy is not an absolute, it's a negotiation. You have to ask a patient, 'What do you want out of this? How far do you want to push?' Because you could push very far. 'Where do you want your life to be? What do you want your life to look like? How far are you willing to participate in a clinical trial or in deeper segments of cancer therapy?' All of that I learned in Boston. And I think that idea was really initiated for me in Boston, and for the world in Boston, because Boston's one of the centers of cancer biology and cancer therapy. Leung: Can you share one story about a patient, maybe Carla from Ipswich? Mukherjee: Yeah, Carla. That's a very important story. Carla was an adult with acute lymphoblastic leukemia. I met her early on in my fellowship. She had young children then and she wanted them to go to college. For some reason she wanted them to go to Princeton University. I was like, 'Carla, we'll get your kids to Princeton. I mean, the kids will get in themselves, but Carla, you'll get to see them in college.' We think about cancer therapy in so many different ways. We think of cancer therapy as medicines, but cancer therapy is psychological. Unlike virtually any other discipline, a cardiologist becomes your psychotherapist. They become your colleague, they become your friend. He or she becomes the person you talk the most intimately about your life with. And Carla lived. We cured her. Leung: You didn't think she would live, though. Mukherjee: I didn't think she would live. Leung: What happened? Mukherjee: No one knows what happened. It was some combination of genetics and therapy and her persistence to come to every appointment. Leung: In the horrible Boston traffic, right? Mukherjee: In the horrible Boston traffic , i n the middle of the winter when the snow was terrible. But she lived and she got to see her children go to college. It was an enormous victory. Leung: How did those conversations with Carla or others go? Did any of it surprise you? Did any of it change your perspective as a doctor? Mukherjee: Every conversation is a surprise. Some people say, 'Listen, I'm done. I've had enough.' And you might not expect it. Some people might say in the beginning that they want to be done and they all of a sudden change their mind and say, 'I want to continue.' So in every conversation you have to negotiate it. You can say to them, 'You're so close, are you sure?' And they might say, 'Yes, I'm sure.' And then you say, 'It's your own game. It's a chess match.' You have to be certain, but you can't be too certain because you have to tell the truth. There's a very beautiful line from Emily Dickinson, which says, 'Tell all the truth, but tell it slant.' And that really means that when you encounter a cancer patient, you always tell the truth. You always tell the truth, but sometimes you have to tell it slant. And by slant, Dickinson means tell it in a way that it can be absorbed, in a way that it's not final. Americans deal with finalities. 'Here is a number. Your survival is x percent.' But that's not true. Your survival is a very complex number that depends on your genetics, your environment, your capacity to tolerate a trial. And so telling the truth's slant, it's an incredible piece of wisdom by Dickinson. Leung: My background is in business and finance reporting, so I was really fascinated to learn about the history of cancer philanthropy and fundraising in Boston. It sounds like we probably pioneered it, right? Mukherjee: Boston was certainly one of the places that pioneered it, along with Sidney Farber and Mary Lasker, who would be two famous figures. Leung: I think about our main cancer center, Dana-Farber, named after Dr. Sidney Farber, who's the father of modern chemotherapy. He really invented this idea of cancer philanthropy, which is so fascinating in your book. How important was he and Lasker in the way we think about cancer now? Mukherjee: Crucially important. Farber and Lasker's partnership lasted a lifetime. It was truly important that they figured out that the only way to beat cancer was not just through private engagement with patients, but through a larger public engagement. Leung: And Mary Lasker was the marketer and fundraiser, right? Mukherjee: She was a marketer and fundraiser. She was amazing at it. She went to Congress, she went to patients. She was a patient advocate, she was a political advocate. She was everything rolled into one and I think that she was just a remarkable figure. She moved it from a disease that was in the backdrop. She came out in front and said, 'We need to talk about this disease. We need to talk about it politically. We need to talk about it financially. We need to talk about it as a budget.' To really think about the idea that this was something special, that patients were suffering, they were underserved, and that they would be better served by a special institute for themselves. That was what Mary Lasker did. She really mobilized Congress and ultimately was responsible for the drafting of the idea of the war on cancer. Congress political entities don't declare wars on diseases, they unfortunately declare wars on nations. But it would be so wonderful if we declared wars on diseases and Mary Lasker was the first person to really coalesce on the idea that the job of Congress was to declare war on diseases, war on things that haunted human beings. Leung: Going forward, what would it take for Boston to continue to be an important place for cancer research? Mukherjee: I think the important thing is to attract talent. And talent comes from different places these days. In the United States, talent has almost always come from a mixture of local talent and immigration. Ecosystems form. Ecosystems are really important because you and I talk to each other one day in the common dining space of an institute, and I say to myself, 'Oh my God, that was a really smart idea. How can I apply that to cancer?' These ecosystems are networks. If anything, the last 10 years have demonstrated the importance of networks in all of social sciences. Boston was, and still to some extent is, one of the magnets of world talent. If you are a kid in Kenya and you want to cure cancer, you say to yourself, 'How can I get myself to the Dana-Farber Cancer Institute?' You drive yourself there, and then you meet other people who have the same vision and then you find that there are funds available for you to be able to do that research. That's what magnetism is, and if you lose that magnetism, I think you lose everything. Leung: Your book lays out how important federal funding was to all the treatments we're seeing now with breast cancer and leukemia. Spell it out a little bit more for people who haven't read your book. Mukherjee: Sometimes I'm just writing a piece about Covid vaccines, and it's the Moderna vaccine. But it's not really the Moderna vaccine, it's the National Institute of Health (NIH) vaccine. The NIH is the one that supported years and years of mRNA research by Drew Weissman and Katalin Kariko to create what would eventually become the Moderna vaccine. Over and over again, the idea of science funding translated into human research has turned out to be enormously valuable. Hundreds of thousands, if not millions of people have been saved by just the drug Herceptin. Think of the number of people in your own life. Each of us can name a person, and think of the network effect. A mother who would've died at age 38, who now is alive at age 52. Those years of her life were given to bringing up her child. It's just impossible for me to enumerate. People have done numbers on this and showed that every dollar spent on the NIH converts into tens, if not hundreds of dollars, saved in human capital. I think we underestimate it. Slashing that is just the worst idea on the planet. Leung: Can private philanthropy make up the difference? Mukherjee: No, no, no, it cannot. Private philanthropy is an adjunct. The central forces have to come from federal sources. Leung: Why? Mukherjee: It's just because private philanthropy historically follows the direction of what we are thinking from the center. That's the seed. It's the spark that lights the fire. And without that fire, we're really done for. Leung: So one of the big takeaways of your book is the need to reimagine how we think about cancer. And how that in itself would be a victory, if we could reimagine how we think about cancer. That cancer isn't an imminent death. That it's not about finding a universal cure, but that the disease can be managed. So talk to me more about that. Mukherjee: I think of cancer more and more as a journey. In some cases, the journey's abruptly terminated, which is sad, but in many, many cases, the journey continues. While the journey continues, we've given back people real lives. They're not just obsessed with the journey. It's not like they're in the hospital all the time. They're going back to their homes, they're going back to their real lives and then coming to the hospital for their treatment. So, I think that's a real change. Leung: What do you think people get wrong about cancer in our society and what is the one thing you want people to understand about the disease? Mukherjee: I think they need to understand it's not a death sentence. It is one word in a sentence that continues for a very, very long time. It's one word in a paragraph and that paragraph continues for a very long time for different cancers. I don't want to give people false hope. Some cancers are deadly, but I also want to give people the idea that they continue their lives beyond cancer, and I think that that's what's missing. Leung: Siddhartha Mukherjee is a physician and assistant professor of medicine and researcher at Columbia University. He's also the author of the 'Emperor of All Maladies' and the 'Emperor of All Maladies: Part 2,' along with other award-winning books on medicine. Listen to more 'Say More' episodes at Kara Mihm of the Globe staff contributed to this report. Shirley Leung is a Business columnist. She can be reached at
Boston Globe
01-05-2025
- Health
- Boston Globe
The C-Word: Let's talk about cancer – starting with my own.
The following is a lightly edited transcript of the May 1 episode of the 'Say More' podcast. Shirley Leung: Welcome to 'Say More' from Boston Globe Opinion. I'm Shirley Leung. This is the first episode of our series, 'The C-Word: Stories of Cancer.' When I was diagnosed with cancer, it's like I was waiting for it my entire life. Because when I was 12, my mom's mom, my Wai Po, died of breast cancer. I watched my chubby cheeked grandma waste away after chemotherapy and a double mastectomy. She, like me, had been diagnosed with breast cancer in her forties, but unlike me, she didn't have the advantage of early detection in the 1970s. There were no annual mammograms. She found the lump herself, and by then, the cancer had spread. Wai Po was only 55 when she passed away in 1984. She had fled Mao Zedong's communist China, but couldn't outrun cancer. Back then it was like the Dark Ages. A diagnosis felt like a death sentence. A 1979 photo of Shirley Leung (l) when she was 7 years old with her grandmother at Longwood Gardens in Pennsylvania. Handout/Kam-Ken Leung For the next month on 'Say More,' we'll be sharing stories of cancer, starting with my own. Some of these stories end in tragedy, some lead to new beginnings. When my cancer journey started, I didn't know whether I was headed for death or a new start. For now, I'm fully cured, but in some ways I'll never quite get over cancer. I'm in the studio with 'Say More' producer Anna Kusmer. Anna Kusmer: I remember the first time you told me you had cancer, we were having dinner together and you mentioned it sort of offhand, and I was really intrigued. I was like, 'I've known Shirley for a while now and I didn't know this about her.' I had a million questions, but I didn't know if it was okay to just grill you about it. Over time I did hear more of your story. How long has it been since your cancer diagnosis and what kind did you have? Leung: So it's been eight years since my successful treatment. I had early-stage breast cancer. Mine was caught by an annual mammogram. It was stage one; I had a single side mastectomy. My left breast is gone now, and I have an implant. I had five years of a drug called Tamoxifen. It's a type of hormone therapy that reduces the chances of my cancer coming back. Kusmer: So you write a lot about your personal life in your columns but you've never written about your cancer. Why did you wait so long to talk publicly about this? Leung: When I was first diagnosed, I thought about writing about it. Between my diagnosis and my first surgery, I was thinking about doing it and I got this really good advice from somebody who said, 'Don't write about it now, you are going to be going through so much surgery and a diagnosis. You need to focus on your treatment.' That was the best advice I got during that period because I would later learn that it took me probably two years until I stopped thinking about cancer every single day. And to stop thinking about the idea that I might die of cancer. Kusmer: Can you take me back to eight years ago when you first found out you had cancer? What were those first couple days like? Leung: I was about 45 years old and I just had my annual mammogram. I got a call back saying, 'I think we want to call you back. Can you do another mammogram?' So I came back and then they said, 'Oh, we want you to have a biopsy now.' So I went in for a biopsy and they took two biopsies in two different places in my left breast. Then I had to wait. It was actually very excruciating to wait. I think from my first mammogram to my biopsy result, it was probably almost three or four weeks, and I was kind of in limbo. And I remember, I got a call from the doctor's office. Kusmer: You were at work, right? Leung: I was at work. I'm thinking, 'Well, I must not have cancer. Who calls you up and tells you over the phone that you have cancer?' So it was almost a relief that the doctor's office called. But no, I learned that no, they actually do give you your cancer diagnosis over the phone. Kusmer: Oh my God. Leung: And I couldn't believe it. So I'm sitting in the office at the Boston Globe. It was literally the week that we were moving from our old headquarters on Morrissey Boulevard in Dorchester into 53 State Street, here. So it was a pretty empty newsroom. I'm unpacking my boxes. I'm trying to file a It was like my world stopped. It was just like all those movies where you're told you have cancer or, some horrible thing and you know, the world, the room was just like spinning. Once the nurse on the other line said ,'You have cancer,' I just stopped listening. I couldn't even understand what she was saying. I have no idea what she said after that. I just knew I had to get off the phone and call my husband right away. Kusmer: So what kind of breast cancer did you have? Leung: So I had something called Ductal carcinoma in Situ (DCIS). It's the kind of breast cancer you wanna have, as my doctor was explaining to me. It's both very treatable and beatable. It's a kind of cancer that's supposed to stay in the breast, which means it's not supposed to break out and spread throughout your body. But I had very aggressive tumors, and if left untreated, it probably would've become invasive. My prognosis was good, but having cancer, it's like a series of cliffhangers. You get diagnosed, then you meet with a lot of different doctors. Then you go through surgery, there's more biopsies. They're trying to figure out if it spread. Not only did they take my left breast, but they took the first lymph node to just make sure the cancer had not spread. And then after that, I didn't have to do chemo. I didn't have to do radiation. But I did have to take five years of a drug called Tamoxifen, and that prevents cancer from recurring, because now they're concerned about my right breast. So they're making sure it doesn't come back. Kusmer: So you didn't come out publicly about your cancer for understandable reasons, but who did you tell? Did you tell your little kids that you had cancer? Leung: It wasn't hard telling my kids. They were only four and six. They had no idea what cancer was or what it could do. Of course I told friends and colleagues about my diagnosis, but the hardest conversation was with my mom. And that surprised me. I actually think I waited a bit to tell her. That's because her mom died of breast cancer and I'm a mom now, and if one of my kids called me up and said 'I have cancer,' it would've crushed me. And so I didn't want to break her heart, telling her that her daughter has breast cancer just like her mom. Leung as a young girl with her grandmother in New York City's Chinatown in an undated photo. Photo by Lou Chen Kusmer: So how did that conversation go with your mom? Leung: It was a hard conversation. I remember she had called me about something else. I think we were talking about summer vacation plans and then I blurted out I can't do any of that because I have cancer. And we both just started crying. I have very vivid memories of that call. When doing this series, I was curious what my mom remembered of that call. We actually never talked about it. Kusmer: Your mom who lives in California, we connected with her via Zoom. We wanted to see what she remembered. Leung (recording of call to mom): Hello. Ma? Leung's mom: Hello. In the office, is it now your home? Leung: Yeah, in my office. She was really nervous, Anna. She must really love me if she was willing to go on my podcast Kusmer: She told us a little bit about her memory of the call. Leung: Do you remember that day? When I gave you a call? Leung's Mom: Yeah. It was morning time. I was shocked, crying. 'Why do you have cancer? You are so young.' 'It's people my age who have cancer, not your age.' Leung: I asked my mom if she was scared about me having cancer. Leung's mom: Of course. Scared. And sad, very sad. Leung: Why were you sad? Leung's mom (translated by Leung): Your kids are so young and if they lost their mother, the family would be broken. Leung: I asked my mom if she was really nervous for me because her own mother had died of breast cancer, and I was really surprised by her answer. Leung's mom: My mom had breast cancer so long ago, 40 years ago, and there are so many advances in medicine and treatment. Leung as a young girl with her grandmother in front of her home in Jackson Heights, New York in an undated photo. Photo by Lou Chen Leung: My mom knew, I think deep down, that I'm not going to be my grandmother. Anna, you and I went to Dana-Farber. I hadn't been to Dana-Farber Cancer Institute until I had my cancer. Had you been to Dana-Farber? Kusmer: I've definitely heard of Dana-Farber. The Jimmy Fund, a philanthropic wing of Dana-Farber loomed extremely large in my childhood. I remember every time we'd go to the movies, there'd be buckets passed around to raise money for the Jimmy Fund. So I've always been aware of this world class cancer institution in Boston, but I've never been inside and it was really interesting to go there with you. Leung (clip from Dana-Farber visit): All right, so we're outside Dana-Farber. This is the main building, right? Leung: I called it the Four Seasons of Hospitals because it's just so welcoming, but also it's very sobering being in there because some of the people there are very sick. Kusmer: When you first walk in there, there's really high ceilings. Tons of light coming in through the atrium. It does look like a hotel lobby. And the juxtaposition between that and what you know about it, it's mostly full of cancer patients, those two things together makes you feel like this is a place of great purpose and importance. Leung: I think purpose is the right word. Often when we talk about cancer, we talk about it as the war on cancer, right? You do feel like this is a place where you are on the front lines of fighting cancer and you have doctors and nurses and staff and researchers helping you battle cancer. Leung (clip from Dana-Farber visit): There's this garden, serene garden, and I remember sometimes you can come in here, it's a healing garden. You don't see this in other hospitals. Kusmer: One place we went to together was this indoor garden. I've never seen that in a hospital before. Did you go there when you were getting treatment? Leung: I did. I did because it's such a special place. Maybe you're waiting in between appointments or before your appointment. After an appointment, you go into this garden and you have these benches and it's warm and it's sunlit and you can just sit there and meditate. As much as cancer is a physical disease, it's also a mind game. Kusmer: It seems like this garden is a physical representation of the fact that it's not just the physical biological support you need in this journey. You also need these other supports like spiritual places to contemplate your life. Leung: It's something my oncologist, Ann Partridge, seemed to really get. Kusmer: Actually right after the garden, we went to see her. Leung (clip from Dana-Farber visit): You look good. Ann Partridge: Thank you, my friend. How about you? How are you? Kusmer: Tell me a bit about Dr. Partridge. Why did you choose her? What did you like about her? Leung: Her specialty is dealing with younger women who have breast cancer. I think the average age of a woman who gets breast cancer in the US is in her early sixties, and so her specialty is women in their twenties, thirties, and early forties. She said she was inspired to work with younger women with breast cancer because of a friend of hers who was diagnosed when she was 30. Partridge: She presented with a lump and sure enough, it was breast cancer. What that did do, at a tender young age for me, was open my eyes to some of the things that the medical community doesn't focus on. So you're focusing on the disease and what treatment do they need? What surgery do they need? Should we give them chemo or not? And she was also grappling with starting to date a guy. 'When do I tell him?' 'And what kind of camisole do I get if I choose to have a mastectomy? And when can I do the reconstruction?' And things that, kind of as a doctor, you're like, 'Talk to the nurses. Go to the boutique.' But when you are either a patient or you're close enough to a patient, when they're sharing those things, you're like, 'Oh, what's she going to do?' We don't know any of this stuff. And more importantly, how is she going to feel in a couple of years as the dust settles with her decisions, decisions about fertility, decisions about reconstruction. So there's a whole Pandora's box that gets opened for our youngest patients, especially that there wasn't as much research to tell us what to think about her future risks, let alone how to counsel her. So that's an area that we focused on a lot to try and bring more information to the table as people are making these difficult decisions. Kusmer: One thing that I really liked about Dr. Partridge is that it seems like she took listening to her patients and really understanding her patients to be one of her biggest jobs besides the technical work of treating cancer, like understanding what their values were in life, what their fears were, and truly trying to get patients to open up to her about these really deep life or death questions. That doesn't seem like every type of doctor would have to wrestle with that. Partridge: I see it as, 'What can I do to make this better for this person?' That's true for everybody that I take care of. How can I make their journey better? I find that as both an extraordinary privilege and responsibility because in order to help make a person's journey better, whether they have low-risk early-stage breast cancer, or they're living with an advanced disease, you have to get to know that person. And that's part of what pulled me into cancer, breast cancer specifically, because it's a long haul journey. Even when they're ultimately going to die of the disease, we often can get them on a treatment that contains it for some time. So to me, that was part of the compelling draw, to take care of patients who are dealing with something very serious. Each bring their own unique gifts and baggage to it, so you can help to get to know them and take care of them and hopefully make their journey better. Leung: Ann, and other oncologists that we talked to for this series, so much of their focus was on quality of life. It wasn't about, 'We are going to do everything possible to kill the cancer, even if it almost kills the patient.' I feel like before it was one size fits all for cancer treatment, and now it's like, 'No, we can customize your treatment so you don't lose all your hair or you don't lose both breasts.' The advances are about allowing people to live better and fuller lives. It's not just about survival. Kusmer: Dr. Partridge also talked a lot about the mental health journey of the cancer patient. She said even mental health experts with cancer struggle. Partridge: I had a patient this past year, who is a psychiatrist. During a forum, she said, 'I'm a psychiatrist. I teach people how to cope. And all of my usual coping mechanisms are not working.' And that's not an uncommon phenomenon. Kusmer: So one thing that surprised me, Shirley, is that you mentioned earlier that you weren't exactly relieved when you found out that you were cancer free. Can you explain that? Leung: Yeah, I was surprised, too. After surgery they test the lymph node so that they know if I am definitely going to beat this cancer. And the doctors are eager, actually to declare you cancer free. And as a cancer patient, I mean, those are the magic words you wanna hear. You are waiting for that moment. And yet I didn't feel cancer free because there's another C-word. Cured. And that can land just as hard. And, I found out, it's just as complicated. And I remember talking to Dr. Partridge about, 'Why don't I feel better? Why don't I feel relieved? This was supposed to be amazing.' She was the one that suggested, I see a therapist and Dana-Farber has a therapist who specializes with cancer patients. And so I went to see a therapist for the first time. Kusmer: So what did you learn? Leung: Well, I learned that it was pretty common for patients to feel this way. I also learned that I still equated cancer with death because of my grandmother's death, and I needed to be reminded that I am not my grandmother. It was hard for me to relax because of cancer. And it was like having a ticking time bomb inside me. And I mean, how many of us know people who beat cancer only for it to return with a vengeance? And I was like, is that going to be me? And I didn't want to jinx it. I didn't want to think that I'd actually beat cancer. Kusmer: So one of the themes of this series is the ways that people who have cancer are treated differently once they do come out and tell people. How did you feel about the way people talked to you and treated you and kind of talked about your cancer while you were going through it? Leung: In the beginning it was awkward. Still to this day, some people still ask me, 'How's your health?' And I'm thinking, 'It's been eight years.' It comes from a good place, right? That they want to recognize that you had cancer, and it was a tough period for you. So I appreciate it. But you are treated differently. People won't talk to you the same way. And it can be a little awkward now because so much of the narrative around cancer is like, 'You are a survivor. You are a warrior.' And I didn't feel like either one of those. I felt lucky, really lucky, that I had a very treatable and beatable cancer. Yes, I had this major surgery, but as cancer goes, it was pretty good. But you can see that cancer has done something to my mind because it's taken me eight years to finally really talk about it. Kusmer: So how do you think having cancer changed you as a person? Leung: I wish I could say it's made me Mother Theresa. When I'm having a bad day or if I'm fighting with my kids or they're upsetting me, I do think, 'Hey, I'm just really glad I'm still here and I can live through these moments.' I also saw, and I think every cancer patient will tell you this, I saw the humanity. I had so many friends, colleagues, and also, people I barely know who came out of the woodwork to support me, to bring me meals, to babysit my kids. I just saw a side of humanity that made me really hopeful and optimistic. And now when other people have cancer or go through some really tough period, I'm there for them. Kusmer: So your little boys from earlier in your story, that 4-year-old and 6-year-old, they aren't so little anymore. I think they're what, 12 and 14 now? Leung: They're taller than me! Kusmer: So what do you want them to know about cancer now that they're old enough to understand? Leung: For them, their first association with cancer, it won't be about death. It'll be about Mom living. Now, one of my son's friends, their father passed away from cancer last year, so they do know that some people die of cancer, but I think it's important for them and that generation to know that cancer can be treatable, can be beatable, and it's a real testament to the advances of medicine. They can actually say 'cancer' and not be scared. Maybe in their lifetime, cancer will be more like heart disease or diabetes. It's a disease that can be managed. It's chronic for some people. Cancer won't haunt them like it did me. Kusmer: Thank you Shirley, so much for sharing your story. I hope other people will reach out and share their own stories and stick around for the rest of these episodes. Leung: Anna, thanks for being on this journey with me. We hope you'll stick around for more episodes on the C-word. Listen to more 'Say More' episodes at Kara Mihm of the Globe staff contributed to this report. Shirley Leung is a Business columnist. She can be reached at
Boston Globe
29-04-2025
- Entertainment
- Boston Globe
Where our restaurant critic likes to eat when she's off the job
Send questions or suggestions to the Starting Point team at . If you'd like the newsletter sent to your inbox, . TODAY'S STARTING POINT Last Thursday was Bring Your Child to Work Day, which means the Globe offices were flooded with smaller, cuter versions of our co-workers, and we got to guess who belongs to whom. We couldn't let them just free-range all day, so there was some educational programming between the dance parties and the snacks. During a session I led titled 'How to Be a Restaurant Critic,' one inquisitive attendee raised his hand with a burning question: 'Do they, like, pay you to do this?' Advertisement I know, dude. It's crazy. If there is one small downside to eating-as-reporting, it's that I rarely go to a restaurant simply because it's a place I enjoy with food I'm in the mood to consume. Cry me a statin-laced river. But every once in a while I do. Today I thought I'd share with you a few of the restaurants I like to visit when I'm not working, on my own dime and time. Kaju Tofu House I come to this Allston Korean standby for sundubu jjigae, bubbling stews made with silken tofu and beef bone broth. But I also can't stop myself from ordering pajeon, kimchi and scallion pancakes. The sweet and spicy pork, delivering a wave of umami with every bite, is a new favorite. I appreciate the tasty array of banchan, side dishes that accompany the meal. And I always bring home some of the house-made kimchi. The website sums up the menu as 'comforting Korean soul food.' This is accurate. Advertisement 56 Harvard Ave., Allston, 617-208-8540 / Mountain House We're going to stay in Allston for a bit. My palate tends to default to Asian cuisines when it gets to pick, and I've been appreciating this Sichuan restaurant since it opened in late 2023. (It's an outpost of popular New York-based Szechuan Mountain House; there's one in LA, too.) It serves a staggering array of delicious dishes, many of them ferociously laced with chiles, in a stylish dining room that feels like a modern riff on an old Chinese inn. From dumplings in chile oil to fried shredded eel to crab with sticky rice to a bouncy-textured dish of Chiba tofu, I've enjoyed it all. 89 Brighton Ave., Allston, 617-329-6920 / Meet Fresh After dinner (or instead of dinner, I won't judge), this Asian dessert spot is spot on. The Allston branch of a Taiwanese chain, it is also conveniently located for a post-Kaju or Mountain House visit. Deciding what to order is the hard part; my brain melts down over the array of elaborate shaved ice creations, soft-serve ice cream, tofu pudding, icy grass jelly with red beans and peanuts, and so much more. I'm usually a minimalist when it comes to desserts, but not when dessert is shaved ice. Almond and caramel puddings, tiny taro balls, mochi, melon jelly, and ice cream? Yes, please. Everything everywhere all at once. Advertisement 140 Brighton Ave., Allston, 617-254-7000 / Ming's Seafood Restaurant Last year, business columnist Shirley Leung and I co-wrote a 477 Hancock St., Quincy, 617-202-5118 / Mahaniyom My love for this Thai restaurant in Brookline is no secret. I gave it 236 Washington St., Brookline, 617-487-5986 / Prairie Fire I do occasionally eat non-Asian cuisine. And I'm always so glad to sit down for dinner at Prairie Fire, an absolutely ideal neighborhood restaurant. Adults can have wood-roasted oysters, fancy pasta, and a nice cocktail; kids can eat the great pizza; everyone is so happy. I pretty much always get the spicy squid ink campanelle with lobster. Advertisement 242 Harvard St., Brookline, 617-396-8199 / Delfino While we are on the subject of Italian food, what could be better than dinner at Delfino? Enter through the purple velvet curtains, sit in the brick-lined room, and eat house-made ravioli or linguine with broccoli rabe and sausages made at nearby Tony's Market. There are people on staff who have seemingly worked here forever, which makes for good vibes. 754 South St., Roslindale, 617-327-8359 / A few postscripts: If you're looking for non-touristy spots to eat by the water this summer, If you're looking for something new, And if you, too, would like to learn 'How to Be a Restaurant Critic,' first make up your restaurant critic alias (the name of your first pet plus your mother's maiden name, of course). Then print out and take a crack at our 🧩 8 Across: | ☀️ 77° POINTS OF INTEREST The Rhode Island State House in Providence last year. CHRISTOPHER CAPOZZIELLO/NYT Boston and New England New leadership: The Rhode Island Senate is poised to Hike to the polls: Milton residents will vote today on Staying put: The number of wealthy Massachusetts households grew from 2022 to 2024. 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( BESIDE THE POINT By Teresa Hanafin ⛱️ Warming up: May in New England, particularly in Massachusetts, is becoming 🦫 Baby boom: If you're as surprised as I am that there are prairie dogs at the Franklin Park Zoo, then buckle up: Now there are prairie dog pups. So far, 12 have emerged from the den, but more could appear. ( Advertisement 🎸 Music icons: The 2025 class of inductees to the Rock & Roll Hall of Fame includes Bad Company, Cyndi Lauper, and OutKast. The ceremony is Nov. 8. ( 🐈 Purr-fect: If you think cats are mean, untrainable, and aloof, the good people of the Catsachusetts Cat Club Northeast 💠 Art Deco anniversary: This distinctive architectural style is marking its centennial this week, and no US building reflects its unique sculptural adornments better than the Chrysler Building in midtown Manhattan. ( 🍿 Retro dining: The 🐝 Buzz off: After repeated swarm disruptions at the Pittsburgh airport, honeybee experts placed hives and swarm boxes on vacant airport grassland, far away from planes. And now it's home to about 4 million of these vital pollinators. ( Thanks for reading Starting Point. This newsletter was edited by ❓ Have a question for the team? Email us at ✍🏼 If someone sent you this newsletter, you can 📬 Delivered Monday through Friday. Devra First can be reached at
