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In 2022 Susan Wojcicki was on prime of the world—CEO of YouTube, mum or dad to 5 youngsters and operating just a few miles a day—when she acquired a surprising analysis: metastatic lung most cancers. She quickly resigned from YouTube and devoted herself to combating the illness and on the lookout for solutions. Why does the main reason for most cancers deaths obtain much less funding than some much less deadly cancers? How may her lung most cancers have progressed up to now undetected? And the way did she get lung most cancers despite the fact that she had by no means smoked? This episode is devoted to Wojcick, who handed away final 12 months.
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TRANSCRIPT
Elah Feder: At some point in late 2022, Susan Wojcicki had plans to satisfy up together with her childhood buddy, Joanna Strober. This is Joanna.
Joanna Strober: We have been alleged to go for a stroll on a Sunday, and she or he referred to as me and she or he canceled as a result of she had some hip ache. And , I simply thought, okay, you in all probability exercised an excessive amount of. Susan was a runner. Possibly she pulled one thing, however she went to her physician after which she- I suppose she acquired an MRI. And it was most cancers, and that was her first indication—hip ache.
Elah Feder: Lung most cancers, and it had unfold, which was surprising. Susan, she was 54 years previous and in prime form, operating just a few miles a day at that time. And on prime of every thing, Susan had by no means smoked.
Joanna Strober: Susan led probably the most wholesome life. She did not eat sugar. She was very cautious about exercising each day. She was very cautious about not consuming pesticides. I imply, she was on the intense of main a wholesome life-style. So sure, it is not simply the not smoking, however she was doing every thing she probably may to remain wholesome.
Elah Feder: Susan’s expertise isn’t as uncommon as you’d assume. Lung most cancers is the most typical form of most cancers on the planet. Third commonest within the US. Smoking continues to be the main trigger, however a rising quantity of people that get lung most cancers do not smoke, have been by no means people who smoke. That is very true of ladies who get lung most cancers.
To be clear, this can be a horrible analysis to get for anybody, whether or not they smoked or not, however for many who have not, there may be an additional layer on prime of all the opposite emotions: confusion. So when Susan acquired this analysis, after all she needed remedies, however she additionally needed solutions. Why did this occur to her?
Elah Feder: That is Misplaced Girls of Science, and I am Elah Feder
Katie Hafner: And I am Katie Hafner and as we speak the story of Susan Wojcicki, who died final 12 months of lung most cancers.
Elah, earlier than we get to Susan’s lung most cancers, I wish to acknowledge—some individuals on the market would possibly already be aware of her identify as a result of Susan Wojcicki was one of the vital profitable and influential individuals on the planet.
Elah Feder: Yeah. Susan was the longtime CEO of YouTube, and she or he acquired concerned in Google very early on, in order that by 2022, her estimated web value was about $800 million.
Um, there is a story that will get quoted so much about her early enterprise acumen. When she was a child, she and her buddy, Joanna Strober—who you heard earlier—they bought what they referred to as spice ropes. This is Joanna once more.
Joanna Strober: It is actually not that massive of a deal. All we did was we made these yellow and orange yarn issues and we put cinnamon in them and we referred to as them spice ropes, and we bought them to the neighbors who after all had to purchase them as a result of they have been neighbors.
Elah Feder: The best way the story will get instructed, it is like, have a look at this Susan child born entrepreneur, however Joanna says, “no, no, no.” The purpose is that they have been simply common youngsters being youngsters.
Katie Hafner: Proper. It was their model of a lemonade stand. Proper?
Elah Feder: Precisely.
Joanna Strober: We weren’t particular. We have been regular 10 12 months olds in a extremely lovely setting that was supportive of our endeavors.
The setting was the Stanford group. We grew up surrounded by good individuals who have been doing actually attention-grabbing analysis and who, fairly truthfully, have been altering the world in numerous methods. A number of scientists, physicists, entrepreneurs. It was a beautiful option to develop up as a result of every thing felt very attainable rising up on the Stanford campus within the seventies.
Elah Feder: Susan grew up on the Stanford campus as a result of her dad was a physics professor there, Stanley Wojcicki. Um, her mother—additionally very spectacular—Esther Wojcicki, she’s a journalist, educator, author. She- she wrote a e book referred to as Tips on how to Increase Profitable Folks, and I imply Esther Wojcicki has the cred to again this up. Uh, a few years in the past, Mattel determined to honor girls in STEM by making Barbies of a few of the extra notable figures. All three of her youngsters made the lower.
Katie Hafner: In fact they did. Esther: mom of champions.
Elah Feder: What you are listening to is a video of Susan, Janet and Anne Wojcicki all unboxing their Barbie likenesses.
Janet Wojcicki: Let’s do physics, arithmetic. Let’s present them what the childhood was actually like!
Elah Feder: You simply heard Janet, she’s the center sister. Uh, she’s a professor of pediatrics and epidemiology at UCSF.
Then there’s the youngest child. Anne.
Katie Hafner: Sure, Anne Wojcicki: the co-founder of 23andMe. Listeners would possibly acknowledge her identify from all of the instances we thank the Anne Wojcicki Basis within the credit—and her basis funded this episode as effectively, proper?
Elah Feder: After which there was Susan, the eldest. I talked to Anne and Janet just a few weeks in the past. All all three sisters have been very shut in age, all born in a span of, of simply 5 years. However speaking to them, it feels like Susan had traditional first little one syndrome. You are gonna hear Anne first.
Anne Wojcicki: She was all the time the accountable one. Janet was not. And- and but-
Janet Wojckick: And also you have been midway in between.
Anne Wojcicki: I used to be midway in between, yeah. My pals all the time appreciated hanging out with Susan, however they did not like hanging out with Janet. After which half is that Susan was so variety. Susan was variety. She was accountable, like she would take us out to ice cream. She would decide me up from ice skating. She was like, all the time on time.
Elah Feder: If Susan Wojcicki promised you ice cream, you have been gonna get ice cream. It is a high quality that absolutely you’d need in a pacesetter. However Anne says Susan wasn’t born to be a mogul or something.
Anne Wojcicki: I would say Susan was very a lot virtually just like the unintended CEO. I by no means would’ve checked out her once we have been youthful and mentioned like, “oh, my sister goes to be a CEO.” You recognize, like there’s positively different individuals I have a look at in highschool who’ve centered on finance and serious about their careers and stuff.
Elah Feder: Susan, however, was a historical past and literature main, however in 1998 she acquired concerned within the creation of a brand new tech firm when she rented out her storage to 2 Guys: Larry Web page and Sergey Brin. They have been beginning a brand new firm, and I believe the identify. Um…
Katie Hafner: Google, if I am not mistaken!
Elah Feder: Google!
Newscaster: somewhat engine that would, we’re speaking about this morning, has nothing to do with the kids’s story a few courageous little locomotive. That is as a result of this engine is a search engine. Google by identify, an web web site, partnered with our personal CBS information.com.
Elah Feder: Susan quickly grew to become the corporate’s first advertising supervisor, and some years after that she led them in shopping for one other tech firm: an organization referred to as YouTube. And in 2014 she was appointed YouTube CEO.
Newscaster 2: Properly, her identify is Susan Wojcicki and she or he’s one of the vital highly effective girls in tech. She’s additionally mom of 4 and greater than eight months pregnant together with her fifth little one. So how did she do all of it?
Elah Feder: So, in 2022, Susan has been CEO of YouTube for eight years. In some way she nonetheless had time to lift 5 kids and run just a few miles a day, which is totally alien to me.
You recognize that Beyonce meme, like Beyonce has as many hours within the day as you do, and it is, like, meant to disgrace you for being insufficient. Um, that’s how I really feel listening to about Susan Wojcicki. Level is she’s doing rather well when she will get this information. And it is a full shock. This is Anne once more.
Anne Wojcicki: I believe whenever you suddenly- like Susan was form of on prime of the world, like she cherished her job, YouTube is taking off and she or he had her 5 youngsters and so they’re all superb and um, after which all of the sudden it was like, your life is gonna be over quickly. Immediately the primary precedence was therapy.
Elah Feder: In a short time, Susan resigned from YouTube and actually gave herself over to combating this.
Joanna Strober: What she actually did was began working with scientists…
Elah Feder: Joanna, once more.
Joanna Strober: …doing the in-depth work to grasp the science and what remedies have been accessible and what she may do, but it surely was very scientifically centered.
Elah Feder: Susan would go on to be taught so much about lung most cancers, and one of many issues that she realized that actually disturbed her is that medical doctors weren’t nice at detecting her form of most cancers: lung most cancers in non-smokers. Typically there aren’t any early indicators, or in Susan’s case, only a few indicators even when the most cancers has progressed. This is her sister, Janet.
Janet Wojcicki: We went to see her, , thoracic oncologist, proper? Her lung oncologist. She’s sitting on the desk and the oncologist is definitely inspecting her and she or he’s listening to her lungs and Susan’s principally saying like, you do not hear something, proper? You, you hear nothing prefer it sounds completely regular, proper? And the oncologist is like, yeah. So simply from a medical examination, she was excellent. There was nothing. So she was like, how is it that I’ve stage 4 lung most cancers? You are an oncologist, you are listening to me, you are me, and like, nothing’s awry. So it’s- it was that form of disconnect that was additionally form of a name to motion.
Elah Feder: How may Susan’s lung most cancers have gone undetected so lengthy that it had unfold? And why is it that when lung most cancers is detected, survival charges aren’t larger? Properly, a part of the explanation may be that we’d like extra funding regardless of some very efficient anti-smoking campaigns, lung most cancers continues to be the main reason for most cancers deaths within the U.S., but it surely solely will get about half the federal analysis funds that breast most cancers does- or it did. The NIH has been slashing analysis funding, together with most cancers analysis. We’ll see how this all shakes out within the coming months and years. In any case, lung most cancers may not be the one most cancers that is in hassle going ahead. However traditionally, a part of the explanation that lung most cancers acquired proportionately much less funding might need to do with attitudes towards lung most cancers. It simply is not considered the identical means that breast or prostate or pancreatic cancers are. It is typically seen as one thing you deliver on your self. This is Anne once more.
Anne Wojcicki: I believe that the stigma has actually harm research- is that folks have a look at it and so they say like, oh, effectively you smoked. And um, and I believe that is one of many issues that Susan actually needed to vary.
Elah Feder: It took a very long time to get this broad consensus that smoking causes lung most cancers. If we return to the 40’s and fifties, that is whenever you first see a bunch of research popping out that exhibit this hyperlink. And even so, for those who requested a health care provider in 1960, if the hyperlink had been confirmed, a fifth mentioned they did not assume so. About half of them nonetheless smoked, however ultimately the opposite facet prevailed. We now have a consensus that smoking does trigger lung most cancers, however the draw back is stigma.
Katie Hafner: You recognize? And the stigma is admittedly, actually deeply embedded in our society. The minute you hear that any individual has been recognized with lung most cancers, the very very first thing you ask is, do they smoke? Have they smoked? Have you ever smoked? Has she smoked? And, so that you instantly assign that stigma to the lung most cancers even when it shortly will get established that there was no smoking. And that would even have an oblique impact on this lack of funding.
Elah Feder: Yeah, that is the suspicion, and naturally the stigma and the sufferer blaming is horrible for individuals who did smoke too. So, that actually bothered Susan and she or he gave some huge cash for analysis, however she was additionally on the similar time simply investigating her personal most cancers. You understand how, how did she get it?
Anne Wojcicki: I believe one of many first issues we did was we acquired the homes examined for radon publicity.
Elah Feder: Katie, have you learnt about radon? Are you aware of radon?
Katie Hafner: I imply, I am acquainted, however I don’t know what that has to do with it. Inform me.
Elah Feder: I solely not too long ago realized about this, so, so radon is a radioactive fuel. It- it feels like one among these scary stuff you learn on the web, however that is actual. It is a radioactive fuel that naturally happens within the floor, but it surely leaks into basements the place it will possibly accumulate to harmful ranges. It has no scent, no- no coloration. So you actually wouldn’t know if it is in your house except you take a look at for it. Um, but it surely’s the main reason for lung most cancers in non-smokers.
Katie Hafner: You imply earlier than secondhand smoke?
Elah Feder: Apparently. Within the U.S. radon is the primary reason for lung most cancers amongst non-smokers in line with the EPA.Different causes, after all, do embrace air air pollution, asbestos publicity, and secondhand smoke.
Katie Hafner: Wow. So, I’ve all the time thought secondhand smoke was it? Nevertheless it sounds prefer it was, it sounds prefer it’s radon.
Elah Feder: Me too. Possibly it was when individuals have been smoking extra.
Katie Hafner: Yeah.
Elah Feder: However yeah, radon is sadly within the lead. Um, Susan’s basement: away from radon.
Katie Hafner: And what about genetics? Final week, , we talked a few researcher named Maud Slye who labored to point out that heredity defined all most cancers.
Elah Feder: Wrongly, however sure.
Katie Hafner: Seems to not be true, however that is okay. You go Maud. Um, are there genes linked to lung most cancers? I suppose that is my query.
Elah Feder: There are, um, however lung most cancers continues to be, for probably the most half, a illness brought about by- by both your setting or your life-style. Some genes have been linked to elevated most cancers danger. For instance, a sure mutation within the EGFR gene. Extra genes may be discovered. It is also attainable that it is not nearly discovering a single gene, however about how mutations in a bunch of genes work together. However yeah, for probably the most half, lung most cancers tends to be about setting and life-style greater than genetics.
This is a component the place there’s generally confusion. Most cancers normally occurs when there is a genetic mutation in a cell, truly a sequence of mutations. And these trigger that cell to start out appearing bizarre and replicating uncontrolled. So in a way, genetics is all the time concerned in most cancers, however on this case, we’re not speaking about inherited genetics, we’re speaking about mutations that you simply get in a few of your cells later in life. They will pop up whenever you’re 10 or 30 or 80 or hopefully by no means. However then, some individuals do have preexisting germline mutations. Some mutations that you’ve got had because you have been somewhat zygote that exist in each cell of your physique. And, these do not normally immediately trigger most cancers on their very own. Um, I believe an analogy may be useful right here. So, think about a mutation as a change. You normally want just a few switches to activate earlier than a cell turns into cancerous. However some individuals are born with one among their switches already within the on place. And that makes them extra susceptible. Does that make sense?
Katie Hafner: It is smart. It, I imply, it makes me take into consideration the BRCA gene.
Elah Feder: Mm-hmm. Precisely.
Katie Hafner: So that you may be born with this mutation that places you at excessive danger of getting breast most cancers, however you would possibly nonetheless not get it, but it surely nonetheless looks like a good suggestion to search out out for those who’re in danger in an effort to take some precautions and plan forward.
Elah Feder: Proper. Though with lung most cancers, genetic screening is difficult. Like I discussed, heredity isn’t the driving issue normally for this type of most cancers. Um, however say- say you do discover you have got a heritable mutation that places you in danger. You are restricted in what you are able to do. It isn’t like BRCA the place you would possibly contemplate a double mastectomy. You are- you are gonna maintain your lungs. You would take further care to keep away from environmental exposures—one thing we actually ought to all do. You would possibly even get common low-dose CT scans—that’s truly one thing that’s advisable for individuals who have smoked after a sure age to detect any lung most cancers early, however these include dangers too: you’re getting somewhat little bit of radiation every time. I’m not saying it is not value it, it may be in case you are very excessive danger, but it surely’s a consideration. Anyway, that is for individuals who should not have lung most cancers already, however are involved a few genetic predisposition. For somebody who does have lung most cancers, yeah, you in all probability wish to know what is going on on in your tumor genetically.
Katie Hafner: So what about Susan’s case? Did she discover a genetic trigger for her lung most cancers that could possibly be actually helpful for her household to know?
Elah Feder: No. Um, Susan didn’t truly take a look at optimistic for any hereditary mutation linked to most cancers, however there are nonetheless genes that won’t have been recognized. Even earlier than her analysis, she and her husband have been donating cash for most cancers analysis via their basis. After her analysis, they ramped this up. Donating to analysis about immunotherapies, early detection. However, additionally funding a brand new challenge at her sister’s Firm 23andMe. It is referred to as the Lung Most cancers Genetic Research. So, they’re making an attempt to construct an enormous database of genetic info from individuals with lung most cancers.
One of many challenge’s objectives is to search out heritable genetic danger elements, however they clarify it is truly larger than that. They wish to know the way heritable mutations, tumor mutations, and life-style all work together in order that they could determine, for instance, why one one who smokes develops most cancers, however one other would not. It may also assist them to develop new therapies. So-
Katie Hafner: I simply wanna interject with one thing that strikes me simply as we’re having this dialog, which is that, um, people who find themselves listening to this in all probability know that 23andMe had plenty of issues, ended up submitting for chapter safety and Anne resigned earlier this 12 months. Um, I am positive that it has been very difficult for Anne, but it surely feels like she is in her absolute best, um, Wojcicki family-like means: making lemonade out of lemons on this regard. That is my preliminary response to every thing you are saying.
Elah Feder: Yeah. And as , 23andMe—whereas it filed for chapter—it lives on and created a nonprofit referred to as the TTAM Analysis Institute. It purchased 23andMe in July this 12 months. And so, 23andMe continues to be going and so is that this challenge. Up to now about 1200 sufferers have signed up and the aim is to achieve 10,000.
Anne Wojcicki: If you concentrate on anyone medical middle, if it is UCSF or at Stanford or Harvard, getting a thousand sufferers coming in is- is so much. And so, that is form of the great thing about with the ability to go and discover individuals across the whole nation, is to have the ability to pull all that knowledge collectively after which make that accessible to the analysis group.
Elah Feder: 23andMe’s Lung Most cancers Genetics Research was formally introduced in July final 12 months. Susan Wojcicki died just a few weeks in a while August ninth, 2024. She was 56.
Katie Hafner: So, Susan by no means did get a solution. She by no means came upon why she had lung most cancers.
Elah Feder: No, she didn’t. And we’re nonetheless making an attempt to grasp so much about lung most cancers on the whole. This is Anne.
Anne Wojcicki: There’s nonetheless similar to so much you do not know. Understanding environmental science I believe is admittedly necessary. We dwell in a really difficult world with plenty of, , there’s fires and there is air pollution and there is what you eat and we simply do not know. You do not know what the influence of all of that’s, and so, you’ll be able to’t- I imply you’ll be able to’t dwell your life making an attempt to measure every thing and fear about every thing. Like in some methods you need to come to phrases with that, you could’t- you’ll be able to’t fear about it on a regular basis.
Elah Feder: It is a massive a part of life. It is understanding that a lot of it’s past our management, and we regularly do not even get solutions. We do not discover out why dangerous issues occur to us. On the similar time, with regards to lung most cancers, there’s extra that we are able to do. This is Janet.
Janet Wojcicki: I imply, if there are modifiable danger elements that we are able to determine—I imply the important thing phrase being modifiable, proper? Then, ideally we may act on them.
Elah Feder: We will combat air air pollution, we are able to cease youngsters from getting their fingers on cigarettes. We will search for extra heritable danger elements and make investments extra money in remedies. As for Susan Wojcicki, regardless of all of her sources and all of her drive, in the end she could not cease the most cancers in her personal physique, however she left her mark in enterprise in most cancers analysis. She left an even bigger mark than most of us ever will, however her sisters and her buddy, Joanna- the factor that they actually keep in mind is how she by no means let any of that success go to her head.
Anne Wojcicki: It did not matter if we have been like some fancy occasion or if Oprah needed to speak to her. She was form of the identical. She was all the time very unaffected. And, it was, like, actually enjoyable going to the Oscars together with her as a result of she’d be like, “ah, I am simply gonna purchase this costume on clearance at Macy’s, and like nobody cares what I put on.” And that was form of the factor that was enjoyable. She’d be like, “it might simply be enjoyable with you and like solely going in order that we are able to hang around.”
Anne Wojcicki I all the time trip in my flats and my skirts. You are going to- are gonna YouTube? I’m truly actually curious. Are you gonna meet YouTube- are you gonna meet Mr. Beast?
Elah Feder: This episode of Misplaced Girls of Science was produced by me, Elah Feder, and hosted by our co-executive producer Katie Hafner.
Our senior managing producer is Deborah Unger. We had fact-checking assist from Danya AbdelHameid. Lily Whear made the episode artwork. Thanks as all the time. To our co-executive producer, Amy Scharf, Eowyn Burtner, our program supervisor, and Jeff DelViscio at our publishing companion, Scientific American. This episode was made with funding from the Anne Wojcicki Basis.
Yow will discover a transcript and a hyperlink to the Lung Most cancers Genetics Research at www.lostwomenofscience.org.
Host
Katie Hafner
Host and Senior Producer
Elah Feder
Visitors
Anne Wojcicki
Anne is Susan Wojcicki’s youngest sister and the co-founder of 23andMe.
Janet Wojcicki
Janet is the center Wojcicki sister. She’s a professor of pediatrics and epidemiology on the College of California, San Francisco (UCSF).
Joanna Strober
Joanna is the co-founder of Midi Well being and a long-time buddy of Susan Wojcicki.
Additional Studying
“From Susan” — Susan Wojcicki’s closing put up, written just a few weeks earlier than she died and revealed on YouTube’s weblog on Nov. 25, 2024.
Tips on how to Increase Profitable Folks. Esther Wojcicki, Houghton Mifflin Harcourt, 2019
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