Cancer, Clock changes, Life on Jupiter?

Introduction

0:00This BBC podcast is supported by ads outside the UK.

0:05Catch the NBA playoffs on Sling TV, the most flexible live TV streaming service, putting consumers in control to watch games their way with flexible subscriptions. Want to catch one game or a full series on ESPN? Grab a one, three or seven day pass. If you want to catch as many games as possible, get a monthly subscription with our ABC, NBC and ESPN combo package. Either way, Sling lets you watch the playoffs your way with no long-term contracts. Learn more at sling.com.

0:37This year, experience the NHL playoffs your way. Want to watch a single? Do or die game seven, a full week of heavy hitting back and forth series. Then check out Sling's one, three and seven day passes. Watch the chase for the cup on ESPN and TNT, starting as low as $4.99. No long-term contracts are overpaying. Just live hockey at home or when you want it. Sling lets you do that. Visit sling.com to learn more.

Prostate Cancer

1:05Hello, welcome to this week's 5 Live Science. I'm Chris Smith from The Naked Scientist. Coming up, Sir Chris Hoy goes public with his terminal prostate cancer diagnosis. The World Health Organisation has declared Egypt malaria-free. It's also time to change the clocks. But what impact does it have on our perception of time? And a bit later on...

1:36Success would be incontrovertible proof from Panymede or Europa, or perhaps both, that we really do have these oceans below the surface. As the Europa Clipper mission begins its six-year slog to study one of Jupiter's icy moons, we ask, will it find the conditions that are right for life? The Naked Scientist on 5 Live. First this week, Sir Chris Hoy, the six-time Olympic cycling champion, has said he's been blown away

2:06by the number of men seeking cancer advice since he revealed his terminal cancer diagnosis. Sir Chris, who's 48, has said that a primary cancer in his prostate has also spread to his bones, and he has between two and four years to live.

Prostate Cancer Management

2:22To find out more about prostate cancer, I went to meet Vincent Yianna-Pragassam, who is Professor of Urology at the University of Cambridge and a consultant at Adambrookes Hospital. It is extremely common as we get older. And prostate cancer is really a disease of the ageing male. The incidence and the chance of finding it is much higher the older men get. But there are no symptoms with prostate cancer, unless it's extremely advanced or has spread. And urinary symptoms in particular are really not a sign of prostate cancer at all. So when people complain of getting up in the night

2:55to go for a wee, for example, this is not a sign of prostate cancer. It's a sign of something happening in the prostate, but not cancer per se. Absolutely correct. So the prostate enlarges with age and there's other mechanisms which actually change as we get older that does cause those symptoms. But it is not prostate cancer, unless it's extremely advanced, which is a fairly rare presentation, particularly for urinary symptoms. In fact, many studies have shown there's an inverse or opposite correlation between having urinary symptoms and the chance of finding prostate cancer.

3:26But of course, because men go to GPs because of the urinary symptoms, they may be found to have prostate cancer by chance. So that association has stuck in the mind of the general public and, in fact, many doctors. Given what you've just said about age being the biggest risk factor, Chris Hoy is therefore presumably very unusual to be just in his late 40s and having this. You're right. The chance of finding prostate cancer in a man under 50 is about one in 500. The chance of having such a lethal or aggressive cancer,

3:58as has been reported in the media, is much, much less than that. In fact, if you look at the national statistics in the UK, actually prostate cancer only contributes about 3.8% of all male deaths, and that is across the ages of 30 to over 90. In men in Chris Hoy's age group, you're talking about less than 0.01%. And even in men in their 80s, it's about 4.5%. So overall, prostate cancer actually is not a major cause

4:29of male deaths in the UK or worldwide. But of course, it's very common. And the complexity of prostate cancer is how to manage it so you don't over-treat things, but equally find those aggressive cancers early enough to be able to actually do something so that it doesn't cause death. Well, let's look at the first of those things first,

Malaria in Egypt

4:48which is how we manage the disease. Say someone like Chris Hoy presents with prostate cancer. How is that controlled or managed or investigated? Prostate cancer is complex because it can have a very indolent path, as I mentioned, or an aggressive path. And actually, most prostate cancers will never go on to cause death or mortality in a man. So a lot depends on getting that characterization of disease first, and also for the doctor or the nurse seeing this patient to actually understand what are the many factors

5:20that have to be considered before you decide on treatment or, in fact, keep an eye on things, which is actually becoming one of the most common ways of managing prostate cancer. Now, in the case of Chris Hoy, that's a very different spectrum. As I understand it, he's been diagnosed with cancer that's already spread. And as I've mentioned, that's extremely rare. In fact, I don't think I've ever seen anyone of that age present with metastatic or cancer that's spread. Now, once that happens, it is incurable. But these days, there are many, many lines of treatment

5:52and things which can help to prolong life. But like I said, again, it's important that we don't over-emphasize that lethal side because it is a vanishingly small part of diagnosis in a young man. And what sorts of treatment options are there? Diverse. And they range from surveillance or monitoring, which is where you keep an eye on things because you know the risk from that cancer is low and a man is more than likely going to die of something else. And again, it depends on presentation because right at the other end of the scale, if you have someone who's got cancer that's spread,

6:22then you're talking about different lines of drug therapy, particularly blocking the male hormone, perhaps some radiotherapy as well. And then further down the line, perhaps chemotherapy and then more experimental things, such as a new wave of agents which are targeting mechanisms in the DNA which have changed, which are found in a proportion of these men. In terms of picking it up, because that was the other point you highlighted, what options are available to us there? If you're looking or trying to detect prostate cancer early, the primary way to do that

6:53is by the serum PSA or the blood test, the PSA test. And there are many efforts trying to do that, including looking at genetic risk scores or other markers. But all of these things, including PSA, have a big problem in that they don't pick up the lethal cancers preferentially, they do, but they will pick up lots of cancers. And a lot of those cancers will not cause problems. So the problem in prostate cancer is not so much that we haven't got tests that will pick things up. But the problem is, when we do, what do we do about it?

7:24If we accept it, that a raised PSA test, for example, could lead to a diagnosis, but that diagnosis doesn't necessarily mean you need to be treated, then actually that's a very practical and pragmatic way to manage prostate cancer. And that's what we do currently in the UK, which I think personally has the best rationale for how to manage prostate cancer. But it doesn't remove away from the fact that there are specific high-risk groups where finding things earlier may be better. And that's really the most novel,

7:55modern concept, is how to identify those higher-risk groups. And who are those people? Who's in the high-risk category? So specifically, I would say men with a strong family history. And the key word is strong family history. So just because you've had a father who's had prostate cancer in his 70s or 80s, that doesn't make it a strong family history. We are really talking about men who in the male lineage in particular have got fathers, brothers in particular, diagnosed at a young age with aggressive disease.

8:26In some families where you have what's known as the BRCA mutation, which also can lead to breast cancer, finding that in familiar lines will put you at higher risk of developing cancer. But the complexity here is it doesn't always mean it's going to be aggressive cancer, but you should start to look earlier.

8:43Black men have a higher risk of also finding cancer. And so those are a higher risk group as well. And there are some other smaller groups which are family members who actually carry mutations which would be considered higher risk. Vincent Yannapagasim from the University of Cambridge and Addenbrookes Hospital.

Malaria Eradication

9:02The World Health Organization has certified Egypt as malaria-free. I've been speaking about the implications with Jane Carlton, who's the director of the Malaria Research Institute at the Johns Hopkins Bloomberg School of Public Health. It's actually one of the big three infectious diseases, which includes HIV, AIDS and TB. And malaria itself is really a tropical disease. So it's found in parts of South America, Southeast Asia, but in particular

9:32in countries in sub-Saharan Africa. And there it causes about 600,000 deaths each year and about 250 million cases each year. So it's really a significant global public health burden. And how long has Egypt been struggling with it? Actually, for hundreds and hundreds of years, it's been known that Egypt has struggled with malaria because there have been studies looking and identifying the malaria parasite DNA

10:04in mummies from ancient Egyptian times. And so we know that, for example, some of the famous pharaohs died of malaria. And in fact, in the 1940s, malaria cases in Egypt really surged to over 3 million per year. And this was mainly due to population displacement during World War II and also due to the construction of the Aswan Dam, which was in the 1960s. So it's been a significant burden in that country for many,

10:34many years. And what manoeuvres or measures have Egypt gone through in order to try to bear down on it? And why has this now finally succeeded? The sorts of measures that countries use to try and decrease the malaria burden are pretty common from country to country. It will include trying to drain some of the swampy areas of the country. And those are the prime mosquito breeding grounds. So mosquitoes transmit the malaria parasite. It's actually the malaria parasite

11:05that gives you malaria, not mosquitoes. But in order to stop what they call transmission chain, what you want to do is to try and decrease the number of mosquitoes or stop mosquitoes from biting people. So if you can stop them from breeding through getting rid of many bodies of standing water, which is where they like to breed, that's one step in the right direction. And the box that's been ticked here is that they have eliminated malaria transmission in Egypt.

11:36This is a temporary thing though, presumably. It could come back if any of those pressures or any of those measures are allowed to lapse and the mosquitoes regain a toehold, the disease gets back into the population. Presumably we're back to square one. It is a bit like that, unfortunately. In order to be certified malaria-free by the World Health Organization, which is a United Nations institution, a country has to be malaria-free for three consecutive years. And that basically means that there

12:07can't have been any malaria cases that were transmitted through mosquito-borne bites in that country. So Egypt has already been under scrutiny to make sure it can maintain this for the past three years. And going forward, as actually has been mentioned by the World Health Organization, they will continue to need to be vigilant and on the lookout for any increases. And that's because mosquitoes don't know borders. Mosquitoes can fly

12:37from one country to the next. And so if the surrounding countries roundabout Egypt have malaria too, then of course that can be brought in to Egypt. So there will continue to be what we call surveillance measures, both for the mosquitoes and also for infected people in Egypt to really try and keep the lid on the disease resurging.

Clock Change Impact

13:00Are we at

Clock Change Impact

13:00risk of, or is Egypt at risk of jumping out of the frying pan and into the fire? Having got rid of malaria, could there not be other diseases hot on its heels that do quite like the urban environment, the high population density that countries like Egypt, as Africa's third most populous nation, and also Cairo, very heavily densely populated, could they end up with other diseases? I'm thinking things like dengue, spread by a different kind of mosquito that really flourishes in urban settings. That's very true, but it's not that

13:32if you get rid of malaria, something else will pop up in its stead. Dengue, a different species of mosquito, not the same one that transmits malaria parasites, it's not going to sort of jump into the niche, as we call it, of malaria. The good news is that the methods that we try and use to decrease the mosquito population, and some of those can be quite sophisticated, actually, from things like stopping the mosquitoes from breeding, through inserting a gene into its genome,

14:02through other basic types of methods, such as spraying areas with insecticide. Those sorts of measures won't only decrease the mosquito population that transmits the malaria parasite, but also those mosquitoes that transmit dengue, too. So, in fact, it's good news, all round, I think, for other diseases which are transmitted by so-called vector-borne diseases. And is it good news for other African countries that haven't yet achieved what Egypt has, but

14:32can they take their lead from what they're doing and try to emulate it? Yes, it is, of course, very good news. I should say, though, that, you know, these methods are used by many countries. Sometimes it's just a numbers game and a time game as well, and then how many resources are available. in order to be able to roll out these methods of control, as we call them. But certainly, yes, I think every time a country is certified as malaria-free, there's a sort of sigh of relief among all

15:03of the other malaria countries because we're really starting to make an impact into the burden. And so a total of, I think, 44 countries have now been granted malaria-free status. But in fact, that leaves another 85 or so countries that still have a big malaria problem. So it's those countries that we'll really be focusing on in the next few decades. And let's hope they're successful too. Thanks very much to Jane Carlton, who's director of

15:33the Malaria Research Institute at the Johns Hopkins Bloomberg School of Public Health. This is 5 Live Science with me, Chris Smith. Still to come, the impact of clock changes on our brains and the hunt for alien life on one of Jupiter's icy moons. But first, a new study has found that an artificial intelligence tool can help people with different views find common ground. It works by more effectively summarising the collective opinion of the group than a human can. The work was carried out by

16:04Google DeepMind and the findings have just been published in the journal Science. Christopher Summerfield at the University of Oxford was involved in the research and he's been telling me all about it. The idea behind the project came from a concept which is well known in political science that our democratic processes can be facilitated if you sample representative groups of people from across the country and get them together and get them to thrash out their point of view on a political issue.

16:35We wondered whether artificial intelligence could be used to make that process simpler. If you have a group of people who want to decide something and you get them around the table, the first limitation is that a table is only so big and so you can only fit so many people around the table. And the second limitation is that when you're having a discussion face to face, only one person can talk at a time. And we wondered whether you could overcome those limitations by getting an AI to

17:06listen to all the different viewpoints and to generate an output which summarised their collective opinion. How do you actually train it to do that in the first place, Chris? Because for instance, if I wanted to do the equivalent thing medically, I wanted to ask an AI engine, has this person got cancer by looking at a brain scan or something, I'd have to have trained it on what a normal brain looks like so it can spot an abnormal one. So how can you ask it to synthesise a collective opinion when all it's

17:37got is a snapshot of a few people's perspectives at that meeting? Great question. So we did in fact train it. We got together small groups of people and we got them to write their private opinions about issues that related to UK public policy. So things like should we lower the voting age to 16? And we got the machine to generate an opinion which you can do because language models you can ask them things and they will respond. And we then got people to rate whether

18:08they agreed or disagreed with the thing that the language model said. By doing that over and over again with lots and lots of participants we were able to train the model to make a really good guess about whether people would be willing to endorse a statement which was generated by the model. If you've got a model which is trying to take everybody's viewpoints into account don't you just end up with it smearing into the middle and everyone's kind of vaguely happy but no one's unhappy but no one's delighted either.

18:38I think that's a super question and there's nothing in the model which will give more weight to one of the participants in the discussion than any other. It's very explicitly trained to give equal weight to everyone who participates. The selection is really beyond the control of the machine itself. But once you have a group which is composed of a bunch of people with different views what the model more or less not quite guarantees but what we trained

19:09it to try and do is to produce the opinion which is going to kind of form the best representation of the distribution of views that you get in that group. And so what that means is rather than just for example finding compromise is it seems to learn to write a statement which reflects obviously the majority view because in a democratic process the majority should be a guide for what the solution is but it also really strongly represents the minority view

19:40so it gives the people reading the statements we think the sense that even if their view was in the minority that they're kind of their voices feel heard. Did you try it poisoning the well as it were just to see what would happen if you injected some really extreme viewpoints in there and see if they were captured nevertheless so for instance people who or synthesize some responses that were so way off the normal distribution

20:11of normality did it end up chucking those in and did you get any bizarre hallucinations out of this because that's been the other thing that people have worried about with AI given systems and it just sort of confabulates things and we end up with things appearing that we don't really think are grounded. So we did do those kinds of tests although we didn't do them with sort of politically toxic inputs rather we made sort of silly messages which had nothing to do with the question at hand and what we found was that to a

20:41great extent the model was prone to ignore contributions to the debate which were completely irrelevant to the argument because it's been trained to be clear and concise it knows to basically ignore that information. As for factuality we didn't control the factuality of the responses and that would be a very interesting innovation because when citizens' juries happen one thing that

21:11the mediators do is they sort of fact check rather like the moderator did in the recent debate between Trump and Harris. And that was Christopher Summerfield from the

Time Perception

21:22University of Oxford. Now it's that time of year again when the clocks go back. The plan is that with the arrival of winter in the Northern Hemisphere we unnaturally shift time to allow us to have more sunlight in the morning. But it can also play havoc with the way we function and it can even distort our perception of time at least for a while. This is what Ruth Ogden, a professor of the psychology of time at Liverpool John Moores University is studying. We did some research during the pandemic which showed that people en masse

21:53experienced time differently particularly during lockdowns. So the research we did in the UK showed that about 80% of people experienced time differently during the pandemic in comparison with before the pandemic. And of that 80% about half felt like time was going more quickly and half felt like time was going more slowly. Basically people who were coping well felt like time was passing quickly so they had a short fast pandemic. pandemic but people who were struggling felt like they had a long slow pandemic. So what we're trying to understand is how do these changes

22:24in time affect our ability to cope and our ability to recover from trauma both during critical life events but also afterwards. So do you feel like your life gets back to normal? Do you feel like your time gets back to normal? Or do you constantly feel slightly discombobulated like you're not quite in sync with everyone else? And if you're not quite in sync what does this do to your sense of well-being? What do we understand though about how our brain registers the passage of

22:55time? Because I can remember, distinctly remember when I was a little kid and my parents used to take me to see my grandparents. They lived a reasonable distance away so it was quite a long car journey for a three or four year old. The journey there seemed to take forever but coming home went more quickly and I noticed that even from a young age. So why would I have had that experience? One of the ways in which we keep track of time is by paying attention to it. If you pay too much attention to time, time drags. If you pay too little attention to time, time

23:26flies. So in the example of a car journey, you're thinking about when you're going to be there. There's a high degree of uncertainty about when you're going to arrive. So you pay lots and lots of attention to time. Are we nearly there yet? And that makes that time drag by. But the other thing that makes time drag by is when we're experiencing lots and lots of new things, we're forming lots and lots of newer memories. And when we make lots of new memories, when we look back on that period, we assume that it was a long period of time. So you're going on a car journey, you don't know where you're

23:57going, you're seeing lots of new things, that helps to make that journey feel really long. When you're on your journey coming home, it's familiar, you know where you're going, there's much less uncertainty. Something that's going to happen this weekend is we are going to change our clocks. And you've written a piece this week where you're quite interested in how that affects people's perception of time. Why are you interested in that specifically? Every year, twice a year, people in the UK experience an imposition of time. So we switch the clocks

24:27forward and we switch the clocks back. And this changes our rhythm. We're incredibly rhythmic preachers. We like to do things at roughly the same time, on roughly the same days. And this helps to keep us in order within our lives. It helps us to feel like we're in the right place at the right time. When we change the clocks, all our normal temporal cues, they all go. They suddenly become out of sync. And we know that this change of the clocks has a really significant impact on health.