Watch the full episode and view show notes here: https://bit.ly/3nMlzW6 Become a member to receive exclusive content: https://bit.ly/3IsZmpM Sign up to receive Peter's email newsletter: https://bit.ly/4c602k2 Max Diehn is a Professor of Radiation Oncology at Stanford and a clinical radiation oncologist specializing in lung cancer. Max’s research focuses on developing novel methods for detecting circulating tumor DNA in the blood of cancer patients and on elucidating the molecular pathways and genes associated with cancer. His interests also include uncovering biomarkers that can predict patient survival, responses to therapy, and disease recurrence. In this packed episode, Max discusses the history of blood-based cancer screening and the importance of understanding the predictive value of tests—sensitivity, specificity, negative predictive value, positive predictive value – and how these metrics play into cancer screening. Max then goes in depth on the topic of liquid biopsies, including the history, current landscape, and possible future of liquid biopsies as a cancer detection tool. He discusses how these non-invasive blood tests can detect DNA/RNA from tumor cells released into the blood as well as the different methods one can use to predict if a cancer is present. He gets granular on the topic of cell-free DNA/RNA signature, methylation patterns, and the importance of knowing mutation information, and he ends with a discussion on the exciting future of liquid biopsies and how we can possibly get to the panacea of cancer screening. We discuss: 0:00:00 - Intro 0:00:08 - Max’s training that planted the seeds for development of liquid biopsies 0:08:45 - Max’s decision to specialize in radiation oncology 0:16:00 - A culture at Stanford that values research and physician scientists 0:18:50 - The motivation to develop liquid biopsies 0:26:47 - History of blood-based cancer screening and understanding the predictive value of tests 0:34:49 - Current state of lung cancer and the need for better screening 0:46:46 - Low-dose CT scans: an important tool for managing lung cancer but with limitations 0:53:21 - Using liquid biopsies to identify circulating tumor cells 1:12:25 - Liquid biopsy research moves from circulating tumor cells to cell-free DNA 1:21:41 - Zeroing-in on circulating tumor DNA in cell-free DNA 1:34:59 - Cell-free RNA and Max’s vision for cancer detection from a blood sample 1:37:41 - Methylation patterns and other informative signatures found in DNA 1:40:15 - Mutation-based methods of liquid biopsies 1:45:27 - Understanding the sensitivity and specificity of a diagnostic test 1:53:57 - Existing clinical liquid biopsy tests and their limitations 2:01:22 - The future of liquid biopsies 2:10:48 - How we get to the panacea of cancer screening -------- About: The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 45 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more. Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life). Learn more: https://peterattiamd.com Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Google Podcasts: http://bit.ly/TheDriveGoogle Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies.