I’m Terrified of Cancer. So I Called My Childhood Friend Kenan Onel, Cancer Geneticist.

0:00 The friend he hasn't seen since sixth grade 5:16 Angelina Jolie, BRCA, and the 20% nobody tells women about 18:23 What a cancer cell actually is - and why tumors evolve 26:31 How cancer actually kills you, and what a seizure is 32:14 The last cigarette: why he can't take the test every week 46:27 The best medicine in the world, and who can't get to it 1:03:23 Telling a family there's nothing left Noam hadn't seen Kenan Onel since high school in Ardsley, where Onel graduated first in the class and Noam, by his own account, drifted somewhere well below. Fifty years later Onel runs genetics and genomics at Roswell Park - the only comprehensive cancer center in all of western New York - and Noam has one thing he wants to ask him about. He's afraid of cancer. His grandfather died of it. His father died of it. He's taken the Grail blood test, it came back clean, and he wants to know why he can't just take it every week. What follows is part reunion and part interrogation. Onel explains what a cancer cell actually is, why tumors evolve like finches in the Galapagos, and what is physically happening to someone during a seizure. He explains how cancer kills - the mechanism, organ by organ. And he tells Noam that the test he's counting on just failed its biggest trial in the UK, which sets off the real argument of the hour: whether a guideline written for a population means anything at all to the one person sitting in the chair. Then, near the end, Noam asks how you tell a family there's nothing left to offer. The answer is the best thing in the episode. Also: the 20% of women who are high-risk and have never been told, the doctor who warned Noam that Pellegrino was bad for his son's bones, a scan booked by 4pm the next afternoon, and one entire podcast without mentioning Israel. Dr. Kenan Onel is Chief of the Division of Genetics and Genomics and Director of the Center for Precision Oncology and Cancer Prevention at Roswell Park Comprehensive Cancer Center. Live from the Table is the official podcast of the world-famous Comedy Cellar.