Vom Cambridge-Krebsforscher zum Gründer: Warum er den Sprung wagt

Perhaps you could give us some insights into how exciting it is to work in science, especially from a monetary perspective. Not at all from a monetary point of view. May I ask what you earn? I receive [amount] per year, for my PhD, which probably cost between 1.5 and 2 million experiments. The costs they incurred for me personally were 100k, but yes, that's how it is. Unfortunately, it's a fact that one in two people in our generation now receives a cancer diagnosis, for example, if smokers get lung cancer. I believe that despite this diagnosis, 75% of people start smoking again. Smoking is the number one preventable factor for cancer. At stage 4, survival, meaning survival across almost all types of cancer, is less than 10%. What about sugar substitutes and Coke Zero and things like that? There are some exciting rumors about that, too. Some might crucify me for that ( in quotation marks), but that 's the evidence-based situation. Moritz, if you were to receive a cancer diagnosis tomorrow, what would be the first step you would take? Wow, let's take a deep breath . Um, I think I'm a very rational person who, if I were to get them, would immediately— I mean, I've seen enough findings in my life. Not because I 'm a doctor, but simply because I've dealt with it. Um, and I know exactly what can positively influence the chances of survival , and what can negatively influence them. And I think I would also try to address these points directly and understand, okay, what are we talking about here? Is this an early stage? Is this a late stage? Um, I personally am looking into the changes in DNA that are important for personalized therapy. That means I would focus on whether there are any changes in my cancer that could be exactly that, um, or that could be positively potentially beneficial. um, I would focus on that, um, and of course then understand, okay, uh, what I can learn independently of um, the one doctor I might go to, about another doctor who recommends it, or about clinical studies and so on and so forth, and I would probably deal with that very intensively. Regardless of medical treatment, chemotherapy, etc., could you actually take measures after a diagnosis that positively influence the healing process through diet, exercise, sleep, or other things, or is it almost too late from the time of diagnosis, and does true cancer healing begin with prevention? So, I would definitely say that this is the true cure for cancer, if such a thing even exists. Healing is always a difficult word for me, as it begins before the diagnosis. Um, regardless of that, you can of course do things that have positive effects in addition to your diagnosis and treatment. So, of course, it's always a question of what perspective you're coming from, or from what status, etc. Have you eaten poorly your whole life? If you've never driven, etc., then if that was essentially the baseline, then that's also a point of attack that you should definitely implement. So, uh, a healthy, protein-rich, fiber-rich diet, balanced, no calorie surplus, uh, exercise during chemotherapy. There is actually evidence for all of this. These are light lines that clearly state that you can do this in addition to most types of cancer, and that it will support the effectiveness of the treatment. Accordingly, these are definitely things you should do if you receive a diagnosis . Um, and regardless of that, yes, because the second part of the question was about whether you should actually start preventative measures in your life before you get a diagnosis. And unfortunately, it's true that one in two people in our generation now gets a cancer diagnosis. Um, should you really say that every second person, yes, well, that's what you mean by "in our generation," meaning that of the people currently living in our population, one can assume that every second person will receive a cancer diagnosis in their lifetime . Yes . Yes, exactly. And how many of those diagnoses are likely to be fatal? Well , I ca n't really say that as a percentage. I believe that currently, worldwide, we're at about the number 2 cause of death: cancer. Worldwide, just for cardiovascular diseases, and I believe there are around 18 million cases per year. This will happen in the next few years, with cancer, uh, cancer deaths, deaths. OK. Um, and that's supposed to increase to around 27 million by 2050, I think. Um, that's crazy. One would actually think that we would have more awareness , that research would progress, that we would have a better health system, and that we could shift more and more awareness towards it. When I look back a little to the generation of our grandparents and imagine that people smoked on flights or in all restaurants, such banal things, where you think, okay, we must have developed as a collective and evolved. Of course, it's a global average, and Germany is now perhaps 1% of this entire, um, almost epidemic of illness, if you look at it that way. But why is it that cancer cases are expected to almost double again in the coming years ? Um, and that it doesn't go back any further . We are getting older. We're simply significantly older. Our life expectancy continues. Our life expectancy is significantly higher. Um, we are, I think on average, living about 10 years longer than people did 30, 40, 50 years ago. Maybe 10 years, let's say 50 years. has been . Um, and cancer is primarily a risk factor due to aging, and aging can't be prevented, so the older you get, the more likely you are to get cancer. Of course, in our psychological understanding or our understanding of cancer, for example, young cases weigh much, much more heavily. So everyone probably knows someone who had leukemia at a young age or bowel cancer before the age of 40 or something like that. These are, um, tragic cases where people are, of course, taken from their lives far too soon . On the other hand, these are still the few cases, and the high incidence of cancer only occurs after 50 or 60 in older age. We're all getting older, and that's part of it . Nevertheless, there are other factors involved, of course, 100%. That's what we want to talk about today. You are a cancer researcher yourself. I'd like to go inside with you today. What are the causes of cancer? How can one treat this preventively, in a certain way? Um, what are the current statistics and influencing factors? What do you do ? Um, before we go into that, I'd like to know why you can talk about this topic and the basics, because I have to say, for my part, I've fortunately (knock on wood) not had any cancer in my family so far. Unfortunately, we've had other deaths and other illnesses, but at least we in our extended family have been spared from cancer . And I also spoke with an entrepreneur this week. His girlfriend is 29 years old and she has cancer, and for two years he has been supporting her, driving her to chemotherapy, picking her up, and you suddenly realize how drastic such a cancer diagnosis is for the person in their environment , how brutal it is and what it does to people. Um, today we want to take a look at science and maybe, with this podcast, also ensure that people like me, who fortunately haven't had much exposure to it, continue to have as little exposure as possible, because we can share some knowledge with our families, for myself, for our friends and family, and say something like: "Hey, the sun is dangerous, but watch out for the keto diet and all those other things, some myths that my grandma always told me, that we can debunk today ." Exactly. Before we get into that, explain the basics to us. I'm 10 years old, and you briefly explain to me what cancer actually is and how it develops. Yes. Um, so very broadly speaking, cancer is a large umbrella category of diseases that affect your body , affect the cells in your body . And these cells are nothing more than degenerated cells. They 've found a way to essentially bypass all the body's safety mechanisms. So, they can do that. The immune system can't control them. Um, they control their environment, their microenvironment, by influencing various factors, but they are cells that are ultimately lawless in the body, and they develop over years and decades. Most of the time, or at least we know that a tumor, a cancer, originates from a single cell. So, it was a cell that made a mistake at some point, and then another mistake, and over time accumulated more and more errors, which then led to cell division, cell renewal, how often such a process happens, and how susceptible is the body to such errors? Well, you have— and this is ultimately the research I'm most involved in—it's in healthy people. I started with this, and this is why I'm talking about it, I started to study the evolution of cancer, its development. [snort] Um, and I did that by first looking at cancer itself. So, what do cancer cells look like? What happens when they're actually inside the body? What properties do they have? What changes do they have at the level of DNA, our biological genetic material, that make them different from normal cells? Hmm. Then at some point I realized, hey, tumor cells are very, very similar to normal cells. They actually look almost identical, except for a few thousand places in the DNA. And DNA is 3 billion base pairs long. Okay, that's 3 billion places that can potentially be changed, but only a few thousand are actually relevant for cancer. Okay, so a minimal change of 0.x%, actually, right, but these changes ultimately give tumors an advantage, or they cause them to develop in that direction. And then, of course, there are other changes at a higher level, but that's too much to go into right now. Hmm. Um , what you can say is that if you have a tumor, you can treat it. You can use chemotherapy, targeted therapies, and immunotherapies these days. Many different mechanical methods can be used to try to treat these cancer cells, and there are thousands of cells in one area. These are treated, and in most cases, this leads to a reduction in the size of part of the tumor. They might even disappear completely if you're not particularly lucky. But what exactly happens during chemotherapy? Chemotherapy is, in essence, an umbrella term for all therapies. What most people commonly talk about are cytostatics. These are chemicals that essentially insert themselves into the DNA. The principle is that they insert themselves into the DNA, and during each cell division, the DNA is duplicated because you have a cell that divides into two, and then you need twice the amount of DNA that was there before, and this has to be distributed to the two daughter cells. During this process, the DNA is replicated, and cytostatics essentially insert themselves into the DNA. This can only happen with errors. They are multiplied, and these errors are so frequent and, as you would say in English, so detrimental that the cell ultimately dies. Okay? And that means the tumor can't spread any further. Exactly. The cells essentially die. They become apoplexy, meaning programmed cell death. And because of this, it ultimately correlates with the tumor's property of being able to grow faster than other cells. That's why you see the typical phenomenon during chemotherapy with cytostatics, for example, hair loss, anemia, and often problems with intestinal mucus. This is all due to the fact that these are rapidly dividing cells. Mhm. And a cytostatic drug doesn't distinguish between a tumor cell and a human cell; it's all essentially the same for the drug, which attacks cell division throughout the entire body. Exactly. And only the cells that grow faster are more likely to die. Mhm. The cells that They multiply slowly, they don't die so quickly. Does that mean that chemotherapy ca n't actually defeat the tumor, but only slow its spread ? Yes, it can, it depends on the characteristics of the tumor. You can't predict that with a camera. There are tumors that respond very, very well to chemotherapy, and which can even be described as a cure. But that's more due to the characteristics of the cells from which the tumor originated . In most cases, chemotherapy is n't the sole first-line treatment anymore; a distinction is made between first-line and second-line therapy. First-line therapies today are often immunotherapies, for example, or if there are specific targeted therapies that can be used, then that's investigated first. A biopsy is taken, and based on the molecular characteristics of the tumor, it's determined whether a targeted therapy can be used for a specific alteration within the tumor . So, that's... It's a highly precise procedure where, ultimately, you pinpoint exactly, okay, there's this change in a specific section, in a particular area. Um, and this change can be directly targeted with a specific inhibitor, a selective drug . And this change is only present in the tumor and not in all other cells. And that's why it works much, much more precisely than, for example, chemotherapy. Are there, um, are there cancer variants that are always curable and which are never curable, or does it always depend on the stage at which I detect it? Yes, well, off the top of my head, I think there are only four types of tumors where one can speak of a true cure. Mhm. Um, one of them is childhood leukemia. Um, with complex chemotherapy, you can do a great deal . So, you're practically cured. [gasps] Um, then, um, actually, um, testicular cancer, because the cells don't have DNA repair capabilities or are only poorly able to do so. are to repair errors. And because of this, um, it happens that when you use chemotherapy and add errors to these cells, I mean, they insert themselves into the DNA, and during cell division, they make extra errors. Um, then it happens that tumor cells in these specific cells respond better to it . Um, [clears throat] otherwise, I don't think I can remember the other two now, but there are very, very few. Otherwise, looking at it independently, it always depends on the stage. So , stage 1, cancer is definitely always more treatable than stage 4. Mm. Because stage 4, that's survival, meaning survival for five years, that 's usually a metric you look at. Yes, across almost all types of cancer, it's under 10%. But if you have stage 1, then it's almost always over 90%. Um, of course, there are variations for specific types of cancer. Yes. [snorts] Um, But from that perspective, that's why I eventually went in the direction of prevention and early detection, because based on these statistics, but also based on the molecular properties of tumors, I thought to myself, you can develop a fantastic drug, you can understand cancer extremely well , but in the end, it's so closely tied to the way the human body functions that the older you get, the more you'll always have this cancer factor in your body. What you can do, however, is try to detect it as early as possible, if the factor is considered a given, and at least try to push it forward to this stage , because if you always detect it at that stage, then the probability that you'll live with it, or be able to live with it, as a chronic illness is significantly higher, and it's no longer the death sentence that people usually associate with it. Let 's move on to prevention , perhaps to conclude the treatment topic. There are always... These rumors, let's say, will continue for another 5 or 10 years, and then, um, cancer won't be a problem anymore. Yes, then we'll have the opportunity to cure cancer universally, then it won't be an issue anymore . You just mentioned the predictions that it will more likely double in the next few years . Um, is that because, on average, we in developing countries don't have access to, um, the medication ? Or is it actually wishful thinking? Is the research not advanced enough? Will the research ever be advanced enough? Give us some insights into when we can get cancer under control. Well, I would also divide that into two things. "Under control" as a chronic illness. In my opinion, that's the most likely scenario, that you're making it a chronic illness, which, as I always like to compare it to, um, skin cancer. Normally, nobody thinks about it anymore. You go for a skin cancer screening, have it done every one or two years, depending on what resources you have. A tumor is discovered in a mother who has some sort of problem, it's removed, and then you forget about it. Mm. Basically, once it's removed, your... well, you could also call it cancer in different stages, or it was called cancer, and um, you don't think about it any further because the probability of anything coming after is relatively low; in the end, it's a chronic illness. Um, and in my opinion, it should be the same for all other types of cancer. Mhm. Regarding the... um... cure, of course, I know this myth, yes, the pharmaceutical industry, for example, is withholding a cure for cancer, or there are already some, or one will come out in the next five years . In my opinion, as harsh as it sounds, that will never be the case because you have to understand, as I just indicated, that cancer isn't a single disease. Mhm. Rather, um, it's a disease that affects all organs, an umbrella term for various organs that function in different ways and have various tasks in your body. Yes. And it would be presumptuous to say that you treat lung cancer the same way or that it has exactly the same characteristics as liver cancer, because the organs have completely different functions. The cells have different functions, they have different exposures, so the lungs are always connected to the outside world . Be it in the context of smoking, in the context of weapons, air pollution, and so on, etc., whereas the liver, of course, primarily deals with alcohol, toxins, or metabolism, and you can't treat that with a single approach. Unfortunately, it doesn't work. Um, and on top of that, every organ undergoes changes throughout life that aren't the same . So, ultimately, the diversity of cancers is so high that perhaps there are conceptual commonalities, like how immunotherapy can work for different types of cancer , but not for all. Um, so there will probably be different medications in the future that work in principle for some types of cancer, but not for all. And that's why there will never be a universal cure in this context. What are we talking about when we discuss these, I don't know, studies or rumors that cancer will soon be cured? Are there new medications that these rumors mention? What are they talking about? What's being discussed? Wow, what are they talking about? For example, there's an interesting rumor from Russia, where they say they have a cancer vaccine that can be used preventively. The rumor usually presents it as being able to get vaccinated against cancer and then not contract it. Okay. The truth, if you dig a little deeper, is that it's for colon cancer. Colon cancer. And probably only for a subcategory, but there isn't much information on that. So, it's essentially abstracted from a very specific case, which is what it actually represents. And that 's often... So. Well, the science and what's actually being developed often generates a use case—one has to say, due to a lack of knowledge—that is much, much larger and which will probably never materialize in practice. This naturally creates expectations that are significantly higher than what science, or frankly, the pharmaceutical industry, can deliver. It's not just expectations that arise, but also— I might even call them conspiracy theories—that the pharmaceutical industry is withholding a cancer cure because they would destroy their market share by billions. On the other hand, I always find the line of reasoning interesting: okay, what happens when you have a vaccine against cancer, and how expensive would it be? How much would it be worth to the individual? Potentially, everyone in the world could take this vaccine . Where, then? No, okay, let's say in 2050 there are perhaps 27 million people who die from cancer, or rather, 27 million cancer cases. These 27 million are your Potential market, but when it comes to cancer-preventive vaccines, we're not talking about 27 million, but potentially 7.5 billion people on this earth. Yes. Um, and they wouldn't just pay €1 for it , but significantly more than the € 20,000 you get for chemotherapy . What would you pay to get a shot and have the chance of never getting cancer in your life? Wow, [laughter] I honestly can't tell you. I don't know . I think it would be worth a lot. That would be incredibly valuable. On the other hand, just because you don't die from cancer doesn't mean you won't die eventually. No, it doesn't mean you 're immortal. You still have to look left and right on the road. And I mean, I do n't mean to sound presumptuous, but I find the thought of getting dementia or Alzheimer's, for example, much worse than getting cancer. And as I said, no offense, um, this is just my opinion, but here too, you can take preventative measures, even with dementia and Alzheimer's. It 's quite well researched, which, uh, I've had cases in my family, so I've looked into it a bit more. There are also things you can do to prevent dementia and Alzheimer's. But let's get straight to prevention. I'd be interested to know how you even got into it. You're 30 years old now, a bit older than me, and I often have these moments where I look at people and think, "Wow, you're so young, cool, look at everything you've already accomplished." It 's similar for you, yeah, you studied at Oxford and Cambridge, you even played an NBA game on the side, and um, it's really remarkable what you've achieved at such a young age. Um, tell me briefly, how did you get into cancer research for so many years? Um, what was your path to it? Um, tell me a little bit. Yeah, it's actually quite... Unspectacular. Sometimes you think, or some people honestly ask me, "Hey, what are you like?" Was there any case in the family or something, or anything classic, where you said, "Okay, I want to understand this specific thing ." That was n't really the case for me. After school, I more or less by chance became aware of the study program in Heidelberg. It was called, or is called, molecular biotechnology. Oh, okay. You didn't do a traditional medical degree? No, I didn't study medicine . I studied molecular biology and biostatistics, so to speak. I familiarized myself with the basics. Ultimately, as a doctor, you naturally have a medical degree, but most people in medical research aren't doctors. The population of doctors working in research is actually very, very rare, especially in basic research, as we would call it. Most people have degrees in the natural sciences ; they are chemists, biochemists, biologists, or physicists in some cases. So, back then, I was drawn to... I became aware of the degree program in Heidelberg , looked into it, and originally wanted to study medicine. But then I thought, maybe treating people is n't really for me. Regarding Heidelberg, you could say it's the most prominent university in Germany, especially when it comes to cancer research or medicine in general. Yes, I would agree, because Heidelberg definitely has the strongest biomedical location in Germany. There's also Munich, and Berlin, which lags a bit behind in research , but in Heidelberg, for example, you have the German Cancer Research Center, the university, the Max Planck Institute, and a very renowned international research institute called BL. It 's a European community that has one of its locations and its main site in Heidelberg. So, you have a very strong biotechnology focus. How competitive is the best German university in this field compared to other countries? How well positioned are we in Germany? In terms of pure knowledge, I think we're very well positioned. I mean, I have n't seen a huge difference in the teaching content or the course itself, for example, compared to Cambridge. Let's be honest, the biggest difference, and I already mentioned this earlier, is the environment. Um, well, yes, in Heidelberg you have many research institutes, many locations, and Munich is now a much more attractive location for biotech, for biomedical research, but the support infrastructure at the university is definitely not as advanced as in Cambridge, Oxford, or London, for example. And that, in my opinion, makes the biggest difference for people's development. The support you receive. You have access to support for every interest you might have, whether it's science, sports, or entrepreneurship. Do you have opportunities to get support, be it financial, with time, or with mentors? Mm. Um, and that's something I think I personally never really perceived in Heidelberg, and that's ultimately the university I can talk about most in Germany. Um, how did you perceive it then? You actually visited the other examples you mentioned in person and were there on-site. Yes. Um, I mean, it's primarily a bit overwhelming at the beginning. Um, because you did your bachelor's in Heidelberg and then went to Oxford for your master's, or what was Oxford like? I wasn't. I did my master's for three-quarters of a year of research at Stanford. Okay. That was during the Corona pandemic, though. So I went there at the beginning of 2020, and then Corona hit, and I stayed anyway. Best time to do research in that field . [laughter] It was still... I did n't regret it. It was great. I still... I took a lot away with me, learned a ton there, and just seeing the campus, living in Silicon Valley, and so on was incredibly impressive and, of course, gives you so much. Mhm. Um, but then, yeah, I ended up doing Stanford in 2020, where I wrote my master's thesis in the research group at Stanford Madison, and then I started my PhD at Cambridge at the end of 2020. I moved there and have been officially there since October 2020. My research there focuses on cancer risk prediction, or rather, understanding the development of different types of cancer in healthy people who, um, usually had high risk factors. My focus was specifically on lung cancer and breast cancer. With lung cancer, it's clear that it's still number one in terms of the number 60%. Smoking is the number one preventable factor for cancer. What are the top three? What are the top three triggers? Well, smoking, um Then alcohol and an unhealthy diet or too little exercise. Yes, in the end, alcohol is number one, and then comes being overweight. Yes, along with infection, actually. So, infections are triggers for cancer, or rather, I don't know, chronic infections. Okay. Give me an example. HPV, that is, human papillomavirus, is a major, or actually the only, or the biggest risk factor for cervical cancer in women, but also, um, something that's totally underestimated in men, um, for example, in the mouth and throat, anus, penis, etc. Yes. Um, that's a major carrier, but there are others too. For example, there's a certain type of bacteria in the intestines that primarily promote colon cancer. Um, then there's another bacterium that lives in the stomach, which is called Helicobacter pylori, which also promotes stomach cancer, but these are chronic infections, so they are chronic processes that ultimately promote this type of cancer over time. You get cancer, and infections are also a second, often forgotten factor that nevertheless plays a role . It's not like you'd say, okay, you get infected and then you get cancer, but rather it's a chronic infection over years, decades, that contributes to the development of cancer. What studies did you enjoy during your research on the shows that really, I'd say, made studying easier , because they were fun, because you thought, wow, this is super exciting, you actually want to spend 3 a.m. poring over studies? Are there a few things that have stuck with you, where you think, wow, this is really, really interesting? Yes. Um, I have to say that the main reason I went to Cambridge back then was primarily because of my current doctoral advisors and my current boss, so to speak, I'm employed in the research group . Ultimately, I... My own projects, which I still lead today. Exactly, even today. Um, that means I've acquired funding for myself, which I can then freely allocate to these projects, but I do it under the umbrella, so to speak, of my boss. And, uh, actually, the reason I went to Cambridge back then was precisely because these two people were my PhD supervisors. Mhm. Uh, because I said, okay, I've read their studies, it's one of the first studies. Um, I was in London for my first stint . Um, I also did a research internship at a large institute in central London, and, um, I remember walking past a colleague's laptop, and she had a publication open, and she said, "Yeah, I was looking at it, you saw this picture, the first figure, and I said, hey, what 's that?" So, yeah, that's a study that's just been published. Um, they're looking They observed mutations, changes, specifically changes in the DNA of a normal esophagus, and ultimately found that when you look at a normal esophagus in humans, the older the person gets, the more changes you find in that esophagus, in every square millimeter of esophagus. But what they also saw was that the more environmental factors you have, like if you smoked or drank, then a 45-year-old or a 40-year-old suddenly looked, in terms of their molecular environment, the same as a 75-year-old who had never smoked . So, in the end, it was almost like premature aging . And I looked into that, I looked at that study. She then said to me, "I think you should do something like that too." She just mentioned it casually . I was like, "Okay, yeah, that sounds cool." Then I looked at that study, those studies, and almost all the studies by my friends. I looked at the dissertations of my doctoral supervisors, read through them , and thought, okay, I want to work with these people, I want to learn from them, this is what I want to do , it makes so much sense that for me this is actually the future of this field, of cancer research. And, um, yes, that's what I did, I said, okay, I'll go there, I'll focus on lung cancer, breast cancer, but also generally on the changes that occur in almost every organ, and how we can make them accessible to the general public. What can we give people about this, what is truly essential, and can we develop tests that can be applied in the healthcare system , can we develop preventative measures? Tests that, for example, alter these changes . It sounds a bit strange, but the changes that we find in the cells, can we perhaps even reverse them, bring them back, can we eliminate them, so to speak? And that's what I'm personally trying to implement in my research, and at the same time, also through social media. The media needs to convey to people that there are various things you can control, but also many things you can't . And unfortunately, that's part of cancer. Let's go through the classic triggers, like smoking. What exactly happens to the body, and how does smoking promote the development of cancer? And how dangerous are vapes? Yes, there are studies on this. I saw a documentary on ZDF Neo Royal or something like that three or three years ago, from the tobacco lobby, that they have to pay less tax on e-cigarettes , which are actually carcinogenic. I don't know if there are any new studies on this, but I'd be very interested to see how this plays out in relation to the development of cancer in our bodies. Tobacco, or smoking in general, is a fascinating example of how things we do to ourselves are directly engraved into our DNA. So, cigarettes contain roughly 1000 carcinogens, or a few thousand carcinogens— chemicals that ultimately promote cancer. That's a carcinogen in itself. 1000, so 1000 different substances that promote cancer, that promote cancer in a single cigarette, so to speak. Yes. And the interesting thing is, of course, they're not all equally potent. Yes. Um, and there's one specific substance, or one chemical, called benzoyl peroxide (BPPV), and it's responsible for most of the DNA changes caused by smoking. That means if you look at a lung cell from a smoker, you can read the DNA and almost predict at which points in that DNA things are exchanged, where changes occur, mutations. And that's because BPPV always binds to the same sites and has the chemical mechanism of specifically targeting those sites . And you can see that through Populations disappear; if you were to analyze thousands of smokers , you would find it in their DNA, in their lungs. The interesting thing is, you do n't just find it in the lungs, you also find it, for example, in the bladder, you find it in the esophagus, you find it in the oral cavity. And that's just what you find from cigarettes purely at the cellular level . There are many, many other mechanisms, um, how this ultimately contributes negatively to your health, because that's always a very interesting thing. Um, the best example is, in the context of smoking, there are many people who keep telling me, okay, um, smoking promotes lung cancer, no question, but my grandmother, she chain-smoked for 50 years of her life and she still lived to be 90. Mhm. And the question that one then asks, or that I always ask, is ultimately, how long was she healthy? So, how long of those 90 years could she really live? And here we distinguish between lifespan and healthspan. A very significant difference, and the health span for lifelong smokers isn't that great. I mean, they're already struggling with COPD, chronic lung disease, for example, at age 60, where they can barely walk 50 meters before bursting into a coughing fit because their lungs simply can't take it anymore. And then you have to take off those rose-tinted glasses and say, okay, cancer isn't the only factor that worsens life; there are many others. So, if we look at a smoker who's been smoking continuously for, say, 10 or 20 years, can we estimate how much that actually affects their life expectancy, their lifespan, or the likelihood of a potential cancer diagnosis? It 's very difficult to quantify. I mean, there are those pictures on cigarette packs, and we all know them, right? And it's been documented that it's scientifically proven that... That it shortens your life expectancy and increases the risk of cancer. Yes, but how measurable is that? How dangerous is it really? Well , you can, of course, measure various factors across a population. That's true, I understand, but are there any figures that make it more tangible? I don't have any that I could quote off the top of my head right now. It 's like this: what we usually look at are pack-years, so to speak, how many cigarettes someone smokes per day over the course of a year . Yes. Um, so a pack would be 20 cigarettes. And this is, for example, one of the best ways to measure something like smoking, but it has its inaccuracies. And there, it primarily involves a so- called dose-response relationship. So, the higher the dose, the more you ultimately smoke, the worse the effect on your lifespan. But you can't just say, okay, I smoke 15 packs of cigarettes and that reduces my life by x years. Of course, it's always... That depends primarily on the other surrounding factors. Yes. Um, a smoker who [sighs] does everything else right, so to speak. He's certainly less [ahem] negatively affected by cigarettes than someone who's also overweight and doesn't exercise. Um, accordingly, these are always factors that you often can't differentiate that precisely . Let's look at vapes in comparison. I just said that with cigarettes themselves, there are 1000 potential triggers that harm the body. What about e-cigarettes and vapes? Yes, including all the Icos Heats stuff. Um, I 'm very proud that I've never in my entire life taken a drag on one of those things . It's always such a cool flex at parties. I smoked once when I was 18 or so for about three months , but I really have a very, very short period of consumption of nicotine tobacco products in my life. I had that. I smoked a lot of shisha as a minor, so it was a bit of a thing, but that stopped after about four years . But yeah, let's put these things into perspective. So, um, e-cigarettes, uh, then the vapes that taste like watermelon, mint, bubblegum, um, shisha. Can you rank them somehow, which is more dangerous? I mean, vapes and e-cigarettes are really, really difficult to differentiate. I'm probably not knowledgeable enough about it to divide them up, and I don't know of any studies that specifically consider, let's take the group of cigarettes, regular [ahem] cigarettes, and shisha. How would you rank them in terms of danger? Smoking, or cigarettes, is still number one. Um, then it's a bit of a question of how much shisha you actually smoke? Uh, generally speaking, it's said that with shisha, you smoke for a much, much longer time and in a much, much larger volume. inhaling. It's roughly said that if you smoke a shisha for, I think, an hour, you inhale the volume of 200 cigarettes. That 's the smoke volume, so if you meet up with friends at a bar in the evening and you smoke a shisha while watching 90 minutes of football, then you've inhaled the equivalent of 200 to 300 cigarettes in terms of volume . That's a rough guideline. Of course, this means that you don't necessarily do it regularly in the same way, and there are also different consumption patterns, etc., etc. So this is just an approximate measurement you have. So, if you do this regularly , then... It's probably number two. On the other hand, I don't want to differentiate so much between that and vaping, because vaping is ultimately something completely different in terms of the exposure, because you have to imagine it like this: vaping has significantly fewer carcinogens than the 1000 that are in cigarettes. Um, that doesn't mean it's inherently better, because a completely different demographic, a completely different group of people usually vapes. Mhm. OK. That means, normally these are mainly young people, yes, often minors, who have never smoked before. Of course, if you ask me, okay, there are smokers who want to quit and then switch to the Wape; that's better than not quitting at all. Um, and that has ultimately been proven epidemiologically. However, what still happens when smokers quit and then switch to Wape is that the risk is still higher than if they had quit completely. So it still contributes to the risk of cancer, and it does so primarily through chronic inflammation. Yes, so do the illnesses caused by vaping affect the body differently than, um, normal tobacco consumption through cigarettes, for example? To be honest, I could n't tell you that right now, it's so bad. Um, I know that, as I said, it promotes chronic inflammation. Um, that means you have, well, I'd have to look that up to see exactly how to define that. Let 's just put the whole tobacco lobby aside for a moment . Um, so why is it that such a poison isn't simply banned? That's an interesting question. I believe in it, so it's perhaps also a bit ethical and semi-political, but simply from a medical point of view . Why do you think it fails? Why is this not feasible? I believe that, first and foremost, it's the people. I believe that this is always our... I am convinced of it, and it is also a bit sad that all problems in our health system primarily stem from the fact that people don't want it. Um, nobody is interested in thinking about their health. Mm. Until your health is gone. And then we're all like, "Okay, what do we do now if I get a cancer diagnosis ? Or if I have a heart attack? Then suddenly it's like, okay, wake-up call. I... I do n't quite remember it 100%, but I mean, I read a statistic a few months ago that said when smokers get a diagnosis, for example, of lung cancer, are in the hospital and are then discharged, I think that despite this diagnosis, 75%, 80% of people start smoking again, even though they've received this diagnosis. There's definitely a... well, I don't know if it's really 75 or 80%, but there's a very, very high percentage, yes, who continue to smoke. So it's crazy, right? That's... but ultimately, that symbolizes the mindset behind it. Like I said, I'm convinced that people will always do it . Especially as you get older, the older you get, the more it becomes a routine that... your life. Something you can give up much more easily, and of course, it's ultimately an addiction. Nicotine addiction is real. Um, that's why approaches like this are also important to me, like the one in Great Britain where, um, in April, what April, yes, um, a sales ban for [sniff] young people under 18 was introduced. That means something completely new about it, the sales ban in the sense that you're not allowed to buy anything at all, so you're never allowed to buy anything again, even for the rest of your life. So anyone who is 18 or younger now will never be able to . That's now the law in the UK. Yes, it's the law, it's a big smoking or cigar ban. So, what do we have now? 2026, that means everyone born in 2008 or later, um, you go into a kiosk or a supermarket and you show them, if you're younger than 2008, or 2008 and 2029 and so on, you'll never buy tobacco products again in your entire life. Allowed. That's the idea. Yes, and that's also a clever idea, because these are the people you can ultimately still influence in their behavior. Everything that comes after that is super difficult to change, and I don't want to say that everything is lost after 40. Yes, but if you've been smoking for 20 years, that 's already difficult. I always find that fascinating, don't you? I do n't even want to, well, in general, people are talking about it during cannabis legalization, hey, smoking and alcohol are also legal, and that's actually much worse, and so on. I'm not at all in that, I'm comparing it to that, but my point is much more, so if, let's say, harder [ahem] drugs like cocaine, for example, are legal, which of course makes total sense, and people are addicted to those too, well, fortunately not everyone, but um, where do you draw the line? And, of course, that's somewhat historically determined, but we have a huge... A huge industry. All around alcohol, the tobacco industry too. I find alcohol even more normalized than the tobacco industry, and it's completely normal that athletes, even at the World Cup, are constantly seeing Bitburger ads, that they drink Jägermeister vodka and schnapps during breaks – it 's all completely normal. And I find it so devastating because, to be quite honest, I would be happy if all these products were made illegal in Germany, and ideally worldwide. I understand, of course, why that's not so easy, but I think the step the United Kingdom is taking is very smart and sustainable, and I strongly support it. So you're on the right track. Although, I would also say that, in my personal opinion, bans shouldn't necessarily be the first approach one tries . I believe that education, and especially targeted education of young people, can potentially achieve something very similar if you do it right. So, let's say you focus on... If you really put a lot of effort into educating people about nutrition, the negative aspects of smoking, alcohol, etc., during their school years, university studies, or whatever, then I think that the vast majority would eventually realize, hey, it's actually not such a good thing. Mhm. And for that to happen, you just have to be clear enough, well, what do you mean by "just"? I mean, we've been trying to do this kind of education for decades, but I still wonder if the education is really targeted enough. Yes, and um, definitely not. I mean, it ca n't be, because the part of the education you have, which is then accepted as socially normal and which we then absorb through social media and television, with the positive emotions conveyed by smoking or alcohol, ca n't be balanced out. I think, in my opinion, no matter how well you educate and work in this field, realistically speaking, probably not . Yes, so in the end, it's just like with smoking. You've known for 75 years that smoking causes lung cancer. and has promoted other types of cancer, which has led us to try to shift this through various means, yes, be it the pictures on cigarettes, be it through other educational campaigns, etc., via public health campaigns, and here here here here here here here we are in 2026 and it's still number one risk factor. Um, that doesn't exactly speak well for human, sorry, human reason. Just imagine, yes, we really did stop consuming alcohol and tobacco overnight in our entire society. No more beer, no more wine, no shots, no mixed drinks, no vaping, nothing. How will that affect our health in the next 100 years? I think that alone will contribute a great deal to us becoming a healthier society overall . Life expectancy, what do you think? [sighs] I'd have to say, no, hypothetically speaking , we'd probably drop from 859, we're at 81 or so now, um, we'd probably drop from 85 to 90 in the next To crack 100 years like that. Um, I mean, in some countries, I think it's Japan or Korea, we're already not that far from, um, 90 years. But yeah, I think, I think that would bring an incredibly positive factor, but then of course there's always the question, there are always other factors, other illnesses that come with it, but it would be cool, it definitely wouldn't be a disadvantage for anyone, except maybe for the industry behind it, but that, uh, yeah, maybe also for some people who like to drink a good glass of wine or can't have fun without alcohol . I don't want to sit here and moralize. I also drink alcohol, although not often and usually not much, but I 'm not like I've been sober for 9 years or anything. Um, but I find the thought experiment very, very exciting. I also find it super interesting. I would really like to see what, um, what that would do to society, be it in terms of health, be it... There are other things. Um, I think that would have a very positive aspect. Let's move from smoking to alcohol. How is that? I think you already said earlier, it's along those lines, so it's not in second place in the ranking, right? You said smoking is in second place, then obesity, and infection. Isn't alcohol carcinogenic, not that bad at all? Well, it's definitely a big factor. So, it comes right after that. Um, with alcohol, you always have to distinguish the mechanism of action, so to speak, how it actually works. Um, and that's where it comes in, if there's a carcinogen present in alcohol , how many are there? There's actually only one. Okay. We have 1000 carcinogens in cigarettes, and we have 1 in alcohol, ultimately, yes. Um, that's what old hat is called, and it acts in different ways in different parts of the body, and it's a natural, um, primarily... The liver, or rather chronic alcoholic liver disease, is a big issue. But it's also, um, the esophagus, mouth, and throat—basically everything where it comes into contact. Yes. Um, and we've looked at, for example, um, and that's why breast cancer is also such a big issue, and it has to be said that it's also very underestimated because it interacts a lot with hormones. So, in women in particular, alcohol consumption significantly increases the risk of breast cancer . Um, which is definitely a big difference, uh, and one that's often forgotten. But if we look at, for example, the mouth—and, for example, there's a study we did ourselves , cheek swabs, uh, which was published last year— we looked at a population of about 1200 people, um, who come from a cohort that represents the general population. And we took a cheek swab from each of them and looked at the changes that occur in these cells of the cheek, in the inner oropharynx. And you can do it just like you, like me. I said that you have a signature from smoking, you have a signature from alcohol. Mhm. And now it's like this: the smoking signature [sniffs] clearly has a significantly higher potential to cause changes that are relevant for mouth, throat, and cancer. So, um, you can differentiate between them. There are certain places in the DNA that are more relevant for oropharyngeal cancer . Certain genes, if they are altered, then you can see that these changes are also recognizable behind mouth and throat cancer . [sighs][gasps] With smoking, as I said, we know that the probability that the smoking signature hits one of these genes and alters it is higher than with alcohol. Mhm. And that's because the alcohol signature preferentially attacks different places in the DNA . Okay. Okay. That means, um, for this specific example, it's probably the liver, for example. For the liver, it's something else entirely, but for the oropharynx... So, alcohol is a less potent carcinogen than smoking, okay. Okay. And you have to consider that in every context, ultimately [ahem], and you can evaluate it differently. Um, for example, smoking is n't really a problem for the liver. Yes, but alcohol is, but even there, the amount of alcohol you consume is usually significantly higher to develop chronic alcoholic liver disease . Um, and chronic alcoholic liver disease doesn't necessarily lead to liver cancer, but it's a high risk factor for liver cancer. That means it's incredibly difficult to differentiate, but basically, the underlying message is that alcohol, regardless of the amount, isn't good for your body, but it does n't have the same potency as smoking, and that's why I often get asked about it on social media. Sometimes I kind of let it slide, I do n't want to say I completely lose it. Mhm. Um, but it's not a level for me. It's something else. Okay. Yes. How is it? With, um, sunlight? Uh, there's this fascinating story about this truck driver. Uh, could you perhaps revisit that and discuss the studies on the risk of cryptorchidism due to, um, sunlight? I live in Mallorca, more hours of sunshine, higher UV index, do I have a greater risk? Perhaps you could briefly recount the story of this truck driver's observation—it 's quite well-known, often heard on social media—and then maybe add the context. Yes. Um, the story is about a case report published 10 or 15 years ago, a description of a case in a specialist journal called the New England Journal of Medicine. It's a journal for medical research, so it's very reputable, absolutely legitimate. If you publish there—well, there are four or five journals, and most people don't know that—there's a very clear ranking within publications. There are journals where, if you publish in them , you've made it in the scientific world. Your career is practically over. If you do n't manage to publish in them, it's significantly more difficult to, for example, become a professor, lead an academic group, or a research group in general. Okay. Um, and the New York University Journal of Medicine is practically the top journal in medical research. It's the most cited, and citations are, uh, the currency of science. Um, and that's where it was published back then, a very short report, but ultimately it's associated with the image of the truck driver, who, I think, drove the same route for 28 years , always sitting in the same spot in his truck. The left side is completely wrinkled, but the right side looks more or less relatively young, and that's one of the most interesting examples of the influence of UV light on the skin. Mhm. And there we are again, just like with smoking and alcohol, there are also UV-related issues. Light, specifically UVA and UVB, creates special signatures in the DNA. Ultimately, every single cell in our skin is exposed to sunlight, to UV light, and undergoes numerous changes in response to this UV light. Specific locations in the DNA are altered, resulting in a multitude of changes. This process is more or less linear. The more hours of sun exposure you get, the more UV radiation you're exposed to, the more changes you experience, and consequently, your risk increases. Of course, there are ways to mitigate this. You can avoid being in the sun outside of peak UV index hours . You can apply sunscreen, wear long clothing, etc. These are all things I would strongly recommend, as well as regular skin screenings. However, we know that sun exposure, especially in childhood, is a significant risk factor for skin cancer later in life. It's because you lay the foundation very, very early on. Imagine, these changes do n't go away. For example, if you had a severe sunburn as a child , it demonstrably increases your risk of skin cancer later in life. This is primarily because you accumulate a huge number of changes in every single skin cell. And each of these skin cells is potentially a precursor to cancer. So, you have to imagine it like this: the field where cancer can grow, where cancer can grow as a plant, is much better prepared and fertilized. Every plant that you then plant there, more or less by chance, can take root and grow better. Okay. Okay . What do you think? You just mentioned being overweight. I have, I don't know, some wisdom from my grandmother that sugar is also, in a way, a growth driver for cancer . Hmm. Is it because sugar itself... um... Is it cancer-promoting, or is it because excessive sugar consumption makes me more susceptible to diabetes, or perhaps there's a higher correlation between people who consume a lot of sugar being overweight and subsequently developing cancer? What about diet in general , in relation to developing cancer? Hmm. Well, it's not primarily the sugar itself, but rather the calorie, the constant calorie surplus. Some people would call this calorie poisoning, because being overweight chronically leads to chronic inflammation in the body. It's like, to stick with this field analogy, the field is better cultivated and better fertilized, and this environment has a positive effect on the cells that are already undergoing changes, just waiting for the next change that will allow them to proliferate . Ultimately, they can grow stronger and then eventually develop into cancer. wars and so on. And being overweight is exactly one of the driving forces behind this, through various factors. It also works hormonally. Um, it's about growth hormones, which all contribute to your body becoming unbalanced. [sighs] And sugar, of course, is cancer-related. Sugar is a myth that you see a lot of on social media. Of course, sugar is n't a wonderful product in itself. Mhm. But it's the amount of sugar that's the problem. If you don't have a calorie surplus and use sugar selectively, and still eat a good, protein-rich, fiber-rich diet—maybe more towards plant-based protein than animal protein— and still consume sugar and have a healthy figure, no excess weight, then the effect is no different than if you completely cut out sugar. Because ultimately, this sugar-related cancer arose from the fact that it makes cancer grow faster and has a specific effect. Um, that's called the Warburg effect. It was discovered in the 1910s and 1920s by Nobel laureates at the time, who found that sugar is preferentially absorbed by the body in relation to cancer. This is now used in PET scans, for example, in certain diagnostic procedures. Because it allows us to visualize cancer. But ultimately, it's not sugar per se that's the problem , but rather mostly unhealthy diets and obesity, which increase the risk. Obesity is associated with 19 different types of cancer. It 's definitely a major problem in the population and will only get worse . And I don't think we should say, " Okay, we have to specifically target sugar as a single food," but rather consistently focus on improving people's diets. As long as it provides a healthy platform, and whether it contains a little sugar or not, as long as it conforms to what humans need and covers the micro and macronutrients, it is unproblematic. What about sugar substitutes and Coke Zero and things like that ? There are some exciting rumors circulating. Yes, aspartame, sucralose. Sure, sweetener, I mean sweetener aspartame, is listed as a carcinogen. Yes . Um, that's primarily, or something like that, the best example. Uh, that's primarily because it failed various tests in mice, or rather in mouse experiments or cell culture experiments, at different doses, which are used to determine carcinogen levels . However, aspartame is the best example of this, or one of the most well-known examples, because the dose you are testing is significantly higher than what you can physiologically absorb in reality. Um, that means we actually know that things like these sweeteners, which are approved, are completely unproblematic in the quantities that people normally consume . OK. Um, some people would now like to accuse me of crucifixion, in quotation marks. Uh, but that's the evidence-based situation, and then okay, so I can, uh, chug down three Cokes Zero a day without hesitation, and I mean, I would n't say that's the best way to consume fluids. So, basically it's still water or sweetened teas. Um, but purely in terms of aspartame content, yeah, you could eat three Coke Zeros. Um, you can , you can, that's basically not a problem. Um, yes. Okay, so you're mainly involved in prevention, uh... Um, what are some of the key prevention strategies that each of us should take to prevent cancer? Of course, minimize the triggers, yes, smoke as little as possible, ideally not at all. Yes, avoid alcohol, get plenty of exercise, don't expose myself to the sun all day when the UV index is high, eat healthily, don't consume too much sugar, exercise to avoid cardiovascular diseases as much as possible, muscle building, muscle maintenance, very, very important, also during chemo or during cancer therapy, very, very underestimated. Definitely a factor that should n't be forgotten. Which of course also has many other positive aspects, especially in old age. Yes . Um, but then of course, once you've completed that, and that's quite a lot, although on the other hand, I personally find it not very surprising, right? Exactly. It's like this: these are super obvious cases, and everyone knows it , but very few people actually put it into practice. Yeah. Um, but then of course there are preventative check-ups after that. So, whether you go through legal channels or privately, preventive medical check-ups are definitely useful and should be attended. So, colonoscopy, mammography, ultrasound, um, if you can afford it, uh, other preventative examinations, which perhaps, well, there are many, for example, early detection tests that are approved in the USA, which are not yet so um widespread in Europe . So, early detection tests for cancer too, have you ever done one yourself? No, I haven't yet. Um, how much does something like that cost ? Approximately $1000. But I could fly to Miami now and for a thousand I could get an early detection test. You can even do some in one or two places in Germany . Um, but does that make sense? Would you recommend this to some people if they have the financial means to buy it? [snorting] They're coming, I would only recommend it if they have a higher risk for some reason . Mhm. Um, so if there were a reason why one should do this now, for example, genetic predisposition, i.e., if you have a higher risk inherited from your mother or father , that is something I would recommend to everyone, something that belongs on this list. That's a good point. You said earlier that, uh, if I regularly drink alcohol or smoke, then my genes also change significantly. That means, assuming I'm, let's say, 30 years old, I drink alcohol very regularly. Do my children then have a higher probability of developing cancer? No, that is, um, you have to distinguish between the heritable component and the non-heritable component. OK. And I understand that the influence of alcohol and cigarettes is on the non- celebratory component, and the other part that's in my DNA remains unchanged, right? Yes. OK. Um, that remains constant. That means, in the end, smoking and alcohol have virtually no effect on egg cells or, um, sperm DNA. That means they remain more or less unchanged. Mm. And as a result, what is inherited remains unchanged. Um, there are of course things like chemotherapy, i.e., cytostatic drugs, that also change that. Mm. And often it happens that, um, you say beforehand, okay, we'll freeze something [sniff], exactly. So that it is avoided that anything is passed on. It's also possible that the chemotherapy could make you infertile, or that the chemotherapy could alter your genetic makeup in such a way that your children might have illnesses, disabilities, or something else. That's possible. Sure, statistically speaking, it's possible that it could happen. Um, in case of doubt, it's usually the changes, so I'd say the influence of getting older . Mhm. So let's say, for example, um, the sperm have significantly more errors in their DNA than the egg cells. Mhm. Simply because she also saw 11 as revolutionary, there are significantly more of them and only one has to win. Um, that means such very critical changes in the DNA, which are brought about in sperm by such things , usually have the consequence that this sperm is less fit. OK. And then you do n't want to win the race. OK. Of course, this can still happen in individual cases , but um, it remains the less likely scenario. A year or two ago, I was looking into an American cancer researcher, and his number one take for cancer prevention was a keto diet and, above all, a focus on a calorie deficit. Um, I don't remember his name right now. I don't know if you know him. Um, what's your take on this topic, um, the keto diet, calorie deficit in the context of cancer prevention? I believe it is not evidence-based and is fundamentally wrong. There is no evidence that a keto diet has any positive aspects regarding prevention. Mhm. Um, there are studies that show that Caloric Restriction Mm. So, Intervent or a 168 WN, yes, um, or rather yours, that it has a positive effect on aging in various organisms. Mhm. The problem with this, and this is the case for most studies, is that the question is always, and here we come back to the general topic of nutrition. What is the baseline? So, what are you comparing the keto diet to? Are you comparing the keto diet to a balanced, healthy diet, like the one I described earlier? with protein, with fiber, with sufficient nutrients that should generally be included in your diet, or are you comparing it to something that the average person, the average American, eats, and that's just not that great, and the probability that the positive effect is based on the poor control group (in quotes) is significantly greater than that it's actually the effect of the keto diet? Okay, so that means either this study exists or this study does not. So, there is no comparison; Keto has relatively few studies anyway, and the studies that do exist show no effect. So it's not preventative anyway, because it's incredibly difficult to measure, but even during chemotherapy or during treatment there are no studies that really prove that it is the case. Um, regardless, I definitely believe that if you give people a healthy diet during therapy or generally as a preventative measure, they will naturally take preventative action, but primarily on the basis that they exercise, that they avoid being overweight and do not promote these inflammatory processes in the body. That's the key takeaway. [snorting] What I'd also be interested in, I also talk a lot with entrepreneurs. You, uh, have now also made your NBA debut and, uh, you also ventured into one or two startup ventures during your studies. I'd be interested to know, if we're talking about cancer research, for example, or science in general, how attractive it is these days to stay in science as a good scientist, or rather, how well it's subsidized and supported so that you don't lose the best people to the private sector. Um, let's maybe take a look at how exciting it is to work in science , especially from a monetary perspective. From a monetary point of view, not really. But does that mean if you're in science, you want to save the world? Do you have a higher purpose behind it? Personally, I am very strongly driven by non-monetary compensation . Yes, from the fact that I know that what I'm doing can hopefully, or at least I tell myself that, lead to a higher purpose and change something in society. M [snorting] um, from a monetary point of view, it's super uninteresting. You have extremely high opportunity costs, being a doctor. Um, so you're doing a Bachelor's and a Master's degree, and then you're doing a doctorate. I had a scholarship in Cambridge and that was, uh, where you take it, I don't have to pay the tuition in the end . Um, they were relatively cheap back then. I started when the rules still applied, um, you have Home and Forer Intuitions Home is about 9000 pounds per year. Mhm. Uh, for your course. Back then it was also 9000, now it's about 45K. So, and that's what they used to call EU Home. Mhm. Now the EU is international. Why like everyone else? Yes . Um, but in the end I was paid for that, and then you also get a stipend every month, like a salary, and that's roughly... wow, we had one that was UK based, it was one of the most competitive, it paid you 524,000 PF per year. Mm. Um, so about 2000 something. Oh, net. Mhm. Um, that's natural, that changes in the end as a post-dog. So, once you've finished your doctorate, that changes minimally. I mean, it 's really insane. Someone in my family has a PhD in chemistry and has now gone into business. He works as an employee in what I would call a chemical company. Yes, everyone has products at home, and I would simply claim that he is significantly more intelligent than I am, especially during his Master's studies and, yes, during his doctorate, when he worked much harder, had much higher standards for his output, and is perhaps much more competent and can demonstrably have a greater impact on our society, at least with his studies and knowledge. Yes . And uh, I earn his annual salary in a week and a half. Yes . And um, I don't mean to say that it's unfair in any way. I mean, he could have chosen to go into business, and um, he was intelligent enough. And, um, let me reiterate, money isn't everything, is it? It's not like I have a happier life or am somehow more fulfilled in relationships just because I don't work in research, for example. Nevertheless, I believe that, um, you can simply have a better life if you are better incentivized and compensated monetarily. And if we live in a country, or even in this entire world, and depend on having good research, on driving innovation, on incentivizing good people to continue working on cancer research, uh, cures, prevention, and on innovation startups emerging from this, then I think that a great deal of money is being allocated completely wrong, and I'm not talking about the free market economy, from which I benefit, but above all, where subsidies and lobbying, in my opinion, are completely misdirected. Mhm. 100%. I believe that, on the one hand, the system is such that scientists often have no idea what is happening around them [ahem]. So, they are often very, very focused on their research and do n't understand that, okay, the money they are getting now, of course they know it's not much , but what you could possibly earn somewhere else. That's why so many of my friends also went for counseling after their doctorate , because they said, okay, this is now the easier way, or rather, what does "easier" mean, but it 's a way to earn money relatively well , relatively quickly. Um, that means many of my friends have gone to BCG, Macky, or whoever. Um, that 's not something scientists are really aware of. Most people do n't really engage with it, and on the other hand, it's also the system that somehow, I'd say, favors people who don't really engage with it, but rather it's designed so that many of these services or research projects are altruistic, that you don't get any financial benefit from them, and ultimately it promotes that . I think what honestly bothers me about it is that there's a brutal amount of money in this industry. Yes, and that's the point. I could understand the altruism if no one, i.e., if the cake is mega small and everyone takes their small slice in order to survive . But the cake is enormous. Yes, if we look at the Corona pandemic, if we look at Biontech, Pfizer, all the corporations in Germany, if we look at Bayer, insurance companies that are connected to it , these are billion-dollar corporations that have a huge lobby. Complete silence on alcohol and tobacco. We just talked about that. That means we have a huge pie, and the slices that go to the people who are really the backbone of this piece of cake get the smallest part, and that 's what bothers me. Because if we were to say, "Hey, there's no money in it, it's not worth it, it would be uneconomical," but it actually is profitable, it's just that the bets that have to be placed are too risky, and then it becomes, let's say , altruistic, and this motivation is instilled in the people who work in research . But at the end of the day, the pie is big enough, it's just that there are a few who line their own pockets, and the people who actually do the real work—I don't want to belittle the entrepreneurs, I 'm from the business world myself— but that's not fair to me, and it's a shame that someone like you, or your committee members, or colleagues, is promised this purpose and everyone else is told, " Hey, You're doing something good for humanity, yes, but you can also do something good and get a piece of the pie, which would be fairer. In any case, as I said, 100%, that's one of the biggest things I criticize about this system, or rather, have repeatedly criticized and criticized in the past , because it's completely schizophrenic to me that it works this way. Yes, so the best example in Germany is that as a doctoral student, you get a permanent position, yes, and it 's not badly paid at all. I think it's paid according to the public sector pay scale, something like E13 in most cases, which is around [sighs] 65k. Yes, I would have estimated 60,000 or so, maybe. That's not such a bad contract, but then you work, but you only get 65% of it because the argument is that the other 35% is essentially for your studies, and therefore the money is budgeted for that, but you're reduced to 65%, and basically, you know... Everyone who does this knows it's not a degree. You just sit there all day working, either in a lab or at home reading scientific research. The work I'm doing now is n't significantly different from what I did for my PhD. Except now I don't have to submit a 300-page dissertation somewhere and take an oral exam. So, for me, it's always been the prime example of how ridiculous it all is. You should really be giving people 100% and then some. [snorting] But that's also why—and to bring this full circle— many people leave academia after their PhD, go into consulting, or join industrial corporations, even though industrial corporations in the UK, for example, do n't pay that much good money. Or they lose out on good people in research, which is a real shame because it also hinders progress in... in research, then it's a hindrance. Yes. Yes, but that's the thing. So, you have to imagine, over the four years, the frustration kind of accumulates. Totally, I'm already frustrated just from the conversation. [laughter] Yes, I can understand that. Um, what's the name of your position now, the one where you do what? It's simply called Postdoctoral Researcher, so postdoctoral, like in Cambridge, where you're currently working and doing research. I'm at an institute that's affiliated with Cambridge, but it's actually independent. It's not actually located in Cambridge itself, but about a half- hour drive away. It's called the Welcome Sanger Institute. Welcome is basically the largest English trust, um, that funds many things. Foundation. Foundation. Exactly. Um, and the Sanger Institute, Fred Sanger is the namesake of it. He was a two-time Nobel laureate, after whom it was named, who, well, the method, so he received two Nobel Prizes . The first one was for being able to sequence DNA, meaning he was able to determine the order of the bases in DNA for the first time using this method . And then the second one was for insulin. Yes, actually, the first time insulin was isolated from pigs back then. And yes, it's a specific institute for genomic research, as it's called, for DNA research. So you have a 9-to-5 job there, or what? You can think of it as a normal 9-to-5 job . Yes, although I honestly interpret that a bit more broadly . So, that's also what I always find appealing about science in that sense, well, you don't get much money, but as I said, the non-monetary compensation is quite okay. You probably have questions about what you earn, and yes, sure, I get about 43,000 PF per year. 43,000, how much is that in euros? [gasps] That 's roughly a factor of 1.15, so okay, 50k, 50k, and that 50k is taxed a bit better than in Germany. So it's a different tax scheme where the first 12 or 16k are tax-free, and then you have a 20% tax bracket up to 50k. Okay. Okay. So [snorts] it effectively pays something like that. Wow, I don't know, 18% on the first few. Okay. So, 50k a year for research for 37 hours to 37 and a half hours per week on paper. Yeah. Um, that's how it is, that's how it is that the baseline, what you get for that in the UK , maybe even a bit above baseline, um, because our institute is very well funded. Yeah, we have a bit of an exceptional position, you just have to say it like that. Um, because every year—not every year, but through a funding scheme of about 6 to 8 years—we get a fixed amount of approximately... from Welcome I think last time it was around 500 million that's given to the institute for these six years, and that's what it runs on. Plus, of course, every group that works there. So, we have different departments, different divisions that focus on different things, and then different groups that work there, and they can also get independent funding from charities, private individuals, companies—there are always funders who contribute additional money, depending on the type of projects and their objectives . But the researcher themselves gets the smallest share of it. I think I already mentioned that beforehand. I have to consider that the 44,000 PF I earn per year , I'll probably spend on experiments within two weeks or so if it's an interesting phase. And that's the ratio, so for my PhD, roughly speaking, he The experiments probably cost between 1.5 and 2 million, and I think the costs for me personally were 100k. Yes, over the four years, but yeah, that's just how it is. You've also done an NBA now. That means one could perhaps speculate, looking into a crystal ball, that you wo n't be working in research anymore at some point. Um, how exciting is it for you not to just go to McInsey or BCG, but to start your own company? Do you have any plans, ideas? What are some exciting markets that you're currently observing from an entrepreneurial perspective? Hmm. Well, my goal has always been to take my research and use it to contribute to society . And I think I've learned over time that it's not enough to do it in a lab setting; ultimately, I want to build it as my own startup in my own context and then eventually make it available to society. That means my research is basically designed to eventually be preventative, i.e., to predict risk with tests. to do with genetic tests . That is, the best example currently, where we are closest to achieving this, is a test [ahem] where we use breast milk for breast cancer, for pregnant women, where we take breast milk, analyze the cells from the breast milk and then ultimately try to determine if someone has a higher risk of breast cancer . If this person has a higher risk , they can then, in principle, receive other preventative treatments, such as ultrasound, mammography, and perhaps an MRI scan, etc., earlier than they currently do, at the age [gasp] when they became pregnant . Normally, in Germany, this is the case from age 45, and the average, or median, age for pregnancies these days is, I believe, around 30. So, in principle, preventative care 15 years in advance . But we know that the changes for breast cancer, for example, most of the changes occur during puberty or early childhood, and these essentially lay the foundation. That means they should all be detectable in These tests. That's one idea. But we also do something similar for the esophagus. Mm. We have all non-invasive samples. Non- invasive simply means that you don't take a piece of tissue, but rather you take a swab of something, you take fluids from the body, and use those. And that's also what we were pursuing, something I already did during my doctorate, where I worked with two friends and colleagues to develop it into a business case in accelerators like Adventure Capital. We talked about it and said, okay, that's what we want to do. And I think at that point we were a bit too far ahead of the curve, in the sense that we were perhaps a bit ahead of the curve in terms of evidence and had created a better case in our heads than we actually had. Now, four years later, I think the evidence is better to show that it can actually work that way. In the coming year, I expect that we will continue in this direction, or that I will continue to work in this direction with my bosses, and that we can hopefully validate the first tests from the institute, and so on and so forth. And the UK is the perfect healthcare system for this, because they embrace everything possible to improve the healthcare system and, above all, prioritize risk assessment and prevention. That's the biggest component for me in this area. However, the other, and much more interesting, area goes even further: the implementation of prevention in the form of medication. Many people don't like this, but I am—and this fits well with our conversation as a whole—I am convinced that we will never completely remove the harmful aspects of our lives from people . Yes, not everyone will stop smoking, not everyone will stop drinking alcohol, not everyone will implement the points we've discussed in a positive way. That means we have to think about how we can actively curb these things nonetheless . And that's what he calls it. In this case, chemoprevention. Mhm. So, you use medication to reduce risk. And that's, um, the second component of these tests. If you can determine with a test whether someone is at high risk, then the next step is to say, okay, this person is at high risk, now you give them medication A, BC, to reduce the risk. Just like with blood pressure lowering medication, with statins, with coronary artery disease—uh, only the equivalent for cancer. And that's ultimately the end goal for me in this field, and it all comes from the research we generate. Um, everything in the infrastructure in the Cambridge area, which is unparalleled in Europe in terms of heads, capital, I think, for biotech. Um, so the WC landscape there is very, very, very good. Um, which is also due to the fact that they get involved with the university very, very early on and actively scout for ideas, actively support, etc., etc. That's also one of the biggest differences to Germany is. Yes. Um, but yes, that's my personal goal. Yes, awesome. I'll be watching, who can follow Moritz on Instagram? I'm not very good at pronouncing your last name. You can definitely say it. [laughter] I'll also include it. Yes. Moritz Pritzibiller, Dr. Moritz Pritzi, um, on Instagram, please follow me . Just follow me there. Super exciting. I always enjoy watching it and wanted to thank you for the great conversation. Thank you. I wish you much success in getting out of the 95s in research and becoming a successful entrepreneur, while still being able to contribute to the well-being of our society. You're already doing that today through your content. So thank you very much for the great conversation and all the best to you.