How A Fringe Idea Led To Lifesaving Cancer Treatments

Over the past century, most cancer research has focused on the tumor itself. Rakesh Jain focused on the tumor's environment instead.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:02Flora Lichtman?

  Hey, it's Flora Lichtman, and you're listening to Science Friday. Today in the show, how one researcher's persistence has changed cancer treatment. In cancer, you might think of the tumor like a seed, of misbehaving cells taking root in the body. And whether it grows and where it grows depends on the conditions, the soil. This seed and soil hypothesis has been around for more than 100 years, and for most of that time, research and treatment has been focused on the seed, the tumor. My next guest has spent nearly 50 years studying the soil. He argues that, just like in a garden, the more you know about the soil,

• 0:45Flora Lichtman?

  the better you understand how the seed will grow. His research has often gone against the grain, and sometimes led to his colleagues avoiding him in the halls, he says. The work has also led to seven FDA-approved treatments for diseases including lung and liver cancer, and earned him a National Medal of Science in 2016. Now, Dr. Rakesh Jain studies the biology of tumors at Harvard Medical School and Massachusetts General Hospital. Rakesh, welcome to Science Friday.

• 1:13Speaker 01

  Thank you so much, Flora. I'm a big fan of yours, so I feel very honored that you've chosen to speak with me today. Thank you.

• 1:21Flora Lichtman?

  That's too kind. Thank you for joining us. Now, in that intro, you know, I set you up as a kind of outsider, at least someone who marches to your own beat. Is that how you think about yourself?

• 1:33Speaker 01

  Yeah, I've always been-- my ideas have always been very counterintuitive. They've been against the grain. And anytime you go against the grain, it's a fight. It's an uphill battle. But when you reach the peak and you see the benefit, it's very gratifying.

• 1:52Flora Lichtman?

  Let's dig into this. So I want to start with a visual. You know, when I think of a tumor, the seed, I picture like a bag of messed up cells.

• 2:05Flora Lichtman?

  Am I right? How wrong is that?

• 2:08Speaker 01

  That is what most people think. But a tumor is more than a bag of cancer cells. It's like an organ which has gone wry. It's an organ which has its own rules. And if you can figure out those rules, we can improve not only detection but treatment of cancer and improve lives of patients. So when I entered the field, and even today, most people focus on the cancer cells. But I decided to focus as what you call the soil. And I found out the soil, it not only helps tumor grow.

• 2:50Speaker 01

  That's understandable, but also confers resistance to every form of therapy. Radiation therapy, chemotherapy, immunotherapy, and all the future therapies which will be coming along.

• 3:03Flora Lichtman?

  And when we talk about soil, you know, what should I be thinking of? Is it just the area right around the tumor? Is it larger than that?

• 3:13Speaker 01

  So if you think of a tumor such as an organ, such as liver or kidney, what tumor is made of is cancer cells. And these cancer cells cannot grow without nutrients, right? Oxygen and nutrients. And for that, they need blood vessels. But unlike normal tissue, these vessels are abnormal. And we were the first to identify their not only abnormal structure, but most importantly, their abnormal function. But in addition to the blood vessels, even if the drugs get out of the blood vessels, they have to cross a distance between blood vessel wall and cancer cells.

• 3:57Speaker 01

  And that distance is covered by all kinds of things. The most important one, which blocks the movement of drugs, is matrix, which is made out of collagen and hyaluronic acids. But in addition to that, there are all kinds of cells on the host, from the patient in there. They include all kinds of immune cells that kill ten cancer bugs and other things. They're full of neuronal cells. And they are now, the new research is showing they're a lot full of bugs, the microbiome. And so each of these affect the outcome of treatment.

• 4:36Flora Lichtman?

  There's a microbiome even within the tumor?

• 4:38Speaker 01

  Oh, yeah, yeah, yeah. Yeah. We know it's there, but the question is, how does it get there? And this is something that has fascinated me in the last 50 years. How do things get into the tumor? And what do they do when they get there?

• 4:50Flora Lichtman?

  Yeah, I wanted to ask about this because I know you've been thinking about the soil, this environment, this complex environment you just described since your PhD, which was, am I right, in chemical engineering, not cancer biology, by the way?

• 5:04Speaker 01

  You're 100% correct. I was trained as a chemical engineer in India. I did my undergraduate at Indian Institute of Technology in Kanpur. I came to this country in 72. Did my masters on mathematical modeling of Delaware River pollution control.

• 5:19Flora Lichtman?

  A different kind of waterway, a different kind of landscape.

• 5:22Speaker 01

  Exactly. And then I was shopping around for a PhD project. And I got very fortunate accident that my PhD advisor, Professor Wei, introduced me to one of the most distinguished tumor pathophysiatologists at the National Cancer Institute. And he had developed a tumor with a single artery and a single input, single output. And I studied using that tumor to look at if you inject a drug in the artery, how much goes into the tumor, comes out the vein.

• 5:54Flora Lichtman?

  Well, because this was the fundamental question, right? That you were asking.

• 5:58Speaker 01

  Yes, yes.

• 5:58Flora Lichtman?

  Does the medicine get to the tumor?

• 6:01Speaker 01

  Yeah. Does it get into the tumor? If it does, where does it get in? What part of the tumor? And what I discovered is, A, most of it bypasses the tumor like Beltway around the city. And two, it gets in highly heterogeneously, not uniformly at all. So cells, some cells are going to get the drug. And they're going to respond. And others are not going to get it. And what is even later on, I discovered is that when the blood supply is poor, it creates hypoxia, that means low oxygen level and acidity. And combination of these two makes a lot of drugs ineffective, even if they can get there. So you see the blood vessels, when they are bad, not only they block the delivery,

• 6:46Speaker 01

  but they also impair the effectiveness of the drugs such as immunotherapy. Once immune, I mean, all patients don't benefit from it.

• 6:56Flora Lichtman?

  You know, does the medicine get to the tumor? Feels like a very good and fundamental question. Why were you a chemical engineering PhD student, like the first person to ask it?

• 7:12Speaker 01

  Well, I'm an engineer, okay? I have to, so in engineering, there is a subject called mass transfer. That means how do things move from one place to another? And that's what we study for our living, all right? And I said, okay, this drug delivery is like a mass transfer problem. So I asked my advisor, could I study that? Because, you know, that's what engineers do. You look at input, output, and then using mathematical modeling, try to figure out what's inside the black box.

• 7:45Flora Lichtman?

  Right.

• 7:46Speaker 01

  So I used that approach and I said, this black box. But that was not very satisfying, even though I realized for my work, the blood flow is a problem. But I wanted to visualize it. I wanted to see the drugs coming in and seeing what's happening to them.

• 8:01Flora Lichtman?

  I'm guessing an engineering approach comes in again.

• 8:04Speaker 01

  You're right, you're right. So, yeah, so what I did is I developed these glass windows.

• 8:13Speaker 01

  Where you can surgically implant them on the brain. So look at brain tumors or brain metastasis. Or breast, and look at breast cancer. Or you can look at liver, et cetera, many organs. And then we developed special microscopes. So you could visualize when you see a drug coming. First, you could visualize the blood flow. And the first thing you say, the flow is not nice. It's good in some parts of the tumor, others it's not flowing at all. But we discovered the mechanism for that, too. And that's an engineering problem.

• 8:46Flora Lichtman?

  It all goes back to that Delaware waterway, doesn't it?

• 8:51Speaker 01

  You got it. Exactly.

• 8:56Flora Lichtman?

  So had anyone watched a tumor in an animal over time like this before?

• 9:01Speaker 01

  Well, actually, there was a study where at NCI, National Cancer Institute, by a person named George Eljair, who had developed something like this. But they didn't have the sophisticated microscopes at that time. So they didn't pursue it. But that was many years ago. And I saw that, and it was sort of back on my mind. But the very first time I studied that was in the rabbit year. I put a window the year of a rabbit when I was an assistant professor at Columbia University in New York and Chemical and J. And there was a professor who was developing these windows. For, not for cancer, I tried to convince him to put cancer cells there, and I couldn't convince him.

• 9:45Speaker 01

  So that's when I said, okay, I need to do this in my own lab.

• 9:47Flora Lichtman?

  Okay, so you have this window now, in mice primarily?

• 9:53Speaker 01

  Well, I started out rabbits, but now only in mice, yeah.

• 9:56Flora Lichtman?

  Okay. And what did you see about the blood flow? What was going on with the blood flow in tumors?

• 10:03Speaker 01

  It's very fascinating. I wish I could show the video to your listeners, because that'll blow their mind.

• 10:12Speaker 01

  Because it will completely change their thinking about cancer. Essentially, what you see is that some part of the tumor, the blood flow is quite brisk, pretty good. In other parts of the region, there's no blood flow. If you gave that tumor to a pathologist, they'll tell you there are blood vessels everywhere. So you're going to ask the question, okay, what's going on? So just visualize like you have a highway and traffic is not moving.

• 10:39Speaker 01

  You see what I mean? I'm sure.

• 10:40Flora Lichtman?

  We've all lived it.

• 10:41Speaker 01

  Yes. So we realized this. And then, obviously, I began to think about when I was a professor of chemical engineering, why would flow stop in a vessel, in a tube?

• 10:53Flora Lichtman?

  You had asked this question. Is medicine getting to the tumors? Because if we're going to treat cancer, we want the medicine to get there.

• 11:00Speaker 01

  You got it.

• 11:01Flora Lichtman?

  You find out that the arteries that would take the medicine there are not working, at least not working very well and definitely not working very well across the tumor.

• 11:13Speaker 01

  Yeah.

• 11:13Flora Lichtman?

  This feels very promising. So are people, are the grants sort of like rolling in at this point? What do people think about this? What does, how does the field think about this?

• 11:22Speaker 01

  Are you kidding? So when I proposed this, my first six grants were rejected in a row.

• 11:29Speaker 01

  When I proposed this, I want to study drug delivery in tumors. This is not an important problem. You need to focus on cancer cells and its genetics. Why are you wasting your career? So it took quite some time. I finished my PhD in 75, December, and I got my first grant in 1980 from NIH.

• 11:52Speaker 01

  So that was very gratifying.

• 11:55Flora Lichtman?

  I bet.

• 11:56Speaker 01

  Yes, yes. But so it was very hard. But I kept at it because I knew if you're going to make a difference in treatment of cancer, we need to figure out what's stopping blood flow and how to improve it.

• 12:13Flora Lichtman?

  We have to take a quick break. But when we come back, how Rakesh Jain's research went from heresy to canon and what it might mean for the future of cancer care.

• 12:30Speaker 02

  Science Friday is supported by PBS, presenting Going Wild. If you love learning about the natural world and meeting the scientists who help us understand it, be sure to check out the new season of Going Wild with Dr. Ray Wynn-Grant. It's the chart-topping and Webby Award-winning podcast from the folks at Nature on PBS, now with a video companion series. In this season of Going Wild, host acclaimed wildlife ecologist Dr. Ray Wynn-Grant heads out into the field to explore the animals, people, and stories that make nature worth saving. Stops include a hibernating black bear den in Arkansas and an underwater shipwreck site off the Florida coast. If you're looking for a place to start, check out the season's debut episode, where Ray joins beloved biologist and influencer Jordan King in the Florida Everglades to learn about

• 13:14Speaker 02

  his unlikely journey into science and how to study a wetland when it's not very, well, wet. So don't miss out. Follow Going Wild with Dr. Ray Wynn-Grant on Apple Podcasts, Spotify, YouTube, or wherever you get your podcasts. Support for Science Friday comes from Science Sandbox, an initiative of the

• 13:32Flora Lichtman?

  Simons Foundation.

• 13:37Flora Lichtman?

  Okay, Rakesh, so we left off with this idea that this work was outside of the box, because you are trying to make the blood vessels that lead to the tumors work so that they can bring medicine to the tumor. But there's also this dogma in cancer research of starving the tumor. So is that partly why it was heretical?

• 13:59Speaker 01

  It was partly because of that definitely. First, because I was not working on cancer cells, okay? That alone was a problem, all right?

• 14:09Flora Lichtman?

  Not the seed.

• 14:10Speaker 01

  Yeah, not the seed, yeah. They said, "You're working on hubcaps instead of the engine," okay?

• 14:14Flora Lichtman?

  Literally, is that what they said?

• 14:18Speaker 01

  Anyway, so since 1971, a very distinguished colleague of mine, late Dr. Judah Fookman, had put forward the idea that we need to starve tumors. And it's a good idea, because that's what surgeons do. When you cut off the tumor from a patient, you cut off its blood supply, its cyanore. The tumor is dead, right? And he was trying to do that in patients in situ, right? And so he was trying to develop what are these drugs called anti-angiogenic drugs.

• 14:48Speaker 01

  And the very first such drug was anti-VEGF drug, known as bevacuzumab, or trade name is Avastin. Well, it's a, it sells for 10-plus billion dollars per year and used by large number of patients. So this drug was originally developed to starve the tumor to death. The reason was because VEGF stands for vascular endothelial growth factor. Vesc, I mean, for the growth factor.

• 15:14Flora Lichtman?

  So it seems like it's going to make them grow, right?

• 15:15Speaker 01

  Yeah, and now if you cut it off, they're not going to grow, right? That was, it's a very cool idea, think about it. And, and except when they tried this in patients, and when mice had, of course, starved the tumor, but when they tried this in patients, it didn't work, the trial failed. But when they combined with chemotherapy, it worked like charm.

• 15:34Flora Lichtman?

  Oh, that's strange, right?

• 15:35Speaker 01

  Yeah, yeah, so I said to myself, hold, hold a second. How can you deliver a drug if you cut off the blood supply? What, why would it make work better? So in the meantime, while I was doing experiments in mice, I was seeing that when you give this drug, you actually improve the blood supply.

• 15:52Flora Lichtman?

  So it does the exact opposite.

• 15:54Speaker 01

  Opposite, you got it, you got it.

• 15:55Flora Lichtman?

  That people thought it did.

• 15:56Speaker 01

  Exactly, for a short time, not permanently. So anyway, so originally, when I proposed this idea in an article in 2001, in, in an article in Nature Medicine, normalizing vessels using anti-drugs that were developed to kill them. I was not.

• 16:15Flora Lichtman?

  How'd that go?

• 16:15Speaker 01

  They, no, it did not go too well. I will not dwell on it because I could give you a long history about my grand rejections, paper, or, or on and on, but anyway.

• 16:24Flora Lichtman?

  Well, what was the worst review? Just give one example.

• 16:27Speaker 01

  Well, what, somebody wrote to me, what's Dr. Jane smoking?

• 16:33Speaker 01

  I still would like to know what Dr. Jane is smoking because I'm a non-smoker all my life.

• 16:42Speaker 01

  Anyway, that was a tough time for me. Friends wouldn't talk to me, they would turn around. Because, you know, and I, and I had so much respect myself for Dr. Fulkman. He liked the idea eventually, when I met with him, explained to him, because he explained why this therapy is working. But the interesting thing is, what What is even cooler is that I found out that later on and showed in 2012 that when you repair the vessels, immune therapy works better.

• 17:10Flora Lichtman?

  Wow.

• 17:10Speaker 01

  And that's what led to many trials of combining these anti-VEGF drugs with immune checkpoint blockers or other things. And guess what? That's how led to the right now there's seven approvals by FDA for lung, liver, endometrial, and lung cancer.

• 17:26Flora Lichtman?

  Lung, liver, endometrial.

• 17:28Speaker 01

  And kidney, sorry, yeah.

• 17:29Flora Lichtman?

  And kidney cancer, all now use this.

• 17:32Speaker 01

  Yes, now this is approved now, yeah. But not only that, there are about 200 trials going on as we speak with such a combination. So I think this is transformational for immune therapy. So anyway, this is a very, this is so gratifying, I cannot tell you, because this also is helping kids with a benign tumor in the ear, show an OMA's, their hearing, that's become the same, their hearing comes back when they don't have hearing and then suddenly, boom, you give this drug at a homeopathic dose and boom, their hearing comes back. And potentially will help about half a billion people worldwide with many diseases.

• 18:09Flora Lichtman?

  You know, you spent, you spent a long time working on this when people were skeptical of it. Did you ever want to quit?

• 18:21Speaker 01

  Are you kidding? No, this is not in me, yeah.

• 18:24Flora Lichtman?

  That's not who you are.

• 18:25Speaker 01

  No, I can't quit because, look, I shouldn't say that I'm turning 75 next week, I'll be on December 18th. I ain't quitting. As long as this brain keeps functioning, as long my neurons keep firing, I want to make a difference in other diseases too, besides cancer. And I'm working on a microbiome, how that can help. I'm working on neuronal, how neuronal cells help cancer cell grow, how to block that in tumors of the kids. So I'm, so I'm, I don't have enough hours in the day to pursue my work.

• 19:10Speaker 01

  That's my problem.

• 19:12Flora Lichtman?

  You want to make the most of your time.

• 19:13Speaker 01

  Yes, I do, I do.

• 19:16Flora Lichtman?

  So back to your research, the other problem that you found when you were looking at these blood vessels is that they were crushed, collapsed. What was happening there and how do you fix a crumpled up blood vessel?

• 19:30Speaker 01

  Okay, so the first question we asked is, A, who's doing this? Two, how much force is being applied? And number three, who's applying it? And number four, how do we get out of it? Right? That's a good engineering problem, too. Okay? We like to measure forces, all right?

• 19:51Flora Lichtman?

  That's the bread and butter of an engineer, yeah.

• 19:54Speaker 01

  Okay, so human tumors apply pressures higher than 120 millimeter mercury. You know what our mean arterial blood pressure is? About 100. So a tumor can compress, apply pressure more than your heart can pump.

• 20:09Flora Lichtman?

  Okay, so it's a high pressure, it's a high pressure zone in your body?

• 20:12Speaker 01

  It collapses.

• 20:13Flora Lichtman?

  Which kind of explains why your blood vessels are cramped, right?

• 20:17Speaker 01

  You got it, collapses. So the next question is, who's collapsing it? Right? So the first thing that collapses are cancer cells, all right? Themselves, they will do that, all right? Because they're growing in a confined space. But the tumor where this is the worst is pancreatic cancer, you know? You know, there's no treatment for it. Or there, all the treatments are really very ineffective. And you know what the tumor, pancreatic cancer has? Has only 5% are seeds. Only 5% cells are cancer cells. That's it.

• 20:50Flora Lichtman?

  Wow.

• 20:51Speaker 01

  The rest is just soil. So soil is compressing. So next question, what in the soil is doing this? And it is the matrix. So the question is, how do you get out of matrix? Right? Selectively. And that's where the next chapter began in my career. Looking for how to reduce matrix, not remove it completely, because if you do that, that's bad news. How to normalize it. Remember the word we use is not removal, but normalizing?

• 21:21Flora Lichtman?

  Normalize it.

• 21:23Speaker 01

  Don't destroy it. I'm a Jane. We don't believe in killing anything, okay? That's my religion, okay? I try to fix things.

• 21:35Speaker 01

  So anyway, so how do we fix the matrix? Lo and behold, a few years later, we discovered that a highly effective anti-hypertensive drug, a drug which is given to patients who have high blood pressure called Lasartan, costs less than dollar per day, it's cheap, safe, given to 20 million people, that can do it.

• 21:59Flora Lichtman?

  Hmm, okay, let me recap here. So you find out that there's a lot of pressure inside these tumors that's doing the collapsing, and you find out that it's actually this sort of matrix that's in between the cancer cells and the other cells in there that's applying the pressure. And you discover this cheap, generic, blood pressure medicine, Lasartan, that seems to reinflate the blood vessels. Does that sound right?

• 22:29Speaker 01

  Yeah, it removes them, yeah.

• 22:31Flora Lichtman?

  What does it do? Does it get rid of the matrix?

• 22:34Speaker 01

  Yeah, what it does, it reduces it. Same thing, normalize it.

• 22:37Flora Lichtman?

  This sounds too good to be true, in a way. A generic, safe, cheap drug?

• 22:42Speaker 01

  Yeah. But we found out one more benefit of it, which is really what I want to talk to you about. This is a recent finding. So, you know, glioblastoma is one of the most deadly brain tumors?

• 22:55Flora Lichtman?

  Yes.

• 22:56Speaker 01

  The last therapy that was work was nearly 20 years ago. Not much has changed. Can you believe then 20 years after so much investment? Immune therapy has failed, everything has failed so far. So what's going on here? So one problem with glioblastoma is, of this kind of brain tumor, is that there's a lot of edema in the brain. Edema means swelling. There's a lot of water, all right? Leaky vessels, there are no lymphatics that can come out, so the water accumulates. And what happens to control the patients who have, you know, this type of tumor, they get steroids for that. They don't like it, but that's only they can control it. So guess what? When you give immune checkpoint blockers, this immune therapy, edema goes up, that means swelling goes up even further.

• 23:40Speaker 01

  So now you have to give patients steroids. Guess what? Steroids are immunosuppressants. So you're expressing both accelerators and brake at the same time. It's not going to do any good, right? What we discovered and published in 2023 that losartan can actually decrease edema.

• 24:05Flora Lichtman?

  Decrease that swelling?

• 24:07Speaker 01

  Yeah, decrease that swelling. And I've been trying to get funding for it and I'm unable to do that.

• 24:12Flora Lichtman?

  You need to do a trial.

• 24:13Speaker 01

  I need to do a trial because I have compelling data in mice. So we have enough evidence to move to a clinical trial.

• 24:20Flora Lichtman?

  But?

• 24:21Speaker 01

  But I can't get money for it.

• 24:23Flora Lichtman?

  Because?

• 24:27Speaker 01

  Well, number one, that the multiple reasons for it. This is a generic drug, so pharmaceutical companies not only make money with it.

• 24:35Flora Lichtman?

  There's no financial incentive.

• 24:36Speaker 01

  There's no financial incentive. So I've tried to approach companies, but that's not working. And with NIH, I don't need to tell you what's going on. I'm so worried about my students and my junior people. I cannot tell you. I cannot tell you how much worried I am for her about them because of the way what's happening to our funding. You know, we are taking all these, not only mine, but many other people's ideas. Patients will never benefit from them unless the NIH invests money in it.

• 25:04Flora Lichtman?

  Let's talk about that a little bit. What do you think is the biggest threat to cancer research right now?

• 25:09Speaker 01

  The biggest threat to cancer research is lack of funding. There are so many brilliant people, so many brilliant ideas. And just to give you an idea, when I started my career, about 25% of the grants were getting funded. You write your application, first round about 25% or maybe second round. Under Biden administration, went down to 11%. Now it's 4%.

• 25:37Speaker 01

  It's like one out of 25. Think about it. And you would think somebody with my track record would get their grant funded the first round. No, it's not happening. No, it's not happening. Now, think about the junior people. Think about that. So it's so sad. I mean, we are world leaders. I mean, more Nobel laureates in medicine have gone to the US than any country in the world, maybe the rest of the world combined, you know? And yet, we are just handing over this leadership to other countries.

• 26:14Flora Lichtman?

  Hmm.

• 26:15Speaker 01

  And we are hurting patients by not investing in this.

• 26:21Flora Lichtman?

  What about attracting talent from other countries?

• 26:25Speaker 01

  Oh, that's hurting too. I mean, right now, if you look at my lab, I have people from Germany, from many countries of Europe, many people from Asia. And if you stop giving them visas, and if you start charging $100,000.

• 26:42Flora Lichtman?

  For the H1B?

• 26:44Speaker 01

  For the H1B. I mean, it's going to hurt not only us, it's going to hurt industry, pharmaceutical companies, it's going to hurt the hospitals. It's going to hurt all of us. Flora, we need to do something about it. And I think the foundations also need to step in, you know? They have money, we know that. I mean, there are a lot of wealthy people in this country. We know that. We are killing, we're killing our young scientists. And I just cannot tell you, Flora, how sad that is.

• 27:21Flora Lichtman?

  How do you think about mentoring right now when it seems so difficult for trainees and for young scientists?

• 27:35Speaker 01

  I sit with them, and I'm trying to support them as much as I can. And I keep reminding them, my first grants were rejected in a row.

• 27:45Speaker 01

  So just hang in there. Just hang in there and I'll continue to support you as long as I can. If necessary, you know, I'll beg, I'll do whatever it takes. Because these are such bright people, they have bright ideas and they have a bright future ahead of them if we just, you know, it's like seed and soil. We need to give some fertilizer to the soil.

• 28:10Flora Lichtman?

  Fertilize.

• 28:11Speaker 01

  Yeah, yeah. And these are just so smart people and dedicated and determined.

• 28:16Flora Lichtman?

  You know, we started this conversation about how even pursuing the soil as opposed to the seed was an uphill battle. Do you feel vindicated? Do you let yourself feel any little bit of that?

• 28:35Speaker 01

  Well, I feel joy, I am not going to deny it. When a trial succeeds, when your concept works, when it helps people, how can it, you smile, you got this, and you forget about all your woes, you forget about all the rejections at that moment.

• 28:52Flora Lichtman?

  What did it mean to you to win the National Medal of Science? I mean, that is, you know, among the biggest science recognitions.

• 29:01Speaker 01

  I cannot tell you how joyful it was to me with the President Barack Obama in the White House. Can you imagine? And look, I'm a foreign, I was born in a little town in India. Can you imagine? This is like way beyond my dreams. Coming and standing in the middle of White House, that was like beyond anything I had imagined.

• 29:21Flora Lichtman?

  What advice do you have for people who are pursuing an idea that is outside the box?

• 29:26Speaker 01

  Hang in there. Number one, just don't give up. You know, there's a difference between being stubborn and stupid and, but that's the fine line you have to sort of figure out for yourself. And I am not stupidly stubborn, that's what I like to think, yeah.

• 29:50Flora Lichtman?

  Yeah, don't be afraid to be wrong, too.

• 29:52Speaker 01

  Oh, no, no, no, you cannot be, yeah. Actually, if you're not wrong, something is not right. Yeah, yeah. If everything's going right full time, that's just, no, there's a little problem.

• 30:07Flora Lichtman?

  What's the purpose of science?

• 30:09Speaker 01

  I think there are two purposes of science. For me, it's more, one is personal joy it gives me. And the second, it's the understanding the mystery of nature is what drives me. Right? But second purpose of science is to serve humanity, to improve the lot of human beings.

• 30:30Flora Lichtman?

  Seeking joy and helping humanity. I think you've done that.

• 30:34Speaker 01

  Thank you. I've been very fortunate.

• 30:37Flora Lichtman?

  Dr. Rakesh Jain is professor of radiation oncology at Harvard Medical School in Boston. And happy early birthday to you.

• 30:44Speaker 01

  Thank you very much.

• 30:47Speaker 01

  Thank you.

• 30:52Flora Lichtman?

  This episode was produced by Rasha Aridi. Special thanks to engineer John Day and the folks at WGBH in Boston for hosting Dr. Jain. We'll see you next time. I'm Flora Lichtman.