Fortune Tellers, Cards and Genetics: Edvīns Miklaševičs at TEDxRiga

Translator: Ilze Garda
Reviewer: Denise RQ Hello. Actually I wondered why I am speaking
now and not in ‘Science for Life.’ Probably a lot of people still
do not consider genetics a science, but rather something of a witchcraft,
with some kind of a fashionable flavour, performed by not always very honest guys. And that in a sense, we do
have something to do with fortune tellers, and, you know, fortune tellers,
witches, card readers intimidated people,
and people were scared by them, scared by fairy tales
like the Grimm brothers’s fairy tales. Nobody today is scared of these things, but people need to be scared all the time. So here we are, geneticists,
who are scaring people. You can say you’re intelligent people,
you are not scared of genetics, OK? Try a genetically modified tomato! Be careful, it contains genes. As a person, being involved
in genetics for more than 20 years, I can assure you that genetics is simple. If a child looks like his father,
that’s because of genetics. If a child looks like a neighbour,
it’s the influence of the enviroment. (Laughter) It’s not a joke. (Applause) And clearly, we all are
some kind of compromise between the genes we inherit
and the influence of environment. Actually, the most difficult thing, and the only difficult thing in genetics is to distinguish where genes finish
and environment starts, or vice versa. As we learned, God doesn’t play dice. God plays cards. Our genes are shuffled
and dealt like cards. Sometimes you have a strong hand,
and sometimes a poor hand, meaning you have some mutations. Diversity of deals, of course,
provides diversity in us, and provides for a diversity
of different predispositions, for example, diabetes,
cardiovascular diseases, cancers, and so on. Then, in some hands, you have just one card
which spoils that particular deal, and you cannot basically play anything. This is what maybe we can call
in clinical medical genetics a delirious mutation. Such a mutation will,
instead of predisposition, turn into predetermination. For example, an average woman in Europe has a 9-10% lifetime risk
of acquiring breast cancer. Unfortunately, a person who is carrying
a particular mutation in some gene, has an 80% risk,
and it is almost inescapable. Even in this relatively small audience, it’s a fair bet to make that at least one of you here
is carrying such a mutation. But it’s not enough
that you all are mutants. Nothing personal,
I’m also a mutant. (Laughter) Our cells are acquiring
more and more mutations during division. It’s just like an imperfect
Gutenberg machine: every time our DNA gets replicated, it aquires new mutations
and carries old mutations, and it makes all our cells
a bit different in the sense of fitness, in a sense of the universe
where they are living, meaning, in us. And our cells are selfish,
they do not very much care about us. They try to be fit, to get
more oxygen from what we breath, more food from what we eat or more,
I don’t know what, coffee, wine, whatever. So fitness of our cells
and our body is starting to [differ] because they have acquired
different mutations. At this point, a small, evil Charles Darwin
starts working within us, and the [fittest] cells are starting
to proliferate with the highest speed. Which means that our best cells
turn into our worst enemy. Cells proliferating
out of control is a cancer. Clearly, we don’t know when we,
or if we, already have cancer or not. We can put the date of our birth – and nowadays this is more precise, my grandfather didn’t know precisely,
he had plus, minus a year – we probably can put
the time of conception, and we can put the time of diagnosis, but we cannot say clearly when one or few of cells
accidentally acquired such a mutation which has already started an avalanche
of invisible events leading to a cancer. Basically, it means
that if you or anybody else is living a long, nice, healthy life, at the end of the life,
you will be rewarded with a cancer. Cancer is basically inescapable. Of course, these are the cards which we are keeping in our hand
and which we inherit, but for those who are
familiar with bridge, we have a partner, a dummy,
who puts the cards on the table, and we can choose to improve
our hand; this is enviroment. The choice of these cards is to choose
the precise card fitting our cards; this is the art of doing. Some years ago, maybe two years ago, I was speaking on the radio about cancer
and then I got the phone call. An elderly man said:
“Why do companies [deliberately] put a substance into shampoo
which causes a cancer?” He was looking for a cause of it. I said: “OK, maybe at first, stop smoking.
Stop running the red light. And then maybe we will
come back to your shampoo.” The guy was not lazy, he called me back
to the radio in 10 minutes and said: “You know, we were
four people in the cancer ward, and only three people were smokers. And you are speaking about smoking,
tell me [rather] about the shampoo.” I will not tell you about the shampoo,
I will show you some choices. Of course, I said cancer is inescapable
which is not exactly true. If from childhood you go
three times a day to a fast food joint, eat Tommy’s hamburgers, and then you get hyperhistaminemia
or something that sounds equally nice; before the tender age of 37,
no chance for cancer. 23,4% of 8-years-old first grade pupils are either overweight or obese. Smart kids: eat fast,
die young. (Laughter) I said [there are] some unlucky people
who have this mutation which basically predetermines them
to breast or ovarian cancer. There are not many things you can do, but one of the most effective
[ways] to avoid or delay it is risk-reducing surgery,
meaning, mastectomy or ovariectomy, and I’m talking about young, bright,
healthy women who go for this surgery. It may look like a quite difficult choice,
but, trust me, it is not, because in some countries, up to 60%
of such affected, healthy women do this. I said that on average, women in Europe has a 10%, 9% lifetime risk
of getting breast cancer. This risk can be reduced twofold
if you deliver three or more children; the first before you are 25. This is a much more difficult choice because only 8% of the families in Latvia
– and something like that in Europe – have three and more kids. Actually big pharmas are now thinking about drugs imitating
pregnancy without delivery. This is not a joke. There is no such drug yet,
but this is considered an option. Welcome to the brave new world.
We’re already there. Now the most difficult choice. Lung and respiratory cancers
are caused only, almost… – OK, I will be conservative – smokers-friendly,
about 95% are smokers. So if you don’t smoke,
or at least you give up smoking, you reduce your probability of getting
lung cancer very [significantly], but it is a very difficult choice. During the last 12 months, only 2.1% of smokers in Europe gave up. Now, I learned to play cards
before I learned to read, that’s true. Which means that you
have to estimate in [cold blood] what you have in your hand: if you are brave enough,
you can apply for genetic tests – they are quite good,
and not so expensive anymore; they are getting cheaper and cheaper – then you estimate your chances, and the important thing is that you don’t drop aces
and use false arguments because card game is a game of cool mind. Last, but not least: genetics incline, they do not compel. The game is in your hands. Thank you for your time. (Applause)

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