1. Can genetically modified food cause cancer? “Genetically modified” is definitely one of the most popular terms in the media in recent years. I just want to say responsibly: so far there is no single quality research paper that can stand up to scrutiny and prove that GM food can cause cancer. My professional opinion of the French study of rats eating GM food causing cancer that has been circulating on the internet is: “Bullshit”. Of course it’s good to see that this kind of claptrap has been withdrawn “GM food is completely harmless” is itself a scientifically unprovable proposition. Even if it remains harmless, there is no guarantee that in 100 years there will be a person who will have a hiccup because of GM. As rigorous scientists, we can only say that it’s harmless until someone can prove it’s harmful. As a less rigorous scientist, I personally think the likelihood of GM being harmful is slim to none. This can be interpreted as self-congratulatory on the one hand, because I know I have been eating all kinds of GM foods in the US for a long time, so I can say that Americans who don’t eat GM can give it a rest. Why do scientists have nothing to do with genetic modification? One is to save money, and the other is to make money. We, the boring scientists, engage in some genetically modified crops or animals, just to let them grow in order to produce a competitive advantage, either to grow strong, or grow faster, or more results, or not be bitten by insects. In the end, it’s all about reducing costs and feeding more people, which is actually the same as Yuan Longping’s previous purpose of artificially selecting and breeding rice, except that with the increase in scientists’ understanding of biological science, especially genetic recombination technology, we can finally not rely on the sky for food, but can construct better plants and animals to sell for money. The Earth’s population is still growing at a rapid rate, and is expected to reach 8 billion around 2040. The demand for food will double, and if there are no GM crops, as the land decreases and the population increases, many people will not have enough to eat, and then there will be people who care about GM or not. People talk about genetic modification, but in the end what is genetic modification, I guess in addition to the “twenty-first century is the century of biology” lulled into the biology department, the vast majority of people just imagined. The essence of genetic modification is to add new functional proteins to cells, which may promote the growth of organisms, or produce resistance to drugs, etc., but in any case, they are just proteins. So when we eat GM foods, we are eating traditional foods + new proteins. The essence of the debate over whether GM food causes disease then should be whether the newly introduced proteins are harmful to humans. The reason I think the possibility of GM being harmful is minimal is because the possibility of this newly introduced protein being harmful is minimal. First: humans have not yet mastered the ability to create entirely new functional proteins on their own. The so-called new proteins introduced by transgenesis are actually all naturally occurring, except that we take some dominant protein from organism A and add it to organism B so that B gets that property. For example, genetically modifying a cow and adding a human insulin protein so that insulin can be extracted from milk, cow right! Since it is a protein that exists in nature, there is no reason why a genetically modified protein should be more harmful than a normal protein. Second: All proteins are made up of 20 basic amino acids, which are broken down into amino acids by proteases in the human stomach and small intestine and absorbed. So no matter what genetically modified product the protein is, it is the 20 amino acids that are ultimately absorbed by the body. The same is true for genetically modified fluorescent shark and Tibetan plateau pure and unpolluted carp; the same is true for McDonald’s genetically modified colorful corn rice and black land grain nutrition rice. All in all, we don’t have to talk about GMOs. I support healthy food and respect personal choice. If you are really afraid of GMOs and can buy food that is not genetically modified, that’s great. If, like me, you don’t have the conditions or the time to identify whether each food is genetically modified, why not take it easy and go for a run instead of watching the news about genetic modification on the internet every day? 2. How to use the latest foreign anti-cancer drugs Since using WeChat, recently people often ask: “I have a relative with XX cancer, I heard there is the latest drug XX in the United States, but China does not sell it, do you have a way to buy it?” These years are the harvest season for the development of new anti-cancer drugs in Europe and the United States, and many of them have achieved quite good results in the clinic, bringing hope to patients and their families. New treatments are available for advanced lung cancer, skin cancer, prostate cancer, leukemia and so on. However, 99% of the new anti-cancer drugs are available in the US and Europe first, and there is often a lag of several years in the Chinese market. Therefore, it is a very real problem for Chinese patients to buy anti-cancer drugs that are only available in Europe and the United States. If your dad is Li Gang, then I am sure there is a magical way. What I am going to say below is just for ordinary families to choose without breaking the law. The first thing to be clear is that anti-cancer drugs are prescription drugs in the US (most European countries), so there is no way to be able to get them except through your doctor. The controls on prescription drugs are very strict in Europe and the United States, and the penalties for treating a doctor who prescribes a drug without seeing the patient are very severe and can lead directly to the revocation of the doctor’s license. Because of the very high salary of American doctors, no one would normally risk doing this. This is very similar to the “high pay for integrity”, on the one hand, “high pay”, on the other hand, “crackdown”, to ensure that everyone abide by the rules. This also fundamentally blocks the opportunity to “legally” sell anti-cancer drugs to China. So to the question at the beginning, sorry, I don’t have access to it. Does that mean there is no way? No, there are still some other ways. The easiest way to deal with this is to have the patient come directly to the US (or Europe). Once they come to the US and find an oncologist and meet the conditions, they will have access to the latest drugs. But there is a basic requirement for this option, which is that the patient should be well enough for a long-haul flight and smooth customs entry. If this basic requirement is met, there are two options for coming to the U.S. to see a doctor, the first is to go through the “front door” and the second is to go through the “side door”. The “front door” means to contact the oncology hospital directly, have them issue an invitation letter, and then go for a visa. This option is very safe, and the whole process will be guided by the U.S. hospital throughout, which is very secure. But the problem is that it requires a large amount of money for the guarantee. As we all know, medical care in the United States and Europe is very expensive, and it is completely dependent on the insurance system to make it possible for everyone to see a doctor. The amount varies from hospital to hospital, but for oncology, millions of RMB is a certainty. “This amount varies from hospital to hospital, but for oncology, millions of RMB is certain. With the relaxation of the US visa policy, patients and their families can come to the US as tourists, thus avoiding the step of having the hospital issue an invitation letter and therefore not requiring a large upfront guarantee. The problem with this is that there is a risk of entry into the country and the possibility of deportation if you are questioned. On the one hand, I understand why people take the “easy way out”, but on the other hand, this kind of behavior is very damaging to the U.S. healthcare system and credit system. The hard-working middle class in the U.S. pays for your care? I support people coming to the U.S. on a tourist visa to save the hassle up front, but if you can afford it, please try not to abuse the “low income” benefit. If, for whatever reason, a patient cannot come to the U.S., is there any other way? Another option is to go to Hong Kong or other places in Europe where controls are not as strict. This is a huge market, I believe there are many people doing it, ask Google or Baidu about everything. The last way is actually the one I want to talk about the most, and people often don’t think about it directly: apply to join a clinical trial in China! Due to the huge Chinese market, the latest anti-cancer drugs now, after or even before approval in Europe and the US, will start clinical trials in China in the hope of being marketed in China as soon as possible, often with 1~3 years in between. This is actually a huge “free medical care” opportunity. Participants in clinical trials are usually not required to pay for the drug and are often given special care and even subsidies. Once you find out about a new drug in a clinical trial in China, you can register at the relevant hospital and, if you meet the requirements, you can join the clinical trial in China, much better than making a trip to the unfamiliar United States. Participating in a clinical trial sounds a bit worrisome: Is my loved one becoming a guinea pig? Not really. Traditionally, the big risk of participating in clinical trials is that the efficacy and dosage are inaccurate; the drug may not work at all, or even if it does work, you may not know how much to use, and the dosage may be too low to be effective or too high to be toxic. However, the clinical trials of new anti-cancer drugs started in China are relatively safer because the same drugs have already passed phase 2 clinical trials in Europe and the United States, and doctors already know the efficacy, effective dose, maximum tolerated dose and so on. Participation in clinical trials under such circumstances is almost no different from treatment after the drug has been confirmed to be approved. By the way, being reminded by the mentors, there is another serious risk of participating in a clinical trial: there is a certain probability (generally less than 50%) of being assigned to the “control group” instead of the “experimental group”. The “control group” generally uses the best treatment available today, while the “experimental group” uses the new drug. Clinical trials are generally “double-blind”, that is, the patients, and the doctors do not know who is in the “control group” and who is in the “experimental group”. So there is still a difference between participating in a clinical trial and coming to the U.S. to receive treatment. There are several databases for checking clinical trials: (1) North American Clinical Trials Registry (ClincalTrials.gov); (2) China Clinical Trials Registry (ChiCTR); (3) World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We wish everyone can have access to new drugs and make cancer no longer a terminal disease soon.