Understanding Cancer w/ Dr. Peter Baik

Episode Information

October 22, 2021

Thoracic Surgeon Dr. Peter Baik talks about his side interest in aeronautical engineering, his own field of thoracic surgery and its rapid acceleration, what exactly cancer is, the importance of lung cancer screening, and more.

Topics Include:

• His initial interest in engineering and and his side passion for aeronautics
• Thoracic oncology and advancements in the field
• The mechanisms and intricacies of cancer
• The causes of lung cancer and the importance of screening
• The hardest part of his job
• Why Doctorpedia appeals to him
• His future plans for the Doctorpedia platform
• What he does to stay healthy

Highlights

• “So the reason why I became a doctor is because I liked anatomy. I initially thought I wanted to be an engineer, specifically aerospace engineer, but in high school, I got to learn about anatomy and physiology. And it was just amazing. And what is more intricate and interesting engineering than the human body?”
• “All this imaging that we have, it’s not perfect. MRI is not perfect. PET scan is not perfect. CT is not perfect. So we have to use all those tools that we have to kind of come to a conclusion that, hey, this is the stage one, you have early stage, therefore, the best thing is to do surgery or radiation, if you cannot tolerate surgery, but it’s not a hundred percent that that’s true.”
• “Now, we’re utilizing robotics. And in the last 10 years, utilization of robotics has grown significantly. And now we’re doing more and more with the robot. And I think that’s the most exciting thing.”
• “Most of the time, you don’t find [lung cancer]. You don’t have any symptoms. You don’t have a cough. You don’t have spitting up blood or coughing up blood. You don’t get shortness of breath. And so that’s why we promote early lung cancer screening CTs on patients who meet the criteria.”
• “The toughest part is when patients do everything to fight cancer, but cancer just takes over and we don’t have any tools or patients not able to tolerate the treatments that we have. And especially the young patients. Patients, families, young kids. It’s very difficult.”
• “On the internet, when you try to find information, you’re going to get many different types of information, right? And so Doctorpedia, the content is created by doctors who are board-certified and experts in their fields. And it’s a one-stop place to obtain that information.”
• “What I’ve been doing is trying to be more active. Age is something that when you’re young you don’t think about, but as you get older and things start to get hurt, things happen. And so I’m now trying to exercise a little more, just some cardio and things like that. Having a supporting person definitely is helpful. So my wife is wonderful. She makes sure that I don’t eat fries everyday, but eat veggies and healthy stuff.”

Episode Transcript

Daniel Lobell: (00:00)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only, and should not be taken as medical advice. Since every person is unique, please consult your healthcare professional for any personal or specific needs.

Daniel Lobell: (00:20)
Hello and welcome to the Doctorpedia podcast. I’m your host, Daniel Lobell, and I’m so honored to have on the line with me today Dr. Peter Baik. How are you, Dr. Baik?

Dr. Peter Baik: (00:32)
Doing well.

Daniel Lobell: (00:32)
I’m excited to have you on for many reasons. One, you’re the very first doctor who does, I hope I say it right, thoracic surgery. Is that correct?

Dr. Peter Baik: (00:41)
Yes. Thoracic surgery.

Daniel Lobell: (00:43)
That we’ve had on the show, but also I think you’re the very first South Korean doctor we’ve had on the show, which is interesting because I don’t know much about South Korea and I’m excited to hear about it, and hopefully the listeners are as well. So I want to start there. I know you were born and raised in South Korea, and what was that like from what you remember and what brought you to America? Let’s start there.

Dr. Peter Baik: (01:06)
Yeah. So I was born there and came to the States when I was 12. The childhood, it’s always good memories when you’re a child. And for me was growing up, moving from different cities within South Korea, there are challenges, but you adapt. And then we came to the States because my parents wanted better opportunity for my brother and I.

Daniel Lobell: (01:28)
What did your parents do for a living in South Korea, and then again, when you got to America?

Dr. Peter Baik: (01:34)
So my mom was a housewife, which is a usual typical work for females in South Korea, but my dad was a school teacher and then a middle management in a large company.

Daniel Lobell: (01:48)
Oh, wow. So you didn’t come from a medical background. What made you decide to become a doctor?

Dr. Peter Baik: (01:54)
So the reason why I became a doctor is because I liked anatomy. I initially thought I wanted to be an engineer, specifically aerospace engineer, but in high school, I got to learn about anatomy and physiology. And it was just amazing. And what is more intricate and interesting engineering than the human body?

Daniel Lobell: (02:16)
It’s so true. It’s such an incredible thing, the body. It’s a miracle. Just all the tiny little things within the body that have to work constantly for the whole body to work that you don’t even think about it.

Dr. Peter Baik: (02:29)
Yes.

Daniel Lobell: (02:30)
I was just talking about this, or maybe I wasn’t, maybe I was thinking about it the other day, about how much of your body functions without you thinking about it. You’re just on autopilot so much. And then the things that I think about so much, I wish I could just put it on autopilot as well. And there’s gotta be a way to reprogram your brain to like, in the same way you blink and you breathe, you eat a certain way or you exercise at a certain time. There’s so much already going on in autopilot from your brain. Why not add another thing or two that — [Daniel chuckles] — how do I do that? I don’t know if that’s your department, but it definitely seems like it’s on topic because of the incredible intricacies of the body that are just going on constantly. So yeah, I think it’s an incredible thing to engineer a body.

Dr. Peter Baik: (03:19)
Yeah. All of these cells, most of the cells in our body, it’s renewed, meaning the old cells die off, the new cells come up. I mean, just billions and billions of cells just working together and getting the signals to work. It’s just incredible.

Daniel Lobell: (03:36)
It’s interesting when you think about it from the perspective of a lazy person, which I’m not, but I have been when I was younger. When I was younger, I was pretty lazy before I had a wife and a kid and a lot going on. I used to just lay on the couch a lot. And I was thinking, I’m being pretty lazy. But when I look back at it, now my body wasn’t lazy at all. It was doing a million things! [Both chuckle]

Dr. Peter Baik: (03:59)
I guess you could put it that way. Yes.

Daniel Lobell: (04:02)
It’s a good way to reframe it.

Dr. Peter Baik: (04:05)
Yes. Your body was doing millions and millions of things automatically without even you giving instructions or doing anything else. However, the body knows that when you’re lazy or, you know, just relaxing, and if you’re in a state where you do that for a prolonged period, your body starts to break down. So for example, if someone is in a coma, their muscle starts wasting. And the reason why is because it’s not being used, it’s not being activated. And so the body knows that, “Hey, we don’t need this.” So it starts to break down. So it’s really important to be active.

Daniel Lobell: (04:43)
It’s so amazing what an intelligent machine the body is to be like, okay, the activities tell the brain to continue to allow for activities.

Dr. Peter Baik: (04:55)
Yep.

Daniel Lobell: (04:55)
But the brain has to decide to do the activities. [Both chuckle] It’s kind of like, I don’t know, it’s pretty incredible to me. And I can totally understand why you chose that over the other engineering option, but why aeronautical engineering? What was the appeal there?

Dr. Peter Baik: (05:12)
I mean, imagine just, not just airplanes, but even animals that fly and just defying gravity. It’s big hunk of metal flying 35,000, 40,000 feet in the air and without dropping to the ground, I mean, it’s just incredible as well.

Daniel Lobell: (05:28)
Yeah, I agree. I can never get over that. It’s incredible. Just to think, it’s metal, it’s this heavy thing and it’s up in the air soaring, that just blows my mind.

Dr. Peter Baik: (05:38)
And then now with the SpaceX, I mean, oh my gosh, it’s incredible what they can do. And what’s amazing is, having those huge rockets just land on a dime. I mean, I know Musk was excited. Oh, I was just as excited when I saw that.

Daniel Lobell: (05:55)
Maybe you still have a passion for it. You ever think maybe you’ll do a little aeronautical engineering on the side?

Dr. Peter Baik: (06:01)
No… Now what I do is, whenever I see a chance to go see airplanes, like for example in Phoenix, there’s a Luke Air Force Base and there’s an area where you could kind of park your car and watch F16s and F35s land. And it’s just amazing to see as well.

Daniel Lobell: (06:20)
Wow. And you’re in Phoenix right now, but you’re not based in Arizona. Are you?

Dr. Peter Baik: (06:24)
No, so I cover both Phoenix and Chicago. I work for a hospital that is just concentrating on cancer care. And so I’m able to actually provide care at both places.

Daniel Lobell: (06:36)
So where do you live?

Dr. Peter Baik: (06:37)
I live in Chicago.

Daniel Lobell: (06:38)
Okay. So you have a lot of time to think about airplanes cause you must be on them all the time.

Dr. Peter Baik: (06:43)
Yeah. I mean, I try to keep myself busy with patients and surgeries and things like that, but yeah. I mean, whenever I hear a plane, I’m always looking up.

Daniel Lobell: (06:51)
So maybe the fascination for you isn’t so much the plane part as much as it’s the air, because you wound up working on lungs. [Daniel chuckles]

Dr. Peter Baik: (07:00)
Ah, you’re right, I never even thought about that,

Daniel Lobell: (07:02)
But you know, you’re big into air.

Dr. Peter Baik: (07:04)
You know, one of my favorite animals is the hummingbird. And I got to work on hummingbirds as a research assistant. And I mean, they hover, they fly forwards and backwards. They could even, and they do flips. And so, just anything that flies.

Daniel Lobell: (07:21)
They’re like mini drones.

Dr. Peter Baik: (07:24)
Oh yeah. Better than drones.

Daniel Lobell: (07:26)
[Daniel chuckles] Yeah. I have them in my yard all the time and they’re just fascinating to watch.

Dr. Peter Baik: (07:31)
And on top of that, their wings beat 60 times a second, the Ruby Throat, right. And if they’re to increase that, they could go up to 80 beats per second.

Daniel Lobell: (07:43)
It’d be very hard to distinguish the difference. Like you would never know if you’re watching a lazy hummingbird.

Dr. Peter Baik: (07:50)
No, you can’t. [Daniel chuckles] They are very territorial and solitary, but not lazy.

Daniel Lobell: (07:54)
Yeah. Well, there’s gotta be some that are lazier than others, but you would never know.

Dr. Peter Baik: (07:58)
Yeah. And they just become food.

Daniel Lobell: (08:04)
[Both chuckle] So, I mentioned thoracic surgery. Can you explain what it is to people? I only know what it is because I read what it is, but I’d rather hear it from you.

Dr. Peter Baik: (08:15)
Yeah, so the broad term for thoracic surgery covers surgery of the chest. And that includes the heart, lungs, esophagus, chest wall, or anything that’s in the chest. But when I say thoracic surgery, I focus on surgeries of the heart, of the lungs, esophagus, and chest wall or any structures within the chest, but not the heart itself. And so there are two types of thoracic surgeons. There are cardiothoracic surgeons and they do both heart and lung surgeries. And then there are general thoracic surgeons like myself who doesn’t do any heart surgeries.

Daniel Lobell: (08:55)
Is there a reason you don’t want to work on the heart?

Dr. Peter Baik: (08:57)
Actually, I’m interested in thoracic oncology. And so I wanted to concentrate on that instead of concentrating on the heart, because I mean, there are a lot of emergencies associated with heart surgeries and you kind of have to specialize. I feel that you have to specialize in order to provide the best care.

Daniel Lobell: (09:15)
What’s the argument on the other side for those who don’t specialize and also work on the heart?

Dr. Peter Baik: (09:20)
Yeah, so the argument for them is that, hey, you could do both. However, the heart surgeons, a lot of times can end up doing their heart procedures because there are sicker patients and there are more physical surgeries. Putting patients on bypass. So those things happen in the morning, first case, second case. And then the lung surgeries usually come later on. And for me, I feel that some of the lung surgeries can be very difficult, especially utilizing minimally invasive approaches like the robot. You have to be more concentrated and do those cases because you just have to do, I mean, the repetition is key. And you just can’t get that with cardiothoracic surgery.

Daniel Lobell: (10:02)
You guys ever have conventions where all the thoracic surgeons get together?

Dr. Peter Baik: (10:06)
Oh yeah, there are many conventions and many meetings and of course, due to COVID, those in-person meetings have kind of stopped. So everything is virtual, but yeah, there are large meetings.

Daniel Lobell: (10:17)
We ought to be able to do them outside now though… You know what? The perfect idea, I just got it. You guys should do it in a park and call it Thoracic Park.

Dr. Peter Baik: (10:26)
[Peter laughs] Yeah. Trying to see a PowerPoint presentations in the park with the sunlight is a little difficult. [Daniel chuckles] Right?

Daniel Lobell: (10:31)
Yeah, I guess so.

Dr. Peter Baik: (10:35)
Yeah. So, and then another thing is this, the field of thoracic oncology is evolving so fast. I mean, trying to keep up with all the latest — even cardiac surgery. You think that bypass surgery, that’s been going on for 30, 40 years, it’s still evolving. I mean, there are techniques that people are using different bypass or profusion protocols or strategies. And then, like the valve surgeries, I mean, there’s now like minimally invasive placed valves called TEVARs. You have to keep up with that. The field is expanding so fast that I think that it’s so difficult to keep up with everything.

Daniel Lobell: (11:15)
What are some of the most exciting advancements that you’ve seen recently?

Dr. Peter Baik: (11:21)
So, well of course for general thoracic surgery like myself, I mean utilizing not just VAT or thoracoscopic or using kind of like laparoscopic or keyhole surgery for belly, but in the chest, it’s called VAT. That’s been around for 15, 20 years and now we’re utilizing robotics. And last 10 years, utilization of robotics has grown significantly. And now we’re doing more and more with the robot. And I think that’s the most exciting thing. And of course, for lung cancer treatment, even though it’s not something that I utilize, it’s called immunotherapy, but for patients, it’s wonderful. I mean, the responses that some of the patients get from immunotherapies, I mean, it’s just incredible. So stage four lung cancers, even five years ago, you will say, “Oh, stage four, your life expectancy, five-year survival is going to be less than 5%, 10%.” Now, there are patients even with stage four disease or metastatic disease or disease that has gone to other parts of the body, they’re living 2, 3, 4 years with the disease. And we don’t have the survival data yet, meaning all of these patients are still living. So we just have to wait until the final data comes out.

Daniel Lobell: (12:43)
Do you think we’re getting closer to actually being able to cure lung cancer, even when it hits these later stages?

Dr. Peter Baik: (12:51)
So the problem with any therapy, immunotherapies or anything like that is, the cancer cells. Even though they’re microscopic and they don’t read any of the textbooks or listen to webinars or podcasts or attend lectures, I mean, they’re really smart. And so they know how to mutate, they get to adapt to different environment. And so eventually, even the best treatments stop working. Then they start growing again and take over. And so curing is still, it would be awesome to be able to cure, but for metastatic disease, it’s very difficult. But for early stage lung cancers, when it’s found when a lung cancer is small, I mean, stage 1A1, which is like the best stage they could have, five-year survival is in the 90th percentile, but still not a hundred percent, because there’s still things that needs to be improved on. And we’re working on finding those things and better staging. And so things get updated. And that’s where all the research comes from.

Daniel Lobell: (13:59)
When you say five-year survival, you mean to say that they’ll live five years, but then that’s it?

Dr. Peter Baik: (14:04)
No. People don’t just drop and die at five-year mark. “Oh, five years from diagnosis. That’s it.” No…

Daniel Lobell: (14:12)
I’m laughing because obviously it’s a terrible thing, but I’m laughing at my own ignorance, but go on please.

Dr. Peter Baik: (14:18)
Yeah. So five-year survival is kind of how the bar is set. Because the chance of dying from the cancer after five years is very low. And so that’s kind of the benchmark that we set when we’re doing research studies. The problem with that is, we know that for example, breast cancer patients. Some of the breast cancers can come back 10, 15 years down the line. So again, the five years, it’s not some magic number that cancer adheres to, but we have to have an objective endpoint to monitor and to continue surveillance and to see. And so right now it’s at five years.

Daniel Lobell: (15:03)
So when we talk about cancer coming back, does that mean it was totally eradicated and it just redeveloped, or does it mean there was some of it that was still there that wasn’t detected and it re-metastasized?

Dr. Peter Baik: (15:18)
One of the things is, the technology’s not there to see if a hundred percent of cancer cells are gone. Just imagine, our body, there’s so many cells, right? Billions and billions of cells, and all of them are eventually going to die off and you form new cells. And when those cells are dividing, new cells are being formed. There’s always a chance that mutation can occur, right? And those cells, I mean, cancer, very simple definition is: a cell that doesn’t want to die, and is able to find a way not to die.

Daniel Lobell: (15:54)
So in its quest for immortality, it kills off everybody.

Dr. Peter Baik: (15:58)
Exactly. It kills no host, more or less. And so you’re probably going to have cells that have mutated, but our body has a check and balance system where, when it notices that, hey, this cell, it’s not right. The coding is not right. It’s not forming right. Then there are the cells that comes and kills it or gets rid of it. Because the word “kill” is kind of, you’ll think that it’s stopping the heart or whatnot, but it’s not.

Daniel Lobell: (16:25)
It’s like there’s cell assassins. These cell assassins are like, “Listen, this guy is out of line. He thinks he can live forever. We don’t buy that around here. He’s going to take us all down, take him out.”

Dr. Peter Baik: (16:36)
Yeah. The cancer cells are the ones that have bypassed it, or are able to disguise themselves as “normal cells.”

Daniel Lobell: (16:49)
Wow. It’s so devious.

Dr. Peter Baik: (16:50)
Yeah. And then when you have this, can you get rid of a hundred percent of cancer cells? Well, no. I mean, for example, if you take it out with surgery and take the entire thing out, and there’s no evidence of disease anywhere else, you could have other mutating cells, cause some patients can have not just one, but two, three lung cancers, for example. And so your body still has that. And is there technology for us to tell that a hundred percent of cancer cells are gone, the particular cancer that we’re treating? We don’t have it. Why? Because, in Star Trek, they have that little machine that examines the body and does surgeries with and how the surgeries, they’re just kinda using it as kind of like a scanner. And he gets stressed out and he’s still tired after holding the machine for five, 10 minutes.

Dr. Peter Baik: (17:36)
We don’t have that yet. What we have to rely on are on imaging. So when we see imaging, CAT scan, PET scan, we see if there are any abnormal lesions that we could see on it. However, again, cancer cells are microscopic. How can you see it on x-ray, CT, or PET scan or things like that? There are size limitations. And so when you stage these patients, that’s why it’s really important to get the accurate staging. And that’s one of the biggest things that I strive to do. And with my colleagues is to have a multidisciplinary approach to make sure that our staging is correct. We know that PET scan, which is the positron emission tomography. What that is, is basically sugar water that’s video labeled, or it’s a radioactive sugar water. And any lesion in your body that uses up sugar will become bright.

Dr. Peter Baik: (18:33)
So there are organs that use a lot of sugar, like the brain, it’s going to light up on PET scan. It gets excreted, processed in the kidney and excreted through the urine. And so kidneys is going to be bright. Ureter, which is the tube that connects the kidney to the bladder, can be bright. Bladder will be bright. Other things that are going to be bright, anything if there’s infection, it could be bright. Inflammation can be bright. Pick up more sugar cells than other areas in the body. And then cancer cells. And to complicate the matter, not all cancer cells show up bright either.

Daniel Lobell: (19:13)
Because they’re in disguise.

Dr. Peter Baik: (19:13)
Well, no, no. Not just disguise, but It’s a type of tumor. It’s not very active. So to show up on PET scan, the cells has to use a lot of sugar. And some cancer cells or cancer types, they are known to not have too many cells that use up a lot of sugar. So it’s not… All this imaging that we have, it’s not perfect. MRI is not perfect. PET scan is not perfect. CT is not perfect. So we have to use all those tools that we have to kind of come to a conclusion that, hey, this is stage one, you have early stage, therefore, the best thing is to do surgery or radiation, if you cannot tolerate surgery. But it’s not a hundred percent that that’s true.

Daniel Lobell: (20:00)
It’s interesting. I went to see the movie Free Guy recently with my wife and daughter. And I don’t know if you’re familiar with this film, but it’s basically about a video game character who’s like a background player, but he decides he’s not a background player. He goes against the code and it’s like throwing off the whole game. And it sounds like a cancer cell. [Both laugh] But basically, they send somebody in and that person communicates with this character. It’s more complicated, I’m not going to give away the film to people, but it got me thinking, what if we could send in an undercover cell that could communicate and detect which are the cancer cells… How much do we understand about the way cells communicate? And are we able to get an inside cell into the body to sort of like spy for us? Is that something that they’re working on?

Dr. Peter Baik: (20:51)
Yeah, I mean, people are working on all those things, trying to have a cell that mimics the cancer cells and then kills it, going in. No, of course. Right now, like immunotherapy or targeted therapy, what that means is, it’s targeting those mutations or the cells, cancer cells have found a way to fight, for example, receptors on the cell. And you’re kind of modifying the pathway or making it where the pathway kind of gets blocked. Or, just a way to change it so that cancer cells cannot evade the normal body’s mechanism by getting rid of it or blocking it. So the cancer cells cannot use that pathway. I don’t know if that makes sense?

Daniel Lobell: (21:35)
I’m trying to figure it out. Can you break it down for me a little more?

Dr. Peter Baik: (21:38)
Yeah. So I’ll simplify it. So each cell has a signal mechanism when it’s time to go. It expresses protein that tells the body or the host that, “Hey, it’s time for me to go, come and get me.” But cancer cells find ways to mitigate that or get rid of it, or ways to block it so that the protein cannot be seen or the signal cannot be seen by the body. And if you block the signal that’s blocking the actual signal that you want it to work, then the body knows, “Hey, that’s a rogue cell and you need to get rid of it.” And it’s amazing how all the scientists are looking at the… I mean, not even microscopic. I mean, these are nano-scale structures. And so that’s why there are so many researchers out there working on this.

Daniel Lobell: (22:30)
It’s incredible. I’ve never understood cancer. I’m sure I still don’t understand it, but I’ve never understood it as clearly as you’ve put it. And it’s really fascinating.

Dr. Peter Baik: (22:38)
Yeah. I’m just making a simple term. I mean, it’s very complex. Cancer biology is very, very, very complex. And there are so many things that we still don’t know yet.

Daniel Lobell: (22:50)
Such as?

Dr. Peter Baik: (22:51)
Such as, like, EGFR. We know that there’s a mutation, it’s a type of mutation that the cells can have and one type of drug works great. But then the cells have found ways to overcome that. And then now, we know that, hey, we know what they use to overcome this. So now we could use another drug, but now the cells are coming back and saying, “Hey, we’re outsmarting you again.” And so we don’t know what that is. And so they’re looking for it. And that’s like the easiest way to kind of describe it.

Daniel Lobell: (23:24)
That seems like once they figure that out, that’s going to be a huge breakthrough.

Dr. Peter Baik: (23:28)
Yes. There’s a huge breakthrough, but, like I said before, cancer cells are smart. They like to evade. So they find ways to grow, and live.

Daniel Lobell: (23:40)
It’s so interesting to understand like you’ve almost made them human. Well, they are human, but the cancer cells, you’ve anthropomorphized them in such a way that you really think about like how important death is for life. I remember when I studied philosophy, learning about how everything must die for things to live. Like you can’t sustain life without death. And it seems like these cancer cells just don’t want to grasp that concept. They need to die for everyone to live. And it’s very philosophical.

Dr. Peter Baik: (24:14)
Very much so. And for example, COVID. What happens? We’re dealing with this novel virus that we’re trying to grab a hold of and it finds ways to evade us and still hurt us. And it mutates and finds other ways to infect people. Things like ebola, for example, ebola is a very bad disease to get. And the mortality rate is going to be high. The problem with ebola that doesn’t get spread like in a pandemic is that it kills off the host too quickly. COVID doesn’t. And so imagine if ebola kind of acted like COVID. And humanity as we know it is caught. And then you hear about drug resistant bacterias these days. And what is this drug resistance caused by? Because we give antibiotics to patients and sometimes we give antibiotics to patients who don’t need it, or it’s not indicated for them, but they still get it. And then what happens? Bacteria has a chance to mutate to resist the drugs. And so now, there are several bacterias that none of the antibiotics work.

Daniel Lobell: (25:28)
Yeah. Do you think there’s a link between COVID and cancer?

Dr. Peter Baik: (25:32)
It’s too soon to tell, because right now things like COVID and cancer, we’re not going to know for about at least 10, 20 years. And we know that for example, HIV and AIDS virus, that causes because of the suppression of the immune system. We could get a type of cancer called Kaposi’s sarcoma. And that’s because of the HIV virus, but with COVID, we don’t know that yet.

Daniel Lobell: (26:04)
Isn’t COVID in the same family as the HIV virus?

Dr. Peter Baik: (26:04)
That I don’t remember exactly, I have to go back to my microbiology days.

Daniel Lobell: (26:08)
I’m not a doctor. I just know things I’ve heard probably from friends of mine or something. So it could be complete misinformation.

Dr. Peter Baik: (26:15)
Of course. And that’s one of the most important things is that you have to get information that’s correct. And that’s the problem with social media these days is, how do you know what’s correct, and what’s not?

Daniel Lobell: (26:28)
Or was it the SARS virus? What type of virus is HIV?

Dr. Peter Baik: (26:30)
They think that it’s kind of SARS COVID, but it could change.

Daniel Lobell: (26:35)
I want to ask you this. I’ve heard over the years of people who have died of lung cancer that didn’t smoke. Is that common? And follow up question, do we understand why people are getting lung cancer outside of smoking?

Dr. Peter Baik: (26:50)
So that is a very important and good question. About 10%, 10%, 20%, up to about 20% of lung cancers are in patients who have never smoked. Of course, some of those patients can have second hand smoking exposure. So even though they did not smoke, per se, they were exposed to the dangers of cigarette smoking, cigarette smoke. For example, in the eighties, there were a lot of flight attendants who had to work in an environment that’s filled with smoke. A tin can that’s flying, enclosed. And so they had increased risk of cancers. But other environmental factors can cause cancers too. Pollution, nickel, lead… All those chemicals that you’re exposed to will increase chance, can potentially increase chance for cancer. Asbestos. We know that takes 40, 50 years for it to kind of reveal itself, but it can cause cancer of the lining of the lung.

Dr. Peter Baik: (27:54)
And that’s well documented. And we know that that’s the reason why we don’t use asbestos anymore. Other reasons that a lot of people don’t think about is radon. There are places that have higher radon levels in the ground. It’s a natural radioactive decay material, gas. You can’t smell it, you can’t feel it, you can’t see it, but it lingers around. And if you breathe it in, it can cause cancer, it causes mutations. If you’re a smoker and you get exposed to radon, your chance of getting lung cancer increases by several fold. But even non-smokers, there’s increased risks. And so anyone that lives near a body of water, lakes, or, like for example, in Oklahoma, underground… If you have a basement. A lot of the places don’t have basements, but if you have basement, you could have elevated levels of radon. And radon is actually right now, the second leading cause of non-smokers lung cancer.

Daniel Lobell: (28:56)
So here you are thinking that you’re living a healthy life on the lake in nature. And you may as well just be smoking in a nightclub every night.

Dr. Peter Baik: (29:04)
No, no. [Daniel chuckles] The chance of getting cancer from radon is much lower than cancer from smoking.

Daniel Lobell: (29:10)
But it’s still shocking that that’s the second leading cause, I mean, that’s… What about mold? Is mold related, like black mold?

Dr. Peter Baik: (29:17)
No. I mean, we talk about black mold, but what is the association with that? We call it environmental, an irritation. But I don’t know if there’s any correlation between it.

Daniel Lobell: (29:29)
Some early signs that you can detect where you can try and catch lung cancer in its early stages if you know to look for these things?

Dr. Peter Baik: (29:36)
That’s the toughest part. Because most of the time, you don’t find it. You don’t have any symptoms. You don’t have like cough. You don’t have like spitting up blood or coughing up blood. You don’t get shortness of breath. You don’t get pain. Until the tumor grows into a sufficient size. And so many of the early stage lung cancers are found incidentally. Say you go and you broke your leg or something, and you get surgery. So you get an x-ray pre-op and they find a lesion. Or you get chest pain, so in the ER, they scan you. They do a CT scan and they find a lesion, but early stage lung cancers, you rarely have symptoms. And so that’s why we promote early lung cancer screening CTs on patients who meet the criteria. Ages between 50 and 80. 20 pack-year history. What that means is usually you calculate it by one pack per day for 20 years, and have used it within the past 15 years. Then, you’re qualified to get lung cancer screening, yearly low dose CT scan. And the low dose CT scan is not something that you can just get a CT scan, there’s stringent criteria to meet the standards so that we’re not exposed to high levels of radiation. Because radiation itself can be cancerous. And what we know is that that improves survival.

Daniel Lobell: (31:06)
So why don’t we just expand the umbrella to include more people in these cancer screenings?

Dr. Peter Baik: (31:12)
In an ideal world where we don’t have to worry about money and cost and everything else, yeah. And the dangers of radiation is not something that we have to worry about, that would be great. But there are dangers of getting too many CTs. That can cause cancer as well, if you get too much…

Daniel Lobell: (31:30)
Isn’t that crazy, looking for cancer can cause cancer if it’s not even there? It’s like, “You want to find me? Here I am now, and you didn’t have any before.”

Dr. Peter Baik: (31:38)
I know. And then on top of that, if you do find something that may necessitate invasive procedures to find out if it’s cancer or not. And then in itself, any procedure that we do is not without any risks. And some procedures are more riskier than others. And then there’s the cost to benefit ratio. How much is it going to benefit? You have to screen 1 million people to save one person. In the grand scheme of things, is that something that we should be doing? In an ideal world we should be able to, but of course you get all these other factors in and that doesn’t make sense.

Daniel Lobell: (32:21)
And then what if the person you save turns out to be evil and he goes and kills all the other people? You never know!

Dr. Peter Baik: (32:26)
You never know.

Daniel Lobell: (32:27)
He could be a cancer cell, on society. [Daniel chuckles] Hopefully not.

Dr. Peter Baik: (32:32)
It’s true.

Daniel Lobell: (32:33)
But yeah, I see what you’re saying. It’s a tough thing. What’s the toughest part for you of your job? And I’m you have to deal with basically heart-wrenching situations all the time. A, how do you deal with it? And B, what’s the toughest part of it?

Dr. Peter Baik: (32:46)
So how do I deal with those situations? I mean, the toughest part is, because being a surgeon, if there are any surgical complications, that’s always a… Even though we do our best to not have any complications, complications do occur. When it does, how to best treat those patients, take care of those patients? And so to me, that’s really important and it’s tough. But the important thing is that if you see I have a complication, you learn, and so that you can’t just do the same thing over and over and over again to expect different results. If the result doesn’t seem ideal, you may have to tweak it a little bit to make sure that that doesn’t happen.

Daniel Lobell: (33:28)
That sounds exactly like what you were saying before about getting rid of cancer. If you do the same thing, it adapts and you can’t beat it anymore.

Dr. Peter Baik: (33:34)
Exactly. And that’s why we say being a physician, being a doctor, is a lifelong commitment. That’s why we read journals with 10 conferences to learn about the new techniques, new technologies, new treatments, new guidelines. And that actually makes it fun.

Daniel Lobell: (33:51)
Yeah, because it’s an ever-changing science. It’s not like boring, the same old thing. There’s something new and exciting, a new way to save people. A new hope. I think it’s that hope and that newness, I suppose, that keeps the job stimulating.

Dr. Peter Baik: (34:07)
And of course. It’s also when I do a surgery on a patient and the patient has stage one lung cancer. It’s great. I like it.

Daniel Lobell: (34:14)
What’s the toughest part?

Dr. Peter Baik: (34:16)
The toughest part is when patients do everything to fight cancer, but cancer just takes over and we don’t have any tools. Or patients are not able to tolerate the treatments that we have. And especially the young patients. Patients with families, young kids. It’s very difficult.

Daniel Lobell: (34:36)
Do you have to talk to a therapist about it, or is there somebody who helps you through when you lose people?

Dr. Peter Baik: (34:41)
I mean, there are therapists out there who can help, but we like to support each other. Talking to other doctors and not just doctors, but staff at the hospital. I mean, people who you work with and who help and support each other. But yeah, I mean, that’s the reason why burnout rate is high and suicide amongst physicians is higher than average.

Daniel Lobell: (35:05)
Let’s talk a little bit, we talked basically about the doctor patient relationship. Let’s talk a little bit about Doctorpedia, what attracted you to Doctorpedia and what kind of work you’re doing with them?

Dr. Peter Baik: (35:17)
Yeah, so I just joined Doctorpedia and the problem right now on the internet is that when you try to find information, you’re going to get many different types of information, right? And so you don’t know what’s correct. You don’t know what’s not, you don’t know who’s talking. Is it an expert that’s talking about it who specializes in that field, or is it someone who gets all the information from textbooks and things like that and just kind of gathers it and writes it and gets proofread? And so Doctorpedia, the contents are created by doctors who are board-certified and experts in their fields. And it’s a one-stop place to obtain those information. The other thing that I noticed was that a lot of the, even on YouTube itself, you get bombarded with so much information. For example, when you have lung surgery, what do you expect? Well, you could have video for 15 minutes about lung surgery and this. We try to kind of give a very succinct answer or information so that the patients are not overwhelmed, not get inundated with other information and confusion. And the other thing that we like to do is, or we’re hoping to do, is that the information, how it flows, you don’t get confused. You will be set up so that you could go in a chronological or the pathway and you don’t get confused. And so that’s where I’m hoping.

Daniel Lobell: (36:54)
And so are you going to be doing videos? Are you working on a specific channel with Doctorpedia? What can the listeners look for from you?

Dr. Peter Baik: (37:01)
Yeah, right now I’m going to start making videos. I have not done that yet, but that’s where I’m hoping to start. And then once that’s done, I will do probably articles and blogs and podcasts and things like that.

Daniel Lobell: (37:14)
Well, this is the first of them anyway. You’re on a podcast for Doctorpedia right now, and it’s been a real pleasure and an eye opening experience speaking with you. Thank you so much for your time.

Dr. Peter Baik: (37:25)
No, no, it’s my pleasure. I mean, there’s so much in medicine that you just don’t understand.

Daniel Lobell: (37:30)
Yeah. Well, you did a great job of breaking it down. I mean, I really, I’ll never look at cancer the same. I think of it as this sneaky spy in the body, putting on disguises and trying to live forever. I’d never thought about it like that before. Doctor, I want to ask you the question I end all these interviews with, which is, what do you personally do to stay healthy?

Dr. Peter Baik: (37:52)
Okay. So what do I do to stay healthy? Like you, I like to relax and chill. But, what I’ve been doing is trying to be more active. As you get older, definitely age is something that when you’re young you don’t think about, but as you get older and things start to get hurt, things happen. And so I’m now trying to exercise a little more and not like trying to be super muscular and cut. No, but just to kind of do some cardio and things like that. I like doing the stairs. But having a supporting person definitely is helpful. So my wife is wonderful. She makes sure that I don’t eat fries everyday, but eat veggies and healthy stuff. Even when I was in medical school and before I got married, I mean, I was eating a lot of Chinese food, pizza, fast food, but since getting married, slowly, now I’m eating a lot more salad, less hamburgers and less fries, fries are not food. And yeah, it’s so hard to do when you’re by yourself. But when you have someone who’s supporting you, keeps you healthy.

Daniel Lobell: (39:05)
Absolutely. I’m happy to hear that she’s keeping you healthy and it’s important that you stay healthy because you’re keeping a lot of other people healthy as well. Thank you so much, Dr. Baik. Thank you for your time, and I look forward to seeing all the great stuff you’re going to be doing on Doctorpedia.

Dr. Peter Baik: (39:21)
Yeah. And again, if you have any questions, any topics that you want to talk about, please let me know and I’ll be happy to help out as much as possible.

Daniel Lobell: (39:28)
Awesome. Well, I look forward to doing that. I’m sure we’ll take you up on that offer.

Dr. Peter Baik: (39:31)
And you know, our kids, they’re walking germ factories.

Daniel Lobell: (39:35)
So I should stay away from my kid? [Daniel laughs]

Dr. Peter Baik: (39:39)
No. Just develop the immunity, just go with it. She gets sick, you know what’s going to happen. Right now she’s coughing. She’s not feeling well. What happens? She wants to be cuddled. And then she coughs on your face.

Daniel Lobell: (39:52)
Yeah, it’s happened.

Dr. Peter Baik: (39:54)
Oh yeah. And it happens multiple times.

Daniel Lobell: (39:56)
Yeah.

Dr. Peter Baik: (39:56)
But that’s fine. That keeps you healthy.

Daniel Lobell: (39:59)
Because the listeners don’t know this, we talked before the show that my daughter’s got a cold, but so you’re saying my daughter’s cold is actually keeping me healthy?

Dr. Peter Baik: (40:06)
Exactly.

Daniel Lobell: (40:08)
Man. God bless her. She’s the best.

Dr. Peter Baik: (40:10)
Yeah. And that two year old mark, almost two? Oh, it’s great.

Daniel Lobell: (40:13)
Yeah. It’s a lot of fun. I’ve had fun with her at every age so far. I hope that that continues forever.

Dr. Peter Baik: (40:21)
Hopefully the changing diaper is the toughest part, I think.

Daniel Lobell: (40:24)
Yeah? I don’t even mind it. I find the whole thing fun, which is funny cause I didn’t even think I wanted to have kids for so many years. Now I’m like, “Oh my gosh, I was so crazy.”

Dr. Peter Baik: (40:33)
But how they grow up, they grow up fast and they change so much. And I was watching actually my kids’ videos when they were babies.

Daniel Lobell: (40:41)
Yeah.

Dr. Peter Baik: (40:42)
And now my kids are, not teenagers yet, but getting close and just the change within 10 years, it’s amazing. Again, it’s the human body. Goes from the transformations.

Daniel Lobell: (40:55)
Yeah. It’s pretty incredible. Doctor, I feel like we could talk for a long time and I think hopefully this will be the first of several podcasts we get to do together.

Dr. Peter Baik: (41:05)
Yeah. That’d be great. I’m always up for it.

Daniel Lobell: (41:07)
All right. Well, safe travels and get home safe. I know you’re in Arizona right now and you just were there doing surgery. So a safe trip back to Chicago.

Dr. Peter Baik: (41:17)
Thank you. Appreciate it.

Daniel Lobell: (41:23)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only and should not be taken as medical advice. Since every person is unique, please consult your healthcare professional for any personal or specific needs.