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Ketamine and Sunscreen
20 Plays25 days ago
Dr. Aidan and Julie give you the skinny on the latest health news.
Why has ketamine been added to the Pharmaceutical Benefits Scheme? What's the deal with science funding in the USA? Could peanut allergies be a thing of the past? And should I really be making my own sunscreen?
Get in touch with us at questions@thismightsting.com.au
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Transcript
Introduction and Program Overview
00:00:00
Speaker
Well, welcome to This Might Sting, a program that's all about giving you the latest news about health issues with a big focus on evidence. My name is Julie McCrossan and Dr Aidan Barron is joining
Ketamine for Depression: Benefits and Risks
00:00:13
Speaker
us. And Aidan, an amazing lineup, new ways of receiving ketamine for depression, government backing for it, help for severe peanut allergies,
00:00:23
Speaker
some wildness on TikTok about do-it-yourself sunscreen, and we'll pick that apart, but also the worrying things happening with funding for science in the United States. And so, as always, a lot to talk about.
00:00:36
Speaker
But can we come to this thing of ketamine being on the pharmaceutical benefit scheme and in the form of a nasal spray? So what is it? What is it for? And is it good news that it's on a nasal spray?
00:00:49
Speaker
So I guess the long and the short of it is that for a while now, we've had a thing called treatment resistant depression, which is a constellation of symptoms. If you think of depression, low mood, less enjoyment in daily activities, difficulty motivating oneself to do tasks, and on the severe end of things, so suicidality.
00:01:07
Speaker
and a feeling that life's not worth living anymore. And it's a really common and really burdensome disease on the individual, on their families, on society. And we need to be doing better to help people. And we've come a long way already. And stigma around depression has dropped a lot.
00:01:23
Speaker
Most depressions, when we talk about depression being biological, it tends to last nine months, a year, a year and a half, two years max. And there's mild, moderate and severe depression.
00:01:37
Speaker
And for the mild depressions, we tend to treat them with things like cognitive behavioral therapy, psychotherapies. And as they get into the more moderate end of the spectrum where they're having a big impact on someone's daily life and perhaps putting that person at risk in terms of suicidality, we tend to start using medications like antidepressants, which have huge benefits and also some side effects as every effective medicine does.
00:02:01
Speaker
We then come to the area of treatment resistant depression, and it's a contentious topic. Some researchers will say that there isn't even such a thing as treatment resistant depression. Other clinicians will say they're clearly as I have a lot of patients with it.
00:02:15
Speaker
What essentially we're talking about is a depression, which is bad. It's having a big impact on someone and the conventional treatments that we're trying aren't working. So the first antidepressant isn't working.
00:02:27
Speaker
Then the second antidepressant isn't working. When you're really in the thick of a depression, it doesn't matter how good the psychological therapy is. You need floaties in the form of antidepressants to help you stay above water in order to receive the psychotherapy.
00:02:41
Speaker
And so I often think of antidepressants as being floaties. You can't focus on your swimming technique. If you're drowning, you need to be able to float and then someone can teach you how to swim. With treatment resistant depression, someone, the floaties aren't working ah essentially is the issue.
00:02:59
Speaker
Ketamine for a while has been proposed as a potential solution. And the reason for this, if we go back, is that what we found probably in the late 90s and early 2000s is that when we used a high dose of ketamine to sedate someone, there was a sort of signal towards an anti-suicidal property that lasted about three days to two weeks.
00:03:18
Speaker
Particularly, and this was in the case of paramedics and emergency doctors sedating someone who was severely distressed. we tended to find that suicidal ideation or that suicide tendency drive went away for a little bit.
00:03:35
Speaker
Ketamine's an interesting drug. I'm going to note out here for a second. We've got different receptors in our brain and receptors are like locks and different chemicals are like keys that unlock locks and then things happen.
00:03:46
Speaker
Ketamine blocks the NMDA receptor. And the NMDA receptor is a phenomenally interesting receptor in the brain. It's involved in all sorts of things to do with mood, neuroplasticity, and excitation of cells.
00:04:01
Speaker
And glutamate or glutamic acid, the most common neurotransmitter in the brain, stimulates the NMDA receptor, ketamine blocks it. And so ketamine in clinical use has this really interesting effect where depending on how much you use depends on what kind of an effect you get. And and we use it all the time in emergency healthcare as paramedics, as doctors, because it's an amazing anesthetic drug. It's an amazing sedative. It's an amazing pain reliever.
00:04:25
Speaker
in emergencies at very low doses, ketamine works in combination with other medications as a fantastic pain reliever. And then as you start to up the dose, what happens is you get the separation from the mind and the body.
00:04:38
Speaker
It's a dissociative. if Your mind literally separates from your body. And so even though things are happening to your body, you're not feeling and experiencing the pain and distress associated with that.
00:04:49
Speaker
It's an extreme version of happy gas, which is also a dissociative. And then as that keeps going and going and going, you end up in the K-hole, which is a zone where you are essentially hallucinating because you have such a separation between your mind and your body that you're not really sensing reality properly. And people will report things like purple dinosaurs, feeling like they're levitating off the bed, a fear of that they're dying, all sorts of weird and wonderful things.
00:05:14
Speaker
If you are a goer to festivals or a party goer, you'll often see people in the K-hole, they've taken too much. And then eventually you end up with the anesthetic dose where someone is completely unconscious.
00:05:26
Speaker
But the beautiful thing about ketamine and the reason we've used it in wall surgery and in emergency situations is it's one of the few anesthetics that actually makes your blood pressure go up instead of down. And it makes your breathing and respiratory rate stay constant rather than dropping off completely.
00:05:41
Speaker
Just before we come back to its use for resistant depression, you've mentioned sure just quickly that people might use it at concerts and so on, not because of a recreational drug.
00:05:52
Speaker
Is that advised or is it ah ah not advised? Yeah, look, I wouldn't be a very good doctor if I said that I advise people to go do drugs. would i But no, the truth is, it's you know and and i'm and I'm teasing you here, there's a few risks.
00:06:06
Speaker
And the biggest risk is that it's not actually ketamine. And that's the biggest risk. You don't know what you're taking. Particularly nowadays, there's a new trend that a lot of the illicit drugs on the market in Australia have nitazines in them, which are a powerful and lethal, potentially synthetic opiate that doesn't show positive on any of the common tests.
00:06:27
Speaker
You really need like high level lab tests to detect it. and it's And I've treated some of the patients with nitazine poisoning and it's very difficult to take care of them. They go long periods without breathing and they do die without care sometimes.
00:06:40
Speaker
So the big risk with all illicit drugs, it's not actually the drug you think it is. That's the big risk. The secondary risks are getting the dosing right. You don't know what the concentration is. You don't know how much you're taking.
00:06:52
Speaker
You are making yourself very vulnerable if you're taking too much. And then over a long period of time, there are significant impacts on if you're taking ketamine on a regular basis, you're you're going to have an impact on your mood, your ability to function.
00:07:04
Speaker
You're going to expose yourself to a higher risk of adverse mental health effects if you're not very careful with dosing, doing it under supervision. And then you can also develop incontinence and bladder issues with there's a, there's Kett bladder, which is commonly referred to when people abuse ketamine over a long period of time in high doses, they can develop a spasm and dysfunction of the, of the sphincter in the bladder.
00:07:25
Speaker
Look, again, when you were outlining how the varied way in which ketammines ketamine is used, you were telling us, I guess, the different impacts it has depending on the dose. So obviously the dose and the capacity of the paramedic or the doctor to give the right dose is important.
00:07:41
Speaker
Again, just before before we come back to its role in depression and helping people with depression, it's commonly said that they use it to tranquilise horses, which I have to say as five foot two woman who's pretty small if a little overweight. That's always frightened me tremendously. What's the link with the horse business?
00:07:59
Speaker
Yeah, look, I'm not a vet, but I'm informed by my veterinary colleagues that they have traditionally used ketamine as an anaesthetic for horses and that it was really common in the in the equine veterinary practice and it came back into sort of human medical practice.
00:08:13
Speaker
I have no idea why they like it for horses, but it's got this sort of ah pervasive stereotype attached with it that ketamine's for horses. And then we joked in the early 2000s, hey, it's not just for horses. It's great for people too.
00:08:25
Speaker
And it's had a real resurgence in anesthetics and emergency medicine practice because it's such a wonderful drug in terms of the different ways that we can use it for pain relief, for anesthesia, and how predictably it works. And we dose it as a milligram per kilogram of body weight.
00:08:39
Speaker
So we dose it really specifically. Different people get different doses. So let's return now to treatment resistant depression and the fact that the pharmaceutical benefit scheme is now offering it to patients with this condition. So in a nasal spray format.
00:08:57
Speaker
So can you go specifically to that and what that's about and and your thoughts on what we need to know? So ketamine is one of the many drugs that could be absorbed by the mucous membranes. So like the lips, the inside of the lips, the gums and the mucosa inside the nose, the rectum is also a mucosal surface.
00:09:15
Speaker
And so a drug like ketamine can be given by a nasal spray. And what that does is it makes it much easier for it to be administered in a wider variety of clinical settings rather than needing a drip to be put into someone's arm and given that way.
00:09:27
Speaker
And it makes it a bit safer ah in that there's a bit more of a sort of delayed onset. It's harder, but it's still very possible, but it's harder to give someone a dangerous dose if you're giving it in a controlled way by nasal spray, according to the instructions. And so Spravato is the nasal spray that has been approved.
00:09:46
Speaker
It's controversial. And in psychiatry, this is still very controversial. It's not settled science. And the reason is ketamine works for depression, but so do most antidepressants.
00:09:59
Speaker
What we're talking about is treatment resistant depression where the other antidepressants don't work. And truth be told, I've had a good look at the literature and most of the systematic reviews and meta-analyses, which pull together all of the studies done, would tend to suggest that actually, if it's treatment-resistant depression, even the ketamine, or in this case, S-ketamine, which has been approved, which is the specific form and shape that the ketamine chemical comes in, probably doesn't have that big an impact.
00:10:29
Speaker
either Which is a bit upsetting for some people. And certainly the purists would be very upset with me saying that, but it's only showing a mild at best improvement when used in conjunction with other antidepressants. This is not the silver bullet that people have painted it out to be.
00:10:47
Speaker
And I guess it's time we move to our next topic, but I guess if you are unfortunate enough to have treatment-resistant depression, your clinicians are probably seeking to help you.
00:10:58
Speaker
And even a mild bit of assistance if faced with something as challenging as that would be
Peanut Allergies and New Treatments
00:11:03
Speaker
good. But look, thank you. We'll keep our eye on escatamine nasal spray, and no doubt there'll be ongoing research notes on the PBS. But look, let's turn to peanut allergies and again we're looking at severe peanut allergies and some trials in the United Kingdom looking at oral immunotherapy that might be able to assist people with but at least to reduce the risk of severe peanut allergy this immunotherapy isn't it it's turning up everywhere so tell us about this one
00:11:34
Speaker
This is a really cool trial. And I really want to give my kudos to the team in the UK because they've done a brilliant double-blind crossover trial, which basically means that they took two groups and they blinded the patients in those groups to what they were getting, whether they were getting the oral immunotherapy, the OIT, or the placebo, the sham.
00:11:53
Speaker
Essentially what they've done is they've said, hey... These are all people in order to participate in the trial, you had to be really sensitive to peanuts. I'm talking like really anaphylactic to peanuts. If we pricked your skin with a tiny dose of peanut protein, you got a really, you got a significant wealth. so So it's this group of people that were enrolled in the trial, people who have proven severe allergies to peanuts.
00:12:16
Speaker
And essentially what they've done with this oral immunotherapy is they have used exposure therapy using the body's own innate immune system. And what they've really done is they've taken microscopic doses of the peanut protein and slowly exposed people to the peanut protein. And again, this isn't peanuts.
00:12:39
Speaker
This is taking peanuts, crushing them up, turning them into a super fine material and extracting just the protein. And when I talk about the protein, I'm not talking about like the weight building protein. I'm talking about the chemicals which signal your immune system that this is what it is.
00:12:54
Speaker
So none of the oils and fats, just the peanut protein. And they've started off with supremely small doses and then worked their way up over a series of weeks. And over the series of weeks, they've worked their way up to pretty high doses to the point where they got people taking 1.4 grams of peanut protein, which is huge. Like thats that's like a whole peanut. And then what they did is after people succeeded at that, they got them eating actual peanuts and peanut flavored treats and snacks.
00:13:25
Speaker
It worked in 80% of the patients. Now they only had 21 patients in this study. So it was a small study. This is a proof of concept. They were very selective with who came in.
00:13:38
Speaker
Four of the patients had multiple episodes of anaphylaxis during the trial. So this was a you know well-supervised trial. They were in a medical setting to start with. They came into a clinic.
00:13:49
Speaker
They were given a sort of gel film thing to put in their mouth with tiny doses of peanuts, protein, and then escalated, took it home in over two weeks, started taking higher and higher doses, and and a few people dropped out.
00:14:01
Speaker
But I think this is awesome. This is a huge breakthrough in people's ability to... you know, enjoy so much of what we take for granted.
00:14:12
Speaker
And the reason is they chose peanuts because peanut allergy tends to be preserved as you get older. There are a lot of allergies that sort of die off and don't give you issues as your body gets older, but peanut allergies and severe peanut allergies tend to really stick around. So they said, let's really tackle this one.
00:14:27
Speaker
You've emphasised that this was done under medical supervision to ensure great safety. And also it's a very small number of people and some even dropped out. and So I guess I'm a little bit surprised that you're so excited.
00:14:40
Speaker
Can you explain what a proof of concept study is? Is that the key to understanding why this matters? Yeah, I mean, the real proper term is a pilot study.
00:14:51
Speaker
And a pilot study is essentially you test something to see that, not to prove it works, but to see that it can be done safely and that it's probably going to be able to reproduce results in a bigger trial. so A pilot study is you take a small group of people and you run them through the experiment as you would in a bigger experiment and see, does anything terrible happen?
00:15:12
Speaker
And can the experiment actually work the way we designed it to? So if we tried to do a pilot study of testing people's allergic response to, let's say, jelly, and we gave them take-home jelly, and half the participants reported that actually when they took the take-home jelly home, it didn't refrigerate properly, it turned into syrup,
00:15:32
Speaker
and no one wanted to drink it, we would say, ah, great. Good thing we only did this in 20 patients. We realized that we need to change the way we do it. Good thing it's just a pilot. We'll change the way we present the jelly. We'll send people home with fridges.
00:15:44
Speaker
All sorts of logistical process issues get worked out in a pilot study so that when you go to a bigger study, a big randomized controlled trial of 100, 200, 300, 1,000 patients, ah thousand patients you've already worked out all the kinks and little issues.
00:15:59
Speaker
And so this is a fantastic trial that I think holds a lot of hope for people because we don't expect these little trials to show benefit. Usually we expect that in these trials, there's a sort of signal of benefit, but really it's much of a muchness.
00:16:14
Speaker
To have had 80% of people in such a small group experience benefit is wild. Normally we expect in 20 people, maybe one or two will have benefit. And that's good enough for us to say, hey, this is potentially a winner.
00:16:26
Speaker
One in 20, that's a lot of people when you do that to a thousand people. but How long do you think it'll be before it goes to um a larger study? They do it with big numbers.
00:16:37
Speaker
This is already being reproduced and patients are already being recruited for larger studies. And the beautiful thing about the scientific community is when someone in the UK finds it works, someone in Australia will go, hang on a second, we should try that here.
00:16:49
Speaker
Because the interesting thing about this study is that there was a predominantly Caucasian population recruited. So they they're very careful to note that they didn't have many people from sort of black ethnicities or sort of racial profiles. They had very few people from Asian ethnicities recruited.
00:17:05
Speaker
And we know that there is generic variability across the world. And so this has to be reproduced. It's not good enough that one trial showed benefit. We need to do multiple big trials that that all work out the same way.
00:17:16
Speaker
need to have different people involved.
Impact of US Science Funding Cuts
00:17:19
Speaker
But it's exciting because, wow, if 16 to 17 out of 21 people experienced benefit and were able to eat peanuts but for the first time in their life.
00:17:28
Speaker
I mean, this is, this is awesome. Yes, and even if it doesn't ultimately lead to a lot of people eating more peanuts, it will bring so much relief to all those families who spend their life, if they're out eating publicly in a restaurant, trying to absolutely be sure that their child or their relative is safe. Look, while we're talking about research, let's just go big picture. We'll hear more about the UK peanut study as it gets bigger.
00:17:53
Speaker
But let's go to the United States because there's just been... So much international concern about what's happening with the Trump administration and universities in general, but scientific research in particular. I think the latest announcement or one of the latest announcements is that the National Institute of Health is being told it's going to have a 40% budget cut, which has the potential, I think, to make a massive difference to public health.
00:18:21
Speaker
And i think a serious concern that other countries like France, Canada and elsewhere are actually trying to poach people out of the United States, because particularly people from other nations are thinking, do you know,
00:18:34
Speaker
Is it safe to stay here and will we get the proper collaboration? So but your thoughts on what's unfolding in the States and what it ultimately means for patients, Aidan? The Trump administration's Department of Government Efficiency has irreversibly slaughtered the capacity of American health research.
00:18:55
Speaker
They have set things back 30, 50 years. There are experiments which cannot just be turned off and turned back on again. The research pipeline is not measured in months, it's measured in decades.
00:19:09
Speaker
So in order to get research off the ground, it's years of grant funding, preliminary research to the point where these massive international collaboratives of multiple universities around the world, multiple research sites around the world, doing incredible science are able to get to the point where they they've got a rhythm, they've got a momentum behind them. And if you lose that momentum, you can't just switch it back on.
00:19:33
Speaker
It takes years to build it up again. And the fact is it takes decades of preparing junior researchers to become mid-level researchers to become research leaders.
00:19:45
Speaker
And when you destroy the hopes and dreams of an entire generation of a country's researchers, they go elsewhere. And so we see the active recruitment of senior research leaders from across the U.S. already moving to other countries, moving to Canada in particular,
00:20:01
Speaker
it is It feels criminal what's happened here, not just because of the impact on people. I don't want to even go into the ethical implications of turning off funding for things like USAID programs and PEPFAR, the President's Emergency Preparedness Relief.
00:20:18
Speaker
against HIV and AIDS in huge amounts of the world. We'll put that aside. The National Institute of Health has been responsible for a huge amount of the medical breakthroughs that we enjoy today.
00:20:32
Speaker
Patients with cystic fibrosis who now live to ripe old ages, who used to die at the age of five, treatments for cancers that you and I feel good going to bed at night knowing that actually we have treatments for things like breast cancer and testicular cancer and hundreds of different cancers.
00:20:49
Speaker
The amount of human development which has come out of the National Institute of Health, it is one of the biggest health research doers in the world. And to have slashed their funding without considering how and what they're doing,
00:21:07
Speaker
is it's insanity and we're all going to suffer because of it. It's not just Americans who are gonna suffer because it wasn't just Americans who are benefiting. Absolutely. but And also, it's my understanding that in places like Australia, there will be many research groups who are part ah of a worldwide network of particular studies that might be linked to the National Institute of um Health in the United States. so that it's Absolutely. like There's going to be a disruption to the work of people and indeed probably to the jobs of people in places like Australia as well.
00:21:41
Speaker
We know that tens of millions of dollars of research funding exists in collaborative efforts between Australian institutes and American institutions. And that's that's just lost to the ether now.
00:21:53
Speaker
It's really upsetting, really upsetting. The thing which I think people forget is how much money comes into the American economy through research and development. This wasn't just ethically bad. It was financially stupid.
00:22:09
Speaker
the billions of dollars generated in revenue every year in pharmaceutical products, in technology, devices that we use every day that have come out of National Institute of Health funding. My perfect example of this is people always ask, why should we fund the space program when we've got problems here on earth?
00:22:29
Speaker
And then they go and heat something up in the microwave. And the only reason we have a microwave is because we had, is because the Americans had a space program and NASA developed the microwave, which we use every single day. That's a perfect example.
00:22:40
Speaker
When we're doing research, the fruits of that labor are useful on an everyday basis and influence the way we live. It's not just a rare disease, fandangle cancer research. The implications of that research are felt every day in the tech we use, in the medicines we use, in the regulations that keep us safe.
00:23:01
Speaker
I know this is now going into the area of conjecture because we seem to be at a time of such significant international instability, it's very hard to predict the future. But say in the economic area where tariffs are being so damaging to the flow of free trade, nations like Australia and many other nations are looking to diversify their exports and imports in order to not be as vulnerable to what's happening in the United States.
00:23:29
Speaker
And I'm just wondering, are there Are we likely to see similar efforts by, for example, major pharmaceutical companies and other cancer researchers, the really big areas of research where they seek to base themselves in European nations or Canada, you've already mentioned? Will there be a similar attempt to diversify?
00:23:50
Speaker
Whereas once, in my experience, many leading researchers, clinicians here in Australia do spend a period of time in the United Kingdom and the United States that somehow that's part of your elite career, if you know what I mean.
00:24:03
Speaker
And I'm wondering, will it be good news for Britain or good news for Canada or good news for parts of Europe that people will diversify? Julie, it's a great question, and I certainly hope so, but I truly have no idea. There's so many complexities in this situation. Whilst funding has been slashed, there's also regulations which have been slashed. And so it's very attractive for private commercial interests to go to places where there aren't as many protections and regulations because you can do more research that's maybe less ethical.
00:24:35
Speaker
ah so For
Sunscreen Myths and Evidence-Based Practices
00:24:36
Speaker
years, we've known that there are multiple... less ethical, ah less ethically conducted companies and research and development groups who've gone to areas like the Middle East, North Africa, and the global South, i.e. the poorer countries on earth to do things that they can't get away with in the sort of global North, the wealthy Western nations.
00:24:57
Speaker
So I guess time will tell. look, ah that one's a bit shaky, but we'll bat on with optimism. ah Let's go to TikTok because our gig here is to challenge foolish nonsense and to bring evidence-based thought to healthcare.
00:25:13
Speaker
And even there's a craze on TikTok where they're encouraging people to make their own homemade sunscreen. Now, we're in the land of melanoma, Australia, the the freakiest of skin cancers. So what's going on TikTok and why does it really matter that you use credible evidence-based products to protect yourself from the sun?
00:25:33
Speaker
Want nitrous sun protection without chemicals? Let's make a DIY sunscreen using ingredients in your kitchen. Grab a glass container, add coconut oil, raw shea butter, mix together.
00:25:46
Speaker
Move over to the stuff top in a double boiler. Stir constantly to make sure that it melts completely till smooth. Add zinc oxide.
00:25:59
Speaker
Add carol seed oil.
00:26:03
Speaker
Turn the heat off. Mix completely. Add lavender and sweet orange essential oil for fragrance. Stir. Let cool. Bottle. Voila! Your sunscreen is ready. Let's try it out. Apply.
00:26:23
Speaker
This is about SPR 40 to 60, depending on the amount of zinc oxide you add. One tablespoon of zinc oxide is equivalent to 15 to 30 SPR. Yeah.
00:26:35
Speaker
Yeah, you're looking a little bit overwhelmed there. I'm looking dejected. I'm sighing. Look, it's a free country, but my God, like...
00:26:46
Speaker
Sunscreen is amazing. There's the way sun cream or sunscreen works, depending on how, I still don't know what's the right way to pronounce it. I should probably look it up. There's two ways that sun cream works.
00:26:58
Speaker
One is that the chemicals in the sun cream reflect back the uv rays from the sun and don't allow them to penetrate to the skin and the other one is that the chemicals in the sun cream actually absorb the uv rays so that the same way that if you put a pebble under a heat lamp the pebble gets hot the chemicals actually absorb the uv rays from the sun and don't let them penetrate to your skin now there's so there's those two different products Full credit to the TikToker, she at least used one of the right products, which is zinc.
00:27:34
Speaker
Zinc is one of those reflector products where that it actually doesn't allow the sun's UV rays to penetrate through. But think about the products that you've used with zinc in them.
00:27:45
Speaker
It's that thick zinc paste. Because if you're going to use zinc, you actually have to create a full barrier of zinc so that the sun doesn't get through, which is why we tend not to use as much zinc and we tend to use the other softer, creamier, oilier products because they have the absorbing chemicals in them. And those chemicals are things, and they're going to sound scary. And i apologize if I'm butchering the names.
00:28:09
Speaker
There's avobenzone. There's ethylhexyl triazone, homosylate, octinoxate, i do octa octocrylene, oxybenzone, they sound like really scary chemicals, but they're not.
00:28:28
Speaker
And I guess the first thing to say is that everything is a chemical. And if I told you what the chemical names for everyday things that we eat are, you'd be terrified. I could give you a list of 23 really long chemicals right now that are all the chemicals inside apple.
00:28:44
Speaker
And in the wrong dose, apple seeds are lethal. There are chemicals inside apple seeds which will kill you if concentrated them ate 2,000 of them at same time. at the same time Obviously using conjecture here, it'd take more than that. You'd have to do some chemical things to them. This is not bad advice for someone to listen to and figure out how to poison themselves with apple seeds. It won't work. You'll just feel very sick.
00:29:05
Speaker
but But what I'm trying to say here is that people think chemistry names equals toxic. And that's what's coming through in this TikTok. There are chemicals which I don't understand. Therefore, they're toxic. Therefore, they're bad for me.
00:29:20
Speaker
And it couldn't be further from the truth for two reasons. One, these chemicals are amazing at protecting you from getting skin cancer and dying. Two, there's a famous saying, the dose makes the poison. And and it's by Paracelsus, the father of modern toxicology. And the same thing comes back to that discussion we were having about ketamine.
00:29:40
Speaker
The dose makes the poison. If you drank all of these chemicals in their pure form, you'd get very sick. but you're not drinking them and they're not in their pure form. And they've been rigorously tested by our therapeutic goods administration to make sure that the current quantity and level and dilution that they're in is perfectly safe.
00:30:01
Speaker
And these chemicals have saved thousands, thousands of lives in Australia and will continue to save thousands of lives, notwithstanding the hundreds of thousands of cancers that are prevented.
00:30:12
Speaker
i Can I just say, as I listen to you, because I hear those names and I don't ah associate them with toxins. but When Cancer Council in New South Wales or South Australia or Queenslanders, Cancer Councils all around the country that sell us tubes of sunscreen,
00:30:29
Speaker
And that it lists on on them what's there. I trust that they are a reputable body that are seeking to stop me from getting a melanoma. And not just that. I'm your average 70-year-old Australian.
00:30:42
Speaker
I've had five basal cell carcinomas. Is that the right term? Yeah, yeah, yeah. BCCs. Basal cell carcinomas. Spot on. So I've had five of them taken off my face and two off my arms.
00:30:54
Speaker
And I have the scars to show it. I've got makeup on today. I cover it up. But to many Australians, we age ourselves dramatically. We have lots of things cut off ourselves.
00:31:05
Speaker
And for some poor people who get the melanoma and it isn't able to be caught in time and treated well, they die. So it you know I guess I'll simply say there is a still, I believe, a significant proportion of the population who have trust for the protections of agencies like the Therapeutic Goods Administration, but also for bodies like cancer councils that are working to give us the sunscreen.
00:31:30
Speaker
Just thought I'd throw the trust message in because we need to rebuild that trust and social media is undermining it, do you think, for the less informed, to be honest? Totally.
00:31:41
Speaker
I couldn't agree more, Julie. And I think the issue is the do your own research crowd. Because I can't do my own research, and neither can you, because I'm not an expert scientist in sun cream. I'm not an organic and inorganic chemist who's an expert in UV radiation blocking chemicals. I'm...
00:32:01
Speaker
I'm a doctor who's able to read scientific research, but even then, if I'm not an expert in that field, I have to trust that the multiple bodies out there who are doing research, who are competing against each other, because keep in mind, science is competitive. It's a competitive sport.
00:32:18
Speaker
Okay, people are probably gonna laugh at me for that one. It's competitive. There's an element of rivalry in it in a really nice way in that people are trying to prove other people wrong and that's what keeps science honest.
00:32:29
Speaker
If someone comes out there and says, I can do these amazing things with drug X, the first thing the other doctors and clinical academics and scientists gonna say is, I'm gonna prove you wrong. And we're gonna repeat that trial and see, does it actually work out? Because oftentimes the effect size, the level of benefit isn't as good as it's first touted to be in the first study.
00:32:48
Speaker
So there is an incentive for scientists to prove each other wrong and to compete to see, do things actually work and are they actually safe? So even if you don't trust the government, and I can understand that in in this age, not trusting the government is a fear that I can at least accept that people have, and I can understand why they might have it.
00:33:09
Speaker
I think we're really privileged in Australia that our government, our public agencies rather, who are overseen by the government have a huge amount of rigor and safety in them. And i'm very i feel very fortunate to live in this country where we can still trust these public agencies.
00:33:24
Speaker
But I get if that's an issue for you. You don't have to trust them. What you can trust is the thousands of scientists who are competing with each other, who are incentivized to prove each other wrong and still keep finding these things are safe and they work well and who are actively competing to see, can I create a better chemical, a better one, a safer one that works even better against skin cancer? Not just SPF 30, SPF
The Importance of Trust in Scientific Research
00:33:49
Speaker
50. If you can't trust in public agencies, at least trust in the competitiveness
00:33:55
Speaker
of of scientists. There's a great story from the US a colleague of mine shared on Twitter the other day. She said, I couldn't convince my dad that global warming was real until he saw that every insurance company had now increased their premiums to account for the effects of natural disasters because of global warming.
00:34:12
Speaker
And it was at that point that he agreed that global warming had to be real because there would be no economic benefit to the insurance companies, including that if it in in their risk assessment if it wasn't. So there was an economic incentive. Now he agrees that global warming's real. and but So trust in the trust in the competitiveness of scientists ah Absolutely, and of course the essence of scientific research is that it's reproducible and that is tested all the time.
00:34:39
Speaker
Look, our time is up. I have to quickly say, when you say you don't do your own research, when I did have ah stage four cancer, I did ask to read some things to help me understand what was happening, but I asked my cancer expert clinical team to recommend two or three things to read that would brief me, but I was able to rely on it being evidence-based. But look, as always,
00:35:00
Speaker
Dr. Aidan Barron, I've really enjoyed our conversation. And what am I taking away from today? yeah You have to think what you're taking away, but I guess I've learned about a proof of concept trial or a the sort of work that's done before big trials are done. And i find that i take comfort in scientific research and I look forward to changes in the United States so it becomes the home and catalyst for quality international research again.
Conclusion and Audience Engagement
00:35:29
Speaker
Over to you to take us out, Aidan. I'm so glad you mentioned that to to finish up with doing your own research. Everyone should go out there and do their own reading.
00:35:40
Speaker
You should go out and do your own reading and find verifiable, trustworthy sources and ask multiple people and make up your own informed opinions. But understand that as non-experts, we have to rely on the opinions of experts. So look for trustworthy experts who have spent years and years dedicated to actual scientific research, not somebody on TikTok who wants to tell you that your sun cream has poisons and here's a great way to mix some lavender and essential oils to protect yourself from the sun.
00:36:12
Speaker
That's all from me. And goodbye from this might sting. And remember, take your medication as prescribed. This Might Sting is hosted by Aidan Barron and Julie McCrossin.
00:36:24
Speaker
Executive produced by Joshua Kirsch. While we always work to give you the best information and tips, nothing in This Might Sting should be construed as personal healthcare care advice.
00:36:35
Speaker
You should always make health decisions in consultation with your general practitioner and specialists. If you'd like to hear us talk about a topic on the show, or if you think we've made a mistake and want to request a correction, please contact us at questions at thismightsting.com.au.