GoGreenNation news

In 2022 Susan Wojcicki was on top of the world—CEO of YouTube, parent to five kids and running a few miles a day—when she received a shocking diagnosis: metastatic lung cancer. She soon resigned from YouTube and dedicated herself to fighting the disease and looking for answers. Why does the leading cause of cancer deaths receive less funding than some less lethal cancers? How could her lung cancer have progressed so far undetected? And how did she get lung cancer even though she had never smoked? This episode is dedicated to Wojcick, who passed away last year.LISTEN TO THE PODCASTOn supporting science journalismIf you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.TRANSCRIPTElah Feder: One day in late 2022, Susan Wojcicki had plans to meet up with her childhood friend, Joanna Strober. Here's Joanna.Joanna Strober: We were supposed to go for a walk on a Sunday, and she called me and she canceled because she had some hip pain. And you know, I just thought, okay, you probably exercised too much. Susan was a runner. Maybe she pulled something, but she went to her doctor and then she- I guess she got an MRI. And it was cancer, and that was her first indication—hip pain.Elah Feder: Lung cancer, and it had spread, which was shocking. Susan, she was 54 years old and in top shape, running a few miles a day at that point. And on top of everything, Susan had never smoked.Joanna Strober: Susan led the most healthy life. She didn't eat sugar. She was very careful about exercising every day. She was very careful about not eating pesticides. I mean, she was on the extreme of leading a healthy lifestyle. So yes, it's not just the not smoking, but she was doing everything she possibly could to stay healthy.Elah Feder: Susan's experience is not as unusual as you'd think. Lung cancer is the most common kind of cancer in the world. Third most common in the US. Smoking is still the leading cause, but a growing number of people who get lung cancer don't smoke, were never smokers. That's especially true of women who get lung cancer.To be clear, this is a terrible diagnosis to get for anyone, whether they smoked or not, but for those who haven't, there can be an extra layer on top of all the other feelings: confusion. So when Susan got this diagnosis, of course she wanted treatments, but she also wanted answers. Why did this happen to her?Elah Feder: This is Lost Women of Science, and I'm Elah FederKatie Hafner: And I'm Katie Hafner and today the story of Susan Wojcicki, who died last year of lung cancer.Elah, before we get to Susan's lung cancer, I want to acknowledge—some people out there might already be familiar with her name because Susan Wojcicki was one of the most successful and influential people in the world.Elah Feder: Yeah. Susan was the longtime CEO of YouTube, and she got involved in Google very early on, so that by 2022, her estimated net worth was about $800 million.Um, there's a story that gets quoted a lot about her early business acumen. When she was a kid, she and her friend, Joanna Strober—who you heard earlier—they sold what they called spice ropes. Here's Joanna again.Joanna Strober: It's really not that big of a deal. All we did was we made these yellow and orange yarn things and we put cinnamon in them and we called them spice ropes, and we sold them to the neighbors who of course had to buy them because they were neighbors.Elah Feder: The way the story gets told, it's like, look at this Susan kid born entrepreneur, but Joanna says, “no, no, no.” The point is they were just regular kids being kids.Katie Hafner: Right. It was their version of a lemonade stand. Right?Elah Feder: Exactly.Joanna Strober: We were not special. We were normal 10 year olds in a really beautiful environment that was supportive of our endeavors.The environment was the Stanford community. We grew up surrounded by smart people who were doing really interesting research and who, quite honestly, were changing the world in lots of ways. Lots of scientists, physicists, entrepreneurs. It was a wonderful way to grow up because everything felt very possible growing up on the Stanford campus in the seventies.Elah Feder: Susan grew up on the Stanford campus because her dad was a physics professor there, Stanley Wojcicki. Um, her mom—also very impressive—Esther Wojcicki, she's a journalist, educator, writer. She- she wrote a book called How to Raise Successful People, and I mean Esther Wojcicki has the cred to back this up. Uh, a couple of years ago, Mattel decided to honor women in STEM by making Barbies of some of the more notable figures. All three of her kids made the cut.Katie Hafner: Of course they did. Esther: mother of champions.Elah Feder: What you're hearing is a video of Susan, Janet and Anne Wojcicki all unboxing their Barbie likenesses.Janet Wojcicki: Let's do physics, mathematics. Let's show them what the childhood was really like!Elah Feder: You just heard Janet, she's the middle sister. Uh, she's a professor of pediatrics and epidemiology at UCSF.Then there's the youngest kid. Anne.Katie Hafner: Yes, Anne Wojcicki: the co-founder of 23andMe. Listeners might recognize her name from all the times we thank the Anne Wojcicki Foundation in the credits—and her foundation funded this episode as well, right?Elah Feder: And then there was Susan, the eldest. I talked to Anne and Janet a few weeks ago. All all three sisters were very close in age, all born in a span of, of just five years. But talking to them, it sounds like Susan had classic first child syndrome. You're gonna hear Anne first.Anne Wojcicki: She was always the responsible one. Janet was not. And- and but-Janet Wojckick: And you were halfway in between.Anne Wojcicki: I was halfway in between, yeah. My friends always liked hanging out with Susan, but they didn't like hanging out with Janet. And then part is that Susan was so kind. Susan was kind. She was responsible, like she would take us out to ice cream. She would pick me up from ice skating. She was like, always on time.Elah Feder: If Susan Wojcicki promised you ice cream, you were gonna get ice cream. This is a quality that surely you'd want in a leader. But Anne says Susan wasn't born to be a mogul or anything.Anne Wojcicki: I'd say Susan was very much almost like the accidental CEO. I never would've looked at her when we were younger and said like, “oh, my sister is going to be a CEO.” You know, like there's definitely other people I look at in high school who have focused on finance and thinking about their careers and stuff.Elah Feder: Susan, on the other hand, was a history and literature major, but in 1998 she got involved in the creation of a new tech company when she rented out her garage to two Guys: Larry Page and Sergey Brin. They were starting a new company, and I think you know the name. Um…Katie Hafner: Google, if I'm not mistaken!Elah Feder: Google!Newscaster: a little engine that could, we're talking about this morning, has nothing to do with the children's story about a brave little locomotive. That's because this engine is a search engine. Google by name, an internet website, partnered with our own CBS news.com.Elah Feder: Susan soon became the company's first marketing manager, and a few years after that she led them in buying another tech company: a company called YouTube. And in 2014 she was appointed YouTube CEO.Newscaster 2: Well, her name is Susan Wojcicki and she's one of the most powerful women in tech. She's also mother of four and more than eight months pregnant with her fifth child. So how did she do it all?Elah Feder: So, in 2022, Susan has been CEO of YouTube for eight years. Somehow she still had time to raise five children and run a few miles a day, which is completely alien to me.You know that Beyonce meme, like Beyonce has as many hours in the day as you do, and it's, like, meant to shame you for being inadequate. Um, that is how I feel hearing about Susan Wojcicki. Point is she's doing really well when she gets this news. And it's a complete shock. Here's Anne again.Anne Wojcicki: I think when you suddenly- like Susan was kind of on top of the world, like she loved her job, YouTube is taking off and she had her five kids and they're all amazing and um, and then suddenly it was like, your life is gonna be over soon. Right away the first priority was treatment.Elah Feder: Very quickly, Susan resigned from YouTube and really gave herself over to fighting this.Joanna Strober: What she really did was started working with scientists…Elah Feder: Joanna, again.Joanna Strober: …doing the in-depth work to understand the science and what treatments were available and what she could do, but it was very scientifically focused.Elah Feder: Susan would go on to learn a lot about lung cancer, and one of the things that she learned that really disturbed her is that doctors were not great at detecting her kind of cancer: lung cancer in non-smokers. Often there are no early signs, or in Susan's case, very few signs even when the cancer has progressed. Here's her sister, Janet.Janet Wojcicki: We went to see her, you know, thoracic oncologist, right? Her lung oncologist. She's sitting on the table and the oncologist is actually examining her and she's listening to her lungs and Susan's basically saying like, you don't hear anything, right? You, you hear nothing like it sounds totally normal, right? And the oncologist is like, yeah. So just from a clinical exam, she was perfect. There was nothing. So she was like, how is it that I have stage four lung cancer? You're an oncologist, you're listening to me, you're looking at me, and like, nothing's awry. So it's- it was that kind of disconnect that was also kind of a call to action.Elah Feder: How could Susan's lung cancer have gone undetected so long that it had spread? And why is it that when lung cancer is detected, survival rates aren't higher? Well, part of the reason might be that we need more funding despite some very effective anti-smoking campaigns, lung cancer is still the leading cause of cancer deaths in the U.S., but it only gets about half the federal research funds that breast cancer does- or it did. The NIH has been slashing research funding, including cancer research. We'll see how this all shakes out in the coming months and years. In any case, lung cancer might not be the only cancer that's in trouble going forward. But historically, part of the reason that lung cancer got proportionately less funding might have to do with attitudes toward lung cancer. It just isn't viewed the same way that breast or prostate or pancreatic cancers are. It's often seen as something you bring on yourself. Here's Anne again.Anne Wojcicki: I think that the stigma has really hurt research- is that people look at it and they say like, oh, well you smoked. And um, and I think that's one of the things that Susan really wanted to change.Elah Feder: It took a long time to get this broad consensus that smoking causes lung cancer. If we go back to the forties and fifties, that's when you first see a bunch of studies coming out that demonstrate this link. And even so, if you asked a doctor in 1960, if the link had been proven, a fifth said they didn't think so. About half of them still smoked, but eventually the other side prevailed. We now have a consensus that smoking does cause lung cancer, but the downside is stigma.Katie Hafner: You know? And the stigma is really, really deeply embedded in our society. The minute you hear that somebody has been diagnosed with lung cancer, the very first thing you ask is, do they smoke? Have they smoked? Have you smoked? Has she smoked? And, so you immediately assign that stigma to the lung cancer even when it quickly gets established that there was no smoking. And that could also have an indirect effect on this lack of funding.Elah Feder: Yeah, that's the suspicion, and of course the stigma and the victim blaming is terrible for people who did smoke too. So, that really bothered Susan and she gave a lot of money for research, but she was also at the same time just investigating her own cancer. You know how, how did she get it?Anne Wojcicki: I think one of the first things we did was we got the houses tested for radon exposure.Elah Feder: Katie, do you know about radon? Are you familiar with radon?Katie Hafner: I mean, I'm familiar, but I have no idea what that has to do with it. Tell me.Elah Feder: I only recently learned about this, so, so radon is a radioactive gas. It- it sounds like one of these scary things you read on the internet, but this is real. It's a radioactive gas that naturally occurs in the ground, but it leaks into basements where it can accumulate to dangerous levels. It has no smell, no- no color. So you really would not know if it's in your home unless you test for it. Um, but it's the leading cause of lung cancer in non-smokers.Katie Hafner: You mean before secondhand smoke?Elah Feder: Apparently. In the U.S. radon is the number one cause of lung cancer among non-smokers according to the EPA.Other causes, of course, do include air pollution, asbestos exposure, and secondhand smoke.Katie Hafner: Wow. So, I've always thought secondhand smoke was it? But it sounds like it was, it sounds like it's radon.Elah Feder: Me too. Maybe it used to be when people were smoking more.Katie Hafner: Yeah.Elah Feder: But yeah, radon is unfortunately in the lead. Um, Susan's basement: clear of radon.Katie Hafner: And what about genetics? Last week, you know, we talked about a researcher named Maud Slye who worked to show that heredity explained all cancer.Elah Feder: Wrongly, but yes.Katie Hafner: Turns out not to be true, but that's okay. You go Maud. Um, are there genes linked to lung cancer? I guess that's my question.Elah Feder: There are, um, but lung cancer is still, for the most part, a disease caused by- by either your environment or your lifestyle. Some genes have been linked to increased cancer risk. For example, a certain mutation in the EGFR gene. More genes might be found. It's also possible that it's not just about finding a single gene, but about how mutations in a bunch of genes interact. But yeah, for the most part, lung cancer tends to be about environment and lifestyle more than genetics.Here's a part where there's sometimes confusion. Cancer usually happens when there's a genetic mutation in a cell, actually a series of mutations. And these cause that cell to start acting weird and replicating out of control. So in a sense, genetics is always involved in cancer, but in this case, we're not talking about inherited genetics, we're talking about mutations that you get in some of your cells later in life. They can pop up when you're 10 or 30 or 80 or hopefully never. But then, some people do have preexisting germline mutations. Some mutations that you have had since you were a little zygote that exist in every cell of your body. And, these don't usually directly cause cancer on their own. Um, I think an analogy might be helpful here. So, imagine a mutation as a switch. You usually need a few switches to turn on before a cell becomes cancerous. But some people are born with one of their switches already in the on position. And that makes them more vulnerable. Does that make sense?Katie Hafner: It makes sense. It, I mean, it makes me think about the BRCA gene.Elah Feder: Mm-hmm. Exactly.Katie Hafner: So you might be born with this mutation that puts you at high risk of getting breast cancer, but you might still not get it, but it still seems like a good idea to find out if you're at risk so that you can take some precautions and plan ahead.Elah Feder: Right. Although with lung cancer, genetic screening is tricky. Like I mentioned, heredity is not the driving factor usually for this kind of cancer. Um, but say- say you do find you have a heritable mutation that puts you at risk. You're limited in what you can do. It's not like BRCA where you might consider a double mastectomy. You're- you're gonna keep your lungs. You could take extra care to avoid environmental exposures—something we really should all do. You might even get regular low-dose CT scans—that’s actually something that is recommended for people who have smoked after a certain age to detect any lung cancer early, but those come with risks too: you’re getting a little bit of radiation each time. I’m not saying it's not worth it, it might be if you are very high risk, but it's a consideration. Anyway, that's for people who do not have lung cancer already, but are concerned about a genetic predisposition. For someone who does have lung cancer, yeah, you probably want to know what's going on in your tumor genetically.Katie Hafner: So what about Susan's case? Did she find a genetic cause for her lung cancer that could be really useful for her family to know?Elah Feder: No. Um, Susan did not actually test positive for any hereditary mutation linked to cancer, but there are still genes that may not have been identified. Even before her diagnosis, she and her husband were donating money for cancer research through their foundation. After her diagnosis, they ramped this up. Donating to research about immunotherapies, early detection. But, also funding a new project at her sister's Company 23andMe. It's called the Lung Cancer Genetic Study. So, they are trying to build a massive database of genetic information from people with lung cancer.One of the project's goals is to find heritable genetic risk factors, but they explain it's actually bigger than that. They want to know how heritable mutations, tumor mutations, and lifestyle all interact so that they might figure out, for example, why one person who smokes develops cancer, but another doesn't. It might also help them to develop new therapies. So-Katie Hafner: I just wanna interject with something that strikes me just as we're having this conversation, which is that, um, people who are listening to this probably know that 23andMe had a lot of problems, ended up filing for bankruptcy protection and Anne resigned earlier this year. Um, I'm sure that it's been very challenging for Anne, but it sounds like she is in her very best, um, Wojcicki family-like way: making lemonade out of lemons in this regard. That's my initial reaction to everything you're saying.Elah Feder: Yeah. And as you know, 23andMe—while it filed for bankruptcy—it lives on and created a nonprofit called the TTAM Research Institute. It bought 23andMe in July this year. And so, 23andMe is still going and so is this project. So far about 1200 patients have signed up and the goal is to reach 10,000.Anne Wojcicki: If you think about any one medical center, if it's UCSF or at Stanford or Harvard, getting a thousand patients coming in is- is a lot. And so, that's kind of the beauty of being able to go and find people around the entire country, is to be able to pull all that data together and then make that accessible to the research community.Elah Feder: 23andMe's Lung Cancer Genetics Study was officially announced in July last year. Susan Wojcicki died a few weeks later on August 9th, 2024. She was 56.Katie Hafner: So, Susan never did get an answer. She never found out why she had lung cancer.Elah Feder: No, she did not. And we're still trying to understand a lot about lung cancer in general. Here's Anne.Anne Wojcicki: There's still just like a lot you don't know. Understanding environmental science I think is really important. We live in a very complicated world with a lot of, you know, there's fires and there's pollution and there's what you eat and we just don't know. You don't know what the impact of all of that is, and so, you can't- I mean you can't live your life trying to measure everything and worry about everything. Like in some ways you have to come to terms with that, that you can't- you can't worry about it all the time.Elah Feder: This is a big part of life. It's understanding that so much of it is beyond our control, and we often don't even get answers. We don't find out why bad things happen to us. At the same time, when it comes to lung cancer, there is more that we can do. Here's Janet.Janet Wojcicki: I mean, if there are modifiable risk factors that we can identify—I mean the key word being modifiable, right? Then, ideally we could act on them.Elah Feder: We can fight air pollution, we can stop kids from getting their hands on cigarettes. We can look for more heritable risk factors and invest more money in treatments. As for Susan Wojcicki, despite all of her resources and all of her drive, ultimately she couldn't stop the cancer in her own body, but she left her mark in business in cancer research. She left a bigger mark than most of us ever will, but her sisters and her friend, Joanna- the thing that they really remember is how she never let any of that success go to her head.Anne Wojcicki: It didn't matter if we were like some fancy party or if Oprah wanted to talk to her. She was kind of the same. She was always very unaffected. And, it was, like, really fun going to the Oscars with her because she'd be like, “ah, I'm just gonna buy this dress on clearance at Macy's, and like no one cares what I wear.” And that was kind of the thing that was fun. She'd be like, “it would just be fun with you and like only going so that we can hang out.”Anne Wojcicki I always ride in my flats and my skirts. You're going to- are gonna YouTube? I’m actually really curious. Are you gonna meet YouTube- are you gonna meet Mr. Beast?Elah Feder: This episode of Lost Women of Science was produced by me, Elah Feder, and hosted by our co-executive producer Katie Hafner.Our senior managing producer is Deborah Unger. We had fact-checking help from Danya AbdelHameid. Lily Whear made the episode art. Thanks as always. To our co-executive producer, Amy Scharf, Eowyn Burtner, our program manager, and Jeff DelViscio at our publishing partner, Scientific American. This episode was made with funding from the Anne Wojcicki Foundation.You can find a transcript and a link to the Lung Cancer Genetics Study at www.lostwomenofscience.org.HostKatie HafnerHost and Senior ProducerElah FederGuestsAnne Wojcicki Anne is Susan Wojcicki’s youngest sister and the co-founder of 23andMe.Janet WojcickiJanet is the middle Wojcicki sister. She’s a professor of pediatrics and epidemiology at the University of California, San Francisco (UCSF).Joanna StroberJoanna is the co-founder of Midi Health and a long-time friend of Susan Wojcicki.Further Reading“From Susan” — Susan Wojcicki’s final post, written a few weeks before she died and published on YouTube’s blog on Nov. 25, 2024.How to Raise Successful People. Esther Wojcicki, Houghton Mifflin Harcourt, 2019The Lung Cancer Genetics Study“Does Lung Cancer Attract Greater Stigma Than Other Cancer Types?” by Laura A. V. Marlow et al., in Lung Cancer, Vol. 88, No. 1; April 2015

After her shocking lung cancer diagnosis, the late Susan Wojcicki dedicated herself to fighting the disease and looking for answers