- [Announcer] Your Fantastic Mind", brought to you in part by Dennis Lockhart in memory of Mary Rose Taylor, and by... (upbeat music) (upbeat music continuing) - [Jaye] This week on "Your Fantastic Mind".

- Glioblastoma, broadly, is an almost uniformly fatal disease.

- [Jaye] We follow a beloved husband and grandfather through an innovative trial that could change how this aggressive brain cancer is treated.

- Proteins are the ones that are actually doing the work in the cell.

- [Jaye] They could be one of the keys to treating Alzheimer's and other neurodegenerative diseases.

Get a glimpse inside the world of proteomics, and how this research could impact all our lives.

- It's a really exciting time to be in the field.

- [Jaye] Plus, the leading dog neuroscientist in the world finds a new project and passion.

- My colleagues think I'm nuts.

I swear I might have the only cows who roll over for belly rubs.

(upbeat music continuing) - Welcome to "Your Fantastic Mind".

I'm Jaye Watson.

Over 50 years ago, the official war on cancer was declared.

Since then, treatment and survival rates have soared, and innovative treatments and breakthroughs are no longer a rarity.

Glioblastoma, the most common primary brain cancer, a cancer that starts in the brain, is still without a cure, and the five-year survival rate is only around 10%.

But a new clinical trial has many goals.

One of them is teaching the brain's immune system how to fight the cancer.

(upbeat music) It was a Ziploc bag.

Out of the blue, Ike Hudson was having trouble opening it.

That was one sign.

Then... - [Ike] I had a grand mal seizure on the way to see my personal physician.

- [Jaye] After a series of tests and scans, Ike was diagnosed with stage four glioblastoma.

- Well, I was in the hospital, and I really had no concept or understanding of what glio was at that time.

It was like, "You have glioblastoma WHO Level Four."

And I'm going, "Okay.

So?

Okay."

- Glioblastoma is one of the most aggressive tumors that that people can face, period.

And certainly, it's the most aggressive tumor of the brain.

- [Jaye] Emory neurosurgeon, Dr Edjah Nduom, says glioblastoma spreads into the surrounding brain, making it impossible to remove the entire tumor with surgery.

- [Edjah] Glioblastoma, broadly, is an almost uniformly fatal disease.

- [Jaye] Dr Nduom researched glioblastoma at the National Institutes of Health before he came to Emory.

- No matter how good of a surgery that I do, there are always going to be some tumor cells right next to the normal cells that I can't take out surgically, and that's where treatments come in.

- [Jaye] Hudson had surgery and chemotherapy and radiation.

Over a year later, a scan shows something that could be a reocurrence of the cancer.

- He has a lesion that, unfortunately, based on the imaging, looks like it's come back.

I'm gonna touch you there.

- [Jaye] If the cancer comes back, what was done the first time might be repeated, surgery, radiation, chemotherapy.

But this time, Ike Hudson has a new option.

- Alright, we're good then.

- [Jaye] That's because Dr Nduom is determined to take glioblastoma from fatal to treatable.

Dr Nduom invited Hudson to be in a new trial.

- What we're trying to do is take one of our most promising combinations of immune therapies, things that harness the immune system, you know, the part of your body that fights off different infections and bacteria, and that sort of thing, but to try and turn that towards the tumor, make it see the tumor and attack the tumor more effectively.

(coffee machine whirring) (door clicking shut) - [Jaye] The day before the first of two surgeries, Ike and his wife, Rena, - Made you some coffee.

- Thank you.

- [Jaye] sit on their porch, their life's dreams reduced to one thing.

- See the grandkids grow up.

Having him around.

I want you around a whole lot longer.

'Cause I don't want to do it without you.

- Instead of just going right in and taking that tumor out, we're instead gonna first confirm that this is actually a representation of tumor that's come back.

I'll make a very small cut on the head.

We use our neuro navigation for the brain to tell us exactly where we are.

We take a piece of it, we walk it off to the pathologist.

The pathologist will be able to tell us right there whether it looks like this is a tumor that has come back, or it doesn't.

Lemme see that drill.

- [Jaye] The area in question is about a centimeter-and-a-half in size.

After drilling a small hole in Hudson's skull, they take a sample of the lesion.

- So we just took two pieces of the lesion that we're gonna walk over to Pathology now, and just make sure that we know what we're dealing with.

- [Jaye] Less than 15 minutes later, Dr Nduom and his team have the answer.

- Now, we did see some signs of treatment response, which you expect to see for any patient that's had radiation in the past.

There'll be some inflammatory cells, and they were there, but we also saw a lot of very atypical cells that are consistent with recurrent glioblastoma.

So the pathologist was able to make the call that, unfortunately, Mr Hudson's tumor has come back.

(mid-tempo piano music) - [Jaye] With the confirmation that the glioblastoma has returned, Nduom is going to place two small catheters in this first surgery.

- We will place something called a microdialysis catheter, which is a small tube that's specifically designed to allow certain substances that are in the brain tissue to go into the catheter, and you put a certain fluid into it, called the perfusate, that seems similar to the cells around the brain.

So I put that fluid in slowly.

The substances in the brain are allowed to diffuse across the membrane, and then the fluid comes out slowly, and we collect it.

And in that way, I'm actually able to get a sampling of what the substances in the brain look like on a minute-to-minute, hour-to-hour basis.

(up-tempo violin music) - [Jaye] This will allow Dr Nduom to measure what Hudson's immune system is saying.

A second catheter is placed in the fluid-filled spaces of Hudson's spine, which also communicates with the brain.

This is critically important for what comes next.

- Very good.

Alright.

Today's a big day, as far as the protocol's concerned.

As you know, the main thing we're trying to figure out is whether these immune therapy drugs work in the brain.

And today is the day that we actually give him one of the immune therapy drugs, one of these checkpoint inhibitors, and then we'll give him some time to let his body respond and see if we can measure a response to it.

So the infusion is gonna happen this afternoon.

- [Jaye] Hudson remains in the hospital after surgery, so that he can receive a combination of checkpoint inhibitors.

- [Edjah] Alright, we're good to go with the infusion.

- [Jaye] First, Dr Nduom is going to take samples from the tubes in Hudson's brain to see how the immune system in the brain is communicating before treatment.

- I'm gonna change out those tubes that we're measuring, to get a baseline of what the immune microenvironment of his brain looks like, how the brain's kinda talking to itself from an immune standpoint.

You have your infusion.

- [Jaye] The infusion will not be delivered through the catheters.

- When they think of putting a catheter into the brain for a brain tumor trial, a lot of people think that what we're doing is putting a drug directly into the brain, and that's not the case here.

That is the case for some studies.

In this case, we're actually taking a drug that is usually given in the bloodstream, in the periphery, with the thought that it will stimulate the immune system and have an effect on the brain, and using our catheters to measure the response to that therapy in the brain.

Again, we'll be checking on you, okay?

- [Jaye] Samples from the catheter in Hudson's brain will be taken every six hours.

A sample from the cerebral spinal fluid and a blood sample will be taken once a day.

At the end of the week, Hudson will undergo the second surgery to remove tumor regrowth.

- Can we have the ultrasound up?

The surface of the brain is a couple of different colors.

Let me see the still for one more time.

- [Jaye] Emory was the first institution in the country to use Gliolan, (gentle orchestral music) a substance that literally makes tumors light up.

- To the naked eye as well, the fluorescence says, "Hey, this is a problem."

So this is the most obvious kinda biggest nodule we're looking at at the beginning.

You can see the surface of the brain there.

This is a smaller nodule that was nearby.

And what I'm gonna do is just make sure that we've given enough to our pathologist to make a good diagnosis.

It's a little pink, with the glial-- - [Jaye] Dr Nduom removes the tumor regrowth.

He will compare this tissue with the tumor tissue taken from the first surgery, before Hudson received the immunotherapy.

- [Edjah] It turns out that-- - [Jaye] Dr and Dome hopes to detect some change in the immune microenvironment of the tumor.

The hope for Ike Hudson and the other patients in this trial is to live longer.

Part of Dr Nduom's hope comes from a different trial at UCLA that showed something unexpected.

- They saw a survival benefit for patients that got the drug before the tumor was taken out.

Why did they see a survival benefit for that subset of patients?

We don't know the answer to that yet.

We're still trying to figure that out.

There is some speculation that maybe you need to give the immune therapeutic to boost the immune system.

Then the immune cells that are in the tumor itself then get educated against what the tumor looks like and how to attack it.

And then you take out the tumor and reduce the amount of tumor that's there, but the immune system remembers.

There is this concept of immune memory.

That's how vaccines work.

That's how, if you get a cold, the next time, hopefully, you're able to fight it off better.

- [Jaye] It will be many months before Dr Nduom and his team know what the immunotherapy did or didn't do for the trial participants.

Even the smallest change will provide profound insight in a disease and diagnosis viewed as hopeless.

It moves the science one step closer to effective treatments.

(mellow music) - What do you want to do after you get home and you get well?

- [Jaye] The worst diagnosis makes things clear.

- Biggest concern is how it affects my family.

I have three very beautiful granddaughters, one of which is 10 months old and has no concept, and one who's seven, and one who's five.

And they don't understand why papa is not feeling well.

(mellow music continuing) - [Jaye] The worst diagnosis is also a magnet for physician scientists like Dr Nduom, determined to change the outcome.

- I've always been interested in big challenges, and my parents had told me when I was little that I could be anything that I wanted to be, and I could be successful at anything that I wanted to be successful at.

And I always knew I wanted to do something that was difficult.

I mean, if I had all that ability, why not use that ability on something that had been a challenge, something that had been facing mankind for a long time.

(mellow music continuing) - Ike Hudson remained on immunotherapy for five months.

He continues treatment for his tumor, and the study team is hopeful that his prolonged treatment with immune therapy will lead to a long, tumor-free interval.

Dr Nduom's samples are undergoing definitive processing.

Results of the trial will be known in early 2024.

(lively music) Did you know that proteomics is gonna be one of the keys to cracking the code to Alzheimer's and other neurodegenerative diseases?

Proteomics, put simply, is the study of proteins.

- [Erik] I see patients with Alzheimer's disease.

- [Jaye] Dr Erik Johnson is a neurologist and researcher.

- [Nick] Changes in the brain are far wider than we had initially anticipated.

- [Jaye] Nick Seyfried is a protein biochemist and researcher.

Together, they study the role of proteins.

- But the proteins are the ones that are actually doing the work in the cell.

They're doing the chemical reactions, they're providing the structure for the cell.

They're communicating.

They're allowing cells to communicate with one another.

So really, to really understand diseases, you have to understand what's going on at the protein level.

There isn't one protein that goes wrong in your body to cause a disease.

It's a systems failure.

The system fails.

There's a whole biological network that is disrupted in the brain, for instance, in Alzheimer's disease.

So in order to understand how the system fails, you have to be able to measure the entire system.

(lively music) - [Jaye] Brain donation helps proteomics research.

- We either get their brain when they come to autopsy.

And these are brain donors, which is very helpful.

And what that allows us to do is map the protein changes in the brains of these patients that have been diagnosed with Alzheimer's disease.

And then we use that map as information to predict the same proteins that we see in the brain as proteins in their biofluids, like plasma and spinal fluid, to see if they're predictive of individuals who are living, of whether they would get, potentially, Alzheimer's disease.

- [Jaye] What Johnson and Seyfried and their teams are learning could lead to drugs to prevent or treat disease.

- Majority of the drugs that are in clinic right now target proteins.

And so if these proteins are changing the brains of these patients, they could themselves be therapeutic targets that can modify disease course.

- [Jaye] The research is also confirming the importance of lifestyle, of the impacts on the brain and body of healthy versus unhealthy aging, and getting a blood test for Alzheimer's is no longer a dream.

- And within the next, I think, 10 years, five to 10 years, we're gonna have a lot more available in terms of blood tests for Alzheimer's disease.

It's a really exciting time to be in the field.

(lively music) - For our final story this week, we are going to take a trip to the country.

We went there to visit a neuroscientist who made a drastic decision during the COVID pandemic.

It was a decision that would lead him unexpectedly to a new research project.

It was also a decision that led him to a whole new life.

(lively music) - [Greg] We've done this now for eight years.

- Yay!

Good job, buddy.

- [Greg] COVID certainly changed me, as it did everyone.

- Nice.

That's better.

Back.

- [Greg] We've trained now over a hundred dogs.

- [Jaye] When the COVID pandemic hit, - We're gonna be assessing your dogs for-- - [Jaye] Neuroscientist Greg Berns' decade of work with dogs came to a halt.

- The dog project kind of dried up, because it was difficult to train dogs to go in the scanner when you couldn't really do it in person.

We'll just go dog by dog.

- [Jaye] Struggling against this new normal, - Seemed like my whole life was on Zoom.

What do y'all think?

- [Jaye] Berns made a life-changing decision.

(car engine whirring) - [Greg] We found this place just kind of magically.

- [Jaye] Berns and his wife sold their home in Atlanta and bought an 85-acre farm an hour south of the city.

- [Greg] My colleagues think I'm nuts.

You know, as they say, "You bought the farm."

- [Jaye] A southern California native, Berns craved nature, expansive spaces.

- I knew nothing about farming.

(trunk engine trundling) - [Jaye] There was that.

Being in nature is one thing.

- I'm learning about grass.

- [Jaye] Running a farm is another.

- Cows look pretty sedate.

You could put 'em out here.

They just have one job, and that's to eat the grass.

So without knowing anything at all about cattle, I acquired a bull and two cows, who turned out to be pregnant.

Come here, Zena.

- [Jaye] Berns bought the zebu cows locally.

Much smaller than typical cows, they are descended from Asia.

- So now I have seven.

This is Bebe.

There's the bull, Ricky Bobby, right there.

So he's the patriarch.

Okay.

- [Jaye] There was a defining incident with Ricky Bobby, the bull, who began to choke on an alfalfa treat Berns had given him one day.

- He started to panic and back away, and I didn't know what to do.

And so I went up to him, and I started stroking his throat, just to kinda push down what was ever in his throat.

Put your head up here.

It seemed to calm him down, and he swallowed it.

And then...

There you go.

After that... How're you doing?

He seemed to be different towards me.

He wasn't so afraid.

He would come up to me, and he very soon started putting his head on my shoulder, like, "Stroke my neck, please."

That licking as a form of affection.

- [Jaye] Berns' pandemic decision to become a farmer has actually led him to his next neuroscience venture.

- They've become the next dog project.

Hey, Tex.

Come on.

I have weirdly become fascinated by, hey, Daisy, cows and cattle, and just, you know, how do they think, how do they see the world, and, more surprisingly, how emotional they are.

Do they have emotional lives?

And I think the answer is quite obviously, yes.

That's what they do with each other.

They'll lick each other.

(cow slurping) What I am doing is training the cows, like dogs, to do things, so that I can ask questions about their cognition and their emotions, so I can give them choices, for example, like, "Do you prefer this thing or that thing?"

"Can you learn a symbol on a piece of paper?"

"Can you learn human language?"

Those are the sorts of questions that we can ask about cattle that have not really been asked before.

(somber music) - [Jaye] The cow project is not a pet project.

It's to provide greater scientific understanding of these animals.

- There's lots known about cattle, but most of that information is from an agricultural production standpoint.

- [Jaye] There's been much reported about commercial farming and the sometimes inhumane conditions and treatment cows endure before slaughter.

- My interest is in, okay, what is the cognitive emotional life of cattle?

And knowing that, how do we give them the best life possible, even if they're headed to be food products?

- [Jaye] What Berns learns could change our understanding of cows, even how we consume meat.

- There's no reason why you couldn't put a QR code on that steak and learn everything about the animal it came from, and so you could track from birth to slaughter what happened to that animal, and how it was raised, and who did it.

That information exists.

It's just not available to a consumer.

It could be, if consumers wanted it.

They like to be pet and treated just like my dogs do.

And, well, that's pretty neat.

♪ Well, here's Dr Berns.

♪ - [Jaye] It's not often you see a bull with its horned head in a human's lap, getting some good rubs, but here it is.

- [Kenneth] This is quite a scene, to be able to see him, to do this.

- I swear I might have the only cows who roll over for belly rubs.

I just have to be careful of the horns.

Now we're getting a little close.

You can watch them with each other.

They're very affectionate with each other.

And then, you know, with time, they began to accept me into that group, and started to behave similarly towards me.

Hello.

- [Jaye] When you make a change, it can change everything, including your friends.

- Well, Tex, how you doing?

Huh?

Are you enjoying yourself today?

It's a beautiful day.

It's a beautiful day on the farm.

- [Greg] He's always the first person I call when I need help, and he comes.

- (whistling) Bebe.

- [Jaye] Pastor Kenneth Peek is his neighbor, a Vietnam veteran, minister, and lifelong farmer.

- [Kenneth] Like I say, I've always had cattle.

- He's the most genuine and giving person I've probably ever met.

I mean, he knows when something's up.

- I think it's fantastic.

I think everybody should see this, and should have the opportunity to really get to know cattle like he's known them.

- [Greg] If I put more hay out, then that's all they'll eat.

- [Kenneth] Exactly.

- [Jaye] Two men with opposite backgrounds, now close friends.

- He's one of my dearest friends.

You're a sight for sore eyes.

You're something, girl.

- [Jaye] United in seeing cows as more than a food source.

- [Greg] Well, Baby is Daisy Duke.

- [Jaye] In our time with the cows, we were greeted timidly at first, then with curious affection.

- [Cameraman] Would you like my camera?

- You like mine?

Do you like my sunglasses?

- He likes your hair.

- Oh, thank you!

Oh, my goodness.

- [Greg] I see that cows have very similar capacities to form bonds with humans that dogs do.

- I know what you mean.

- The difference is that it's much more difficult, it's a slower process.

And cows, because they're prey animals, or they're evolved from animals that are hunted by other animals, by nature, they're not as trusting as a dog.

Dogs are easy.

- [Cameraman] Oh, my goodness.

- [Greg] You take an animal like a cow, who's inherently afraid of everything, for the most part, and to form a bond with them takes extra effort.

But when it happens, in many ways, it's more rewarding.

- [Cameraman] Okay, you're good.

- [Jaye] The timing of this, of the move to a farm, of discovering his connection to his cows, came while Berns was writing a book called "The Self Delusion", which is about the stories we tell ourselves about our lives and who we are.

- If we don't have the story, then all we have is a collection of events that happen to us without anything to link them together.

(lively guitar music) - [Jaye] We are the architects of our stories, which are a combination of our memories, and everything we consume in life, from childhood fairytales to movies and books, and even other people's experiences.

We often forget we have the power to change our story in ways big or small.

- I think it's empowering to know that it is a story, that our sense of self and our sense of life is kind of this moving target.

And it's kind of a folly to think that you're ever gonna get your hands completely around it.

And the best that you can do is tell a narrative that suits you the best.

(boots rustling through grass) - [Jaye] One could say the plot twist in Berns' story was moving to the farm.

- [Greg] That was not, not even in the outline at the beginning.

(somber music) - [Jaye] There is the cow project.

There is the farm with its pastures and woods.

At this point in this new chapter of his life story, with so much yet to do and discover, Berns is certain of one thing, he's meant to be here.

- [Greg] I mean, to me it feels just perfect.

(mellow music) - That's gonna do it for us this week.

We'll see you next time on "Your Fantastic Mind".

(upbeat music) (upbeat music continuing) - [Announcer] "Your Fantastic Mind", brought to you in part by Dennis Lockhart in memory of Mary Rose Taylor, and by...