Scientists and Religious Leaders Need to Be More Transparent
[Editor's Note: This essay is in response to our current Big Question series: "How can the religious and scientific communities work together to foster a culture that is equipped to face humanity's biggest challenges?"]
As a Jesuit Catholic priest, and a molecular geneticist, this question has been a fundamental part of my adult life. But first, let me address an issue that our American culture continues to struggle with: how do science and religion actually relate to each other? Is science about the "real" world, and religion just about individual or group beliefs about how the world should be?
Or are science and religion in direct competition with both trying to construct explanations of reality that are "better" or more real than the other's approach? These questions have generated much discussion among scientists, philosophers, and theologians.
The recent advances in our understanding of genetics show how combining the insights of science and religion can be beneficial.
First, we need to be clear that science and religion are two different ways human beings use to understand reality. Science focuses on observable, quantifiable, physical aspects of our universe, whereas, religion, while taking physical reality into consideration, also includes the immaterial, non-quantifiable, human experiences and concepts which relate to the meaning and purpose of existence. While scientific discoveries also often stimulate such profound reflections, these reflections are not technically a part of scientific methodology.
Second, though different in both method and focus, neither way of understanding reality produces a more "real" or accurate comprehension of our human existence. In fact, most often both science and religion add valuable insights into any particular situation, providing a more complete understanding of it as well as how it might be improved.
The recent advances in our understanding of genetics show how combining the insights of science and religion can be beneficial. For instance, the study of genetic differences among people around the world has shown us that the idea that we could accurately classify people as belonging to different races—e.g. African, Caucasian, Asian, etc.—is actually quite incorrect on a biological level. In fact, in many ways two people who appear to be of different races, perhaps African and Caucasian, could be more similar genetically than two people who appear to be of the same African race.
This scientific finding, then, challenges us to critically review the social categories some use to classify people as different from us, and, therefore, somehow of less worth to society. From this perspective, one could argue that this scientific insight synergizes well with some common fundamental religious beliefs regarding the fundamental equality all people have in their relationship to the Divine.
However, this synergy between science and religion is not what we encounter most often in the mass media or public policy debates. In part, this is due to the fact that science and religion working well together is not normally considered newsworthy. What does get attention is when science appears to conflict with religion, or, perhaps more accurately, when the scientific community conflicts with religious communities regarding how a particular scientific advance should be applied. These disagreements usually are not due to a conflict between scientific findings and religious beliefs, but rather between differing moral, social or political agendas.
One way that the two sides can work together is to prioritize honesty and accuracy in public debates instead of crafting informational campaigns to promote political advantage.
For example, genetically modified foods have been a source of controversy for the past several decades. While the various techniques used to create targeted genetic changes in plants—e.g. drought or pest resistance—are scientifically intricate and complex, explaining these techniques to the public is similar to explaining complex medical treatments to patients. Hence, the science alone is not the issue.
The controversy arises from the differing goals various stakeholders have for this technology. Obviously, companies employing this technology want it to be used around the world both for its significantly improved food production, and for improved revenue. Opponents, which have included religious communities, focus more on the social and cultural disruption this technology can create. Since a public debate between a complex technology on one side, and a complex social situation on the other side, is difficult to undertake well, the controversy has too often been reduced to sound bites such as "Frankenfoods." While such phrases may be an effective way to influence public opinion, ultimately, they work against sensible decision-making.
One way that the two sides can work together is to prioritize honesty and accuracy in public debates instead of crafting informational campaigns to promote political advantage. I recognize that presenting a thorough and honest explanation of an organization's position does not fit easily into our 24-hour-a-day-sound-bite system, but this is necessary to make the best decisions we can if we want to foster a healthier and happier world.
Climate change and human genome editing are good examples of this problem. These are both complex issues with impacts that extend well beyond just science and religious beliefs—including economics, societal disruption, and an exacerbation of social inequalities. To achieve solutions that result in significant benefits for the vast majority of people, we must work to create a knowledgeable public that is encouraged to consider the good of both one's own community as well as that of all others. This goal is actually one that both scientific and religious organizations claim to value and pursue.
The experts often fail to understand sufficiently what the public hopes, wants, and fears.
Unfortunately, both types of organizations often fall short because they focus only on informing and instructing instead of truly engaging the public in deliberation. Often both scientists and religious leaders believe that the public is not capable of sufficiently understanding the complexities of the issues, so they resort to assuming that the public should just do what the experts tell them.
However, there is significant research that demonstrates the ability of the general public to grasp complex issues in order to make sound decisions. Hence, it is the experts who often fail to understand how their messages are being received and what the public hopes, wants, and fears.
Overall, I remain sanguine about the likelihood of both religious and scientific organizations learning how to work better with each other, and together with the public. Working together for the good of all, we can integrate the insights and the desires of all stakeholders in order to face our challenges with well-informed reason and compassion for all, particularly those most in need.
[Ed. Note: Don't miss the other perspectives in this Big Question series, from a science scholar and a Rabbi/M.D.]
A new type of cancer therapy is shrinking deadly brain tumors with just one treatment
Few cancers are deadlier than glioblastomas—aggressive and lethal tumors that originate in the brain or spinal cord. Five years after diagnosis, less than five percent of glioblastoma patients are still alive—and more often, glioblastoma patients live just 14 months on average after receiving a diagnosis.
But an ongoing clinical trial at Mass General Cancer Center is giving new hope to glioblastoma patients and their families. The trial, called INCIPIENT, is meant to evaluate the effects of a special type of immune cell, called CAR-T cells, on patients with recurrent glioblastoma.
How CAR-T cell therapy works
CAR-T cell therapy is a type of cancer treatment called immunotherapy, where doctors modify a patient’s own immune system specifically to find and destroy cancer cells. In CAR-T cell therapy, doctors extract the patient’s T-cells, which are immune system cells that help fight off disease—particularly cancer. These T-cells are harvested from the patient and then genetically modified in a lab to produce proteins on their surface called chimeric antigen receptors (thus becoming CAR-T cells), which makes them able to bind to a specific protein on the patient’s cancer cells. Once modified, these CAR-T cells are grown in the lab for several weeks so that they can multiply into an army of millions. When enough cells have been grown, these super-charged T-cells are infused back into the patient where they can then seek out cancer cells, bind to them, and destroy them. CAR-T cell therapies have been approved by the US Food and Drug Administration (FDA) to treat certain types of lymphomas and leukemias, as well as multiple myeloma, but haven’t been approved to treat glioblastomas—yet.
CAR-T cell therapies don’t always work against solid tumors, such as glioblastomas. Because solid tumors contain different kinds of cancer cells, some cells can evade the immune system’s detection even after CAR-T cell therapy, according to a press release from Massachusetts General Hospital. For the INCIPIENT trial, researchers modified the CAR-T cells even further in hopes of making them more effective against solid tumors. These second-generation CAR-T cells (called CARv3-TEAM-E T cells) contain special antibodies that attack EFGR, a protein expressed in the majority of glioblastoma tumors. Unlike other CAR-T cell therapies, these particular CAR-T cells were designed to be directly injected into the patient’s brain.
The INCIPIENT trial results
The INCIPIENT trial involved three patients who were enrolled in the study between March and July 2023. All three patients—a 72-year-old man, a 74-year-old man, and a 57-year-old woman—were treated with chemo and radiation and enrolled in the trial with CAR-T cells after their glioblastoma tumors came back.
The results, which were published earlier this year in the New England Journal of Medicine (NEJM), were called “rapid” and “dramatic” by doctors involved in the trial. After just a single infusion of the CAR-T cells, each patient experienced a significant reduction in their tumor sizes. Just two days after receiving the infusion, the glioblastoma tumor of the 72-year-old man decreased by nearly twenty percent. Just two months later the tumor had shrunk by an astonishing 60 percent, and the change was maintained for more than six months. The most dramatic result was in the 57-year-old female patient, whose tumor shrank nearly completely after just one infusion of the CAR-T cells.
The results of the INCIPIENT trial were unexpected and astonishing—but unfortunately, they were also temporary. For all three patients, the tumors eventually began to grow back regardless of the CAR-T cell infusions. According to the press release from MGH, the medical team is now considering treating each patient with multiple infusions or prefacing each treatment with chemotherapy to prolong the response.
While there is still “more to do,” says co-author of the study neuro-oncologist Dr. Elizabeth Gerstner, the results are still promising. If nothing else, these second-generation CAR-T cell infusions may someday be able to give patients more time than traditional treatments would allow.
“These results are exciting but they are also just the beginning,” says Dr. Marcela Maus, a doctor and professor of medicine at Mass General who was involved in the clinical trial. “They tell us that we are on the right track in pursuing a therapy that has the potential to change the outlook for this intractable disease.”
Since the early 2000s, AI systems have eliminated more than 1.7 million jobs, and that number will only increase as AI improves. Some research estimates that by 2025, AI will eliminate more than 85 million jobs.
But for all the talk about job security, AI is also proving to be a powerful tool in healthcare—specifically, cancer detection. One recently published study has shown that, remarkably, artificial intelligence was able to detect 20 percent more cancers in imaging scans than radiologists alone.
Published in The Lancet Oncology, the study analyzed the scans of 80,000 Swedish women with a moderate hereditary risk of breast cancer who had undergone a mammogram between April 2021 and July 2022. Half of these scans were read by AI and then a radiologist to double-check the findings. The second group of scans was read by two researchers without the help of AI. (Currently, the standard of care across Europe is to have two radiologists analyze a scan before diagnosing a patient with breast cancer.)
The study showed that the AI group detected cancer in 6 out of every 1,000 scans, while the radiologists detected cancer in 5 per 1,000 scans. In other words, AI found 20 percent more cancers than the highly-trained radiologists.
Scientists have been using MRI images (like the ones pictured here) to train artificial intelligence to detect cancers earlier and with more accuracy. Here, MIT's AI system, MIRAI, looks for patterns in a patient's mammograms to detect breast cancer earlier than ever before. news.mit.edu
But even though the AI was better able to pinpoint cancer on an image, it doesn’t mean radiologists will soon be out of a job. Dr. Laura Heacock, a breast radiologist at NYU, said in an interview with CNN that radiologists do much more than simply screening mammograms, and that even well-trained technology can make errors. “These tools work best when paired with highly-trained radiologists who make the final call on your mammogram. Think of it as a tool like a stethoscope for a cardiologist.”
AI is still an emerging technology, but more and more doctors are using them to detect different cancers. For example, researchers at MIT have developed a program called MIRAI, which looks at patterns in patient mammograms across a series of scans and uses an algorithm to model a patient's risk of developing breast cancer over time. The program was "trained" with more than 200,000 breast imaging scans from Massachusetts General Hospital and has been tested on over 100,000 women in different hospitals across the world. According to MIT, MIRAI "has been shown to be more accurate in predicting the risk for developing breast cancer in the short term (over a 3-year period) compared to traditional tools." It has also been able to detect breast cancer up to five years before a patient receives a diagnosis.
The challenges for cancer-detecting AI tools now is not just accuracy. AI tools are also being challenged to perform consistently well across different ages, races, and breast density profiles, particularly given the increased risks that different women face. For example, Black women are 42 percent more likely than white women to die from breast cancer, despite having nearly the same rates of breast cancer as white women. Recently, an FDA-approved AI device for screening breast cancer has come under fire for wrongly detecting cancer in Black patients significantly more often than white patients.
As AI technology improves, radiologists will be able to accurately scan a more diverse set of patients at a larger volume than ever before, potentially saving more lives than ever.