Risk Never Sleeps Podcast: Episode #145

Cancer Isn’t One Size Fits All: Why Treatment Shouldn’t Be Either
Guest: Jim Foote, CEO and Co-Founder, First Ascent Biomedical
Host: Ed Gaudet
Date: November 6, 2025

Episode Overview

This episode delves into the future of cancer care with Jim Foote, CEO and Co-Founder of First Ascent Biomedical. Jim discusses how his company is reinventing oncology by using functional precision medicine—developing personalized cancer treatments tailored to the unique biology of each patient. The conversation covers the inadequacies of current “standard of care” approaches, the role of AI in customizing therapies, Jim’s personal motivation following a family tragedy, and lessons learned from a career spanning technology, cybersecurity, and healthcare.

Key Discussion Points & Insights

1. What Is Functional Precision Medicine?

• Jim Foote explains First Ascent’s approach:
  “What it really means is designing a customized, personalized treatment program specific to you and the biology of your cancer—as individualized as your fingerprint.” (00:47)
• A move away from “one size fits all” in cancer care.
• The limitations of standard of care—based on population averages rather than individual specifics.

2. Partnerships & Platform Background

• First Ascent is negotiating partnerships with organizations like the Mayo Clinic, notably for leveraging large-scale data in AI-driven therapy customization. (01:20)
• The company has been validating its approach and technology for over a decade and officially launched in 2018. (01:28)

3. Integrating AI and Rich Biology Data

• First Ascent’s innovation came when they combined advanced biological data with their technological platform in 2018.
  “In 2018 is when we really brought the biology pieces and the technology pieces together to really help support patients better.” (02:01)
• Jim offers a unique analogy: treating cancer as an “electrical circuit” and targeting multiple points to switch off malignancy. (01:40)
• Their AI is focused not on large population datasets, but on creating a “truly n of one study” for each patient.
  “Our training set is all about you... when we analyze a patient they’re their own control.” (09:09)

4. The Human Cost and Personal Motivation

• Jim’s transition from a tech and cybersecurity career to cancer innovation was catalyzed by the loss of his teenage son to cancer:
  “My son was one of those one in three. He died from cancer at the age of 17.” (03:10)
• He was struck by the disparity between business technology and what was available to clinicians:
  “I had access to tools and technology at my fingertips to make trivial decisions in business that these professionals didn’t have to make great decisions about somebody’s care.” (03:31)
• “Cancer picked the fight with the wrong guys… It won that battle, but I’m going to win the war.” (03:59, 04:07)

5. Technology, Cybersecurity & Cancer: Unlikely Parallels

• Jim draws comparisons between cybercriminals and cancer:
  “They both want to evade detection. They both want to constantly mutate and morph so that you can’t find them. And they’ll take everything from you if you let them.” (04:58)
• Urgency in both cybersecurity and patient care—emphasizing the need for anticipation and proactive defense.

6. Rethinking the Standard of Care

• Critique of current protocols:
  “Standard of care is great, but it still results in one in three cancer patients dying. It is the number one killer of children by disease type. And the standard of care is built off averages over time.” (02:26)
• First Ascent enables a radical improvement:
  “When doctors use our platform to help guide treatment, patients benefit 83% of the time better than standard of care.” (09:43)
• Potential to impact the fate of hundreds of thousands:
  “618,000 Americans will die from cancer in 2025… to be able to have a potential impact on helping them have better outcomes by 83%. That’s why I’m so excited about what we did.” (09:59)

Memorable Quotes & Notable Moments

On Career Motivation and Mission

• ”Cancer picked the fight with the wrong guys… It won that battle, but I’m going to win the war.” – Jim Foote (04:07)
• ”I’ve never had more fun, worked harder and made less money in my entire career, so I must be doing something right.” – Jim Foote (07:08)

On Advice to His Younger Self

• “Don’t let anybody ever tell you there’s something you can’t do.” (08:09)
• “I always equate healthcare and specifically oncology like NASA… SpaceX comes along, do it faster, cheaper and safer, because they weren’t rocket scientists. And I think that’s where we are with healthcare today…” (08:27)

Leadership & Taking Risks

• Referencing bungee jumping in New Zealand as the “riskiest thing” ever done (10:33–12:19), a metaphor for calculated risk-taking in business and life.

On Failure and Pushing New Boundaries

• “Don’t be afraid to take risks. …If you’re not taking risks and failing, you’re not pushing the limits of technology and your own abilities. But you should only fail once, learn from it and improve.” (13:49)

Key Segment Timestamps

• 00:47 – What is functional precision medicine?
• 01:28–02:24 – Company history and the tech/biology fusion
• 03:10–03:52 – The personal loss that prompted the company’s founding
• 04:58 – Cancer and cybercrime parallels
• 07:08–07:58 – Career reflections and advice for younger self
• 09:09–09:59 – How First Ascent’s AI and approach differs from mainstream models, “n of one” medicine, and patient outcome improvement
• 10:33–12:19 – “Riskiest thing I’ve ever done”: Bungee jumping in New Zealand
• 13:49–14:38 – Advice to young people entering healthcare and cyber

Speaker Attribution & Tone

Jim Foote’s perspective is visionary, personal, and pragmatic, weaving stories of loss and hope, technical mastery, and a relentless quest to make patient care as individualized as possible. The conversation with Ed Gaudet is frank, fast-paced, and peppered with humor, pop culture references, and practical insights.

Additional Noteworthy Segments

• Personal Interests – Jim’s love for the outdoors (mountain biking, skiing, running) and music taste (Eagles, U2, Creed, Pink Floyd, “everything from Hannah Montana to Nickelback”). (07:30, 12:41)
• Bungee Jump Story – A vivid account reflecting Jim’s willingness to take risks, both personally and professionally. (10:33–12:19)
• Advice for New Professionals – Lean into your strengths, embrace failure as learning, and maintain authenticity and grace in a divided world. (13:49–15:02)

Final Takeaways

• Cancer treatment must become as individualized as patients themselves—“as unique as your fingerprint.”
• Dramatic improvements in outcomes are possible with a data-driven, AI-enabled, personalized approach.
• The urgency and mindset drawn from cybersecurity and technology fields can and should transform healthcare.
• Taking risks—personally and professionally—is essential to innovation and impact.

Notable Quote to Remember:

“Our training set is all about you… when we analyze a patient they’re their own control. It’s a truly n of one study.”
— Jim Foote (09:09)