| Recorded at | November 15, 2016 |
|---|---|
| Event | TED@IBM |
| Duration (min:sec) | 12:13 |
| Video Type | TED Institute Talk |
| Words per minute | 160.37 slow |
| Readability (FK) | 27.75 very difficult |
| Speaker | Joshua Smith |
Official TED page for this talk
Synopsis
What if every home had an early-warning cancer detection system? Researcher Joshua Smith is developing a nanobiotechnology "cancer alarm" that scans for traces of disease in the form of special biomarkers called exosomes. In this forward-thinking talk, he shares his dream for how we might revolutionize cancer detection and, ultimately, save lives.
| 1 | 00:16 | "You have cancer." | ||
| 2 | 00:20 | Sadly, about 40 percent of us will hear those three words within our lifetime, | ||
| 3 | 00:25 | and half will not survive. | ||
| 4 | 00:28 | This means that two out of five of your closest friends and relatives | ||
| 5 | 00:32 | will be diagnosed with some form of cancer, | ||
| 6 | 00:35 | and one will die. | ||
| 7 | 00:39 | Beyond the physical hardships, | ||
| 8 | 00:40 | roughly one-third of cancer survivors here in the US | ||
| 9 | 00:43 | will go into debt from treatment. | ||
| 10 | 00:45 | And they're at least two and a half times more likely to declare bankruptcy | ||
| 11 | 00:49 | than those without cancer. | ||
| 12 | 00:51 | This disease is pervasive. | ||
| 13 | 00:53 | It's emotionally draining | ||
| 14 | 00:55 | and, for many, | ||
| 15 | 00:56 | financially destructive. | ||
| 16 | 00:59 | But a cancer diagnosis doesn't have to be a death sentence. | ||
| 17 | 01:03 | Finding cancer early, | ||
| 18 | 01:05 | closer its genesis, | ||
| 19 | 01:06 | is one of the critical factors to improving treatment options, | ||
| 20 | 01:10 | reducing its emotional impact | ||
| 21 | 01:12 | and minimizing financial burdens. | ||
| 22 | 01:15 | Most importantly, | ||
| 23 | 01:16 | finding cancer early -- | ||
| 24 | 01:17 | which is one of the primary aims of my research -- | ||
| 25 | 01:20 | greatly enhances your odds of survival. | ||
| 26 | 01:23 | If we just look at the case of breast cancer for example, | ||
| 27 | 01:26 | we find that those who are diagnosed and treated at stage one | ||
| 28 | 01:30 | have a five-year survival rate of nearly 100 percent -- | ||
| 29 | 01:34 | odds that decrease to just 22 percent if treated at stage four. | ||
| 30 | 01:39 | And similar trends are found for colorectal and ovarian cancer. | ||
| 31 | 01:45 | Now, we're all aware that an early diagnosis that is accurate | ||
| 32 | 01:51 | is critical for survival. | ||
| 33 | 01:55 | The problem is that many cancer diagnostic tools are invasive, | ||
| 34 | 01:59 | costly, | ||
| 35 | 02:00 | often inaccurate | ||
| 36 | 02:01 | and they can take an agonizing amount of time to get the results back. | ||
| 37 | 02:06 | Still worse, when it comes to some forms of cancer, | ||
| 38 | 02:08 | such as ovarian, liver or pancreatic cancer, | ||
| 39 | 02:13 | good screening methods simply don't exist, | ||
| 40 | 02:16 | meaning that often people wait until physical symptoms surface, | ||
| 41 | 02:20 | which are themselves already indicators of late-stage progression. | ||
| 42 | 02:25 | Like a tornado strike in an area without an early warning system, | ||
| 43 | 02:29 | there is no alarm to warn, | ||
| 44 | 02:31 | for the danger is already at your doorstep | ||
| 45 | 02:34 | when your odds of survival are greatly reduced. | ||
| 46 | 02:39 | Having the convenience and accessibility of regular screening options | ||
| 47 | 02:43 | that are affordable, noninvasive and could provide results much sooner, | ||
| 48 | 02:48 | would provide us with a formidable weapon in the fight against cancer. | ||
| 49 | 02:54 | An early warning would allow us to get out ahead of the disease | ||
| 50 | 02:57 | instead of merely following in its relentless wake. | ||
| 51 | 03:00 | And this is exactly what I've been doing. | ||
| 52 | 03:02 | For the past three years, I've been developing technologies | ||
| 53 | 03:05 | that could ultimately aid clinicians | ||
| 54 | 03:07 | with rapid, early-stage cancer diagnostics. | ||
| 55 | 03:10 | And I've been fueled by a deep scientific curiosity, | ||
| 56 | 03:14 | and a passion to change these statistics. | ||
| 57 | 03:18 | Last year however, | ||
| 58 | 03:20 | this fight became much more personal | ||
| 59 | 03:23 | when my wife was diagnosed with breast cancer. | ||
| 60 | 03:27 | It was an experience that added a strong and unexpected emotional dimension | ||
| 61 | 03:31 | to these efforts. | ||
| 62 | 03:35 | I know firsthand how life-altering treatment can be, | ||
| 63 | 03:39 | and I'm keenly aware of the emotional havoc | ||
| 64 | 03:42 | that cancer can wreak on a family, | ||
| 65 | 03:44 | which in our case included our two young daughters. | ||
| 66 | 03:48 | Because we found it early during a routine mammogram, | ||
| 67 | 03:51 | we were able to focus primarily on treatment options | ||
| 68 | 03:55 | for the localized tumor, | ||
| 69 | 03:56 | reaffirming to me how important an early diagnosis is. | ||
| 70 | 04:02 | Unlike other forms of cancer, | ||
| 71 | 04:05 | mammograms do offer an early-stage screening option for breast cancer. | ||
| 72 | 04:08 | Still, not everyone has this done, | ||
| 73 | 04:11 | or they may develop breast cancer | ||
| 74 | 04:12 | before the middle age recommendation for having a mammogram. | ||
| 75 | 04:17 | So, there's still a lot of room for improvement, | ||
| 76 | 04:19 | even for cancers that do have screening options, | ||
| 77 | 04:21 | and, of course, considerable benefits for those that don't. | ||
| 78 | 04:25 | A key challenge then for cancer researchers | ||
| 79 | 04:28 | is to develop methods | ||
| 80 | 04:29 | that make regular screening for many types of cancers | ||
| 81 | 04:33 | much more accessible. | ||
| 82 | 04:35 | Imagine a scenario where during your regular checkup, | ||
| 83 | 04:38 | your doctor can take a simple, noninvasive urine sample, | ||
| 84 | 04:42 | or other liquid biopsy, | ||
| 85 | 04:44 | and present you with the results before you even leave the doctor's office. | ||
| 86 | 04:48 | Such a technology could dramatically reduce the number of people | ||
| 87 | 04:52 | who slip through the net of an early-stage cancer diagnosis. | ||
| 88 | 04:56 | My research team of engineers and biochemists | ||
| 89 | 04:59 | is working on exactly this challenge. | ||
| 90 | 05:02 | We're working on ways to frequently activate an early-stage cancer alarm | ||
| 91 | 05:07 | by enabling regular screenings that would start when a person is healthy | ||
| 92 | 05:11 | so that action could be taken to stop cancer the moment it emerges, | ||
| 93 | 05:15 | and before it can progress beyond its infancy. | ||
| 94 | 05:20 | The silver bullet in this case are tiny vesicles, | ||
| 95 | 05:23 | little escape pods regularly shed by cells called exosomes. | ||
| 96 | 05:28 | Exosomes are important biomarkers | ||
| 97 | 05:31 | that provide an early-warning system for the development of cancer. | ||
| 98 | 05:35 | And because they're abundantly present in just about every bodily fluid, | ||
| 99 | 05:38 | including blood, urine and saliva, | ||
| 100 | 05:41 | they're extremely attractive for noninvasive liquid biopsies. | ||
| 101 | 05:46 | There's just one problem. | ||
| 102 | 05:48 | An automated system for rapidly sorting these important biomarkers | ||
| 103 | 05:52 | is not currently available. | ||
| 104 | 05:55 | We've created a technology that we call nano-DLD | ||
| 105 | 05:58 | that is capable of precisely this: | ||
| 106 | 06:01 | automated exosome isolation | ||
| 107 | 06:04 | to aid rapid cancer diagnostics. | ||
| 108 | 06:07 | Exosomes are the newest early-warning weapon, if you will, | ||
| 109 | 06:11 | to emerge on the liquid biopsy front. | ||
| 110 | 06:13 | And they're really, really small. | ||
| 111 | 06:15 | They measure just 30 to 150 nanometers in diameter. | ||
| 112 | 06:20 | This is so tiny | ||
| 113 | 06:21 | that you could fit about a million of them into a single red blood cell. | ||
| 114 | 06:25 | That's roughly the difference between a golf ball | ||
| 115 | 06:27 | and a fine grain piece of sand. | ||
| 116 | 06:30 | Once thought to be little bins for unwanted cellular waste, | ||
| 117 | 06:34 | it has been found that cells actually communicate | ||
| 118 | 06:37 | by producing and absorbing these exosomes | ||
| 119 | 06:40 | which contain surface receptors, | ||
| 120 | 06:43 | proteins and other genetic material collected from their cell of origin. | ||
| 121 | 06:48 | When absorbed by a neighboring cell, | ||
| 122 | 06:51 | exosomes release their contents into the receiving cell, | ||
| 123 | 06:54 | and can set in motion fundamental changes in gene expression -- | ||
| 124 | 06:58 | some good, | ||
| 125 | 06:59 | and this is where cancer comes in, | ||
| 126 | 07:01 | some bad. | ||
| 127 | 07:02 | Because they are clothed in the material of the mother cell, | ||
| 128 | 07:06 | and contain a sample of its environment, | ||
| 129 | 07:08 | they provide a genetic snapshot of that cell's health and its origin. | ||
| 130 | 07:15 | All of these qualities make exosomes invaluable messengers | ||
| 131 | 07:18 | that potentially allow physicians | ||
| 132 | 07:19 | to eavesdrop on your health at the cellular level. | ||
| 133 | 07:23 | To catch cancer early, however, | ||
| 134 | 07:25 | you have to frequently intercept these messages | ||
| 135 | 07:28 | to determine when cancer-causing troublemakers within your body | ||
| 136 | 07:32 | decide to start staging a coup, | ||
| 137 | 07:33 | which is why regular screening is so critical | ||
| 138 | 07:36 | and why we're developing technologies to make this possible. | ||
| 139 | 07:40 | While the first exosome-based diagnostics emerged on the market just this year, | ||
| 140 | 07:46 | they are not yet part of mainstream healthcare options. | ||
| 141 | 07:51 | In addition to their recent emergence, | ||
| 142 | 07:53 | another factor that's limiting their widespread adoption | ||
| 143 | 07:56 | is that currently, no automated exosome isolation system exists | ||
| 144 | 08:00 | to make regular screening economically accessible. | ||
| 145 | 08:04 | The current gold standard for exosome isolation | ||
| 146 | 08:07 | includes ultracentrifugation, | ||
| 147 | 08:09 | a process requiring expensive laboratory equipment, | ||
| 148 | 08:12 | a trained lab tech | ||
| 149 | 08:13 | and about 30 hours of time to process a sample. | ||
| 150 | 08:18 | We've come up with a different approach for achieving automated exosome isolation | ||
| 151 | 08:23 | from a sample such as urine. | ||
| 152 | 08:25 | We use a chip-based, continuous flow separation technique | ||
| 153 | 08:29 | called deterministic lateral displacement. | ||
| 154 | 08:32 | And we have done with it | ||
| 155 | 08:34 | what the semiconductor industry has done so successfully for the past 50 years. | ||
| 156 | 08:38 | We shrunk the dimensions of this technology | ||
| 157 | 08:40 | from the micron scale to the true nanoscale. | ||
| 158 | 08:44 | So how does it work? | ||
| 159 | 08:46 | In a nutshell, | ||
| 160 | 08:47 | a set of tiny pillars separated by nanoscopic gaps | ||
| 161 | 08:51 | are arranged in such a way | ||
| 162 | 08:52 | that the system divides the fluid into streamlines, | ||
| 163 | 08:55 | with the larger cancer-related nanoparticles being separated | ||
| 164 | 08:59 | through a process of redirection from the smaller, healthier ones, | ||
| 165 | 09:02 | which can in contrast | ||
| 166 | 09:04 | move around the pillars in a zigzag-type motion | ||
| 167 | 09:07 | in the direction of fluid flow. | ||
| 168 | 09:09 | The net result is a complete separation of these two particle populations. | ||
| 169 | 09:15 | You can visualize this separation process | ||
| 170 | 09:18 | similar to traffic on a highway that separates into two roads, | ||
| 171 | 09:22 | with one road going into a low-clearance tunnel under a mountain, | ||
| 172 | 09:26 | and the other road going around it. | ||
| 173 | 09:28 | Here, smaller cars can go through the tunnel | ||
| 174 | 09:31 | while larger trucks, carrying potentially hazardous material, | ||
| 175 | 09:34 | are forced to take the detour route. | ||
| 176 | 09:37 | Traffic is effectively separated by size and contents | ||
| 177 | 09:41 | without impeding its flow. | ||
| 178 | 09:43 | And this is exactly how our system works on a much, much smaller scale. | ||
| 179 | 09:49 | The idea here is that the separation process for screening | ||
| 180 | 09:53 | could be as simple as processing a sample of urine, blood or saliva, | ||
| 181 | 09:57 | which is a near-term possibility within the next few years. | ||
| 182 | 10:00 | Ultimately, it could be used to isolate and detect target exosomes | ||
| 183 | 10:06 | associated with a particular type of cancer, | ||
| 184 | 10:09 | sensing and reporting their presence within minutes. | ||
| 185 | 10:12 | This would make rapid diagnostics virtually painless. | ||
| 186 | 10:16 | Broadly speaking, | ||
| 187 | 10:17 | the ability to separate and enrich biomarkers | ||
| 188 | 10:20 | with nanoscale precision in an automated way, | ||
| 189 | 10:24 | opens the door to better understanding diseases such as cancer, | ||
| 190 | 10:27 | with applications ranging from sample preparation to diagnostics, | ||
| 191 | 10:31 | and from drug resistance monitoring to therapeutics. | ||
| 192 | 10:35 | Even before my wife's bout with cancer, | ||
| 193 | 10:37 | it was a dream of mine to facilitate the automation of this process -- | ||
| 194 | 10:41 | to make regular screening more accessible, | ||
| 195 | 10:44 | similar to the way Henry Ford made the automobile accessible | ||
| 196 | 10:47 | to the general population | ||
| 197 | 10:49 | through development of the assembly line. | ||
| 198 | 10:51 | Automation is the key to accessibility. | ||
| 199 | 10:56 | And in the spirit of the Hoover dream, | ||
| 200 | 10:57 | "a chicken in every pot and a car in every garage," | ||
| 201 | 11:00 | we're developing a technology | ||
| 202 | 11:02 | that could ultimately place an early-warning cancer detection system | ||
| 203 | 11:06 | in every home. | ||
| 204 | 11:07 | This would allow every man, woman and child | ||
| 205 | 11:09 | the opportunity to be regularly tested while they're still healthy, | ||
| 206 | 11:14 | catching cancer when it first emerges. | ||
| 207 | 11:17 | It is my hope and dream | ||
| 208 | 11:18 | to help people around the world avoid the high costs -- | ||
| 209 | 11:22 | physical, financial and emotional -- | ||
| 210 | 11:25 | faced by today's cancer patients, | ||
| 211 | 11:27 | hardships that I'm well acquainted with. | ||
| 212 | 11:31 | I'm also happy to report that because we caught my wife's cancer early, | ||
| 213 | 11:35 | her treatment was successful, | ||
| 214 | 11:37 | and she is now, thankfully, cancer-free. | ||
| 215 | 11:39 | (Applause) | ||
| 216 | 11:47 | It is an outcome that I would like to see for everyone with a cancer diagnosis. | ||
| 217 | 11:53 | With the work that my team has already done | ||
| 218 | 11:55 | on separation of nanoscale biomarkers | ||
| 219 | 11:57 | for rapid, early-stage cancer diagnostics, | ||
| 220 | 12:00 | I am optimistic that within the next decade, | ||
| 221 | 12:03 | this type of technology will be available, | ||
| 222 | 12:06 | helping protect our friends, our family and future generations. | ||
| 223 | 12:10 | Even if we are so unlucky as to be diagnosed with cancer, | ||
| 224 | 12:14 | that early-stage alarm will provide a strong beacon of hope. | ||
| 225 | 12:18 | Thank you. | ||
| 226 | 12:19 | (Applause) |