New nanotech to detect cancer early | Joshua Smith

88,314 views ・ 2017-03-01

TED


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"You have cancer."
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Sadly, about 40 percent of us will hear those three words within our lifetime,
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and half will not survive.
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This means that two out of five of your closest friends and relatives
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will be diagnosed with some form of cancer,
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and one will die.
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Beyond the physical hardships,
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roughly one-third of cancer survivors here in the US
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will go into debt from treatment.
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And they're at least two and a half times more likely to declare bankruptcy
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than those without cancer.
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This disease is pervasive.
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It's emotionally draining
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and, for many,
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financially destructive.
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But a cancer diagnosis doesn't have to be a death sentence.
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Finding cancer early,
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closer its genesis,
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is one of the critical factors to improving treatment options,
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reducing its emotional impact
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and minimizing financial burdens.
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Most importantly,
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finding cancer early --
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which is one of the primary aims of my research --
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greatly enhances your odds of survival.
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If we just look at the case of breast cancer for example,
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we find that those who are diagnosed and treated at stage one
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have a five-year survival rate of nearly 100 percent --
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odds that decrease to just 22 percent if treated at stage four.
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And similar trends are found for colorectal and ovarian cancer.
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Now, we're all aware that an early diagnosis that is accurate
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is critical for survival.
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The problem is that many cancer diagnostic tools are invasive,
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costly,
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often inaccurate
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and they can take an agonizing amount of time to get the results back.
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Still worse, when it comes to some forms of cancer,
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such as ovarian, liver or pancreatic cancer,
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good screening methods simply don't exist,
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meaning that often people wait until physical symptoms surface,
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which are themselves already indicators of late-stage progression.
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Like a tornado strike in an area without an early warning system,
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there is no alarm to warn,
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for the danger is already at your doorstep
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when your odds of survival are greatly reduced.
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Having the convenience and accessibility of regular screening options
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that are affordable, noninvasive and could provide results much sooner,
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would provide us with a formidable weapon in the fight against cancer.
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An early warning would allow us to get out ahead of the disease
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instead of merely following in its relentless wake.
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And this is exactly what I've been doing.
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For the past three years, I've been developing technologies
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that could ultimately aid clinicians
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with rapid, early-stage cancer diagnostics.
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And I've been fueled by a deep scientific curiosity,
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and a passion to change these statistics.
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Last year however,
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this fight became much more personal
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when my wife was diagnosed with breast cancer.
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It was an experience that added a strong and unexpected emotional dimension
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to these efforts.
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I know firsthand how life-altering treatment can be,
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and I'm keenly aware of the emotional havoc
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that cancer can wreak on a family,
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which in our case included our two young daughters.
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Because we found it early during a routine mammogram,
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we were able to focus primarily on treatment options
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for the localized tumor,
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reaffirming to me how important an early diagnosis is.
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Unlike other forms of cancer,
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mammograms do offer an early-stage screening option for breast cancer.
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Still, not everyone has this done,
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or they may develop breast cancer
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before the middle age recommendation for having a mammogram.
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So, there's still a lot of room for improvement,
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even for cancers that do have screening options,
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and, of course, considerable benefits for those that don't.
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A key challenge then for cancer researchers
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is to develop methods
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that make regular screening for many types of cancers
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much more accessible.
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Imagine a scenario where during your regular checkup,
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your doctor can take a simple, noninvasive urine sample,
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or other liquid biopsy,
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and present you with the results before you even leave the doctor's office.
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Such a technology could dramatically reduce the number of people
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who slip through the net of an early-stage cancer diagnosis.
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My research team of engineers and biochemists
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is working on exactly this challenge.
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We're working on ways to frequently activate an early-stage cancer alarm
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by enabling regular screenings that would start when a person is healthy
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so that action could be taken to stop cancer the moment it emerges,
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and before it can progress beyond its infancy.
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The silver bullet in this case are tiny vesicles,
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little escape pods regularly shed by cells called exosomes.
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Exosomes are important biomarkers
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that provide an early-warning system for the development of cancer.
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And because they're abundantly present in just about every bodily fluid,
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including blood, urine and saliva,
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they're extremely attractive for noninvasive liquid biopsies.
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There's just one problem.
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An automated system for rapidly sorting these important biomarkers
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is not currently available.
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We've created a technology that we call nano-DLD
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that is capable of precisely this:
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automated exosome isolation
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to aid rapid cancer diagnostics.
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Exosomes are the newest early-warning weapon, if you will,
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to emerge on the liquid biopsy front.
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And they're really, really small.
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They measure just 30 to 150 nanometers in diameter.
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This is so tiny
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that you could fit about a million of them into a single red blood cell.
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That's roughly the difference between a golf ball
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and a fine grain piece of sand.
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Once thought to be little bins for unwanted cellular waste,
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it has been found that cells actually communicate
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by producing and absorbing these exosomes
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which contain surface receptors,
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proteins and other genetic material collected from their cell of origin.
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When absorbed by a neighboring cell,
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exosomes release their contents into the receiving cell,
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and can set in motion fundamental changes in gene expression --
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some good,
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and this is where cancer comes in,
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some bad.
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Because they are clothed in the material of the mother cell,
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and contain a sample of its environment,
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they provide a genetic snapshot of that cell's health and its origin.
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All of these qualities make exosomes invaluable messengers
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that potentially allow physicians
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to eavesdrop on your health at the cellular level.
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To catch cancer early, however,
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you have to frequently intercept these messages
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to determine when cancer-causing troublemakers within your body
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decide to start staging a coup,
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which is why regular screening is so critical
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and why we're developing technologies to make this possible.
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While the first exosome-based diagnostics emerged on the market just this year,
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they are not yet part of mainstream healthcare options.
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In addition to their recent emergence,
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another factor that's limiting their widespread adoption
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is that currently, no automated exosome isolation system exists
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to make regular screening economically accessible.
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The current gold standard for exosome isolation
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includes ultracentrifugation,
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a process requiring expensive laboratory equipment,
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a trained lab tech
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and about 30 hours of time to process a sample.
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We've come up with a different approach for achieving automated exosome isolation
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from a sample such as urine.
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We use a chip-based, continuous flow separation technique
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called deterministic lateral displacement.
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And we have done with it
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what the semiconductor industry has done so successfully for the past 50 years.
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We shrunk the dimensions of this technology
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from the micron scale to the true nanoscale.
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So how does it work?
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In a nutshell,
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a set of tiny pillars separated by nanoscopic gaps
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are arranged in such a way
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that the system divides the fluid into streamlines,
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with the larger cancer-related nanoparticles being separated
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through a process of redirection from the smaller, healthier ones,
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which can in contrast
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move around the pillars in a zigzag-type motion
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in the direction of fluid flow.
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The net result is a complete separation of these two particle populations.
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You can visualize this separation process
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similar to traffic on a highway that separates into two roads,
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with one road going into a low-clearance tunnel under a mountain,
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and the other road going around it.
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Here, smaller cars can go through the tunnel
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while larger trucks, carrying potentially hazardous material,
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are forced to take the detour route.
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Traffic is effectively separated by size and contents
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without impeding its flow.
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And this is exactly how our system works on a much, much smaller scale.
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The idea here is that the separation process for screening
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could be as simple as processing a sample of urine, blood or saliva,
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which is a near-term possibility within the next few years.
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Ultimately, it could be used to isolate and detect target exosomes
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associated with a particular type of cancer,
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sensing and reporting their presence within minutes.
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This would make rapid diagnostics virtually painless.
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Broadly speaking,
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the ability to separate and enrich biomarkers
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with nanoscale precision in an automated way,
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opens the door to better understanding diseases such as cancer,
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with applications ranging from sample preparation to diagnostics,
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and from drug resistance monitoring to therapeutics.
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Even before my wife's bout with cancer,
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it was a dream of mine to facilitate the automation of this process --
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to make regular screening more accessible,
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similar to the way Henry Ford made the automobile accessible
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to the general population
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through development of the assembly line.
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Automation is the key to accessibility.
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And in the spirit of the Hoover dream,
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"a chicken in every pot and a car in every garage,"
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we're developing a technology
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that could ultimately place an early-warning cancer detection system
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in every home.
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This would allow every man, woman and child
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the opportunity to be regularly tested while they're still healthy,
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catching cancer when it first emerges.
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It is my hope and dream
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to help people around the world avoid the high costs --
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physical, financial and emotional --
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faced by today's cancer patients,
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hardships that I'm well acquainted with.
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I'm also happy to report that because we caught my wife's cancer early,
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her treatment was successful,
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and she is now, thankfully, cancer-free.
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(Applause)
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It is an outcome that I would like to see for everyone with a cancer diagnosis.
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With the work that my team has already done
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on separation of nanoscale biomarkers
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for rapid, early-stage cancer diagnostics,
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I am optimistic that within the next decade,
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this type of technology will be available,
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helping protect our friends, our family and future generations.
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Even if we are so unlucky as to be diagnosed with cancer,
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that early-stage alarm will provide a strong beacon of hope.
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Thank you.
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(Applause)
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