This tiny particle could roam your body to find tumors | Sangeeta Bhatia

110,005 views ・ 2016-06-07

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In the space that used to house one transistor,
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we can now fit one billion.
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That made it so that a computer the size of an entire room
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now fits in your pocket.
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You might say the future is small.
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As an engineer,
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I'm inspired by this miniaturization revolution in computers.
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As a physician,
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I wonder whether we could use it to reduce the number of lives lost
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due to one of the fastest-growing diseases on Earth:
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cancer.
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Now when I say that,
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what most people hear me say is that we're working on curing cancer.
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And we are.
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But it turns out
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that there's an incredible opportunity to save lives
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through the early detection and prevention of cancer.
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Worldwide, over two-thirds of deaths due to cancer are fully preventable
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using methods that we already have in hand today.
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Things like vaccination, timely screening
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and of course, stopping smoking.
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But even with the best tools and technologies that we have today,
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some tumors can't be detected
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until 10 years after they've started growing,
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when they are 50 million cancer cells strong.
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What if we had better technologies
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to detect some of these more deadly cancers sooner,
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when they could be removed,
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when they were just getting started?
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Let me tell you about how miniaturization might get us there.
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This is a microscope in a typical lab
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that a pathologist would use for looking at a tissue specimen,
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like a biopsy or a pap smear.
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This $7,000 microscope
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would be used by somebody with years of specialized training
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to spot cancer cells.
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This is an image from a colleague of mine at Rice University,
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Rebecca Richards-Kortum.
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What she and her team have done is miniaturize that whole microscope
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into this $10 part,
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and it fits on the end of an optical fiber.
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Now what that means is instead of taking a sample from a patient
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and sending it to the microscope,
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you can bring the microscope to the patient.
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And then, instead of requiring a specialist to look at the images,
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you can train the computer to score normal versus cancerous cells.
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Now this is important,
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because what they found working in rural communities,
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is that even when they have a mobile screening van
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that can go out into the community and perform exams
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and collect samples
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and send them to the central hospital for analysis,
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that days later,
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women get a call with an abnormal test result
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and they're asked to come in.
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Fully half of them don't turn up because they can't afford the trip.
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With the integrated microscope and computer analysis,
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Rebecca and her colleagues have been able to create a van
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that has both a diagnostic setup and a treatment setup.
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And what that means is that they can do a diagnosis
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and perform therapy on the spot,
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so no one is lost to follow up.
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That's just one example of how miniaturization can save lives.
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Now as engineers,
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we think of this as straight-up miniaturization.
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You took a big thing and you made it little.
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But what I told you before about computers
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was that they transformed our lives
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when they became small enough for us to take them everywhere.
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So what is the transformational equivalent like that in medicine?
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Well, what if you had a detector
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that was so small that it could circulate in your body,
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find the tumor all by itself
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and send a signal to the outside world?
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It sounds a little bit like science fiction.
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But actually, nanotechnology allows us to do just that.
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Nanotechnology allows us to shrink the parts that make up the detector
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from the width of a human hair,
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which is 100 microns,
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to a thousand times smaller,
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which is 100 nanometers.
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And that has profound implications.
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It turns out that materials actually change their properties
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at the nanoscale.
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You take a common material like gold,
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and you grind it into dust, into gold nanoparticles,
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and it changes from looking gold to looking red.
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If you take a more exotic material like cadmium selenide --
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forms a big, black crystal --
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if you make nanocrystals out of this material
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and you put it in a liquid,
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and you shine light on it,
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they glow.
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And they glow blue, green, yellow, orange, red,
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depending only on their size.
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It's wild! Can you imagine an object like that in the macro world?
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It would be like all the denim jeans in your closet are all made of cotton,
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but they are different colors depending only on their size.
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(Laughter)
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So as a physician,
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what's just as interesting to me
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is that it's not just the color of materials
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that changes at the nanoscale;
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the way they travel in your body also changes.
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And this is the kind of observation that we're going to use
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to make a better cancer detector.
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So let me show you what I mean.
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This is a blood vessel in the body.
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Surrounding the blood vessel is a tumor.
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We're going to inject nanoparticles into the blood vessel
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and watch how they travel from the bloodstream into the tumor.
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Now it turns out that the blood vessels of many tumors are leaky,
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and so nanoparticles can leak out from the bloodstream into the tumor.
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Whether they leak out depends on their size.
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So in this image,
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the smaller, hundred-nanometer, blue nanoparticles are leaking out,
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and the larger, 500-nanometer, red nanoparticles
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are stuck in the bloodstream.
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So that means as an engineer,
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depending on how big or small I make a material,
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I can change where it goes in your body.
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In my lab, we recently made a cancer nanodetector
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that is so small that it could travel into the body and look for tumors.
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We designed it to listen for tumor invasion:
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the orchestra of chemical signals that tumors need to make to spread.
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For a tumor to break out of the tissue that it's born in,
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it has to make chemicals called enzymes
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to chew through the scaffolding of tissues.
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We designed these nanoparticles to be activated by these enzymes.
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One enzyme can activate a thousand of these chemical reactions in an hour.
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Now in engineering, we call that one-to-a-thousand ratio
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a form of amplification,
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and it makes something ultrasensitive.
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So we've made an ultrasensitive cancer detector.
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OK, but how do I get this activated signal to the outside world,
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where I can act on it?
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For this, we're going to use one more piece of nanoscale biology,
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and that has to do with the kidney.
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The kidney is a filter.
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Its job is to filter out the blood and put waste into the urine.
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It turns out that what the kidney filters
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is also dependent on size.
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So in this image, what you can see
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is that everything smaller than five nanometers
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is going from the blood, through the kidney, into the urine,
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and everything else that's bigger is retained.
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OK, so if I make a 100-nanometer cancer detector,
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I inject it in the bloodstream,
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it can leak into the tumor where it's activated by tumor enzymes
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to release a small signal
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that is small enough to be filtered out of the kidney
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and put into the urine,
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I have a signal in the outside world that I can detect.
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OK, but there's one more problem.
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This is a tiny little signal,
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so how do I detect it?
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Well, the signal is just a molecule.
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They're molecules that we designed as engineers.
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They're completely synthetic, and we can design them
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so they are compatible with our tool of choice.
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If we want to use a really sensitive, fancy instrument
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called a mass spectrometer,
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then we make a molecule with a unique mass.
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Or maybe we want make something that's more inexpensive and portable.
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Then we make molecules that we can trap on paper,
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like a pregnancy test.
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In fact, there's a whole world of paper tests
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that are becoming available in a field called paper diagnostics.
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Alright, where are we going with this?
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What I'm going to tell you next,
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as a lifelong researcher,
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represents a dream of mine.
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I can't say that's it's a promise;
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it's a dream.
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But I think we all have to have dreams to keep us pushing forward,
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even -- and maybe especially -- cancer researchers.
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I'm going to tell you what I hope will happen with my technology,
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that my team and I will put our hearts and souls
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into making a reality.
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OK, here goes.
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I dream that one day,
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instead of going into an expensive screening facility
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to get a colonoscopy,
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or a mammogram,
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or a pap smear,
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that you could get a shot,
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wait an hour,
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and do a urine test on a paper strip.
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I imagine that this could even happen
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without the need for steady electricity,
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or a medical professional in the room.
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Maybe they could be far away
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and connected only by the image on a smartphone.
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Now I know this sounds like a dream,
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but in the lab we already have this working in mice,
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where it works better than existing methods
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for the detection of lung, colon and ovarian cancer.
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And I hope that what this means
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is that one day we can detect tumors in patients
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sooner than 10 years after they've started growing,
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in all walks of life,
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all around the globe,
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and that this would lead to earlier treatments,
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and that we could save more lives than we can today,
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with early detection.
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Thank you.
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(Applause)
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