The Future of Early Cancer Detection? | Jorge Soto | TED Talks

Translator: Raquel Senra Fernández Reviewer: Serv. de Norm. Lingüística U. de Santiago de Compostela

Almost a year ago,

Fai cousa dun ano,

my aunt started suffering back pains.

á miña tía comezou a doerlle o lombo.

She went to see the doctor

Foi ao médico

and they told her it was a normal injury

e dixéronlle que era unha lesión común

for someone who had been playing tennis

para alguén que xogou ao tennis

for almost 30 years.

durante case 30 anos.

They recommended that she do some therapy,

Recomendáronlle terapia,

but after a while she wasn't feeling better,

mais un tempo despois sentíase igual

so the doctors decided to do further tests.

e decidiron facer máis probas.

They did an x-ray

Fixo unha radiografía

and discovered an injury in her lungs,

e descubriron unha lesión nos pulmóns

and at the time they thought that the injury

que interpretaron como

was a strain in the muscles and tendons

tensión nos músculos e tendóns

between her ribs,

entre as costelas,

but after a few weeks of treatment,

pero tras varias semanas de tratamento

again her health wasn't getting any better.

seguía igual.

So finally, they decided to do a biopsy,

Á fin, decidiron facerlle unha biopsia

and two weeks later,

e, dúas semanas despois,

the results of the biopsy came back.

chegaron os resultados:

It was stage 3 lung cancer.

cancro de pulmón de grao 3.

Her lifestyle was almost free of risk.

A súa forma de vida non podía ter relación,

She never smoked a cigarette,

xa que nunca fumou,

she never drank alcohol,

nunca bebeu alcol

and she had been playing sports

e fixo deporte

for almost half her life.

case a metade da súa vida.

Perhaps, that is why it took them almost six months

Quizais por iso lles levou case seis meses

to get her properly diagnosed.

facer unha diagnose correcta.

My story might be, unfortunately,

Por desgraza, a miña historia

familiar to most of you.

pode resultarvos familiar.

One out of three people sitting in this audience

A 1 de cada 3 persoas deste público

will be diagnosed with some type of cancer,

diagnosticaráselle algún tipo de cancro

and one out of four

e 1 de cada 4

will die because of it.

morrerá por isto.

Not only did that cancer diagnosis

Non só a diagnose do cancro

change the life of our family,

cambiou a vida da nosa familia,

but that process of going

senón que o proceso de ir

back and forth with new tests,

e vir con novas probas,

different doctors describing symptoms,

médicos que describían síntomas,

discarding diseases over and over,

descartaban doenzas unha e outra vez,

was stressful and frustrating,

foi estresante e frustrante,

especially for my aunt.

sobre todo para miña tía.

And that is the way cancer diagnosis has been done

E así é como se diagnostica o cancro

since the beginning of history.

dende o comezo da historia.

We have 21st-century medical treatments and drugs

Temos tratamentos e fármacos do séc. XXI

to treat cancer,

para tratar o cancro

but we still have 20th-century procedures

pero os métodos e procesos de diagnose

and processes for diagnosis, if any.

son do XX, se é que hai algún.

Today, most of us have to wait for symptoms

Hoxe, a maioría temos que ter síntomas

to indicate that something is wrong.

para saber que algo vai mal.

Today, the majority of people still don't have access

Hoxe, a maioría non temos acceso

to early cancer detection methods,

a métodos de diagnose precoz do cancro,

even though we know

aínda sabendo que,

that catching cancer early

coller o cancro cedo

is basically the closest thing we have

é basicamente o máis parecido

to a silver bullet cure against it.

a ter unha cura milagrosa.

We know that we can change this in our lifetime,

Sabemos que podemos cambialo

and that is why my team and I

e por iso o meu equipo e eu

have decided to begin this journey,

comezamos este traxecto

this journey to try to make cancer detection

para tratar de diagnosticar o cancro

at the early stages

nas primeiras fases

and monitoring the appropriate response at the molecular level

e dar coa mellor solución a nivel molecular

easier, cheaper, smarter

dun xeito máis doado, económico, intelixente

and more accessible than ever before.

e máis accesible que nunca.

The context, of course,

Por suposto, o contexto

is that we're living at a time

é que estamos no tempo

where technology is disrupting our present

onde a tecnoloxía muda todo

at exponential rates,

a un ritmo exponencial

and the biological realm is no exception.

e o campo da bioloxía tamén.

It is said today that biotech is advancing

Parece que a biotecnoloxía está a avanzar

at least six times faster than the growth rate

cando menos seis veces máis rápido

of the processing power of computers.

que a capacidade de procesamento dos ordenadores.

But progress in biotech

O progreso en biotecnoloxía

is not only being accelerated,

non só se acelera,

it is also being democratized.

senón que tamén se democratiza.

Just as personal computers or the Internet

Igual que os ordenadores, Internet

or smartphones leveled the playing field

ou os smartphones igualaron o campo de acción

for entrepreneurship, politics or education,

para o emprendemento, a política ou a educación,

recent advances have leveled it up for biotech progress as well,

os últimos avances tamén fixeron que a biotecnoloxía progrese,

and that is allowing

o que permite

multidisciplinary teams like ours

que equipos multidisciplinares coma o noso

to try to tackle and look at these problems

traten de afrontar e ver estes problemas

with new approaches.

con novos enfoques.

We are a team of scientists and technologists

Somos científicos e tecnólogos

from Chile, Panama,

de Chile, Panamá,

Mexico, Israel and Greece,

México, Israel e Grecia,

and based on recent scientific discoveries,

e en base a descubertas científicas recentes,

we believe that we have found

cremos que atopamos

a reliable and accurate way

unha forma fiable e precisa

of detecting several types of cancer

de detectar varios tipos de cancro

at the very early stages through a blood sample.

nas fases iniciais a través do sangue.

We do it by detecting a set of very small molecules

Detectamos unhas moléculas moi pequenas

that circulate freely in our blood

que circulan libremente no sangue

called microRNAs.

que se chaman microARN.

To explain what microRNAs are

Para explicar o que son

and their important role in cancer,

e a súa importancia no cancro,

I need to start with proteins,

empezarei polas proteínas,

because when cancer is present in our body,

xa que, cando temos cancro,

protein modification is observed

estas modifícanse

in all cancerous cells.

nas células cancerosas.

As you might know,

Como xa saberedes,

proteins are large biological molecules

as proteínas son moléculas

that perform different functions within our body,

que realizan diferentes funcións no corpo,

like catalyzing metabolic reactions

como catalizar as reaccións metabólicas,

or responding to stimuli

respostar aos estímulos

or replicating DNA,

ou replicar o ADN,

but before a protein is expressed or produced,

pero antes de que isto suceda,

relevant parts of its genetic code

partes relevantes do código xenético

present in the DNA

presentes no ADN,

are copied into the messenger RNA,

cópianse no ARN mensaxeiro

so this messenger RNA

e este ten instrucións

has instructions on how to build a specific protein,

para construír unha proteína específica

and potentially it can build hundreds of proteins,

e pode construír centos delas,

but the one that tells them when to build them

pero os que dicen cando construílas

and how many to build

e cantas construír

are microRNAs.

son os microARN.

So microRNAs are small molecules

Os microARN son pequenas moléculas

that regulate gene expression.

que regulan a expresión xenética.

Unlike DNA, which is mainly fixed,

A diferenza do ADN, que non soe variar,

microRNAs can vary depending on internal

os microARN poden facelo dependendo

and environmental conditions at any given time,

do estado interno e do ambiente,

telling us which genes are actively expressed at that particular moment.

comunicándonos que xenes se expresan dun xeito activo.

And that is what makes microRNAs

E por iso os microARN

such a promising biomarker for cancer,

son un biomarcador prometedor

because as you know,

porque, como xa sabedes,

cancer is a disease of altered gene expression.

o cancro é a doenza da expresión xénica alterada.

It is the uncontrolled regulation of genes.

A regulación xénica sen control.

Another important thing to consider

Outro dato importante

is that no two cancers are the same,

é que non hai dous cancros iguais,

but at the microRNA level, there are patterns.

pero no nivel dos microARN hai patróns.

Several scientific studies have shown

Varios estudos científicos demostraron

that abnormal microRNA expression levels

que uns niveis de expresión de microARN anormais

varies and creates a unique, specific pattern

varían e crean un patrón único e concreto

for each type of cancer,

para cada tipo de cancro,

even at the early stages,

mesmo nas primeiras fases,

reflecting the progression of the disease,

reflectindo o avance da doenza

and whether it's responding to medication

e se responde ao tratamento

or in remission,

ou se remite,

making microRNAs a perfect,

convertendo aos microARN

nun biomarcador perfecto e moi sensible.

highly sensitive biomarker.

However, the problem with microRNAs

Con todo, o problema cos microARN

is that we cannot use existing DNA-based technology

é que non se pode usar a tecnoloxía baseada no ADN

to detect them in a reliable way,

para detectalo dun xeito fiable,

because they are very short sequences of nucleotides,

por ser secuencias moi curtas de nucleótidos,

much smaller than DNA.

moito máis pequenas que o ADN.

And also, all microRNAs are very similar to each other,

Tamén porque os microARN parécense moito,

with just tiny differences.

teñen diferenzas minúsculas.

So imagine trying to differentiate two molecules,

É como diferenciar dúas moléculas,

extremely similar, extremely small.

extremadamente similares e pequenas.

We believe that we have found a way to do so,

Cremos ter atopado a forma de facelo

and this is the first time that we've shown it in public.

e ides ser os primeiros en coñecela.

Let me do a demonstration.

Vouvos facer unha mostra.

Imagine that next time you go to your doctor

Imaxinade a próxima vez que ides ao médico

and do your next standard blood test,

para facer unha análise de sangue

a lab technician extracts a total RNA,

e vos extraen unha mostra total de ARN,

which is quite simple today,

bastante sinxelo hoxe en día,

and puts it in a standard 96-well plate like this one.

e póñena nunha placa de 96 cuncas.

Each well of these plates

A cada cunca destas placas

has specific biochemistry that we assign,

asignámoslle un bioquímico concreto

that is looking for a specific microRNA,

que busca un microARN concreto

acting like a trap that closes

e actúa como unha trampa que se pecha

only when the microRNA is present in the sample,

só cando o microARN está na mostra,

and when it does, it will shine with green color.

e cando isto sucede, ten un brillo verde.

To run the reaction,

Para que reaccione,

you put the plate inside a device like this one,

métela nun dispositivo coma este

and then you can put your smartphone on top of it.

e colocas o teu smartphone sobre el.

If we can have a camera here

Podedes colocar a cámara aquí

so you can see my screen.

para que vexades a pantalla?

A smartphone is a connected computer

O smartphone é un ordenador conectado

and it's also a camera,

e tamén é unha cámara,

good enough for our purpose.

dabondo para o noso propósito.

The smartphone is taking pictures,

O smartphone tira fotos

and when the reaction is over,

e cando a reacción remate,

it will send the pictures

enviará as fotos

to our online database for processing

á base de datos en liña

para procesalas e interpretalas.

and interpretation.

This entire process lasts around 60 minutes,

Este proceso dura uns 60 minutos

but when the process is over,

pero cando remata,

wells that shine are matched with the specific microRNAs

emparella as que brillan cos microARN

and analyzed in terms of how much and how fast

e analízaos en termos de canto

they shine.

e como de rápido brillan.

And then, when this entire process is over,

Cando este proceso remata,

this is what happens.

isto é o que acontece:

This chart is showing the specific microRNAs

a gráfica amosa os microARN específicos

present in this sample

presentes nesta mostra

and how they reacted over time.

e como reaccionaron co tempo.

Then, if we take this specific pattern of microRNA

Se este patrón específico de microARN

of this person's samples

das mostras desta persoa

and compare it with existing scientific documentation

comparámolo coa documentación

that correlates microRNA patterns

dos patróns de microARN

with a specific presence of a disease,

da presenza específica dunha doenza,

this is how pancreatic cancer looks like.

así veremos o cancro de páncreas.

This inside is a real sample

Aquí dentro temos unha mostra real

where we just detected pancreatic cancer.

na que detectamos cancro de páncreas.

(Applause)

(Aplausos)

Another important aspect of this approach

Outro aspecto importante

is the gathering and mining of data in the cloud,

é que reúne e extrae os datos na nube,

so we can get results in real time

así temos resultados en tempo real

and analyze them with our contextual information.

e analizámolos en contexto.

If we want to better understand

Se queremos entender mellor

and decode diseases like cancer,

e descodificar estas doenzas,

we need to stop treating them

hai que deixar de tratalas

as acute, isolated episodes,

como graves e illadas,

and consider and measure everything

para considerar e medir todo

that affects our health on a permanent basis.

o que afecta a nosa saúde.

This entire platform is a working prototype.

A plataforma é un prototipo.

It uses state-of-the-art molecular biology,

Emprega bioloxía molecular de vangarda,

a low-cost, 3D-printed device,

un dispositivo de baixo custo impreso en 3D

and data science

e datos científicos

to try to tackle one of humanity's toughest challenges.

para abordar un dos retos máis difíciles.

Since we believe early cancer detection

Como cremos que a detección precoz

should really be democratized,

debería democratizarse,

this entire solution costs at least 50 times less

esta solución custa case un 50% menos

than current available methods,

que os métodos que temos na actualidade

and we know that the community can help us

e a comunidade pode axudarnos

accelerate this even more,

a aceleralo máis,

so we're making the design of the device

así que deseñamos o dispositivo

open-source.

en código aberto.

(Applause)

(Aplausos)

Let me say very clearly

Permitídeme dicir claramente

that we are at the very early stages,

que estamos nas primeiras etapas,

but so far, we have been able

pero puidemos identificar

to successfully identify the microRNA pattern

con éxito os patróns de microARN

of pancreatic cancer, lung cancer,

de cancro de páncreas, de pulmón,

breast cancer and hepatic cancer.

de mama e de fígado.

And currently, we're doing a clinical trial

Estamos a traballar nun ensaio clínico

in collaboration with the German Cancer Research Center

en colaboración co Centro Alemán de Investigación Oncolóxica

with 200 women for breast cancer.

con 200 mulleres con cancro de mama.

(Applause)

(Aplausos)

This is the single non-invasive,

Esta é a única proba non invasiva,

accurate and affordable test

precisa e económica

that has the potential to dramatically change

que posibilita un cambio radical

how cancer procedures and diagnostics

nos métodos e diagnoses

have been done.

que se fan ata o momento.

Since we're looking for the microRNA patterns

Como buscamos patróns de microARN

in your blood at any given time,

no sangue nun momento dado,

you don't need to know which cancer you're looking for.

non é preciso saber que cancro buscas.

You don't need to have any symptoms.

Non é preciso ter ningún síntoma.

You only need one milliliter of blood

Só é preciso un mililitro de sangue

and a relatively simple array of tools.

e unhas ferramentas relativamente simples.

Today, cancer detection happens mainly

Hoxe, adoita detectarse o cancro

when symptoms appear.

cando aparecen os síntomas.

That is, at stage 3 or 4,

É dicir, no grao 3 ou 4

and I believe that is too late.

e creo que é demasiado tarde.

It is too expensive for our families.

É demasiado caro para as nosas familias.

It is too expensive for humanity.

É demasiado caro para a humanidade.

We cannot lose the war against cancer.

Non podemos perder contra o cancro.

It not only costs us billions of dollars,

Cústanos miles de millóns de dólares,

but it also costs us the people we love.

pero tamén nos custa a nosa xente.

Today, my aunt, she's fighting bravely

Hoxe, miña tía loita valerosamente

and going through this process with a very positive attitude.

e segue o proceso moi positiva.

However, I want fights like this

Con todo, quero que este tipo de loitas

to become very rare.

sexan moi pouco frecuentes.

I want to see the day

Desexo que chegue o día

when cancer is treated easily

no que sexa doado tratar o cancro

because it can be routinely diagnosed

porque se detecta sistematicamente

at the very early stages,

nas primeiras fases

and I'm certain

e estou seguro

that in the very near future,

de que moi pronto,

because of this

grazas a este avance

and other breakthroughs that we are seeing

e a outros que vemos

every day in the life sciences,

nas ciencias biolóxicas,

the way we see cancer

a nosa perspectiva cara o cancro

will radically change.

cambiará dun xeito radical.

It will give us the chance of detecting it early,

Daranos a oportunidade de detectalo cedo,

understanding it better,

de entendelo mellor

and finding a cure.

e de descubrir unha cura.

Thank you very much.

Moitas grazas.

(Applause)

(Aplausos)