A simple new blood test that can catch cancer early | Jimmy Lin

Translator: Leah Ligate Reviewer: Nelson Simfukwe

Cancer.

Saratani.

Many of us have lost family, friends or loved ones

Wengi wetu tumepoteza ndugu wa familia marafiki au wapendwa wetu

to this horrible disease.

kwa ugonjwa huu mbaya sana.

I know there are some of you in the audience

Nafahamu kuna baadhi yenu katika hadhira hii

who are cancer survivors,

ni manusura wa saratani,

or who are fighting cancer at this moment.

au ambao wanapambana na saratani kwa sasa.

My heart goes out to you.

Moyo wangu unaguswa nanyi.

While this word often conjures up emotions of sadness and anger and fear,

Wakati neno hili linaleta hisia za huzuni na hasira na hofu,

I bring you good news from the front lines of cancer research.

Ninakuletea habari njema kutoka kwenye utafiti wa saratani

The fact is, we are starting to win the war on cancer.

Ukweli ni kwamba tunaanza kushinda vita ya saratani.

In fact, we lie at the intersection

Kiukweli, tupo katikati

of the three of the most exciting developments within cancer research.

kwenye mambo matatu endelevu ndani utafiti wa Saratani wa kusisimua

The first is cancer genomics.

Ya kwanza ni genome ya Saratani

The genome is a composition

Genome ni uundwaji

of all the genetic information encoded by DNA

wa taarifa za kijenetikia zilizosimbwa na DNA

in an organism.

ndani ya kiumbehai

In cancers, changes in the DNA called mutations

Kwenye saratani, mabadiliko ya DNA yaitwayo ubadilikaji seli

are what drive these cancers to go out of control.

ni kile kinachosukuma saratani hizi kushindwa kudhibitiwa

Around 10 years ago, I was part of the team at Johns Hopkins

Karibia miaka 10 iliyopita nilikuwa sehemu ya timu ya John Hopkins

that first mapped the mutations of cancers.

watu wa kwanza kuunda ramani ya mabadiliko ya saratani

We did this first for colorectal,

Tulifanya kwanza kwa ya utumbo,

breast, pancreatic and brain cancers.

matiti, kongosho na saratani ya ubongo

And since then, there have been over 90 projects in 70 countries

Na kuanzia hapo,, kumekuwa na zaidi ya miradi 90 kwenye nchi 70

all over the world,

duniani kote

working to understand the genetic basis of these diseases.

inayofanyia kazi kuelewa msingi wa jenetikia ya magonjwa haya.

Today, tens of thousands of cancers are understood

Leo hii, maelfu ya magonjwa ya saratani yanaeleweka

down to exquisite molecular detail.

hadi kipengele bora cha mwanzo cha molekyuli

The second revolution is precision medicine,

Mapinduzi ya pili ni tiba mahsusi,

also known as "personalized medicine."

yajulikanayo pia kama "tiba kulingana na ugonjwa".

Instead of one-size-fits-all methods to be able to treat cancers,

badala ya njia ya tiba aina moja kutumika kutibu saratani zote,

there is a whole new class of drugs that are able to target cancers

kuna madaraja mapya ya dawa ambazo yanaweza kulenga saratani

based on their unique genetic profile.

kulingana na wasifu wake wa kipekee kijenetikia

Today, there are a host of these tailor-made drugs,

Leo kuna makazi ya hizi dawa zilizotengenezwa

called targeted therapies,

ziitwazo tiba za kulenga,

available to physicians even today

zinazopatikana kwa kila daktari hata leo

to be able to personalize their therapy for their patients,

kuweza kupanga tiba mahsusi kwa wagonjwa wao,

and many others are in development.

na nyingine nyingi zinaendelezwa.

The third exciting revolution is immunotherapy,

mapinduzi ya tatu ya kusisimua ni tiba ya kingamaradhi

and this is really exciting.

na hii inasisimua kweli.

Scientists have been able to leverage the immune system

Wanasanyansi wameweza kutumia vizuri mfumo wa kinga

in the fight against cancer.

kupambana dhidi ya saratani.

For example, there have been ways where we find the off switches of cancer,

Kwa mfano, kumekuwa na njia ambazo tunakuta huzima saratani,

and new drugs have been able to turn the immune system back on,

na dawa mpya zimeweza kugeuza mfumo wa kinga tena,

to be able to fight cancer.

kuweza kupambana na saratani.

In addition, there are ways where you can take away immune cells

Kwa kuongezea, kuna njia ambazo unaweza kuondoa seli za kinga

from the body,

kutoka mwilini,

train them, engineer them and put them back into the body

kuzifunza, kuziunda na kuzirudisha tena mwilini

to fight cancer.

kupambana na saratani.

Almost sounds like science fiction, doesn't it?

Inaonekana kama hadithi ya sayansi ya kutunga si ndio?

While I was a researcher at the National Cancer Institute,

Wakati nilipokuwa mtafiti kwenye Chuo cha Taifa cha Saratani,

I had the privilege of working with some of the pioneers of this field

Nilibahatika kufanyakazi na baadhi ya waanzilishi wa idara hii

and watched the development firsthand.

na kuangalia maendeleo ya awali.

It's been pretty amazing.

imekuwa ya kustaajabisha sana.

Today, over 600 clinical trials are open,

Leo, kuna zaidi ya majaribio 600 ya kikliniki,

actively recruiting patients to explore all aspects in immunotherapy.

yakuwafunza wagonjwa kuangalia vipengele vyote vya tiba ya kingamaradhi

While these three exciting revolutions are ongoing,

Wakati mapinduzi haya matatu ya kusisimua yanaendelea,

unfortunately, this is only the beginning,

bahati mbaya huu ni mwanzo tu,

and there are still many, many challenges.

na bado kuna changamoto nyingi.

Let me illustrate with a patient.

Ngoja nitolee mfano kwa mgonjwa

Here is a patient with a skin cancer called melanoma.

Hapa ni mgonjwa mwenye saratani ya ngozi iitwayo melanoma.

It's horrible; the cancer has gone everywhere.

ni mbaya sana; saratani imeenea kila mahali.

However, scientists were able to map the mutations of this cancer

Ingawa wanasayansi waliweza kuunda ramani ya mabadiliko ya saratani hii

and give a specific treatment that targets one of the mutations.

na kutoa tiba mahsusi kwa kulenga mabadiliko

And the result is almost miraculous.

Na matokeo ni karibia muujiza.

Tumors almost seem to melt away.

Uvimbe ulionekana kuyeyuka kabisa.

Unfortunately, this is not the end of the story.

Bahati mbaya huu sio mwisho wa hadithi.

A few months later, this picture is taken.

Miezi michache baadae, hii picha ilipigwa.

The tumor has come back.

Uvimbe umerudi tena.

The question is: Why?

Swali ni: Kwanini?

The answer is tumor heterogeneity.

Jibu ni uvimbe mbalimbali

Let me explain.

Ngoja nifafanue zaidi.

Even a cancer as small as one centimeter in diameter

Hata saratani ndogo kiasi cha sentimita moja katika mduara

harbors over a hundred million different cells.

huhifadhi seli zaidi ya milioni mia moja tofauti.

While genetically similar,

Pamoja na kufanana kijenetikia,

there are small differences in these different cancers

kuna tofauti ndogo katika saratani hizi tofauti

that make them differently prone to different drugs.

inazozifanya zigeuke tofauti kwa dawa tofauti.

So even if you have a drug that's highly effective,

Hivyo hata kama una dawa yenye kufanya kazi vizuri,

that kills almost all the cells,

ambayo huua karibia seli zote,

there is a chance that there's a small population

kunauwezekano kwamba kuna idadi ndogo ya seli

that's resistant to the drug.

ambayo ni sugu kwa dawa.

This ultimately is the population

Hii hatimaye ni idadi ya seli

that comes back,

ambazo hurudi,

and takes over the patient.

na kumchukua tena mgonjwa.

So then the question is: What do we do with this information?

Sasa basi swali ni: Tunafanyia nini taarifa hii?

Well, the key, then,

Chamsingi basi,

is to apply all these exciting advancements in cancer therapy earlier,

Ni kutumia maboresho yote haya ya kusisimua kwa tiba ya saratani mapema,

as soon as we can,

mapema tunavyoweza,

before these resistance clones emerge.

kabla ya seli sugu zinazojinakili kuibuka

The key to cancer and curing cancer is early detection.

Kitu muhimu kwa saratani na kuitibu ni kuigundua mapema

And we intuitively know this.

na wote tunaelewa haraka hili.

Finding cancer early results in better outcomes,

Kugundua saratani mapema hupelekea matokeo mazuri,

and the numbers show this as well.

na takwimu zinaonyesha hili pia.

For example, in ovarian cancer, if you detect cancer in stage four,

Mfano, katika saratani ya ovari, ukiigundua ikiwa hatua ya nne,

only 17 percent of the women survive at five years.

ni asilimia 17 pekee ya wanawake husalia kwa miaka mitano

However, if you are able to detect this cancer as early as stage one,

Ingawa, ikiwa utaweza kugundua saratani hii mapema ikiwa hatua ya kwanza,

over 92 percent of women will survive.

zaidi ya asilimia 92 watasalia.

But the sad fact is, only 15 percent of women are detected at stage one,

Kinachohuzuni sha ni, asilimia 15 tu ya wanawake hugundua ikiwa hatua ya kwanza,

whereas the vast majority, 70 percent, are detected in stages three and four.

ambapo wengi wao, asilimia 70 hugunduka katia hatua ya tatu au ya nne.

We desperately need better detection mechanisms for cancers.

Tunahitaji bila kukata tamaa njia bora za kugundua saratani.

The current best ways to screen cancer fall into one of three categories.

Njia bora za sasa za kupima saratani ziko kwenye moja ya vipengele vitatu,

First is medical procedures,

Kwanza ni vipimo vya kitabibu,

which is like colonoscopy for colon cancer.

kama vile kolonoskopi kiangaza utumbo kwa saratani ya utumbo.

Second is protein biomarkers, like PSA for prostate cancer.

Pili ni vipimo vya protini, kama PSA kwa saratani ya tezi dume.

Or third, imaging techniques,

Au tatu vipimo vya picha,

such as mammography for breast cancer.

kama mamografi kwa saratani ya matiti.

Medical procedures are the gold standard;

Vipimo vya kitatibu ni viwango bora;

however, they are highly invasive

ingawa, hutumia vifaa vyenye ncha

and require a large infrastructure to implement.

na huhitaji miundombinu itumiayo eneo kubwa kwa upimaji.

Protein markers, while effective in some populations,

Vipimo ya Protini, vikiwa na matokeo mazuri kwa baadhi ya majaribio,

are not very specific in some circumstances,

havitoi majibu kamili kwa hali nyingine za majaribio

resulting in high numbers of false positives,

ambayo hupelekea matokeo ya kiwango kisicho sahihi,

which then results in unnecessary work-ups and unnecessary procedures.

ambayo pia hupelekea utafiti zaidi usio na lazima au upasuaji

Imaging methods, while useful in some populations,

utafiti kwa njia ya picha waweza kuwa na manufaa kwa baadhi

expose patients to harmful radiation.

huweka wagonjwa kwenye mionzi hatarishi.

In addition, it is not applicable to all patients.

kwa kuongezea, haitumiki kwa wagonjwa wote.

For example, mammography has problems in women with dense breasts.

Mfano, kipimo cha mamografia kina matatizo kwa wanawake wenye matiti yaliyojaa

So what we need is a method that is noninvasive,

Hivyo tunachohitaji ni njia ambazo hazihitaji upasuaji

that is light in infrastructure,

huo ni mwanga kwa miundombinu,

that is highly specific,

na ni bayana kikamillifu

that also does not have false positives,

ambayo pia haina majibu yasiyo sahihi

does not use any radiation

haitumii mionzi yoyote

and is applicable to large populations.

na inatumika kwa idadi kubwa

Even more importantly,

na cha muhimu zaidi

we need a method to be able to detect cancers

tunahitaji njia itakayoweza kugundua saratani

before they're 100 million cells in size.

kabla kufikia ukubwa wa seli milioni 100

Does such a technology exist?

Teknolojia ya aina hiyo ipo?

Well, I wouldn't be up here giving a talk if it didn't.

Nisingkuwepo hapa kufanya mjadala kama isingekuwepo.

I'm excited to tell you about this latest technology we've developed.

Nina shauku ya kuwaambia kuhusu teknolojia mpya tuliyoendeleza

Central to our technology is a simple blood test.

Kiini cha teknolojia yetu ni kipimo rahisi cha damu

The blood circulatory system, while seemingly mundane,

Mfumo wa mzunguko wa damu, wakati unaonekana ni wa kawaida

is essential for you to survive,

ni muhimu sana kwa wewe kuishi

providing oxygen and nutrients to your cells,

kutoa hewa ya oksijeni na virutubisho kwa seli zako,

and removing waste and carbon dioxide.

na kuondoa taka na kaboni daioksidi

Here's a key biological insight:

Haya ni melezo ya msingi kibaolojia:

Cancer cells grow and die faster than normal cells,

Seli za saratani hukua na kufa haraka kuliko seli za kawaida,

and when they die,

na zinapokufa,

DNA is shed into the blood system.

DNA hunyambuka kwenye mfumo wa damu,

Since we know the signatures of these cancer cells

Kwakuwa tunajua alama ya seli hizi za saratani

from all the different cancer genome sequencing projects,

kwenye saratani tofauti za kazi za mfuatano wa genome

we can look for those signals in the blood

tunaweza kuona hivyo viashiria kwenye damu

to be able to detect these cancers early.

kuweza kugundua saratani hizi mapema.

So instead of waiting for cancers to be large enough to cause symptoms,

Hivyo badala ya kusubiri kwa saratani kuwa kubwa kiasi cha kuonyesha dalili,

or for them to be dense enough to show up on imaging,

au kwa zenyewe kujaa kiasi cha kuonekana kwa vipimo vya picha

or for them to be prominent enough

au kwa zenyewe kujitokeza vyakutosha

for you to be able to visualize on medical procedures,

kwa wewe kuweza kuziona kwenye mchakato wa kitabibu

we can start looking for cancers while they are relatively pretty small,

tunaweza kuanza kutafuta saratani zingali bado ndogo sana,

by looking for these small amounts of DNA in the blood.

kwa kuangalia hiki kiasi kidogo cha DNA kwenye damu.

So let me tell you how we do this.

Hivyo ngoja niwaambie tunavyofanya

First, like I said, we start off with a simple blood test --

Kwanza kama nilivyosema, tunaanza na kipimo rahisi cha damu--

no radiation, no complicated equipment --

bila mionzi, bila vifaa vya kutatanisha--

a simple blood test.

kipimo rahisi cha damu.

Then the blood is shipped to us,

Kisha damu huletwa kwetu,

and what we do is extract the DNA out of it.

na tunachofanya tunatoa DNA kutoka kwenye damu

While your body is mostly healthy cells,

Wwakati mwili wako una seli zenye afya

most of the DNA that's detected will be from healthy cells.

DNA nyingi zinazogundulika zinakuwa kutoka kwenye seli zenye afya.

However, there will be a small amount, less than one percent,

Ingawa kunaweza kuwa na kiasi kidogo, pungufu ya asilimia moja,

that comes from the cancer cells.

zinazotoka kwenye seli za saratani

Then we use molecular biology methods to be able to enrich this DNA

Kisha hutumia njia za molekyuli kibaolojia kurutubisha hii DNA

for areas of the genome which are known to be associated with cancer,

kwa maeneo ya genome ambayo hufahamika kuhusishwa na saratani.

based on the information from the cancer genomics projects.

kutokana na taarifa kutoka kwenye kazi za genome za saratani

We're able to then put this DNA into DNA-sequencing machines

Tunaweza kuweka hii DNA kwenye mashine za mfuatano wa DNA

and are able to digitize the DNA into A's, C's, T's and G's

na zinaweza kuweka DNA kidigitali kuwa A,C,T na G

and have this final readout.

na kufikia tamati kuzisoma

Ultimately, we have information of billions of letters

Hatimaye , tuna taarifa ya mabilioni ya herufi

that output from this run.

matokeo hayo kwa majaribio haya,

We then apply statistical and computational methods

Tunayatumia njia za kitakwimu na za ukokotoaji

to be able to find the small signal that's present,

kuweza kupata viashiria vidogo vilivyopo

indicative of the small amount of cancer DNA in the blood.

vinavyoonyesha kiasi kidogo cha DNA za saratani kwenye damu.

So does this actually work in patients?

Kwahiyo hii inafanya kazi kwa wagonjwa?

Well, because there's no way of really predicting right now

Hivyo, kwakuwa hakuna njia ya kutegemea kutabiri sasa hivi

which patients will get cancer,

wagonjwa wapi watapata saratani

we use the next best population:

tunatumia idadi bora inayofuata:

cancers in remission;

saratani zilizotulia:

specifically, lung cancer.

hususan, saratani ya mapafu

The sad fact is, even with the best drugs that we have today,

kinachosikitisha, pamoja na dawa bora tulizonazo hivi leo,

most lung cancers come back.

saratani nyingi za mapafu hurudi.

The key, then, is to see

kitu muhimu basi ni kuona

whether we're able to detect these recurrences of cancers

ikiwa tunaweza kugundua kujirudia huku kwa saratani

earlier than with standard methods.

mapema zaidi ya kutumia njia za kawaida

We just finished a major trial

Hivi karibuni tumemaliza jaribio kubwa

with Professor Charles Swanton at University College London,

pamoja na Profesa Charles Swaton kwenye Chuo kikuu London,

examining this.

kuchunguza hili.

Let me walk you through an example of one patient.

Ngoja niwaelekeze kupitia mfano wa mgonjwa mmoja.

Here's an example of one patient who undergoes surgery

Hapa ni mfano wa mgonjwa mmoja anayefanyiwa upasuaji

at time point zero,

kwa wakati nukta sifuri,

and then undergoes chemotherapy.

na kisha anapitia tibakemo inayotumia kemikali

Then the patient is under remission.

Kisha mgonjwa huingia kipindi cha ugonjwa kutulia

He is monitored using clinical exams and imaging methods.

Hufuatiliwa kwa kutumia njia za uchunguzi na picha

Around day 450, unfortunately, the cancer comes back.

ikifika siku ya 450, bahati mbaya saratani inarudi.

The question is: Are we able to catch this earlier?

Swali ni: tunaweza kuigundua mapema?

During this whole time, we've been collecting blood serially

Kwa kipindi chote hiki tumekuwa tukikusanya damu kwa mfululizo

to be able to measure the amount of ctDNA in the blood.

kuweza kupima kiasi cha ctDNA kwenye damu.

So at the initial time point, as expected,

Kwa muda cha awali , kama ilivyotegemewa

there's a high level of cancer DNA in the blood.

kuna kiwango kikubwa cha DNA ya saratani kwenye damu.

However, this goes away to zero in subsequent time points

Ingawa hii huenda kuwa sifuri katika pointi za muda unaofuata

and remains negligible after subsequent points.

na kubakia isiyo na umuhimu baada ya pointi zinazofuata

However, around day 340, we see the rise of cancer DNA in the blood,

Ingawa, karibia siku ya 340, tunaona ongezeko la DNA kwenye damu,

and eventually, it goes up higher for days 400 and 450.

na hatimaye inaongezeka kwa siku ya 400 na 450,

Here's the key, if you've missed it:

Hiki ni muhimu, kama ilikupita:

At day 340, we see the rise in the cancer DNA in the blood.

kwenye siku ya 340 tunaona ongezeko la DNA ya saratani kwenye damu.

That means we are catching this cancer over a hundred days earlier

Hii inamaanisha tunaikamata hii saratani zaidi ya siku mia moja mapema

than traditional methods.

kuliko njia zilizo zoeleka.

This is a hundred days earlier where we can give therapies,

Hii ni siku mia moja mapema ambapo tunaweza kutoa tiba,

a hundred days earlier where we can do surgical interventions,

siku mia moja mapema tunaweza kuzuia kwa kufanya upasuaji

or even a hundred days less for the cancer to grow

au hata pungufu ya siku mia moja kwa saratani kukua

or a hundred days less for resistance to occur.

au pungufu ya siku mia moja kwa usugu wa ugonjwa. kutokea

For some patients, this hundred days means the matter of life and death.

Kwa baadhi ya wagonjwa siku hizi mia moja ni suala la kufa au kupona

We're really excited about this information.

Tuna shauku kubwa kuhusu taarifa hii.

Because of this assignment, we've done additional studies now

Kwa sababu ya kazi hii tumefanya utafiti wa ziada sasa

in other cancers,

katika saratani nyingine

including breast cancer, lung cancer

ikijumuisha saratani ya matiti, mapafu

and ovarian cancer,

na saratani ya ovari,

and I can't wait to see how much earlier we can find these cancers.

nina hamu kubwa kuona ni mapema kiasi gani tutagundua saratani hizi.

Ultimately, I have a dream,

Hatimaye, nina ndoto,

a dream of two vials of blood,

ndoto ya vichupa viwili vya damu,

and that, in the future, as part of all of our standard physical exams,

na hiyo, mbeleni, kama sehemu ya uchunguzi wetu wa kawaida wa mwili,

we'll have two vials of blood drawn.

tutakuwa na vichupa 2 vilivyotolewa damu

And from these two vials of blood we will be able to compare

na kwenye vichupa hivi vya damu tutaweza kulinganisha

the DNA from all known signatures of cancer,

DNA kutoka kwenye alama zote za saratani

and hopefully then detect cancers months to even years earlier.

kwa matumaini ya kugundua saratani miezi au hata miaka mapema

Even with the therapies we have currently,

Hata pamoja na tiba tulizonazo sasa,

this could mean that millions of lives could be saved.

hii inamaanisha mamilioni ya maisha yanaweza kuokolewa.

And if you add on to that recent advancements in immunotherapy

na ukiongezea maendeleo hivi karibuni ya tiba ya kingamaradhi

and targeted therapies,

na tiba za kulenga

the end of cancer is in sight.

mwisho wa saratani unaonekana.

The next time you hear the word "cancer,"

Utakapo sikia tena neno "saratani"

I want you to add to the emotions: hope.

Nataka uongeze kwenye hisia: matumaini.

Hold on.

Subiri kwanza.

Cancer researchers all around the world are working feverishly

Watafiti wa saratani duniani wanafanya kazi kwa msisimko mkubwa

to beat this disease,

kuushinda ugonjwa huu

and tremendous progress is being made.

na maendeleo makubwa yanafanywa.

This is the beginning of the end.

Huu ni mwanzo wa mwisho wake.

We will win the war on cancer.

Tutashinda vita dhidi ya saratani.

And to me, this is amazing news.

Na kwangu, hizi ni habari za kustaajabu

Thank you.

Ahsanteni.

(Applause)

(Makofi)