Diagnosing Cancer in 15 Minutes or Less -Cause/Action: Raj Krishnan at TEDxSanDiego 2012

Diagnosing Cancer in 15 Minutes or Less -Cause/Action: Raj Krishnan at TEDxSanDiego 2012

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Translator: Akinori Oyama
Reviewer: Ruojing Zhou (Applause) One of the worst aspects
of my undergraduate in electrical engineering was that there weren’t a lot of women. (Laughter) So, I was actually
very socially awkward. I didn’t know how to interact or talk
to a lot of girls. So, when I went to a graduate school
for bioengineering at UCSD, there was this girl
that I had a huge crush on, and luckily, I had a chance to actually
be in a party with her. So, when I met her
at this party, I managed to get her alone.
I was having a conversation. I was hoping
everything was going well. I figured
I was doing good. So, finally, I gathered up my courage
and I asked her out on a date. And, she responded with “Sure.”
and my heart soared. And then, she had the kicker, “When they find the cure for cancer.”
and walked away. (Laughter) So, as I there, dejected, I was actually working on cancer
at the time. (Laughter) So, I started thinking of “Why is it so difficult to actually
work on this, and find a cure for cancer?” “why isn’t there
an easier way to do this?” Let’s talk about cancer,
for a little bit, what it entails
and what the different aspects are. Cancer is basically
cells gone wild. All it is is a cell that gets a mutation
and divides uncontrollably. Doesn’t matter
where it happens in your body. It causes a quarter
of all deaths worldwide. And it costs about a hundred billion dollars
in direct costs in America alone. And about twice as much as that
in the indirect costs due to a lost productivity
and time, and so forth. The main reason
that this is the case is that if you look at the life span of a tumor
going from stage 0 all the way up to stage 4 Stage 4 being
that it spreads everywhere. Stage 0: it’s just started. About stage 2 to stage 3 is where actually
most of the cancers are currently detected. Usually, you start
bleeding profusely. After a while, you have unexplained pains
or headaches, or you have other symptoms
that certainly show up. So, you go to the doctor, and the doctor
actually diagnoses you. We actually need to detect cancer here,
stage 0 to stage 1. The reason why is because if you were
to look at a 5 year survival rate, it’s a huge difference. If you look at the 4 major cancers
that are affecting America right now, you have lung, prostate,
colorectal, and breast. The blue in this graph represents
early stage, or localized. The red in this graph represents
late stage, or spread. You can look at
the survival rates. It’s about anywhere between 4 to 15 times
as much for the 4 major cancers. And this is true
for every single cancer. How many times have you guys heard, “He has cancer,
but luckily they caught it early?” If you look at the survival rate as well,
the other thing that stands out is if you find it early enough, most these
cancers are close to a 100% cure rates. So, you don’t actually need necessarily
a magic pill, you just need to find it early. Conversely, if you look at
the 5 year mortality rate of these same cancers,
you can see that in the blue again is the incidents now,
how many people get it, and then, the red is the mortality,
how many people die from it. For lung cancer, you have
about 75% death. But for the other 3 cancers,
colorectal, breast and prostate, you have much lower levels,
still unacceptable, but much lower levels. And, the part of the reason why is because for colorectal cancer
you have colonoscopies, for breast cancer
you have mammograms, and for prostate cancer
you have PSA, so you can actually find it earlier
and actually treat it. But almost every other cancer,
you have nothing. And part of the reason why is because we have a lot of
ineffective and costly detection methods. So, to give you an example,
I am gonna give you a quick analogy as to why this is
the case right now. So, there is a drunk guy
looking for his keys under the lamp post. And, a police officer walks by,
and he has a conversation with the drunk guy and he says,
“Well, what are you doing here?” Drunk guy says,
“I’m looking for my keys.” So, police officer gets
down on his hands and knees, and searches under
the spotlight as well. After a few minutes, he gives up,
and he gets up, and he goes, “I can’t find your keys.
Are you sure you lost them here?” And, the drunk guy goes,
“No, I lost them over there.” So, the police officer says,
“Why are you searching over here?” “Well, because here is where the light is.
I can’t see over there.” In the same way,
right now, the reason we have these ineffective
detection methods is because that’s
where our technology is. We identify
what we can see. If we can’t see it, we don’t actually
bother identifying it. So, we’re looking somewhere. We need to look everywhere
and that’s the key. In other words, you wanna take
this hidden key. You wanna actually reveal it. So, what is this hidden key
and how can we actually identify it? Here is a quote
by Dr. Leland H. Hartwell, who has the Nobel Prize in
Medicine and Physiology, says “The biggest payoff in cancer
would be the discovery of biomarkers measured in blood
that reflect early-stage cancer.” So, you need 2 things
to actually be able to detect these cancers. One is a blood-based biomarker
that’s indicative of every single cancer, and has to rely on
what the definition of cancer is. The other one is a technology to isolate
and detect this biomarker to actually have an effect. So to explain where this biomarker
is coming from, I am gonna take you back again
to another analogy to give you an idea
of how it works. So, imagine a single cell
is like a brick. And, basically, you are
going to be forming a house out of it. You have a blueprint
that’s really easy. Brick by brick,
your cells actually build into an organ. And you get a nice,
beautiful house. Well, cancer is basically
disease in mutation. It’s the equivalent of throwing bricks
as fast as possible into a pile. And yuu see what you get,
you get a giant mountain. But at the same time,
the same effects occur. There are a lot
of shattered bricks. You get brick dust debris
flying everywhere. So, in the same way, if you take
these cells and they proliferate rapidly, which is what the definition of cancer is,
a lot of the cells die. They release what’s known
as cell free DNA, which is their innards outwards
because they explode. If you can isolate that DNA
from your blood stream, and using current sequencing
as well as other technologies that exist, you can actually identify
whether or not you have cancer, where that cancer is located,
what type of treatment to give, and so on, and so forth. So, the next thing you need is a technology
to actually be able to isolate this. This is what I was working on. So, you can use
AC electric field microarrays. That’s actually what you are looking at
right now is a simulation of what it actually [looks] like. So, the blue here is a
micro-electric array. And the yellow circles are micro electrons,
about 80 microns in diameter. So they are about
the width of human hair. What I am gonna do is I am gonna show you
a quick video of how this actually works. So, take your blood
which is broken down into red blood cells, white blood cells,
DNA, and a bunch of other things. But we are keeping
it simple here. Then, you turn on
the electric field. So, all you are gonna do is
just push a button. Your cells and everything you don’t want
will move away from the electrodes. And at the same time
that this is occurring the high molecular weight DNA,
which you are about to see in green, moves onto the electrodes. That’s it. Just as simple as that.
Just push a button and walk away. Then, you do
a simple fluidic wash. You wash away your cells and stuff
you don’t want, and there is your DNA. You can actually identify with that DNA
whether you have a problem or not, and use secondary analysis. So, here is what it actually looks like. It takes a single drop of blood
and about 15 minutes. You put it in, you turn the electric
field on, you just let it run through. For a normal patient, this is exactly
what you’ll see. This is normal pooled serum. but it works the way for plasma,
blood, whatever you wanna actually use. This is what a cancer patient
looks like. You can actually see this bright green rings
that actually show up are cell free DNA that’s in your blood stream. Here is what it looks like if you do it all over a whole bunch
of different cancers. On the top left, you can actually see
a normal sample. And then, on the others, you can see
breast cancer, colorectal cancer, pancreatic cancers as well as
prostate cancer. In each every one of these,
you will see a whole bunch of this DNA showing up that doesn’t actually exist
in the normal samples. So, by isolating this DNA, you can actually
now start identifying early stage whether or not somebody has something as well as use it with secondary markers
to go forward. So, early detection
through a blood-based biomarker is this hidden key
to actually curing cancer. So, if you combine this
with the new technologies that are coming out,
which is a targeted therapy, sequencing that’s getting
faster and cheaper every day, you will actually be able to identify
whether or not a person has cancer, where that cancer is located,
and how to go forward. Within the next 15 years, I hope and I believe
there would be a plausible path forward towards an actual cure for cancer,
for every kind of cancer. I just wanna say, when that day comes… (Laughter) and, you know
who you are out there… (Laughter) … I expect a phone call. Thank you. (Applause)

12 thoughts on “Diagnosing Cancer in 15 Minutes or Less -Cause/Action: Raj Krishnan at TEDxSanDiego 2012”

  1. I am crossing my fingers that this is a tech that will not only be effective but so inexpensive that EVERY person can get this test once a year.

  2. You took my ideAl ,the ideal was to find it in baby's of the cr13 hereditary cancer to remove it in the fetus. Out of the strain of d&a there is only 12 strain in a healthy baby but a baby with 13 strains it cancer there fore it you can find it before birth take it out baby's born heathy that is the base of the ideal

  3. Wait a minute. Cancer cells do not enter the lymph nodes and blood vessels until stage 2 and 3. So there's no trace in the blood in stage 0 and 1. So how does this work exactly?

  4. Great presentation, but it's an a**hole move to pull the girl into it. She said no–you should leave her alone rather than use her as a punchline to get some laughs.

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