[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.88,0:00:02.74,Default,,0000,0000,0000,,"We're declaring war against cancer,
Dialogue: 0,0:00:02.76,0:00:05.36,Default,,0000,0000,0000,,and we will win this war by 2015."
Dialogue: 0,0:00:06.44,0:00:10.18,Default,,0000,0000,0000,,This is what the US Congress\Nand the National Cancer Institute declared
Dialogue: 0,0:00:10.20,0:00:12.76,Default,,0000,0000,0000,,just a few years ago, in 2003.
Dialogue: 0,0:00:13.56,0:00:16.66,Default,,0000,0000,0000,,Now, I don't know about you,\Nbut I don't buy that.
Dialogue: 0,0:00:16.68,0:00:18.74,Default,,0000,0000,0000,,I don't think we quite won this war yet,
Dialogue: 0,0:00:18.76,0:00:21.40,Default,,0000,0000,0000,,and I don't think\Nanyone here will question that.
Dialogue: 0,0:00:21.80,0:00:24.30,Default,,0000,0000,0000,,Now, I will argue that a primary reason
Dialogue: 0,0:00:24.32,0:00:26.46,Default,,0000,0000,0000,,why we're not winning\Nthis war against cancer
Dialogue: 0,0:00:26.48,0:00:28.78,Default,,0000,0000,0000,,is because we're fighting blindly.
Dialogue: 0,0:00:28.80,0:00:32.38,Default,,0000,0000,0000,,I'm going to start by sharing with you\Na story about a good friend of mine.
Dialogue: 0,0:00:32.40,0:00:33.62,Default,,0000,0000,0000,,His name is Ehud,
Dialogue: 0,0:00:33.64,0:00:36.78,Default,,0000,0000,0000,,and a few years ago,\NEhud was diagnosed with brain cancer.
Dialogue: 0,0:00:36.80,0:00:38.66,Default,,0000,0000,0000,,And not just any type of brain cancer:
Dialogue: 0,0:00:38.68,0:00:41.86,Default,,0000,0000,0000,,he was diagnosed with one\Nof the most deadly forms of brain cancer.
Dialogue: 0,0:00:41.88,0:00:43.10,Default,,0000,0000,0000,,In fact, it was so deadly
Dialogue: 0,0:00:43.12,0:00:45.78,Default,,0000,0000,0000,,that the doctors told him\Nthat they only have 12 months,
Dialogue: 0,0:00:45.80,0:00:49.22,Default,,0000,0000,0000,,and during those 12 months,\Nthey have to find a treatment.
Dialogue: 0,0:00:49.24,0:00:50.70,Default,,0000,0000,0000,,They have to find a cure,
Dialogue: 0,0:00:50.72,0:00:52.88,Default,,0000,0000,0000,,and if they cannot\Nfind a cure, he will die.
Dialogue: 0,0:00:53.80,0:00:55.26,Default,,0000,0000,0000,,Now, the good news, they said,
Dialogue: 0,0:00:55.28,0:00:58.22,Default,,0000,0000,0000,,is that there are tons\Nof different treatments to choose from,
Dialogue: 0,0:00:58.24,0:00:59.46,Default,,0000,0000,0000,,but the bad news is
Dialogue: 0,0:00:59.48,0:01:03.02,Default,,0000,0000,0000,,that in order for them to tell\Nif a treatment is even working or not,
Dialogue: 0,0:01:03.04,0:01:05.54,Default,,0000,0000,0000,,well, that takes them\Nabout three months or so.
Dialogue: 0,0:01:05.56,0:01:07.94,Default,,0000,0000,0000,,So they cannot try that many things.
Dialogue: 0,0:01:07.96,0:01:11.06,Default,,0000,0000,0000,,Well, Ehud is now going\Ninto his first treatment,
Dialogue: 0,0:01:11.08,0:01:14.34,Default,,0000,0000,0000,,and during that first treatment,\Njust a few days into that treatment,
Dialogue: 0,0:01:14.36,0:01:17.70,Default,,0000,0000,0000,,I'm meeting with him, and he tells me,\N"Adam, I think this is working.
Dialogue: 0,0:01:17.72,0:01:20.54,Default,,0000,0000,0000,,I think we really lucked out here.\NSomething is happening."
Dialogue: 0,0:01:20.56,0:01:23.02,Default,,0000,0000,0000,,And I ask him, "Really?\NHow do you know that, Ehud?"
Dialogue: 0,0:01:23.04,0:01:25.26,Default,,0000,0000,0000,,And he says, "Well,\NI feel so terrible inside.
Dialogue: 0,0:01:25.28,0:01:27.14,Default,,0000,0000,0000,,Something's gotta be working up there.
Dialogue: 0,0:01:27.16,0:01:28.38,Default,,0000,0000,0000,,It just has to."
Dialogue: 0,0:01:28.40,0:01:32.84,Default,,0000,0000,0000,,Well, unfortunately, three months later,\Nwe got the news, it didn't work.
Dialogue: 0,0:01:33.52,0:01:35.58,Default,,0000,0000,0000,,And so Ehud goes\Ninto his second treatment.
Dialogue: 0,0:01:35.60,0:01:36.86,Default,,0000,0000,0000,,And again, the same story.
Dialogue: 0,0:01:36.88,0:01:39.62,Default,,0000,0000,0000,,"It feels so bad, something's\Ngotta be working there."
Dialogue: 0,0:01:39.64,0:01:42.58,Default,,0000,0000,0000,,And then three months later,\Nagain we get bad news.
Dialogue: 0,0:01:42.60,0:01:46.54,Default,,0000,0000,0000,,Ehud is going into his third treatment,\Nand then his fourth treatment.
Dialogue: 0,0:01:46.56,0:01:49.08,Default,,0000,0000,0000,,And then, as predicted, Ehud dies.
Dialogue: 0,0:01:49.80,0:01:54.38,Default,,0000,0000,0000,,Now, when someone really close to you\Nis going through such a huge struggle,
Dialogue: 0,0:01:54.40,0:01:56.22,Default,,0000,0000,0000,,you get really swamped with emotions.
Dialogue: 0,0:01:56.24,0:01:58.34,Default,,0000,0000,0000,,A lot of things\Nare going through your head.
Dialogue: 0,0:01:58.36,0:01:59.82,Default,,0000,0000,0000,,For me, it was mostly outrage.
Dialogue: 0,0:01:59.84,0:02:04.54,Default,,0000,0000,0000,,I was just outraged that, how come\Nthis is the best that we can offer?
Dialogue: 0,0:02:04.56,0:02:06.86,Default,,0000,0000,0000,,And I started looking\Nmore and more into this.
Dialogue: 0,0:02:06.88,0:02:10.34,Default,,0000,0000,0000,,As it turns out, this is not just\Nthe best that doctors could offer Ehud.
Dialogue: 0,0:02:10.36,0:02:14.18,Default,,0000,0000,0000,,It's not just the best doctors could offer\Npatients with brain cancer generally.
Dialogue: 0,0:02:14.20,0:02:17.40,Default,,0000,0000,0000,,We're actually not doing that well\Nall across the board with cancer.
Dialogue: 0,0:02:18.24,0:02:20.10,Default,,0000,0000,0000,,I picked up one of those statistics,
Dialogue: 0,0:02:20.12,0:02:22.90,Default,,0000,0000,0000,,and I'm sure some of you\Nhave seen those statistics before.
Dialogue: 0,0:02:22.92,0:02:26.38,Default,,0000,0000,0000,,This is going to show you here\Nhow many patients actually died of cancer,
Dialogue: 0,0:02:26.40,0:02:28.42,Default,,0000,0000,0000,,in this case females in the United States,
Dialogue: 0,0:02:28.44,0:02:29.74,Default,,0000,0000,0000,,ever since the 1930s.
Dialogue: 0,0:02:29.76,0:02:32.94,Default,,0000,0000,0000,,You'll notice that there aren't\Nthat many things that have changed.
Dialogue: 0,0:02:32.96,0:02:34.26,Default,,0000,0000,0000,,It's still a huge issue.
Dialogue: 0,0:02:34.28,0:02:36.02,Default,,0000,0000,0000,,You'll see a few changes, though.
Dialogue: 0,0:02:36.04,0:02:38.58,Default,,0000,0000,0000,,You'll see lung cancer,\Nfor example, on the rise.
Dialogue: 0,0:02:38.60,0:02:39.80,Default,,0000,0000,0000,,Thank you, cigarettes.
Dialogue: 0,0:02:40.36,0:02:42.86,Default,,0000,0000,0000,,And you'll also see that,\Nfor example, stomach cancer
Dialogue: 0,0:02:42.88,0:02:46.22,Default,,0000,0000,0000,,once used to be one\Nof the biggest killers of all cancers,
Dialogue: 0,0:02:46.24,0:02:47.68,Default,,0000,0000,0000,,is essentially eliminated.
Dialogue: 0,0:02:48.48,0:02:50.54,Default,,0000,0000,0000,,Now, why is that?\NAnyone knows, by the way?
Dialogue: 0,0:02:50.56,0:02:53.90,Default,,0000,0000,0000,,Why is it that humanity is no longer\Nstruck by stomach cancer?
Dialogue: 0,0:02:53.92,0:02:58.78,Default,,0000,0000,0000,,What was the huge, huge\Nmedical technology breakthrough
Dialogue: 0,0:02:58.80,0:03:02.16,Default,,0000,0000,0000,,that came to our world\Nthat saved humanity from stomach cancer?
Dialogue: 0,0:03:03.24,0:03:07.06,Default,,0000,0000,0000,,Was it maybe a new drug,\Nor a better diagnostic?
Dialogue: 0,0:03:07.08,0:03:08.38,Default,,0000,0000,0000,,You guys are right, yeah.
Dialogue: 0,0:03:08.40,0:03:11.02,Default,,0000,0000,0000,,It's the invention of the refrigerator,
Dialogue: 0,0:03:11.04,0:03:13.66,Default,,0000,0000,0000,,and the fact that we're\Nno longer eating spoiled meats.
Dialogue: 0,0:03:13.68,0:03:15.98,Default,,0000,0000,0000,,So the best thing\Nthat happened to us so far
Dialogue: 0,0:03:16.00,0:03:17.94,Default,,0000,0000,0000,,in the medical arena in cancer research
Dialogue: 0,0:03:17.96,0:03:20.15,Default,,0000,0000,0000,,is the fact that\Nthe refrigerator was invented.
Dialogue: 0,0:03:20.18,0:03:21.38,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:03:21.40,0:03:22.66,Default,,0000,0000,0000,,And so -- yeah, I know.
Dialogue: 0,0:03:22.68,0:03:24.10,Default,,0000,0000,0000,,We're not doing so well here.
Dialogue: 0,0:03:24.12,0:03:26.46,Default,,0000,0000,0000,,I don't want to miniaturize the progress
Dialogue: 0,0:03:26.48,0:03:29.86,Default,,0000,0000,0000,,and everything that's been done\Nin cancer research.
Dialogue: 0,0:03:29.88,0:03:33.30,Default,,0000,0000,0000,,Look, there is like 50-plus years\Nof good cancer research
Dialogue: 0,0:03:33.32,0:03:36.74,Default,,0000,0000,0000,,that discovered major, major things\Nthat taught us about cancer.
Dialogue: 0,0:03:36.76,0:03:38.50,Default,,0000,0000,0000,,But all that said,
Dialogue: 0,0:03:38.52,0:03:41.09,Default,,0000,0000,0000,,we have a lot of heavy lifting\Nto still do ahead of us.
Dialogue: 0,0:03:42.92,0:03:46.02,Default,,0000,0000,0000,,Again, I will argue that the primary\Nreason why this is the case,
Dialogue: 0,0:03:46.04,0:03:48.04,Default,,0000,0000,0000,,why we have not done that remarkably well,
Dialogue: 0,0:03:48.06,0:03:49.90,Default,,0000,0000,0000,,is really we're fighting blindly here.
Dialogue: 0,0:03:49.92,0:03:52.14,Default,,0000,0000,0000,,And this is where\Nmedical imaging comes in.
Dialogue: 0,0:03:52.16,0:03:53.84,Default,,0000,0000,0000,,This is where my own work comes in.
Dialogue: 0,0:03:54.40,0:03:57.14,Default,,0000,0000,0000,,And so to give you a sense\Nof the best medical imaging
Dialogue: 0,0:03:57.16,0:03:59.66,Default,,0000,0000,0000,,that's offered today\Nto brain cancer patients,
Dialogue: 0,0:03:59.68,0:04:01.86,Default,,0000,0000,0000,,or actually generally\Nto all cancer patients,
Dialogue: 0,0:04:01.88,0:04:03.82,Default,,0000,0000,0000,,take a look at this PET scan right here.
Dialogue: 0,0:04:03.84,0:04:05.08,Default,,0000,0000,0000,,Let's see. There we go.
Dialogue: 0,0:04:05.64,0:04:07.34,Default,,0000,0000,0000,,So this is a PET/CT scan,
Dialogue: 0,0:04:07.36,0:04:09.82,Default,,0000,0000,0000,,and what you'll see in this PET/CT scan
Dialogue: 0,0:04:09.84,0:04:13.06,Default,,0000,0000,0000,,is the CT scan will show you\Nwhere the bones are,
Dialogue: 0,0:04:13.08,0:04:15.48,Default,,0000,0000,0000,,and the PET scan will show you\Nwhere tumors are.
Dialogue: 0,0:04:15.96,0:04:18.18,Default,,0000,0000,0000,,Now, what you can see here
Dialogue: 0,0:04:18.20,0:04:20.62,Default,,0000,0000,0000,,is essentially a sugar molecule
Dialogue: 0,0:04:20.64,0:04:22.46,Default,,0000,0000,0000,,that was added a small little tag
Dialogue: 0,0:04:22.48,0:04:24.58,Default,,0000,0000,0000,,that is signaling to us\Noutside of the body,
Dialogue: 0,0:04:24.60,0:04:25.90,Default,,0000,0000,0000,,"Hey, I'm here."
Dialogue: 0,0:04:25.92,0:04:29.74,Default,,0000,0000,0000,,And those sugar molecules are injected\Ninto these patients by the billions,
Dialogue: 0,0:04:29.76,0:04:31.46,Default,,0000,0000,0000,,and they're going all over the body
Dialogue: 0,0:04:31.48,0:04:33.56,Default,,0000,0000,0000,,looking for cells\Nthat are hungry for sugar.
Dialogue: 0,0:04:34.32,0:04:36.98,Default,,0000,0000,0000,,You'll see that the heart,\Nfor example, lights up there.
Dialogue: 0,0:04:37.00,0:04:39.22,Default,,0000,0000,0000,,That's because the heart\Nneeds a lot of sugar.
Dialogue: 0,0:04:39.24,0:04:41.58,Default,,0000,0000,0000,,You'll also see that the bladder\Nlights up there.
Dialogue: 0,0:04:41.60,0:04:44.22,Default,,0000,0000,0000,,That's because the bladder\Nis the thing that's clearing
Dialogue: 0,0:04:44.24,0:04:45.64,Default,,0000,0000,0000,,the sugar away from our body.
Dialogue: 0,0:04:46.10,0:04:48.10,Default,,0000,0000,0000,,And then you'll see a few other hot spots,
Dialogue: 0,0:04:48.12,0:04:49.74,Default,,0000,0000,0000,,and these are in fact the tumors.
Dialogue: 0,0:04:49.76,0:04:51.90,Default,,0000,0000,0000,,Now, this is a really\Na wonderful technology.
Dialogue: 0,0:04:51.92,0:04:55.06,Default,,0000,0000,0000,,For the first time it allowed us\Nto look into someone's body
Dialogue: 0,0:04:55.08,0:04:57.46,Default,,0000,0000,0000,,without picking up\Neach and every one of the cells
Dialogue: 0,0:04:57.48,0:04:59.34,Default,,0000,0000,0000,,and putting them under the microscope,
Dialogue: 0,0:04:59.36,0:05:02.38,Default,,0000,0000,0000,,but in a noninvasive way\Nallowing us to look into someone's body
Dialogue: 0,0:05:02.40,0:05:04.54,Default,,0000,0000,0000,,and ask, "Hey,\Nhas the cancer metastasized?
Dialogue: 0,0:05:04.56,0:05:05.78,Default,,0000,0000,0000,,Where is it?"
Dialogue: 0,0:05:05.80,0:05:08.30,Default,,0000,0000,0000,,And the PET scans here\Nare showing you very clearly
Dialogue: 0,0:05:08.32,0:05:10.60,Default,,0000,0000,0000,,where are these hot spots,\Nwhere is the tumor.
Dialogue: 0,0:05:11.48,0:05:14.78,Default,,0000,0000,0000,,So as miraculous as this might seem,
Dialogue: 0,0:05:14.80,0:05:17.68,Default,,0000,0000,0000,,unfortunately, well, it's not that great.
Dialogue: 0,0:05:18.32,0:05:20.40,Default,,0000,0000,0000,,You see, those\Nsmall little hot spots there.
Dialogue: 0,0:05:21.24,0:05:24.76,Default,,0000,0000,0000,,Can anyone guess how many cancer cells\Nare in any one of these tumors?
Dialogue: 0,0:05:26.60,0:05:28.94,Default,,0000,0000,0000,,So it's about 100 million cancer cells,
Dialogue: 0,0:05:28.96,0:05:31.66,Default,,0000,0000,0000,,and let me make sure\Nthat this number sunk in.
Dialogue: 0,0:05:31.68,0:05:34.02,Default,,0000,0000,0000,,In each and every one\Nof these small little blips
Dialogue: 0,0:05:34.04,0:05:35.62,Default,,0000,0000,0000,,that you're seeing on the image,
Dialogue: 0,0:05:35.64,0:05:39.74,Default,,0000,0000,0000,,there needs to be\Nat least 100 million cancer cells
Dialogue: 0,0:05:39.76,0:05:41.30,Default,,0000,0000,0000,,in order for it to be detected.
Dialogue: 0,0:05:41.32,0:05:43.78,Default,,0000,0000,0000,,Now, if that seemed to you\Nlike a very large number,
Dialogue: 0,0:05:43.80,0:05:45.48,Default,,0000,0000,0000,,it is a very large number.
Dialogue: 0,0:05:46.64,0:05:48.70,Default,,0000,0000,0000,,This is in fact\Nan incredibly large number,
Dialogue: 0,0:05:48.72,0:05:52.06,Default,,0000,0000,0000,,because what we really need\Nin order to pick up something early enough
Dialogue: 0,0:05:52.08,0:05:55.02,Default,,0000,0000,0000,,to do something about it,\Nto do something meaningful about it,
Dialogue: 0,0:05:55.04,0:05:58.18,Default,,0000,0000,0000,,well, we need to pick up tumors\Nthat are a thousand cells in size,
Dialogue: 0,0:05:58.20,0:06:00.34,Default,,0000,0000,0000,,and ideally just\Na handful of cells in size.
Dialogue: 0,0:06:00.36,0:06:02.38,Default,,0000,0000,0000,,So we're clearly\Npretty far away from this.
Dialogue: 0,0:06:02.40,0:06:04.66,Default,,0000,0000,0000,,So we're going to play\Na little experiment here.
Dialogue: 0,0:06:04.68,0:06:07.14,Default,,0000,0000,0000,,I'm going to ask each of you\Nto now play and imagine
Dialogue: 0,0:06:07.16,0:06:08.52,Default,,0000,0000,0000,,that you are brain surgeons.
Dialogue: 0,0:06:09.00,0:06:13.02,Default,,0000,0000,0000,,And you guys are now at an operating room,
Dialogue: 0,0:06:13.04,0:06:15.06,Default,,0000,0000,0000,,and there's a patient in front of you,
Dialogue: 0,0:06:15.08,0:06:18.80,Default,,0000,0000,0000,,and your task is to make sure\Nthat the tumor is out.
Dialogue: 0,0:06:19.40,0:06:22.78,Default,,0000,0000,0000,,So you're looking down at the patient,
Dialogue: 0,0:06:22.80,0:06:25.14,Default,,0000,0000,0000,,the skin and the skull\Nhave already been removed,
Dialogue: 0,0:06:25.16,0:06:26.70,Default,,0000,0000,0000,,so you're looking at the brain.
Dialogue: 0,0:06:26.72,0:06:28.42,Default,,0000,0000,0000,,And all you know about this patient
Dialogue: 0,0:06:28.44,0:06:31.26,Default,,0000,0000,0000,,is that there's a tumor\Nabout the size of a golf ball or so
Dialogue: 0,0:06:31.28,0:06:33.60,Default,,0000,0000,0000,,in the right frontal lobe\Nof this person's brain.
Dialogue: 0,0:06:34.08,0:06:35.42,Default,,0000,0000,0000,,And that's more or less it.
Dialogue: 0,0:06:35.44,0:06:38.66,Default,,0000,0000,0000,,So you're looking down, and unfortunately\Neverything looks the same,
Dialogue: 0,0:06:38.68,0:06:41.78,Default,,0000,0000,0000,,because brain cancer tissue\Nand healthy brain tissue
Dialogue: 0,0:06:41.80,0:06:43.38,Default,,0000,0000,0000,,really just look the same.
Dialogue: 0,0:06:43.40,0:06:45.30,Default,,0000,0000,0000,,And so you're going in with your thumb,
Dialogue: 0,0:06:45.32,0:06:47.66,Default,,0000,0000,0000,,and you start to press\Na little bit on the brain,
Dialogue: 0,0:06:47.68,0:06:50.10,Default,,0000,0000,0000,,because tumors tend to be\Na little harder, stiffer,
Dialogue: 0,0:06:50.12,0:06:52.74,Default,,0000,0000,0000,,and so you go in and go\Na little bit like this and say,
Dialogue: 0,0:06:52.76,0:06:54.74,Default,,0000,0000,0000,,"It seems like the tumor is right there."
Dialogue: 0,0:06:54.76,0:06:57.42,Default,,0000,0000,0000,,Then you take out your knife\Nand start cutting the tumor
Dialogue: 0,0:06:57.44,0:06:58.70,Default,,0000,0000,0000,,piece by piece by piece.
Dialogue: 0,0:06:58.72,0:07:00.42,Default,,0000,0000,0000,,And as you're taking the tumor out,
Dialogue: 0,0:07:00.44,0:07:02.66,Default,,0000,0000,0000,,then you're getting\Nto a stage where you think,
Dialogue: 0,0:07:02.68,0:07:04.82,Default,,0000,0000,0000,,"Alright, I'm done.\NI took out everything."
Dialogue: 0,0:07:04.84,0:07:06.38,Default,,0000,0000,0000,,And at this stage, if that's --
Dialogue: 0,0:07:06.40,0:07:09.10,Default,,0000,0000,0000,,so far everything sounded,\Nlike, pretty crazy --
Dialogue: 0,0:07:09.12,0:07:12.82,Default,,0000,0000,0000,,you're now about to face the most\Nchallenging decision of your life here.
Dialogue: 0,0:07:12.84,0:07:14.38,Default,,0000,0000,0000,,Because now you need to decide,
Dialogue: 0,0:07:14.40,0:07:17.10,Default,,0000,0000,0000,,should I stop here\Nand let this patient go,
Dialogue: 0,0:07:17.12,0:07:20.06,Default,,0000,0000,0000,,risking that there might be\Nsome leftover cancer cells behind
Dialogue: 0,0:07:20.08,0:07:21.94,Default,,0000,0000,0000,,that I just couldn't see,
Dialogue: 0,0:07:21.96,0:07:24.62,Default,,0000,0000,0000,,or should I take away some extra margins,
Dialogue: 0,0:07:24.64,0:07:27.50,Default,,0000,0000,0000,,typically about an inch or so\Naround the tumor
Dialogue: 0,0:07:27.52,0:07:29.72,Default,,0000,0000,0000,,just to be sure that I removed everything?
Dialogue: 0,0:07:31.40,0:07:35.24,Default,,0000,0000,0000,,So this is not a simple decision to make,
Dialogue: 0,0:07:35.84,0:07:37.78,Default,,0000,0000,0000,,and unfortunately this is the decision
Dialogue: 0,0:07:37.80,0:07:41.14,Default,,0000,0000,0000,,that brain cancer surgeons\Nhave to take every single day
Dialogue: 0,0:07:41.16,0:07:42.76,Default,,0000,0000,0000,,as they're seeing their patients.
Dialogue: 0,0:07:43.32,0:07:46.26,Default,,0000,0000,0000,,And so I remember talking\Nto a few friends of mine in the lab,
Dialogue: 0,0:07:46.28,0:07:48.66,Default,,0000,0000,0000,,and we say, "Boy,\Nthere's got to be a better way."
Dialogue: 0,0:07:48.68,0:07:52.10,Default,,0000,0000,0000,,But not just like you tell a friend\Nthat there's got to be a better way.
Dialogue: 0,0:07:52.12,0:07:54.07,Default,,0000,0000,0000,,There's just got to be a better way here.
Dialogue: 0,0:07:54.10,0:07:55.62,Default,,0000,0000,0000,,This is just incredible.
Dialogue: 0,0:07:55.64,0:07:57.30,Default,,0000,0000,0000,,And so we looked back.
Dialogue: 0,0:07:57.32,0:08:00.30,Default,,0000,0000,0000,,Remember those PET scans I told you about,\Nthe sugar and so on.
Dialogue: 0,0:08:00.32,0:08:03.06,Default,,0000,0000,0000,,We said, hey, how about\Ninstead of using sugar molecules,
Dialogue: 0,0:08:03.08,0:08:06.22,Default,,0000,0000,0000,,let's maybe take tiny, tiny\Nlittle particles made of gold,
Dialogue: 0,0:08:06.24,0:08:09.90,Default,,0000,0000,0000,,and let's program them with some\Ninteresting chemistry around them.
Dialogue: 0,0:08:09.92,0:08:12.34,Default,,0000,0000,0000,,Let's program them\Nto look for cancer cells.
Dialogue: 0,0:08:12.36,0:08:14.46,Default,,0000,0000,0000,,And then we will inject\Nthese gold particles
Dialogue: 0,0:08:14.48,0:08:16.74,Default,,0000,0000,0000,,into these patients by the billions again,
Dialogue: 0,0:08:16.76,0:08:18.74,Default,,0000,0000,0000,,and we'll have them go all over the body,
Dialogue: 0,0:08:18.76,0:08:20.74,Default,,0000,0000,0000,,and just like secret agents, if you will,
Dialogue: 0,0:08:20.76,0:08:23.58,Default,,0000,0000,0000,,go and walk by\Nevery single cell in our body
Dialogue: 0,0:08:23.60,0:08:25.30,Default,,0000,0000,0000,,and knock on the door of that cell,
Dialogue: 0,0:08:25.32,0:08:28.06,Default,,0000,0000,0000,,and ask, "Are you a cancer cell\Nor are you a healthy cell?
Dialogue: 0,0:08:28.08,0:08:30.10,Default,,0000,0000,0000,,If you're a healthy cell, we're moving on.
Dialogue: 0,0:08:30.12,0:08:32.86,Default,,0000,0000,0000,,If you're a cancer cell,\Nwe're sticking in and shining out
Dialogue: 0,0:08:32.88,0:08:34.98,Default,,0000,0000,0000,,and telling us,\N"Hey, look at me, I'm here."
Dialogue: 0,0:08:35.00,0:08:37.38,Default,,0000,0000,0000,,And they'll do it\Nthrough some interesting cameras
Dialogue: 0,0:08:37.40,0:08:38.82,Default,,0000,0000,0000,,that we developed in the lab.
Dialogue: 0,0:08:38.84,0:08:41.78,Default,,0000,0000,0000,,And once we see that,\Nmaybe we can guide brain cancer surgeons
Dialogue: 0,0:08:41.80,0:08:45.20,Default,,0000,0000,0000,,towards taking only the tumor\Nand leaving the healthy brain alone.
Dialogue: 0,0:08:45.72,0:08:48.78,Default,,0000,0000,0000,,And so we've tested that,\Nand boy, this works well.
Dialogue: 0,0:08:48.80,0:08:50.78,Default,,0000,0000,0000,,So I'm going to show you an example now.
Dialogue: 0,0:08:50.80,0:08:52.58,Default,,0000,0000,0000,,What you're looking at here
Dialogue: 0,0:08:52.60,0:08:56.54,Default,,0000,0000,0000,,is an image of a mouse's brain,
Dialogue: 0,0:08:56.56,0:08:59.70,Default,,0000,0000,0000,,and we've implanted\Ninto this mouse's brain
Dialogue: 0,0:08:59.72,0:09:00.98,Default,,0000,0000,0000,,a small little tumor.
Dialogue: 0,0:09:01.00,0:09:03.62,Default,,0000,0000,0000,,And so this tumor is now\Ngrowing in this mouse's brain,
Dialogue: 0,0:09:03.64,0:09:06.30,Default,,0000,0000,0000,,and then we've taken a doctor\Nand asked the doctor
Dialogue: 0,0:09:06.32,0:09:09.14,Default,,0000,0000,0000,,to please operate on the mouse\Nas if that was a patient,
Dialogue: 0,0:09:09.16,0:09:11.58,Default,,0000,0000,0000,,and take out piece by piece\Nout of the tumor.
Dialogue: 0,0:09:11.60,0:09:13.38,Default,,0000,0000,0000,,And while he's doing that,
Dialogue: 0,0:09:13.40,0:09:16.38,Default,,0000,0000,0000,,we're going to take images\Nto see where the gold particles are.
Dialogue: 0,0:09:16.40,0:09:18.02,Default,,0000,0000,0000,,And so we're going to first start
Dialogue: 0,0:09:18.04,0:09:20.46,Default,,0000,0000,0000,,by injecting these gold particles\Ninto this mouse,
Dialogue: 0,0:09:20.48,0:09:23.38,Default,,0000,0000,0000,,and we're going to see\Nright here at the very left there
Dialogue: 0,0:09:23.40,0:09:24.66,Default,,0000,0000,0000,,that image at the bottom
Dialogue: 0,0:09:24.68,0:09:27.18,Default,,0000,0000,0000,,is the image that shows\Nwhere the gold particles are.
Dialogue: 0,0:09:27.20,0:09:29.26,Default,,0000,0000,0000,,The nice thing\Nis that these gold particles
Dialogue: 0,0:09:29.28,0:09:31.30,Default,,0000,0000,0000,,actually made it all the way to the tumor,
Dialogue: 0,0:09:31.32,0:09:34.98,Default,,0000,0000,0000,,and then they shine out and tell us,\N"Hey, we're here. Here's the tumor."
Dialogue: 0,0:09:35.00,0:09:36.38,Default,,0000,0000,0000,,So now we can see the tumor,
Dialogue: 0,0:09:36.40,0:09:38.54,Default,,0000,0000,0000,,but we're not showing this\Nto the doctor yet.
Dialogue: 0,0:09:38.56,0:09:41.62,Default,,0000,0000,0000,,We're asking the doctor,\Nnow please start cutting away the tumor,
Dialogue: 0,0:09:41.64,0:09:45.06,Default,,0000,0000,0000,,and you'll see here the doctor\Njust took the first quadrant of the tumor
Dialogue: 0,0:09:45.08,0:09:47.30,Default,,0000,0000,0000,,and you see that first quadrant\Nis now missing.
Dialogue: 0,0:09:47.32,0:09:49.78,Default,,0000,0000,0000,,The doctor then took\Nthe second quadrant, the third,
Dialogue: 0,0:09:49.80,0:09:51.54,Default,,0000,0000,0000,,and now it appears to be everything.
Dialogue: 0,0:09:51.56,0:09:54.30,Default,,0000,0000,0000,,And so at this stage,\Nthe doctor came back to us and said,
Dialogue: 0,0:09:54.32,0:09:56.58,Default,,0000,0000,0000,,"Alright, I'm done.\NWhat do you want me to do?
Dialogue: 0,0:09:56.60,0:09:58.18,Default,,0000,0000,0000,,Should I keep things as they are
Dialogue: 0,0:09:58.20,0:10:00.70,Default,,0000,0000,0000,,or do you want me to take\Nsome extra margins around?"
Dialogue: 0,0:10:00.72,0:10:02.38,Default,,0000,0000,0000,,And then we said, "Well, hang on."
Dialogue: 0,0:10:02.40,0:10:04.82,Default,,0000,0000,0000,,We told the doctor,\N"You've missed those two spots,
Dialogue: 0,0:10:04.84,0:10:06.84,Default,,0000,0000,0000,,so rather than taking huge margins around,
Dialogue: 0,0:10:06.86,0:10:08.70,Default,,0000,0000,0000,,only take out those tiny little areas.
Dialogue: 0,0:10:08.72,0:10:10.74,Default,,0000,0000,0000,,Take them out,\Nand then let's take a look."
Dialogue: 0,0:10:10.76,0:10:13.62,Default,,0000,0000,0000,,And so the doctor took them away,\Nand lo and behold,
Dialogue: 0,0:10:13.64,0:10:15.66,Default,,0000,0000,0000,,the cancer is now completely gone.
Dialogue: 0,0:10:15.68,0:10:17.06,Default,,0000,0000,0000,,Now, the important thing
Dialogue: 0,0:10:17.08,0:10:19.70,Default,,0000,0000,0000,,is that it's not just\Nthat the cancer is completely gone
Dialogue: 0,0:10:19.72,0:10:21.06,Default,,0000,0000,0000,,from this person's brain,
Dialogue: 0,0:10:21.08,0:10:22.40,Default,,0000,0000,0000,,or from this mouse's brain.
Dialogue: 0,0:10:23.16,0:10:24.42,Default,,0000,0000,0000,,The most important thing
Dialogue: 0,0:10:24.44,0:10:27.34,Default,,0000,0000,0000,,is that we did not have to take\Nhuge amounts of healthy brain
Dialogue: 0,0:10:27.36,0:10:28.58,Default,,0000,0000,0000,,in the process.
Dialogue: 0,0:10:28.60,0:10:30.78,Default,,0000,0000,0000,,And so now we can actually imagine a world
Dialogue: 0,0:10:30.80,0:10:34.70,Default,,0000,0000,0000,,where doctors and surgeons,\Nas they take away a tumor,
Dialogue: 0,0:10:34.72,0:10:36.14,Default,,0000,0000,0000,,they actually know what to take out,
Dialogue: 0,0:10:36.17,0:10:38.28,Default,,0000,0000,0000,,and they no longer\Nhave to guess with their thumb.
Dialogue: 0,0:10:39.52,0:10:43.46,Default,,0000,0000,0000,,Now, here's why it's extremely important\Nto take those tiny little leftover tumors.
Dialogue: 0,0:10:43.48,0:10:46.34,Default,,0000,0000,0000,,Those leftover tumors,\Neven if it's just a handful of cells,
Dialogue: 0,0:10:46.36,0:10:49.42,Default,,0000,0000,0000,,they will grow to recur the tumor,
Dialogue: 0,0:10:49.44,0:10:51.10,Default,,0000,0000,0000,,for the tumor to come back.
Dialogue: 0,0:10:51.12,0:10:53.06,Default,,0000,0000,0000,,In fact, the reason why 80 to 90 percent
Dialogue: 0,0:10:53.08,0:10:55.30,Default,,0000,0000,0000,,of those brain cancer surgeries\Nultimately fail
Dialogue: 0,0:10:55.32,0:10:59.10,Default,,0000,0000,0000,,is because of those small little\Nextra margins that were left positive,
Dialogue: 0,0:10:59.12,0:11:01.80,Default,,0000,0000,0000,,those small little leftover tumors\Nthat were left there.
Dialogue: 0,0:11:03.44,0:11:05.62,Default,,0000,0000,0000,,So this is clearly very nice,
Dialogue: 0,0:11:05.64,0:11:09.94,Default,,0000,0000,0000,,but what I really want to share with you\Nis where I think we're heading from here.
Dialogue: 0,0:11:09.96,0:11:11.62,Default,,0000,0000,0000,,And so in my lab at Stanford,
Dialogue: 0,0:11:11.64,0:11:17.16,Default,,0000,0000,0000,,my students and I are asking,\Nwhat should we be working on now?
Dialogue: 0,0:11:17.60,0:11:20.46,Default,,0000,0000,0000,,And I think where\Nmedical imaging is heading to
Dialogue: 0,0:11:20.48,0:11:22.82,Default,,0000,0000,0000,,is the ability to look into the human body
Dialogue: 0,0:11:22.84,0:11:26.28,Default,,0000,0000,0000,,and actually see each and every one\Nof these cells separately.
Dialogue: 0,0:11:27.00,0:11:28.74,Default,,0000,0000,0000,,The ability like this would allow us
Dialogue: 0,0:11:28.76,0:11:31.66,Default,,0000,0000,0000,,to actually pick up tumors\Nway, way earlier in the process,
Dialogue: 0,0:11:31.68,0:11:35.60,Default,,0000,0000,0000,,way before it's 100 million cells inside,\Nso we can actually do something about it.
Dialogue: 0,0:11:36.20,0:11:39.62,Default,,0000,0000,0000,,An ability to see each and every one\Nof the cells might also allow us
Dialogue: 0,0:11:39.64,0:11:41.02,Default,,0000,0000,0000,,to ask insightful questions.
Dialogue: 0,0:11:41.04,0:11:43.14,Default,,0000,0000,0000,,So in the lab,\Nwe are now getting to a point
Dialogue: 0,0:11:43.16,0:11:46.42,Default,,0000,0000,0000,,where we can actually start asking\Nthese cancer cells real questions,
Dialogue: 0,0:11:46.44,0:11:50.22,Default,,0000,0000,0000,,like, for example, are you responding\Nto the treatment we are giving you or not?
Dialogue: 0,0:11:50.24,0:11:53.70,Default,,0000,0000,0000,,So if you're not responding, we'll know\Nto stop the treatment right away,
Dialogue: 0,0:11:53.72,0:11:55.76,Default,,0000,0000,0000,,days into the treatment, not three months.
Dialogue: 0,0:11:56.48,0:11:58.66,Default,,0000,0000,0000,,And so also for patients like Ehud
Dialogue: 0,0:11:58.68,0:12:03.10,Default,,0000,0000,0000,,that are going through these\Nnasty, nasty chemotherapy drugs,
Dialogue: 0,0:12:03.12,0:12:04.38,Default,,0000,0000,0000,,for them not to suffer
Dialogue: 0,0:12:04.40,0:12:07.30,Default,,0000,0000,0000,,through those horrendous\Nside effects of the drugs
Dialogue: 0,0:12:07.32,0:12:09.98,Default,,0000,0000,0000,,when the drugs are\Nin fact not even helping them.
Dialogue: 0,0:12:10.00,0:12:12.94,Default,,0000,0000,0000,,So to be frank here,
Dialogue: 0,0:12:12.96,0:12:16.42,Default,,0000,0000,0000,,we're pretty far away\Nfrom winning the war against cancer,
Dialogue: 0,0:12:16.44,0:12:17.70,Default,,0000,0000,0000,,just to be realistic.
Dialogue: 0,0:12:17.72,0:12:19.62,Default,,0000,0000,0000,,But at least I am hopeful
Dialogue: 0,0:12:19.64,0:12:23.78,Default,,0000,0000,0000,,that we should be able to fight this war\Nwith better medical imaging techniques
Dialogue: 0,0:12:23.80,0:12:25.66,Default,,0000,0000,0000,,in the way that is not blind.
Dialogue: 0,0:12:25.68,0:12:26.90,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:12:26.92,0:12:29.16,Default,,0000,0000,0000,,(Applause)