Medicine's future? There's an app for that
-
0:01 - 0:02A couple of years ago,
-
0:02 - 0:05when I was attending
the TED conference in Long Beach, -
0:05 - 0:07I met Harriet.
-
0:07 - 0:10We'd actually met online before --
not the way you're thinking. -
0:10 - 0:12We were introduced
because we both knew Linda Avey, -
0:12 - 0:16one of the founders of the first
online personal genomic companies. -
0:16 - 0:18And because we shared
our genetic information with Linda, -
0:19 - 0:20she could see that Harriet and I shared
-
0:20 - 0:24a very rare type of mitochondrial DNA,
haplotype K1a1b1a, -
0:24 - 0:26which meant we were distantly related.
-
0:26 - 0:29We actually share the same
genealogy with Ötzi the Iceman. -
0:29 - 0:31So -- Ötzi, Harriet and me.
-
0:31 - 0:34And being the current day, of course,
we started our own Facebook group. -
0:34 - 0:35You're all welcome to join.
-
0:36 - 0:39When I met Harriet in person
the next year at the TED conference, -
0:39 - 0:42she'd gone online and ordered
our own happy haplotype T-shirts. -
0:42 - 0:43(Laughter)
-
0:43 - 0:44Why am I telling you this story?
-
0:44 - 0:47What does it have to do
with the future of health? -
0:47 - 0:49Well, the way I met Harriet is an example
-
0:49 - 0:52of how leveraging cross-disciplinary,
exponentially growing technologies -
0:52 - 0:55is affecting our future
of health and wellness -- -
0:55 - 0:56from low-cost gene analysis
-
0:56 - 0:58to the ability to do
powerful bioinformatics -
0:58 - 1:01to the connection of the Internet
and social networking. -
1:02 - 1:03What I'd like to talk about today
-
1:03 - 1:05is understanding
these exponential technologies. -
1:05 - 1:07We often think linearly.
-
1:07 - 1:10But if you think about it,
if you have a lily pad -
1:10 - 1:12and it just divided every single day --
-
1:12 - 1:15two, four, eight, sixteen --
in 15 days, you'd have 32,000. -
1:15 - 1:17What do you think you'd have in a month?
-
1:17 - 1:18We're at a billion.
-
1:18 - 1:20If we start to think exponentially,
-
1:20 - 1:24we can see how this is starting to affect
all the technologies around us. -
1:24 - 1:27Many of these technologies,
speaking as a physician and innovator, -
1:27 - 1:30we can start to leverage,
to impact the future of our own health -
1:30 - 1:31and of health care,
-
1:31 - 1:34and to address many of the major
challenges in health care today, -
1:34 - 1:37ranging from the exponential costs
to the aging population, -
1:37 - 1:40the way we really don't use
information very well today, -
1:40 - 1:42the fragmentation of care
-
1:42 - 1:45and the often very difficult course
of adoption of innovation. -
1:45 - 1:49And one of the major things we can do
is move the curve to the left. -
1:49 - 1:52We spend most of our money
on the last 20 percent of life. -
1:52 - 1:55What if we could incentivize physicians
in the health care system -
1:55 - 1:56and our own selves
-
1:56 - 1:59to move the curve to the left
and improve our health, -
1:59 - 2:00leveraging technology as well?
-
2:00 - 2:03Now my favorite example
of exponential technology, -
2:03 - 2:04we all have in our pocket.
-
2:04 - 2:07If you think about it,
these are really dramatically improving. -
2:07 - 2:09I mean, this is the iPhone 4.
-
2:09 - 2:12Imagine what the iPhone 8
will be able to do. -
2:12 - 2:14Now, I've gained some insight into this.
-
2:14 - 2:17I've been the track share
for the medicine portion -
2:17 - 2:19of a new institution
called Singularity University, -
2:19 - 2:21based in Silicon Valley.
-
2:21 - 2:24We bring together each summer
about 100 very talented students -
2:24 - 2:25from around the world.
-
2:25 - 2:28And we look at these exponential
technologies from medicine, -
2:28 - 2:31biotech, artificial intelligence,
robotics, nanotechnology, space, -
2:31 - 2:34and address how we can cross-train
and leverage these -
2:34 - 2:35to impact major unmet goals.
-
2:35 - 2:37We also have seven-day executive programs.
-
2:37 - 2:39And coming up next month is FutureMed,
-
2:39 - 2:43a program to help cross-train
and leverage technologies into medicine. -
2:43 - 2:44Now, I mentioned the phone.
-
2:44 - 2:48These mobile phones have over 20,000
different mobile apps available. -
2:48 - 2:51There's one out of the UK
where you can pee on a little chip, -
2:51 - 2:52connect it to your iPhone,
-
2:52 - 2:53and check for an STD.
-
2:53 - 2:56I don't know if I'd try that,
but it's available. -
2:56 - 2:58There are other sorts of applications.
-
2:58 - 3:00Merging your phone
and diagnostics, for example, -
3:00 - 3:02measuring your blood glucose
on your iPhone -
3:02 - 3:04and sending that to your physician,
-
3:04 - 3:07so they can better understand
and you can better understand -
3:07 - 3:08your blood sugars as a diabetic.
-
3:08 - 3:11So let's see how exponential
technologies are taking health care. -
3:11 - 3:12Let's start with faster.
-
3:12 - 3:15It's no secret that computers,
through Moore's law, -
3:15 - 3:17are speeding up faster and faster.
-
3:17 - 3:19We can do more powerful things with them.
-
3:19 - 3:21They're really approaching --
in many cases, surpassing -- -
3:21 - 3:23the ability of the human mind.
-
3:23 - 3:27But where I think computational speed
is most applicable is in imaging. -
3:27 - 3:29The ability now to look
inside the body in real time -
3:29 - 3:31with very high resolution
-
3:31 - 3:32is really becoming incredible.
-
3:32 - 3:35And we're layering multiple
technologies -- PET scans, CT scans -
3:35 - 3:38and molecular diagnostics --
-
3:38 - 3:40to find and seek things
at different levels. -
3:40 - 3:44Here you're going to see the very highest
resolution MRI scan done today, -
3:44 - 3:47of Marc Hodosh, the curator of TEDMED.
-
3:47 - 3:49And now we can see inside of the brain
-
3:49 - 3:51at a resolution and ability
never before available, -
3:51 - 3:56and essentially learn how to reconstruct
and maybe even reengineer -
3:56 - 3:57or backwards engineer the brain,
-
3:57 - 4:00so we can better understand
pathology, disease and therapy. -
4:00 - 4:04We can look inside with real-time
fMRI in the brain at real time. -
4:04 - 4:07And by understanding these sorts
of processes and these connections, -
4:07 - 4:10we're going to understand the effects
of medication or meditation -
4:10 - 4:13and better personalize
and make effective, for example, -
4:13 - 4:14psychoactive drugs.
-
4:14 - 4:17The scanners for these are getting
smaller, less expensive -
4:17 - 4:18and more portable.
-
4:18 - 4:21And this sort of data explosion
available from these -
4:21 - 4:23is really almost becoming a challenge.
-
4:23 - 4:26The scan of today takes up
about 800 books, or 20 gigabytes. -
4:26 - 4:29The scan in a couple of years
will be one terabyte, or 800,000 books. -
4:29 - 4:31How do you leverage that information?
-
4:31 - 4:32Let's get personal.
-
4:32 - 4:35I won't ask who here's had a colonoscopy,
but if you're over age 50, -
4:35 - 4:37it's time for your screening colonoscopy.
-
4:37 - 4:40How'd you like to avoid
the pointy end of the stick? -
4:40 - 4:42Now there's essentially
virtual colonoscopy. -
4:42 - 4:43Compare those two pictures.
-
4:43 - 4:46As a radiologist, you can basically
fly through your patient's colon, -
4:46 - 4:49and augmenting that
with artificial intelligence, -
4:49 - 4:51potentially identify a lesion
that we might have missed, -
4:51 - 4:53but using AI on top of radiology,
-
4:53 - 4:55we can find lesions
that were missed before. -
4:55 - 4:57Maybe this will encourage
people to get colonoscopies -
4:57 - 4:59that wouldn't have otherwise.
-
4:59 - 5:01This is an example of this paradigm shift.
-
5:01 - 5:04We're moving to this integration
of biomedicine, information technology, -
5:04 - 5:08wireless and, I would say, mobile now --
this era of digital medicine. -
5:08 - 5:11Even my stethoscope is now digital,
and of course, there's an app for that. -
5:11 - 5:14We're moving, obviously,
to the era of the tricorder. -
5:14 - 5:16So the handheld ultrasound
is basically surpassing -
5:16 - 5:18and supplanting the stethoscope.
-
5:18 - 5:21These are now at a price point
of what used to be 100,000 euros -
5:21 - 5:23or a couple hundred-thousand dollars.
-
5:23 - 5:24For about 5,000 dollars,
-
5:24 - 5:28I can have the power of a very powerful
diagnostic device in my hand. -
5:28 - 5:31Merging this now with the advent
of electronic medical records -- -
5:31 - 5:33in the US, we're still
less than 20 percent electronic; -
5:33 - 5:36here in the Netherlands,
I think it's more than 80 percent. -
5:36 - 5:39Now that we're switching
to merging medical data, -
5:39 - 5:40making it available electronically,
-
5:40 - 5:43we can crowd-source the information,
and as a physician, -
5:43 - 5:45I can access my patients' data
from wherever I am, -
5:45 - 5:47just through my mobile device.
-
5:47 - 5:50And now, of course, we're in the era
of the iPad, even the iPad 2. -
5:50 - 5:51Just last month,
-
5:51 - 5:53the first FDA-approved
application was approved -
5:53 - 5:57to allow radiologists to do actual
reading on these sorts of devices. -
5:57 - 5:59So certainly, the physicians
of today, including myself, -
5:59 - 6:01are completely reliable on these devices.
-
6:01 - 6:03And as you saw just about a month ago,
-
6:03 - 6:06Watson from IBM beat
the two champions in "Jeopardy." -
6:06 - 6:08So I want you to imagine
when, in a couple of years, -
6:08 - 6:11we've started to apply
this cloud-based information, -
6:11 - 6:14when we really have the AI physician
and leverage our brains to connectivity -
6:14 - 6:17to make decisions and diagnostics
at a level never done. -
6:17 - 6:21Already today, you don't need to go
to your physician in many cases. -
6:21 - 6:24Only in about 20 percent of visits
do you need to lay hands on the patient. -
6:24 - 6:26We're now in the era of virtual visits.
-
6:26 - 6:29From Skype-type visits
you can do with American Well, -
6:29 - 6:32to Cisco, that's developed a very complex
health presence system, -
6:32 - 6:35the ability to interact with
your health care provider is different. -
6:35 - 6:38And these are being augmented
even by our devices, again, today. -
6:38 - 6:41My friend Jessica sent me
a picture of her head laceration, -
6:41 - 6:43so I can save her a trip
to the emergency room, -
6:43 - 6:44and do diagnostics that way.
-
6:44 - 6:47Or maybe we can leverage
today's gaming technology, -
6:47 - 6:48like the Microsoft Kinect,
-
6:48 - 6:51hack that to enable diagnostics,
for example, in diagnosing stroke, -
6:51 - 6:54using simple motion detection,
using $100 devices. -
6:54 - 6:57We can actually now visit
our patients robotically. -
6:57 - 6:58This is the RP7;
-
6:58 - 7:01if I'm a hematologist,
I can visit another clinic or hospital. -
7:01 - 7:04These are being augmented
by a whole suite of tools -
7:04 - 7:05actually in the home now.
-
7:05 - 7:07We already have wireless scales.
-
7:07 - 7:09You step on the scale,
tweet your weight to your friends, -
7:09 - 7:11they can keep you in line.
-
7:11 - 7:13We have wireless blood pressure cuffs.
-
7:13 - 7:15A whole gamut of technologies
are being put together. -
7:15 - 7:18Instead of wearing kludgy devices,
we put on a simple patch. -
7:18 - 7:19This was developed at Stanford.
-
7:19 - 7:23It's called iRhythm; it completely
supplants the prior technology -
7:23 - 7:25at a much lower price point,
with much more effectivity. -
7:25 - 7:28We're also in the era today
of quantified self. -
7:28 - 7:31Consumers now can basically buy
$100 devices, like this little Fitbit. -
7:31 - 7:33I can measure my steps,
my caloric outtake. -
7:33 - 7:35I can get insight into that
on a daily basis -
7:36 - 7:38and share it with my friends or physician.
-
7:38 - 7:41There's watches that measure
your heart rate, Zeo sleep monitors, -
7:41 - 7:43a suite of tools
that enable you to leverage -
7:43 - 7:45and have insight into your own health.
-
7:45 - 7:47As we start to integrate this information,
-
7:47 - 7:50we'll know better what to do with it,
and have better insight -
7:50 - 7:52into our own pathologies,
health and wellness. -
7:52 - 7:55There's even mirrors
that can pick up your pulse rate. -
7:55 - 7:56And I would argue, in the future,
-
7:56 - 8:00we'll have wearable devices
in our clothes, monitoring us 24/7. -
8:00 - 8:03And just like the OnStar system
in cars, your red light might go on. -
8:03 - 8:06It won't say "check engine";
it'll be a "check your body" light, -
8:06 - 8:08and you'll go get it taken care of.
-
8:08 - 8:09Probably in a few years,
-
8:09 - 8:12you'll look in your mirror
and it'll be diagnosing you. -
8:12 - 8:13(Laughter)
-
8:13 - 8:15For those of you with kiddos at home,
-
8:15 - 8:18how would you like a wireless
diaper that supports your -- -
8:18 - 8:19(Laughter)
-
8:19 - 8:21More information, I think,
than you might need, -
8:21 - 8:23but it's going to be here.
-
8:23 - 8:26Now, we've heard a lot today
about technology and connection. -
8:26 - 8:28And I think some of these technologies
-
8:28 - 8:31will enable us to be more connected
with our patients, to take more time -
8:31 - 8:34and do the important
human-touch elements of medicine, -
8:34 - 8:36as augmented by these technologies.
-
8:36 - 8:38Now, we've talked about
augmenting the patient. -
8:38 - 8:40How about augmenting the physician?
-
8:40 - 8:42We're now in the era
of super-enabling the surgeon, -
8:42 - 8:46who can now go into the body and do
robotic surgery, which is here today, -
8:46 - 8:49at a level that was not really possible
even five years ago. -
8:49 - 8:52And now this is being augmented
with further layers of technology, -
8:52 - 8:53like augmented reality.
-
8:53 - 8:56So the surgeon can see
inside the patient, through their lens, -
8:56 - 8:59where the tumor is,
where the blood vessels are. -
8:59 - 9:01This can be integrated
with decision support. -
9:01 - 9:04A surgeon in New York can help
a surgeon in Amsterdam, for example. -
9:04 - 9:07And we're entering an era
of truly scarless surgery called NOTES, -
9:07 - 9:10where the robotic endoscope
can come out the stomach -
9:10 - 9:12and pull out that gallbladder,
-
9:12 - 9:14all in a scarless way and robotically.
-
9:14 - 9:17This is called NOTES, and it's coming --
basically scarless surgery, -
9:17 - 9:19as mediated by robotic surgery.
-
9:19 - 9:21Now, how about controlling other elements?
-
9:21 - 9:24For those who have
disabilities -- the paraplegic, -
9:24 - 9:27there's the brain-computer
interface, or BCI, -
9:27 - 9:29where chips have been put
on the motor cortex -
9:29 - 9:31of completely quadriplegic patients,
-
9:31 - 9:33and they can control
a cursor or a wheelchair -
9:33 - 9:35or, potentially, a robotic arm.
-
9:35 - 9:37These devices are getting smaller
-
9:37 - 9:39and going into more and more
of these patients. -
9:39 - 9:40Still in clinical trials,
-
9:40 - 9:43but imagine when we can connect
these, for example, -
9:43 - 9:44to the amazing bionic limb,
-
9:44 - 9:47such as the DEKA Arm,
built by Dean Kamen and colleagues, -
9:47 - 9:49which has 17 degrees
of motion and freedom, -
9:49 - 9:51and can allow the person who's lost a limb
-
9:51 - 9:54to have much higher dexterity or control
than they've had in the past. -
9:55 - 9:58So we're really entering the era
of wearable robotics, actually. -
9:58 - 10:00If you haven't lost a limb
but had a stroke, -
10:00 - 10:01you can wear these augmented limbs.
-
10:02 - 10:05Or if you're a paraplegic -- I've visited
the folks at Berkeley Bionics -- -
10:05 - 10:06they've developed eLEGS.
-
10:06 - 10:08I took this video last week.
-
10:08 - 10:11Here's a paraplegic patient, walking
by strapping on these exoskeletons. -
10:11 - 10:13He's otherwise completely
wheelchair-bound. -
10:13 - 10:15This is the early era
of wearable robotics. -
10:16 - 10:18And by leveraging
these sorts of technologies, -
10:18 - 10:20we're going to change
the definition of disability -
10:20 - 10:23to, in some cases, be superability,
or super-enabling. -
10:23 - 10:26This is Aimee Mullins, who lost
her lower limbs as a young child, -
10:26 - 10:28and Hugh Herr, who's a professor at MIT,
-
10:28 - 10:30who lost his limbs in a climbing accident.
-
10:30 - 10:34And now both of them can climb better,
move faster, swim differently -
10:34 - 10:37with their prosthetics
than us normal-abled persons. -
10:37 - 10:39How about other exponentials?
-
10:39 - 10:42Clearly the obesity trend is exponentially
going in the wrong direction, -
10:42 - 10:44including with huge costs.
-
10:44 - 10:47But the trend in medicine
is to get exponentially smaller. -
10:47 - 10:50A few examples: we're now in the era
of "Fantastic Voyage," the iPill. -
10:50 - 10:53You can swallow this
completely integrated device. -
10:53 - 10:55It can take pictures of your GI system,
-
10:55 - 10:57help diagnose and treat
as it moves through your GI tract. -
10:57 - 10:59We get into even smaller micro-robots
-
10:59 - 11:02that will eventually, autonomously,
move through your system, -
11:02 - 11:04and be able to do things surgeons can't do
-
11:04 - 11:06in a much less invasive manner.
-
11:06 - 11:08Sometimes these might
self-assemble in your GI system, -
11:08 - 11:10and be augmented in that reality.
-
11:10 - 11:13On the cardiac side,
pacemakers are getting smaller -
11:13 - 11:14and much easier to place,
-
11:14 - 11:17so no need to train an interventional
cardiologist to place them. -
11:17 - 11:20And they'll be wirelessly telemetered
to your mobile devices, -
11:20 - 11:23so you can go places
and be monitored remotely. -
11:23 - 11:24These are shrinking even further.
-
11:24 - 11:28This one is in prototyping
by Medtronic; it's smaller than a penny. -
11:28 - 11:31Artificial retinas, the ability to put
arrays on the back of the eyeball -
11:31 - 11:32and allow the blind to see --
-
11:32 - 11:35also in early trials,
but moving into the future. -
11:35 - 11:37These are going to be game-changing.
-
11:37 - 11:38Or for those of us who are sighted,
-
11:38 - 11:41how about having
the assisted-living contact lens? -
11:41 - 11:43Bluetooth, Wi-Fi available --
beams back images to your eye. -
11:43 - 11:45(Laughter)
-
11:45 - 11:47Now, if you have trouble
maintaining your diet, -
11:47 - 11:49it might help to have some extra imagery
-
11:49 - 11:52to remind you how many calories
are going to be coming at you. -
11:52 - 11:55How about enabling the pathologist
to use their cell phone -
11:55 - 11:57to see at a microscopic level
-
11:57 - 12:00and to lumber that data back to the cloud
and make better diagnostics? -
12:00 - 12:02In fact, the whole era
of laboratory medicine -
12:02 - 12:04is completely changing.
-
12:04 - 12:06We can now leverage microfluidics,
-
12:06 - 12:08like this chip made
by Steve Quake at Stanford. -
12:08 - 12:10Microfluidics can replace
an entire lab of technicians; -
12:10 - 12:14put it on a chip, enable thousands
of tests at the point of care, -
12:14 - 12:15anywhere in the world.
-
12:15 - 12:18This will really leverage technology
to the rural and the underserved -
12:18 - 12:22and enable what used to be thousand-dollar
tests to be done for pennies, -
12:22 - 12:23and at the point of care.
-
12:23 - 12:26If we go down the small
pathway a little bit further, -
12:26 - 12:28we're entering the era of nanomedicine,
-
12:28 - 12:29the ability to make devices super-small,
-
12:30 - 12:32to the point where we can
design red blood cells -
12:32 - 12:35or microrobots that monitor
our blood system or immune system, -
12:35 - 12:38or even those that might clear out
the clots from our arteries. -
12:38 - 12:40Now how about exponentially cheaper?
-
12:40 - 12:43Not something we usually think
about in the era of medicine, -
12:43 - 12:47but hard disks used to be 3,400 dollars
for 10 megabytes -- exponentially cheaper. -
12:47 - 12:49In genomics now, the genome
cost about a billion dollars -
12:49 - 12:52about 10 years ago,
when the first one came out. -
12:52 - 12:55We're now approaching essentially
a $1,000 genome, probably next year. -
12:55 - 12:57And in two years, a $100 genome.
-
12:57 - 12:58What will we do with $100 genomes?
-
12:58 - 13:01Soon we'll have millions
of these tests available. -
13:01 - 13:04Then it gets interesting, when we start
to crowd-source that information, -
13:04 - 13:06and enter the era
of true personalized medicine: -
13:06 - 13:09the right drug for the right person
at the right time, -
13:09 - 13:12instead of what we're doing now,
which is the same drug for everybody, -
13:12 - 13:15blockbuster drug medications,
which don't work for the individual. -
13:15 - 13:19Many different companies are working
on leveraging these approaches. -
13:19 - 13:21I'll show you a simple example,
from 23andMe again. -
13:21 - 13:23My data indicates
I've got about average risk -
13:23 - 13:26for developing macular degeneration,
a kind of blindness. -
13:26 - 13:29But if I take that same data,
upload it to deCODEme, -
13:29 - 13:33I can look at my risk for type 2 diabetes;
I'm at almost twice the risk. -
13:33 - 13:36I might want to watch how much dessert
I have at lunch, for example. -
13:36 - 13:37It might change my behavior.
-
13:38 - 13:40Leveraging my knowledge
of my pharmacogenomics: -
13:40 - 13:43how my genes modulate,
what my drugs do and what doses I need -
13:43 - 13:45will become increasingly important,
-
13:45 - 13:47and once in the hands
of individuals and patients, -
13:47 - 13:50will make better drug dosing
and selection available. -
13:50 - 13:53So again, it's not just genes,
it's multiple details -- -
13:53 - 13:55our habits, our environmental exposures.
-
13:55 - 13:58When was the last time your doctor
asked where you've lived? -
13:58 - 14:00Geomedicine: where you live,
what you've been exposed to, -
14:00 - 14:02can dramatically affect your health.
-
14:02 - 14:04We can capture that information.
-
14:04 - 14:06Genomics, proteomics, the environment --
-
14:06 - 14:08all this data streaming at us
individually and as physicians: -
14:08 - 14:10How do we manage it?
-
14:10 - 14:13We're now entering the era
of systems medicine, systems biology, -
14:13 - 14:15where we can start to integrate
all this information. -
14:15 - 14:18And by looking at the patterns,
for example, in our blood, -
14:18 - 14:20of 10,000 biomarkers in a single test,
-
14:20 - 14:23we can look at patterns and detect disease
at a much earlier stage. -
14:23 - 14:27This is called by Lee Hood,
the father of the field, P4 Medicine. -
14:27 - 14:30We'll be predictive and know
what you're likely to have. -
14:30 - 14:32We can be preventative;
that prevention can be personalized. -
14:32 - 14:35More importantly,
it'll be increasingly participatory. -
14:35 - 14:37Through websites like PatientsLikeMe
-
14:37 - 14:40or managing your data on Microsoft
HealthVault or Google Health, -
14:40 - 14:42leveraging this together
in participatory ways -
14:42 - 14:44will be increasingly important.
-
14:44 - 14:46I'll finish up with exponentially better.
-
14:46 - 14:48We'd like to get therapies
better and more effective. -
14:48 - 14:51Today we treat high blood pressure
mostly with pills. -
14:51 - 14:52What if we take a new device,
-
14:52 - 14:55knock out the nerve vessels
that help mediate blood pressure, -
14:55 - 14:58and in a single therapy,
basically cure hypertension? -
14:58 - 15:00This is a new device
doing essentially that. -
15:00 - 15:02It should be on the market
in a year or two. -
15:02 - 15:04How about more targeted
therapies for cancer? -
15:04 - 15:07I'm an oncologist and know that most
of what we give is essentially poison. -
15:08 - 15:11We learned at Stanford and other places
that we can discover cancer stem cells, -
15:11 - 15:15the ones that seem to be really
responsible for disease relapse. -
15:15 - 15:17So if you think of cancer as a weed,
-
15:17 - 15:19we often can whack the weed away
and it seems to shrink, -
15:19 - 15:21but it often comes back.
-
15:21 - 15:22So we're attacking the wrong target.
-
15:22 - 15:24The cancer stem cells remain,
-
15:24 - 15:26and the tumor can return
months or years later. -
15:26 - 15:29We're now learning to identify
the cancer stem cells -
15:29 - 15:32and identify those as targets
and go for the long-term cure. -
15:32 - 15:34We're entering the era
of personalized oncology, -
15:34 - 15:36the ability to leverage
all of this data together, -
15:37 - 15:38analyze the tumor
-
15:38 - 15:41and come up with a real, specific cocktail
for the individual patient. -
15:41 - 15:43I'll close with regenerative medicine.
-
15:43 - 15:45I've studied a lot about stem cells.
-
15:45 - 15:47Embryonic stem cells
are particularly powerful. -
15:47 - 15:49We have adult stem cells
throughout our body; -
15:49 - 15:51we use those in bone marrow
transplantation. -
15:51 - 15:55Geron, last year, started the first trial
using human embryonic stem cells -
15:55 - 15:57to treat spinal cord injuries.
-
15:57 - 15:59Still a phase I trial, but evolving.
-
15:59 - 16:02We've been using adult stem cells
in clinical trials for about 15 years -
16:02 - 16:06to approach a whole range of topics,
particularly cardiovascular disease. -
16:06 - 16:10If we take our own bone marrow cells
and treat a patient with a heart attack, -
16:10 - 16:13we can see much improved
heart function and better survival -
16:13 - 16:16using our own bone marrow derived cells
after a heart attack. -
16:16 - 16:18I invented a device
called the MarrowMiner, -
16:18 - 16:20a much less invasive way
for harvesting bone marrow. -
16:20 - 16:23It's now been FDA approved;
hopefully on the market in the next year. -
16:24 - 16:25Hopefully you can appreciate the device
-
16:25 - 16:29going through the patient's body removing
bone marrow, not with 200 punctures, -
16:29 - 16:32but with a single puncture,
under local anesthesia. -
16:32 - 16:33Where is stem-cell therapy going?
-
16:33 - 16:34If you think about it,
-
16:34 - 16:38every cell in your body has the same DNA
you had when you were an embryo. -
16:38 - 16:40We can now reprogram your skin cells
-
16:40 - 16:43to actually act like a pluripotent
embryonic stem cell -
16:43 - 16:46and utilize those, potentially, to treat
multiple organs in the same patient, -
16:46 - 16:48making personalized stem cell lines.
-
16:48 - 16:51I think there'll be a new era
of your own stem cell banking -
16:51 - 16:55to have in the freezer your own cardiac
cells, myocytes and neural cells -
16:55 - 16:57to use them in the future,
should you need them. -
16:57 - 17:00We're integrating this now
with a whole era of cellular engineering, -
17:00 - 17:04and integrating exponential technologies
for essentially 3D organ printing, -
17:04 - 17:05replacing the ink with cells,
-
17:05 - 17:08and essentially building
and reconstructing a 3D organ. -
17:08 - 17:10That's where things are heading.
-
17:10 - 17:11Still very early days,
-
17:11 - 17:14but I think, as integration
of exponential technologies, -
17:14 - 17:15this is the example.
-
17:15 - 17:17So in closing, as you think
about technology trends -
17:17 - 17:19and how to impact health and medicine,
-
17:19 - 17:21we're entering an era of miniaturization,
-
17:21 - 17:24decentralization and personalization.
-
17:24 - 17:25And by pulling these things together,
-
17:25 - 17:28if we start to think about
how to understand and leverage them, -
17:28 - 17:32we're going to empower the patient,
enable the doctor, enhance wellness -
17:32 - 17:34and begin to cure the well
before they get sick. -
17:34 - 17:38Because I know as a doctor, if someone
comes to me with stage I disease, -
17:38 - 17:40I'm thrilled; we can often cure them.
-
17:40 - 17:41But often it's too late,
-
17:41 - 17:43and it's stage III or IV
cancer, for example. -
17:43 - 17:45So by leveraging
these technologies together, -
17:45 - 17:48I think we'll enter a new era
that I like to call stage 0 medicine. -
17:48 - 17:52And as a cancer doctor,
I'm looking forward to being out of a job. -
17:52 - 17:53Thanks very much.
-
17:53 - 17:55(Applause)
-
17:55 - 17:57Host: Thank you. Thank you.
-
17:57 - 17:58(Applause)
-
17:58 - 18:00Take a bow, take a bow.
- Title:
- Medicine's future? There's an app for that
- Speaker:
- Daniel Kraft
- Description:
-
At TEDxMaastricht, Daniel Kraft offers a fast-paced look at the next few years of innovations in medicine, powered by new tools, tests and apps that bring diagnostic information right to the patient's bedside.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 18:01
Krystian Aparta commented on English subtitles for Medicine's future? There's an app for that | ||
Krystian Aparta edited English subtitles for Medicine's future? There's an app for that | ||
Krystian Aparta edited English subtitles for Medicine's future? There's an app for that | ||
Morton Bast edited English subtitles for Medicine's future? There's an app for that | ||
Morton Bast edited English subtitles for Medicine's future? There's an app for that | ||
TED added a translation |
Krystian Aparta
The English transcript was updated on 5/30/2017.