0:00:00.557,0:00:04.235
In the space that used[br]to house one transistor,

0:00:04.259,0:00:07.098
we can now fit one billion.

0:00:07.636,0:00:11.533
That made it so that a computer[br]the size of an entire room

0:00:11.557,0:00:14.146
now fits in your pocket.

0:00:14.170,0:00:17.189
You might say the future is small.

0:00:17.611,0:00:18.818
As an engineer,

0:00:18.842,0:00:22.827
I'm inspired by this miniaturization[br]revolution in computers.

0:00:22.851,0:00:24.199
As a physician,

0:00:24.223,0:00:29.946
I wonder whether we could use it[br]to reduce the number of lives lost

0:00:29.970,0:00:34.077
due to one of the fastest-growing[br]diseases on Earth:

0:00:34.101,0:00:35.519
cancer.

0:00:35.543,0:00:36.798
Now when I say that,

0:00:36.822,0:00:40.600
what most people hear me say[br]is that we're working on curing cancer.

0:00:40.624,0:00:41.887
And we are.

0:00:41.911,0:00:43.062
But it turns out

0:00:43.086,0:00:45.887
that there's an incredible[br]opportunity to save lives

0:00:45.911,0:00:49.244
through the early detection[br]and prevention of cancer.

0:00:49.785,0:00:55.164
Worldwide, over two-thirds of deaths[br]due to cancer are fully preventable

0:00:55.188,0:00:57.988
using methods that we already[br]have in hand today.

0:00:58.406,0:01:01.305
Things like vaccination, timely screening

0:01:01.329,0:01:03.562
and of course, stopping smoking.

0:01:04.316,0:01:07.909
But even with the best tools[br]and technologies that we have today,

0:01:07.933,0:01:09.996
some tumors can't be detected

0:01:10.020,0:01:13.690
until 10 years after[br]they've started growing,

0:01:13.714,0:01:17.477
when they are 50 million[br]cancer cells strong.

0:01:18.178,0:01:19.857
What if we had better technologies

0:01:19.881,0:01:22.987
to detect some of these more[br]deadly cancers sooner,

0:01:23.011,0:01:24.313
when they could be removed,

0:01:24.337,0:01:26.538
when they were just getting started?

0:01:26.562,0:01:29.837
Let me tell you about how[br]miniaturization might get us there.

0:01:31.140,0:01:33.428
This is a microscope in a typical lab

0:01:33.452,0:01:37.008
that a pathologist would use[br]for looking at a tissue specimen,

0:01:37.032,0:01:39.470
like a biopsy or a pap smear.

0:01:39.927,0:01:41.995
This $7,000 microscope

0:01:42.019,0:01:45.275
would be used by somebody[br]with years of specialized training

0:01:45.299,0:01:47.088
to spot cancer cells.

0:01:48.126,0:01:51.172
This is an image from a colleague[br]of mine at Rice University,

0:01:51.196,0:01:52.774
Rebecca Richards-Kortum.

0:01:52.798,0:01:56.625
What she and her team have done[br]is miniaturize that whole microscope

0:01:56.649,0:01:58.624
into this $10 part,

0:01:58.648,0:02:01.464
and it fits on the end[br]of an optical fiber.

0:02:01.923,0:02:05.557
Now what that means is instead[br]of taking a sample from a patient

0:02:05.581,0:02:07.230
and sending it to the microscope,

0:02:07.254,0:02:09.810
you can bring the microscope[br]to the patient.

0:02:10.260,0:02:14.619
And then, instead of requiring[br]a specialist to look at the images,

0:02:14.643,0:02:19.705
you can train the computer to score[br]normal versus cancerous cells.

0:02:20.084,0:02:21.254
Now this is important,

0:02:21.278,0:02:24.315
because what they found[br]working in rural communities,

0:02:24.339,0:02:27.578
is that even when they have[br]a mobile screening van

0:02:27.602,0:02:30.435
that can go out into the community[br]and perform exams

0:02:30.459,0:02:31.864
and collect samples

0:02:31.888,0:02:35.104
and send them to the central[br]hospital for analysis,

0:02:35.128,0:02:36.472
that days later,

0:02:36.496,0:02:39.163
women get a call[br]with an abnormal test result

0:02:39.187,0:02:40.804
and they're asked to come in.

0:02:40.828,0:02:45.171
Fully half of them don't turn up[br]because they can't afford the trip.

0:02:45.721,0:02:49.145
With the integrated microscope[br]and computer analysis,

0:02:49.169,0:02:51.997
Rebecca and her colleagues[br]have been able to create a van

0:02:52.021,0:02:55.807
that has both a diagnostic setup[br]and a treatment setup.

0:02:55.831,0:02:58.545
And what that means[br]is that they can do a diagnosis

0:02:58.569,0:03:01.256
and perform therapy on the spot,

0:03:01.280,0:03:03.418
so no one is lost to follow up.

0:03:03.831,0:03:07.779
That's just one example of how[br]miniaturization can save lives.

0:03:08.148,0:03:09.301
Now as engineers,

0:03:09.325,0:03:12.070
we think of this[br]as straight-up miniaturization.

0:03:12.094,0:03:14.531
You took a big thing[br]and you made it little.

0:03:14.555,0:03:16.806
But what I told you before about computers

0:03:16.830,0:03:19.076
was that they transformed our lives

0:03:19.100,0:03:23.401
when they became small enough[br]for us to take them everywhere.

0:03:23.785,0:03:28.081
So what is the transformational[br]equivalent like that in medicine?

0:03:28.500,0:03:31.636
Well, what if you had a detector

0:03:31.660,0:03:35.922
that was so small that it could[br]circulate in your body,

0:03:35.946,0:03:38.359
find the tumor all by itself

0:03:38.383,0:03:40.752
and send a signal to the outside world?

0:03:41.079,0:03:43.156
It sounds a little bit[br]like science fiction.

0:03:43.180,0:03:47.083
But actually, nanotechnology[br]allows us to do just that.

0:03:47.415,0:03:52.296
Nanotechnology allows us to shrink[br]the parts that make up the detector

0:03:52.320,0:03:54.157
from the width of a human hair,

0:03:54.181,0:03:55.841
which is 100 microns,

0:03:55.865,0:03:58.420
to a thousand times smaller,

0:03:58.444,0:04:00.346
which is 100 nanometers.

0:04:00.370,0:04:03.180
And that has profound implications.

0:04:03.583,0:04:07.226
It turns out that materials[br]actually change their properties

0:04:07.250,0:04:08.846
at the nanoscale.

0:04:09.279,0:04:11.777
You take a common material like gold,

0:04:11.801,0:04:15.122
and you grind it into dust,[br]into gold nanoparticles,

0:04:15.146,0:04:18.458
and it changes from looking[br]gold to looking red.

0:04:19.082,0:04:22.895
If you take a more exotic material[br]like cadmium selenide --

0:04:22.919,0:04:25.093
forms a big, black crystal --

0:04:25.117,0:04:27.718
if you make nanocrystals[br]out of this material

0:04:27.742,0:04:29.315
and you put it in a liquid,

0:04:29.339,0:04:31.163
and you shine light on it,

0:04:31.187,0:04:32.353
they glow.

0:04:32.377,0:04:38.008
And they glow blue, green,[br]yellow, orange, red,

0:04:38.032,0:04:40.307
depending only on their size.

0:04:40.887,0:04:44.890
It's wild! Can you imagine an object[br]like that in the macro world?

0:04:44.914,0:04:51.485
It would be like all the denim jeans[br]in your closet are all made of cotton,

0:04:51.509,0:04:55.820
but they are different colors[br]depending only on their size.

0:04:56.212,0:04:57.908
(Laughter)

0:04:58.982,0:05:00.506
So as a physician,

0:05:00.530,0:05:02.754
what's just as interesting to me

0:05:02.778,0:05:05.078
is that it's not just[br]the color of materials

0:05:05.102,0:05:07.033
that changes at the nanoscale;

0:05:07.057,0:05:10.665
the way they travel[br]in your body also changes.

0:05:11.137,0:05:13.936
And this is the kind of observation[br]that we're going to use

0:05:13.960,0:05:16.134
to make a better cancer detector.

0:05:16.158,0:05:17.911
So let me show you what I mean.

0:05:18.686,0:05:20.883
This is a blood vessel in the body.

0:05:20.907,0:05:23.318
Surrounding the blood vessel is a tumor.

0:05:23.683,0:05:26.724
We're going to inject nanoparticles[br]into the blood vessel

0:05:26.748,0:05:30.928
and watch how they travel[br]from the bloodstream into the tumor.

0:05:31.464,0:05:35.816
Now it turns out that the blood vessels[br]of many tumors are leaky,

0:05:35.840,0:05:40.206
and so nanoparticles can leak out[br]from the bloodstream into the tumor.

0:05:40.628,0:05:43.762
Whether they leak out[br]depends on their size.

0:05:44.129,0:05:45.279
So in this image,

0:05:45.303,0:05:49.674
the smaller, hundred-nanometer,[br]blue nanoparticles are leaking out,

0:05:49.698,0:05:53.094
and the larger, 500-nanometer,[br]red nanoparticles

0:05:53.118,0:05:54.895
are stuck in the bloodstream.

0:05:54.919,0:05:57.022
So that means as an engineer,

0:05:57.046,0:06:01.038
depending on how big[br]or small I make a material,

0:06:01.062,0:06:04.103
I can change where it goes in your body.

0:06:05.249,0:06:09.891
In my lab, we recently made[br]a cancer nanodetector

0:06:09.915,0:06:15.163
that is so small that it could travel[br]into the body and look for tumors.

0:06:15.477,0:06:19.569
We designed it to listen[br]for tumor invasion:

0:06:19.593,0:06:24.366
the orchestra of chemical signals[br]that tumors need to make to spread.

0:06:24.932,0:06:27.834
For a tumor to break out[br]of the tissue that it's born in,

0:06:27.858,0:06:30.574
it has to make chemicals called enzymes

0:06:30.598,0:06:33.182
to chew through[br]the scaffolding of tissues.

0:06:33.763,0:06:38.485
We designed these nanoparticles[br]to be activated by these enzymes.

0:06:39.034,0:06:44.946
One enzyme can activate a thousand[br]of these chemical reactions in an hour.

0:06:45.462,0:06:49.020
Now in engineering, we call[br]that one-to-a-thousand ratio

0:06:49.044,0:06:50.609
a form of amplification,

0:06:50.633,0:06:52.805
and it makes something ultrasensitive.

0:06:52.829,0:06:56.662
So we've made an ultrasensitive[br]cancer detector.

0:06:57.220,0:07:02.120
OK, but how do I get this activated[br]signal to the outside world,

0:07:02.144,0:07:03.882
where I can act on it?

0:07:03.906,0:07:07.458
For this, we're going to use[br]one more piece of nanoscale biology,

0:07:07.482,0:07:09.266
and that has to do with the kidney.

0:07:09.659,0:07:11.575
The kidney is a filter.

0:07:11.996,0:07:16.625
Its job is to filter out the blood[br]and put waste into the urine.

0:07:17.197,0:07:19.859
It turns out that what the kidney filters

0:07:19.883,0:07:22.445
is also dependent on size.

0:07:22.901,0:07:24.841
So in this image, what you can see

0:07:24.865,0:07:27.874
is that everything smaller[br]than five nanometers

0:07:27.898,0:07:32.003
is going from the blood,[br]through the kidney, into the urine,

0:07:32.027,0:07:34.697
and everything else[br]that's bigger is retained.

0:07:35.176,0:07:40.123
OK, so if I make a 100-nanometer[br]cancer detector,

0:07:40.147,0:07:42.619
I inject it in the bloodstream,

0:07:42.643,0:07:48.073
it can leak into the tumor[br]where it's activated by tumor enzymes

0:07:48.097,0:07:50.453
to release a small signal

0:07:50.477,0:07:53.699
that is small enough to be[br]filtered out of the kidney

0:07:53.723,0:07:55.901
and put into the urine,

0:07:55.925,0:07:59.966
I have a signal in the outside world[br]that I can detect.

0:08:00.588,0:08:02.640
OK, but there's one more problem.

0:08:02.664,0:08:04.410
This is a tiny little signal,

0:08:04.434,0:08:06.406
so how do I detect it?

0:08:06.730,0:08:08.965
Well, the signal is just a molecule.

0:08:08.989,0:08:11.656
They're molecules[br]that we designed as engineers.

0:08:11.680,0:08:14.858
They're completely synthetic,[br]and we can design them

0:08:14.882,0:08:18.121
so they are compatible[br]with our tool of choice.

0:08:18.145,0:08:21.587
If we want to use a really[br]sensitive, fancy instrument

0:08:21.611,0:08:23.575
called a mass spectrometer,

0:08:23.599,0:08:26.110
then we make a molecule[br]with a unique mass.

0:08:26.671,0:08:30.370
Or maybe we want make something[br]that's more inexpensive and portable.

0:08:30.394,0:08:34.177
Then we make molecules[br]that we can trap on paper,

0:08:34.201,0:08:35.905
like a pregnancy test.

0:08:35.929,0:08:38.555
In fact, there's a whole[br]world of paper tests

0:08:38.579,0:08:43.091
that are becoming available[br]in a field called paper diagnostics.

0:08:43.711,0:08:46.037
Alright, where are we going with this?

0:08:46.724,0:08:48.293
What I'm going to tell you next,

0:08:48.317,0:08:50.143
as a lifelong researcher,

0:08:50.167,0:08:52.046
represents a dream of mine.

0:08:52.396,0:08:54.489
I can't say that's it's a promise;

0:08:54.513,0:08:56.005
it's a dream.

0:08:56.029,0:08:59.616
But I think we all have to have dreams[br]to keep us pushing forward,

0:08:59.640,0:09:03.577
even -- and maybe especially --[br]cancer researchers.

0:09:03.601,0:09:07.100
I'm going to tell you what I hope[br]will happen with my technology,

0:09:07.124,0:09:11.215
that my team and I will put[br]our hearts and souls

0:09:11.239,0:09:12.761
into making a reality.

0:09:13.289,0:09:14.987
OK, here goes.

0:09:15.011,0:09:18.366
I dream that one day,

0:09:18.390,0:09:21.645
instead of going into[br]an expensive screening facility

0:09:21.669,0:09:23.174
to get a colonoscopy,

0:09:23.198,0:09:24.521
or a mammogram,

0:09:24.545,0:09:25.953
or a pap smear,

0:09:26.585,0:09:28.304
that you could get a shot,

0:09:28.328,0:09:29.988
wait an hour,

0:09:30.012,0:09:32.807
and do a urine test on a paper strip.

0:09:33.653,0:09:36.460
I imagine that this could even happen

0:09:36.484,0:09:39.147
without the need for steady electricity,

0:09:39.171,0:09:41.775
or a medical professional in the room.

0:09:41.799,0:09:43.296
Maybe they could be far away

0:09:43.320,0:09:46.130
and connected only by the image[br]on a smartphone.

0:09:46.854,0:09:48.589
Now I know this sounds like a dream,

0:09:48.613,0:09:51.732
but in the lab we already[br]have this working in mice,

0:09:51.756,0:09:53.835
where it works better[br]than existing methods

0:09:53.859,0:09:57.830
for the detection of lung,[br]colon and ovarian cancer.

0:09:58.603,0:10:00.837
And I hope that what this means

0:10:00.861,0:10:06.037
is that one day we can[br]detect tumors in patients

0:10:06.061,0:10:09.354
sooner than 10 years[br]after they've started growing,

0:10:09.378,0:10:11.363
in all walks of life,

0:10:11.387,0:10:13.236
all around the globe,

0:10:13.260,0:10:15.995
and that this would lead[br]to earlier treatments,

0:10:16.019,0:10:19.617
and that we could save more lives[br]than we can today,

0:10:19.641,0:10:20.925
with early detection.

0:10:21.686,0:10:22.868
Thank you.

0:10:22.892,0:10:30.375
(Applause)