WEBVTT 00:00:00.557 --> 00:00:04.235 In the space that used to house one transistor, 00:00:04.259 --> 00:00:07.098 we can now fit one billion. 00:00:07.636 --> 00:00:11.533 That made it so that a computer the size of an entire room 00:00:11.557 --> 00:00:14.146 now fits in your pocket. 00:00:14.170 --> 00:00:17.189 You might say the future is small. NOTE Paragraph 00:00:17.611 --> 00:00:18.818 As an engineer, 00:00:18.842 --> 00:00:22.827 I'm inspired by this miniaturization revolution in computers. 00:00:22.851 --> 00:00:24.199 As a physician, 00:00:24.223 --> 00:00:29.946 I wonder whether we could use it to reduce the number of lives lost 00:00:29.970 --> 00:00:34.077 due to one of the fastest-growing diseases on Earth: 00:00:34.101 --> 00:00:35.519 cancer. 00:00:35.543 --> 00:00:36.798 Now when I say that, 00:00:36.822 --> 00:00:40.600 what most people hear me say is that we're working on curing cancer. 00:00:40.624 --> 00:00:41.887 And we are. 00:00:41.911 --> 00:00:43.062 But it turns out 00:00:43.086 --> 00:00:45.887 that there's an incredible opportunity to save lives 00:00:45.911 --> 00:00:49.244 through the early detection and prevention of cancer. NOTE Paragraph 00:00:49.785 --> 00:00:55.164 Worldwide, over two-thirds of deaths due to cancer are fully preventable 00:00:55.188 --> 00:00:57.988 using methods that we already have in hand today. 00:00:58.406 --> 00:01:01.305 Things like vaccination, timely screening 00:01:01.329 --> 00:01:03.562 and of course, stopping smoking. 00:01:04.316 --> 00:01:07.909 But even with the best tools and technologies that we have today, 00:01:07.933 --> 00:01:09.996 some tumors can't be detected 00:01:10.020 --> 00:01:13.690 until 10 years after they've started growing, 00:01:13.714 --> 00:01:17.477 when they are 50 million cancer cells strong. 00:01:18.178 --> 00:01:19.857 What if we had better technologies 00:01:19.881 --> 00:01:22.987 to detect some of these more deadly cancers sooner, 00:01:23.011 --> 00:01:24.313 when they could be removed, 00:01:24.337 --> 00:01:26.538 when they were just getting started? NOTE Paragraph 00:01:26.562 --> 00:01:29.837 Let me tell you about how miniaturization might get us there. 00:01:31.140 --> 00:01:33.428 This is a microscope in a typical lab 00:01:33.452 --> 00:01:37.008 that a pathologist would use for looking at a tissue specimen, 00:01:37.032 --> 00:01:39.470 like a biopsy or a pap smear. 00:01:39.927 --> 00:01:41.995 This $7,000 microscope 00:01:42.019 --> 00:01:45.275 would be used by somebody with years of specialized training 00:01:45.299 --> 00:01:47.088 to spot cancer cells. 00:01:48.126 --> 00:01:51.172 This is an image from a colleague of mine at Rice University, 00:01:51.196 --> 00:01:52.774 Rebecca Richards-Kortum. 00:01:52.798 --> 00:01:56.625 What she and her team have done is miniaturize that whole microscope 00:01:56.649 --> 00:01:58.624 into this $10 part, 00:01:58.648 --> 00:02:01.464 and it fits on the end of an optical fiber. 00:02:01.923 --> 00:02:05.557 Now what that means is instead of taking a sample from a patient 00:02:05.581 --> 00:02:07.230 and sending it to the microscope, 00:02:07.254 --> 00:02:09.810 you can bring the microscope to the patient. 00:02:10.260 --> 00:02:14.619 And then, instead of requiring a specialist to look at the images, 00:02:14.643 --> 00:02:19.705 you can train the computer to score normal versus cancerous cells. NOTE Paragraph 00:02:20.084 --> 00:02:21.254 Now this is important, 00:02:21.278 --> 00:02:24.315 because what they found working in rural communities, 00:02:24.339 --> 00:02:27.578 is that even when they have a mobile screening van 00:02:27.602 --> 00:02:30.435 that can go out into the community and perform exams 00:02:30.459 --> 00:02:31.864 and collect samples 00:02:31.888 --> 00:02:35.104 and send them to the central hospital for analysis, 00:02:35.128 --> 00:02:36.472 that days later, 00:02:36.496 --> 00:02:39.163 women get a call with an abnormal test result 00:02:39.187 --> 00:02:40.804 and they're asked to come in. 00:02:40.828 --> 00:02:45.171 Fully half of them don't turn up because they can't afford the trip. 00:02:45.721 --> 00:02:49.145 With the integrated microscope and computer analysis, 00:02:49.169 --> 00:02:51.997 Rebecca and her colleagues have been able to create a van 00:02:52.021 --> 00:02:55.807 that has both a diagnostic setup and a treatment setup. 00:02:55.831 --> 00:02:58.545 And what that means is that they can do a diagnosis 00:02:58.569 --> 00:03:01.256 and perform therapy on the spot, 00:03:01.280 --> 00:03:03.418 so no one is lost to follow up. NOTE Paragraph 00:03:03.831 --> 00:03:07.779 That's just one example of how miniaturization can save lives. 00:03:08.148 --> 00:03:09.301 Now as engineers, 00:03:09.325 --> 00:03:12.070 we think of this as straight-up miniaturization. 00:03:12.094 --> 00:03:14.531 You took a big thing and you made it little. 00:03:14.555 --> 00:03:16.806 But what I told you before about computers 00:03:16.830 --> 00:03:19.076 was that they transformed our lives 00:03:19.100 --> 00:03:23.401 when they became small enough for us to take them everywhere. 00:03:23.785 --> 00:03:28.081 So what is the transformational equivalent like that in medicine? 00:03:28.500 --> 00:03:31.636 Well, what if you had a detector 00:03:31.660 --> 00:03:35.922 that was so small that it could circulate in your body, 00:03:35.946 --> 00:03:38.359 find the tumor all by itself 00:03:38.383 --> 00:03:40.752 and send a signal to the outside world? 00:03:41.079 --> 00:03:43.156 It sounds a little bit like science fiction. 00:03:43.180 --> 00:03:47.083 But actually, nanotechnology allows us to do just that. 00:03:47.415 --> 00:03:52.296 Nanotechnology allows us to shrink the parts that make up the detector 00:03:52.320 --> 00:03:54.157 from the width of a human hair, 00:03:54.181 --> 00:03:55.841 which is 100 microns, 00:03:55.865 --> 00:03:58.420 to a thousand times smaller, 00:03:58.444 --> 00:04:00.346 which is 100 nanometers. 00:04:00.370 --> 00:04:03.180 And that has profound implications. NOTE Paragraph 00:04:03.583 --> 00:04:07.226 It turns out that materials actually change their properties 00:04:07.250 --> 00:04:08.846 at the nanoscale. 00:04:09.279 --> 00:04:11.777 You take a common material like gold, 00:04:11.801 --> 00:04:15.122 and you grind it into dust, into gold nanoparticles, 00:04:15.146 --> 00:04:18.458 and it changes from looking gold to looking red. 00:04:19.082 --> 00:04:22.895 If you take a more exotic material like cadmium selenide -- 00:04:22.919 --> 00:04:25.093 forms a big, black crystal -- 00:04:25.117 --> 00:04:27.718 if you make nanocrystals out of this material 00:04:27.742 --> 00:04:29.315 and you put it in a liquid, 00:04:29.339 --> 00:04:31.163 and you shine light on it, 00:04:31.187 --> 00:04:32.353 they glow. 00:04:32.377 --> 00:04:38.008 And they glow blue, green, yellow, orange, red, 00:04:38.032 --> 00:04:40.307 depending only on their size. 00:04:40.887 --> 00:04:44.890 It's wild! Can you imagine an object like that in the macro world? 00:04:44.914 --> 00:04:51.485 It would be like all the denim jeans in your closet are all made of cotton, 00:04:51.509 --> 00:04:55.820 but they are different colors depending only on their size. NOTE Paragraph 00:04:56.212 --> 00:04:57.908 (Laughter) NOTE Paragraph 00:04:58.982 --> 00:05:00.506 So as a physician, 00:05:00.530 --> 00:05:02.754 what's just as interesting to me 00:05:02.778 --> 00:05:05.078 is that it's not just the color of materials 00:05:05.102 --> 00:05:07.033 that changes at the nanoscale; 00:05:07.057 --> 00:05:10.665 the way they travel in your body also changes. 00:05:11.137 --> 00:05:13.936 And this is the kind of observation that we're going to use 00:05:13.960 --> 00:05:16.134 to make a better cancer detector. NOTE Paragraph 00:05:16.158 --> 00:05:17.911 So let me show you what I mean. 00:05:18.686 --> 00:05:20.883 This is a blood vessel in the body. 00:05:20.907 --> 00:05:23.318 Surrounding the blood vessel is a tumor. 00:05:23.683 --> 00:05:26.724 We're going to inject nanoparticles into the blood vessel 00:05:26.748 --> 00:05:30.928 and watch how they travel from the bloodstream into the tumor. 00:05:31.464 --> 00:05:35.816 Now it turns out that the blood vessels of many tumors are leaky, 00:05:35.840 --> 00:05:40.206 and so nanoparticles can leak out from the bloodstream into the tumor. 00:05:40.628 --> 00:05:43.762 Whether they leak out depends on their size. 00:05:44.129 --> 00:05:45.279 So in this image, 00:05:45.303 --> 00:05:49.674 the smaller, hundred-nanometer, blue nanoparticles are leaking out, 00:05:49.698 --> 00:05:53.094 and the larger, 500-nanometer, red nanoparticles 00:05:53.118 --> 00:05:54.895 are stuck in the bloodstream. 00:05:54.919 --> 00:05:57.022 So that means as an engineer, 00:05:57.046 --> 00:06:01.038 depending on how big or small I make a material, 00:06:01.062 --> 00:06:04.103 I can change where it goes in your body. NOTE Paragraph 00:06:05.249 --> 00:06:09.891 In my lab, we recently made a cancer nanodetector 00:06:09.915 --> 00:06:15.163 that is so small that it could travel into the body and look for tumors. 00:06:15.477 --> 00:06:19.569 We designed it to listen for tumor invasion: 00:06:19.593 --> 00:06:24.366 the orchestra of chemical signals that tumors need to make to spread. 00:06:24.932 --> 00:06:27.834 For a tumor to break out of the tissue that it's born in, 00:06:27.858 --> 00:06:30.574 it has to make chemicals called enzymes 00:06:30.598 --> 00:06:33.182 to chew through the scaffolding of tissues. 00:06:33.763 --> 00:06:38.485 We designed these nanoparticles to be activated by these enzymes. 00:06:39.034 --> 00:06:44.946 One enzyme can activate a thousand of these chemical reactions in an hour. 00:06:45.462 --> 00:06:49.020 Now in engineering, we call that one-to-a-thousand ratio 00:06:49.044 --> 00:06:50.609 a form of amplification, 00:06:50.633 --> 00:06:52.805 and it makes something ultrasensitive. 00:06:52.829 --> 00:06:56.662 So we've made an ultrasensitive cancer detector. NOTE Paragraph 00:06:57.220 --> 00:07:02.120 OK, but how do I get this activated signal to the outside world, 00:07:02.144 --> 00:07:03.882 where I can act on it? 00:07:03.906 --> 00:07:07.458 For this, we're going to use one more piece of nanoscale biology, 00:07:07.482 --> 00:07:09.266 and that has to do with the kidney. 00:07:09.659 --> 00:07:11.575 The kidney is a filter. 00:07:11.996 --> 00:07:16.625 Its job is to filter out the blood and put waste into the urine. 00:07:17.197 --> 00:07:19.859 It turns out that what the kidney filters 00:07:19.883 --> 00:07:22.445 is also dependent on size. 00:07:22.901 --> 00:07:24.841 So in this image, what you can see 00:07:24.865 --> 00:07:27.874 is that everything smaller than five nanometers 00:07:27.898 --> 00:07:32.003 is going from the blood, through the kidney, into the urine, 00:07:32.027 --> 00:07:34.697 and everything else that's bigger is retained. 00:07:35.176 --> 00:07:40.123 OK, so if I make a 100-nanometer cancer detector, 00:07:40.147 --> 00:07:42.619 I inject it in the bloodstream, 00:07:42.643 --> 00:07:48.073 it can leak into the tumor where it's activated by tumor enzymes 00:07:48.097 --> 00:07:50.453 to release a small signal 00:07:50.477 --> 00:07:53.699 that is small enough to be filtered out of the kidney 00:07:53.723 --> 00:07:55.901 and put into the urine, 00:07:55.925 --> 00:07:59.966 I have a signal in the outside world that I can detect. NOTE Paragraph 00:08:00.588 --> 00:08:02.640 OK, but there's one more problem. 00:08:02.664 --> 00:08:04.410 This is a tiny little signal, 00:08:04.434 --> 00:08:06.406 so how do I detect it? 00:08:06.730 --> 00:08:08.965 Well, the signal is just a molecule. 00:08:08.989 --> 00:08:11.656 They're molecules that we designed as engineers. 00:08:11.680 --> 00:08:14.858 They're completely synthetic, and we can design them 00:08:14.882 --> 00:08:18.121 so they are compatible with our tool of choice. 00:08:18.145 --> 00:08:21.587 If we want to use a really sensitive, fancy instrument 00:08:21.611 --> 00:08:23.575 called a mass spectrometer, 00:08:23.599 --> 00:08:26.110 then we make a molecule with a unique mass. 00:08:26.671 --> 00:08:30.370 Or maybe we want make something that's more inexpensive and portable. 00:08:30.394 --> 00:08:34.177 Then we make molecules that we can trap on paper, 00:08:34.201 --> 00:08:35.905 like a pregnancy test. 00:08:35.929 --> 00:08:38.555 In fact, there's a whole world of paper tests 00:08:38.579 --> 00:08:43.091 that are becoming available in a field called paper diagnostics. NOTE Paragraph 00:08:43.711 --> 00:08:46.037 Alright, where are we going with this? 00:08:46.724 --> 00:08:48.293 What I'm going to tell you next, 00:08:48.317 --> 00:08:50.143 as a lifelong researcher, 00:08:50.167 --> 00:08:52.046 represents a dream of mine. 00:08:52.396 --> 00:08:54.489 I can't say that's it's a promise; 00:08:54.513 --> 00:08:56.005 it's a dream. 00:08:56.029 --> 00:08:59.616 But I think we all have to have dreams to keep us pushing forward, 00:08:59.640 --> 00:09:03.577 even -- and maybe especially -- cancer researchers. NOTE Paragraph 00:09:03.601 --> 00:09:07.100 I'm going to tell you what I hope will happen with my technology, 00:09:07.124 --> 00:09:11.215 that my team and I will put our hearts and souls 00:09:11.239 --> 00:09:12.761 into making a reality. 00:09:13.289 --> 00:09:14.987 OK, here goes. 00:09:15.011 --> 00:09:18.366 I dream that one day, 00:09:18.390 --> 00:09:21.645 instead of going into an expensive screening facility 00:09:21.669 --> 00:09:23.174 to get a colonoscopy, 00:09:23.198 --> 00:09:24.521 or a mammogram, 00:09:24.545 --> 00:09:25.953 or a pap smear, 00:09:26.585 --> 00:09:28.304 that you could get a shot, 00:09:28.328 --> 00:09:29.988 wait an hour, 00:09:30.012 --> 00:09:32.807 and do a urine test on a paper strip. 00:09:33.653 --> 00:09:36.460 I imagine that this could even happen 00:09:36.484 --> 00:09:39.147 without the need for steady electricity, 00:09:39.171 --> 00:09:41.775 or a medical professional in the room. 00:09:41.799 --> 00:09:43.296 Maybe they could be far away 00:09:43.320 --> 00:09:46.130 and connected only by the image on a smartphone. NOTE Paragraph 00:09:46.854 --> 00:09:48.589 Now I know this sounds like a dream, 00:09:48.613 --> 00:09:51.732 but in the lab we already have this working in mice, 00:09:51.756 --> 00:09:53.835 where it works better than existing methods 00:09:53.859 --> 00:09:57.830 for the detection of lung, colon and ovarian cancer. 00:09:58.603 --> 00:10:00.837 And I hope that what this means 00:10:00.861 --> 00:10:06.037 is that one day we can detect tumors in patients 00:10:06.061 --> 00:10:09.354 sooner than 10 years after they've started growing, 00:10:09.378 --> 00:10:11.363 in all walks of life, 00:10:11.387 --> 00:10:13.236 all around the globe, 00:10:13.260 --> 00:10:15.995 and that this would lead to earlier treatments, 00:10:16.019 --> 00:10:19.617 and that we could save more lives than we can today, 00:10:19.641 --> 00:10:20.925 with early detection. NOTE Paragraph 00:10:21.686 --> 00:10:22.868 Thank you. NOTE Paragraph 00:10:22.892 --> 00:10:30.375 (Applause)