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In the space that used
to house one transistor,

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we can now fit one billion.

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That made it so that a computer
the size of an entire room

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now fits in your pocket.

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You might say the future is small.

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As an engineer,

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I'm inspired by this miniaturization
revolution in computers.

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As a physician,

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I wonder whether we could use it
to reduce the number of lives lost

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due to one of the fastest-growing
diseases on Earth:

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cancer.

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Now when I say that,

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what most people hear me say
is that we're working on curing cancer.

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And we are,

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but it turns out that there's
an incredible opportunity

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to save lives through the early
detection and prevention of cancer.

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Worldwide, over two-thirds of deaths
due to cancer are fully preventable

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using methods that we already
have in hand today.

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Things like vaccination, timely screening
and of course, stopping smoking.

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But even with the best tools
and technologies that we have today,

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some tumors can't be detected

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until 10 years after
they've started growing,

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when they are 50 million
cancer cells strong.

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What if we had better technologies

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to detect some of these more
deadly cancers sooner?

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When they could be removed,

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when they were just getting started.

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Let me tell you about how
miniaturization might get us there.

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This is a microscope in a typical lab

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that a pathologist would use
for looking at a tissue specimen,

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like a biopsy or a pap smear.

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This $7,000 microscope

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would be used by somebody
with years of specialized training

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to spot cancer cells.

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This is an image from a colleague
of mine at Rice University,

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Rebecca Richards-Kortum.

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What she and her team have done

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is miniaturize that whole
microscope into this $10 part

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and it fits on the end
of an optical fiber.

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Now what that means is instead
of taking a sample from a patient

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and sending it to the microscope,

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you can bring the microscope
to the patient.

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And then instead of requiring
a specialist to look at the images,

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you can train the computer to score
normal versus cancerous cells.

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Now this is important

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because what they found
working in rural communities,

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is that even when they have
a mobile screening van

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that can go out into the community
and perform exams

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and collect samples,

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and send them to the central
hospital for analysis,

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that days later,

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women get a call
with an abnormal test result

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and they're asked to come in.

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Fully half of them don't turn up
because they can't afford the trip.

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Now with the integrated microscope
and computer analysis,

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Rebecca and her colleagues
have been able to create a van

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that has both a diagnostic setup
and a treatment setup.

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And what that means
is that they can do a diagnosis

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and perform therapy on the spot,

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so no one is lost to follow up.

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That's just one example of how
miniaturization can save lives.

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Now as engineers,

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we think of this as
straight-up miniaturization.

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You took a big thing
and you made it little.

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But what I told you before about computers

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was that they transformed our lives

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when they became small enough
for us to take them everywhere.

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So what is the transformational
equivalent like that in medicine?

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Well, what if you had a detector

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that was so small that it could
circulate in your body,

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find the tumor all by itself

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and send a signal to the outside world?

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It sounds a little bit
like science fiction,

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but actually, nanotechnology
allows us to do just that.

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Nanotechnology allows us to shrink
the parts that make up the detector

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from the width of a human hair,

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which is 100 microns,

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to a thousand times smaller,

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which is 100 nanometers.

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And that has profound implications.

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It turns out

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that materials actually change
their properties at the nanoscale.

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You take a common material like gold,

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and you grind it into dust,

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into gold nanoparticles,

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and it changes from looking
gold to looking red.

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If you take a more exotic material
like cadmium selenide --

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forms a big, black crystal --

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if you make nanocrystals
out of this material

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and you put it in a liquid,

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and you shine light on it,

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they glow.

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And they glow blue, green,
yellow, orange, red,

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depending only on their size.

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It's wild.

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Can you imagine an object
like that in the macro world?

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It would be like all the denim jeans
in your closet are all made of cotton,

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but they are different colors
depending only on their size.

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(Laughter)

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So as a physician,

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what's just as interesting to me,

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is that it's not just
the color of materials

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that changes at the nanoscale;

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the way they travel
in your body also changes.

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And this is the kind of observation
that we're going to use

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to make a better cancer detector.

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So let me show you what I mean.

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This is a blood vessel in the body.

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Surrounding the blood vessel is a tumor.

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We're going to inject nanoparticles
into the blood vessel

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and watch how they travel
from the bloodstream into the tumor.

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Now it turns out that the blood vessels
of many tumors are leaky,

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and so nanoparticles can leak out
from the bloodstream into the tumor.

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Whether they leak out
depends on their size.

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So in this image,

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the smaller, hundred-nanometer,
blue nanoparticles are leaking out,

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and the larger, 500-nanometer,
red nanoparticles

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are stuck in the bloodstream.

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So that means as an engineer,

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depending on how big
or small I make a material,

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I can change where it goes in your body.

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In my lab, we recently made
a cancer nanodetector

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that is so small that it could travel
into the body and look for tumors.

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We designed it to listen
for tumor invasion:

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the orchestra of chemical signals
that tumors need to make to spread.

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For a tumor to break out
of the tissue that it's born in,

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it has to make chemicals called enzymes

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to chew through
the scaffolding of tissues.

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We designed these nanoparticles
to be activated by these enzymes.

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One enzyme can activate a thousand
of these chemical reactions in an hour.

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Now in engineering,

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we call that one-to-one thousand
ratio a form of amplification,

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and it makes something ultrasensitive.

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So we've made an ultrasensitive
cancer detector.

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OK, but how do I get this activated
signal to the outside world

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where I can act on it?

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For this we're going to use
one more piece of nanoscale biology

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and that has to do with the kidney.

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So the kidney is a filter.

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It's job is to filter out the blood
and put waste into the urine.

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It turns out that what the kidney filters
is also dependent on size.

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So in this image,

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what you can see

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is that everything smaller than five
nanometers is going from the blood,

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through the kidney into the urine,

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and everything else
that's bigger is retained.

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OK, so if I make a 100-nanometer
cancer detector,

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I inject it in the bloodstream,

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it can leak into the tumor,

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where it's activated by tumor enzymes
to release a small signal

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that is small enough to be
filtered out of the kidney

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and put into the urine,

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I have a signal in the outside
world that I can detect.

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OK, but there's one more problem.

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This is a tiny, little signal,

156
00:08:04,592 --> 00:08:06,564
so how do I detect it?

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00:08:06,897 --> 00:08:09,077
Well, the signal is just a molecule.

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There are molecules
that we designed as engineers --

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00:08:11,905 --> 00:08:13,764
they're completely synthetic --

160
00:08:13,764 --> 00:08:18,319
and we can design them so that they
are compatible with our tool of choice.

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If we want to use a really
sensitive, fancy instrument

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called a mass spectrometer,

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then we make a molecule
with a unique mass.

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Or maybe we want make something
that's more inexpensive and portable.

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Then we make molecules
that we can trap on paper,

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like a pregnancy test.

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In fact there's a whole
world of paper tests

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00:08:38,810 --> 00:08:43,322
that are becoming available
in a field called Paper Diagnostics.

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All right, where are we going with this?

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What I'm going to tell you next,

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00:08:48,554 --> 00:08:50,247
as a life-long researcher,

172
00:08:50,247 --> 00:08:52,126
represents a dream of mine.

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I can't say that's it's a promise;

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00:08:54,665 --> 00:08:55,942
it's a dream.

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But I think we all have to have dreams
to keep us pushing forward,

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00:08:59,850 --> 00:09:00,850
even --

177
00:09:00,850 --> 00:09:03,626
and maybe especially,
cancer researchers.

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00:09:03,816 --> 00:09:07,220
I'm going to tell you what I hope
will happen with my technology,

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00:09:07,220 --> 00:09:10,013
that my team and I will try --

180
00:09:10,013 --> 00:09:13,417
we'll put our heart and souls
into making a reality.

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00:09:13,417 --> 00:09:15,182
OK, here goes ...

182
00:09:15,194 --> 00:09:18,572
I dream that one day,

183
00:09:18,572 --> 00:09:23,379
instead of going into an expensive
screening facility to get a colonoscopy,

184
00:09:23,379 --> 00:09:24,725
or a mammogram,

185
00:09:24,725 --> 00:09:26,935
or a pap smear,

186
00:09:26,935 --> 00:09:28,536
that you could get a shot,

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00:09:28,536 --> 00:09:30,219
wait an hour,

188
00:09:30,219 --> 00:09:33,377
and do a urine test on a paper strip.

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00:09:33,876 --> 00:09:39,486
I imagine that this could even happen
without the need for steady electricity,

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00:09:39,486 --> 00:09:42,067
or a medical professional in the room.

191
00:09:42,067 --> 00:09:43,550
Maybe they could be far away

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00:09:43,550 --> 00:09:46,360
and connected only by
the image on a smartphone.

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00:09:46,955 --> 00:09:48,671
Now I know this sounds like a dream,

194
00:09:48,671 --> 00:09:51,897
but in the lab we already
have this working in mice,

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00:09:51,897 --> 00:09:54,137
where it works better
than existing methods

196
00:09:54,137 --> 00:09:58,108
for the detection of lung, colon
and ovarian cancer.

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00:09:58,834 --> 00:10:01,028
And I hope that what this means

198
00:10:01,028 --> 00:10:06,186
is that one day we can
detect tumors in patients

199
00:10:06,186 --> 00:10:09,590
sooner than 10 years
after they've started growing,

200
00:10:09,590 --> 00:10:11,598
in all walks of life,

201
00:10:11,598 --> 00:10:13,470
all around the globe,

202
00:10:13,470 --> 00:10:16,228
and that this would lead
to earlier treatments,

203
00:10:16,228 --> 00:10:21,058
and that we could save more lives
than we can today with early detection.

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00:10:21,686 --> 00:10:22,801
Thank you.

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00:10:23,242 --> 00:10:24,728
(Applause)