[Script Info] Title: [Events] Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text Dialogue: 0,0:00:11.31,0:00:13.16,Default,,0000,0000,0000,,"We're declaring war against cancer, Dialogue: 0,0:00:13.16,0:00:15.76,Default,,0000,0000,0000,,and we will win this war by 2015." Dialogue: 0,0:00:16.98,0:00:20.72,Default,,0000,0000,0000,,This is what the US Congress\Nand the National Cancer Institute declared Dialogue: 0,0:00:20.75,0:00:23.31,Default,,0000,0000,0000,,just a few years ago, in 2003. Dialogue: 0,0:00:24.05,0:00:27.15,Default,,0000,0000,0000,,Now, I don't know about you,\Nbut I don't buy that. Dialogue: 0,0:00:27.15,0:00:29.20,Default,,0000,0000,0000,,I don't think we quite won this war yet, Dialogue: 0,0:00:29.21,0:00:31.85,Default,,0000,0000,0000,,and I don't think\Nanyone here will question that. Dialogue: 0,0:00:32.28,0:00:34.78,Default,,0000,0000,0000,,Now, I will argue that a primary reason Dialogue: 0,0:00:34.79,0:00:36.93,Default,,0000,0000,0000,,why we're not winning\Nthis war against cancer Dialogue: 0,0:00:36.94,0:00:39.24,Default,,0000,0000,0000,,is because we're fighting blindly. Dialogue: 0,0:00:39.26,0:00:42.84,Default,,0000,0000,0000,,I'm going to start by sharing with you\Na story about a good friend of mine. Dialogue: 0,0:00:42.86,0:00:44.08,Default,,0000,0000,0000,,His name is Ehud, Dialogue: 0,0:00:44.10,0:00:47.24,Default,,0000,0000,0000,,and a few years ago,\NEhud was diagnosed with brain cancer. Dialogue: 0,0:00:47.27,0:00:49.13,Default,,0000,0000,0000,,And not just any type of brain cancer: Dialogue: 0,0:00:49.14,0:00:52.32,Default,,0000,0000,0000,,he was diagnosed with one\Nof the most deadly forms of brain cancer. Dialogue: 0,0:00:52.34,0:00:53.56,Default,,0000,0000,0000,,In fact, it was so deadly Dialogue: 0,0:00:53.58,0:00:56.24,Default,,0000,0000,0000,,that the doctors told him\Nthat they only have 12 months, Dialogue: 0,0:00:56.26,0:00:59.68,Default,,0000,0000,0000,,and during those 12 months,\Nthey have to find a treatment. Dialogue: 0,0:00:59.71,0:01:01.17,Default,,0000,0000,0000,,They have to find a cure, Dialogue: 0,0:01:01.17,0:01:03.33,Default,,0000,0000,0000,,and if they cannot\Nfind a cure, he will die. Dialogue: 0,0:01:04.17,0:01:05.63,Default,,0000,0000,0000,,Now, the good news, they said, Dialogue: 0,0:01:05.65,0:01:08.58,Default,,0000,0000,0000,,is that there are tons\Nof different treatments to choose from, Dialogue: 0,0:01:08.58,0:01:09.80,Default,,0000,0000,0000,,but the bad news is Dialogue: 0,0:01:09.82,0:01:13.36,Default,,0000,0000,0000,,that in order for them to tell\Nif a treatment is even working or not, Dialogue: 0,0:01:13.36,0:01:15.86,Default,,0000,0000,0000,,well, that takes them\Nabout three months or so. Dialogue: 0,0:01:15.87,0:01:18.25,Default,,0000,0000,0000,,So they cannot try that many things. Dialogue: 0,0:01:18.25,0:01:21.35,Default,,0000,0000,0000,,Well, Ehud is now going\Ninto his first treatment, Dialogue: 0,0:01:21.35,0:01:24.61,Default,,0000,0000,0000,,and during that first treatment,\Njust a few days into that treatment, Dialogue: 0,0:01:24.63,0:01:27.97,Default,,0000,0000,0000,,I'm meeting with him, and he tells me,\N"Adam, I think this is working. Dialogue: 0,0:01:27.97,0:01:30.78,Default,,0000,0000,0000,,I think we really lucked out here.\NSomething is happening." Dialogue: 0,0:01:30.81,0:01:33.27,Default,,0000,0000,0000,,And I ask him, "Really?\NHow do you know that, Ehud?" Dialogue: 0,0:01:33.29,0:01:35.51,Default,,0000,0000,0000,,And he says, "Well,\NI feel so terrible inside. Dialogue: 0,0:01:35.53,0:01:37.39,Default,,0000,0000,0000,,Something's gotta be working up there. Dialogue: 0,0:01:37.41,0:01:38.63,Default,,0000,0000,0000,,It just has to." Dialogue: 0,0:01:38.63,0:01:43.07,Default,,0000,0000,0000,,Well, unfortunately, three months later,\Nwe got the news, it didn't work. Dialogue: 0,0:01:44.02,0:01:46.08,Default,,0000,0000,0000,,And so Ehud goes\Ninto his second treatment. Dialogue: 0,0:01:46.10,0:01:47.36,Default,,0000,0000,0000,,And again, the same story. Dialogue: 0,0:01:47.37,0:01:50.11,Default,,0000,0000,0000,,"It feels so bad, something's\Ngotta be working there." Dialogue: 0,0:01:50.13,0:01:53.07,Default,,0000,0000,0000,,And then three months later,\Nagain we get bad news. Dialogue: 0,0:01:53.09,0:01:57.03,Default,,0000,0000,0000,,Ehud is going into his third treatment,\Nand then his fourth treatment. Dialogue: 0,0:01:57.03,0:01:59.55,Default,,0000,0000,0000,,And then, as predicted, Ehud dies. Dialogue: 0,0:02:00.42,0:02:04.100,Default,,0000,0000,0000,,Now, when someone really close to you\Nis going through such a huge struggle, Dialogue: 0,0:02:05.01,0:02:06.83,Default,,0000,0000,0000,,you get really swamped with emotions. Dialogue: 0,0:02:06.83,0:02:08.92,Default,,0000,0000,0000,,A lot of things\Nare going through your head. Dialogue: 0,0:02:08.93,0:02:10.39,Default,,0000,0000,0000,,For me, it was mostly outrage. Dialogue: 0,0:02:10.40,0:02:15.10,Default,,0000,0000,0000,,I was just outraged that, how come\Nthis is the best that we can offer? Dialogue: 0,0:02:15.12,0:02:17.42,Default,,0000,0000,0000,,And I started looking\Nmore and more into this. Dialogue: 0,0:02:17.42,0:02:20.88,Default,,0000,0000,0000,,As it turns out, this is not just\Nthe best that doctors could offer Ehud. Dialogue: 0,0:02:20.89,0:02:24.71,Default,,0000,0000,0000,,It's not just the best doctors could offer\Npatients with brain cancer generally. Dialogue: 0,0:02:24.72,0:02:27.92,Default,,0000,0000,0000,,We're actually not doing that well\Nall across the board with cancer. Dialogue: 0,0:02:28.72,0:02:30.58,Default,,0000,0000,0000,,I picked up one of those statistics, Dialogue: 0,0:02:30.58,0:02:33.36,Default,,0000,0000,0000,,and I'm sure some of you\Nhave seen those statistics before. Dialogue: 0,0:02:33.37,0:02:36.83,Default,,0000,0000,0000,,This is going to show you here\Nhow many patients actually died of cancer, Dialogue: 0,0:02:36.83,0:02:38.85,Default,,0000,0000,0000,,in this case females in the United States, Dialogue: 0,0:02:38.86,0:02:40.16,Default,,0000,0000,0000,,ever since the 1930s. Dialogue: 0,0:02:40.16,0:02:43.34,Default,,0000,0000,0000,,You'll notice that there aren't\Nthat many things that have changed. Dialogue: 0,0:02:43.34,0:02:44.64,Default,,0000,0000,0000,,It's still a huge issue. Dialogue: 0,0:02:44.65,0:02:46.39,Default,,0000,0000,0000,,You'll see a few changes though. Dialogue: 0,0:02:46.39,0:02:48.93,Default,,0000,0000,0000,,You'll see lung cancer,\Nfor example, on the rise. Dialogue: 0,0:02:48.95,0:02:50.15,Default,,0000,0000,0000,,Thank you, cigarettes. Dialogue: 0,0:02:50.94,0:02:53.44,Default,,0000,0000,0000,,And you'll also see that,\Nfor example, stomach cancer Dialogue: 0,0:02:53.44,0:02:56.78,Default,,0000,0000,0000,,once used to be one\Nof the biggest killers of all cancers, Dialogue: 0,0:02:56.79,0:02:58.23,Default,,0000,0000,0000,,is essentially eliminated. Dialogue: 0,0:02:58.84,0:03:00.90,Default,,0000,0000,0000,,Now, why is that?\NAnyone knows, by the way? Dialogue: 0,0:03:00.92,0:03:04.26,Default,,0000,0000,0000,,Why is it that humanity is no longer\Nstruck by stomach cancer? Dialogue: 0,0:03:04.27,0:03:09.13,Default,,0000,0000,0000,,What was the huge, huge\Nmedical technology breakthrough Dialogue: 0,0:03:09.14,0:03:12.50,Default,,0000,0000,0000,,that came to our world\Nthat saved humanity from stomach cancer? Dialogue: 0,0:03:13.71,0:03:17.53,Default,,0000,0000,0000,,Was it maybe a new drug,\Nor a better diagnostic? Dialogue: 0,0:03:17.53,0:03:18.83,Default,,0000,0000,0000,,You guys are right, yeah. Dialogue: 0,0:03:18.85,0:03:21.47,Default,,0000,0000,0000,,It's the invention of the refrigerator, Dialogue: 0,0:03:21.47,0:03:24.09,Default,,0000,0000,0000,,and the fact that we're\Nno longer eating spoiled meats. Dialogue: 0,0:03:24.10,0:03:26.40,Default,,0000,0000,0000,,So the best thing\Nthat happened to us so far Dialogue: 0,0:03:26.41,0:03:28.35,Default,,0000,0000,0000,,in the medical arena in cancer research Dialogue: 0,0:03:28.36,0:03:30.55,Default,,0000,0000,0000,,is the fact that\Nthe refrigerator was invented. Dialogue: 0,0:03:30.58,0:03:31.78,Default,,0000,0000,0000,,(Laughter) Dialogue: 0,0:03:31.79,0:03:33.05,Default,,0000,0000,0000,,And so -- yeah, I know. Dialogue: 0,0:03:33.07,0:03:34.49,Default,,0000,0000,0000,,We're not doing so well here. Dialogue: 0,0:03:34.49,0:03:36.83,Default,,0000,0000,0000,,I don't want to miniaturize the progress Dialogue: 0,0:03:36.84,0:03:40.22,Default,,0000,0000,0000,,and everything that's been done\Nin cancer research. Dialogue: 0,0:03:40.42,0:03:43.84,Default,,0000,0000,0000,,Look, there is like 50-plus years\Nof good cancer research Dialogue: 0,0:03:43.84,0:03:47.26,Default,,0000,0000,0000,,that discovered major, major things\Nthat taught us about cancer. Dialogue: 0,0:03:47.27,0:03:49.01,Default,,0000,0000,0000,,But all that said, Dialogue: 0,0:03:49.01,0:03:51.58,Default,,0000,0000,0000,,we have a lot of heavy lifting\Nto still do ahead of us. Dialogue: 0,0:03:53.31,0:03:56.41,Default,,0000,0000,0000,,Again, I will argue that the primary\Nreason why this is the case, Dialogue: 0,0:03:56.43,0:03:58.43,Default,,0000,0000,0000,,why we have not done that remarkably well, Dialogue: 0,0:03:58.46,0:04:00.30,Default,,0000,0000,0000,,is really we're fighting blindly here. Dialogue: 0,0:04:00.31,0:04:02.53,Default,,0000,0000,0000,,And this is where\Nmedical imaging comes in. Dialogue: 0,0:04:02.53,0:04:04.21,Default,,0000,0000,0000,,This is where my own work comes in. Dialogue: 0,0:04:04.93,0:04:07.67,Default,,0000,0000,0000,,And so to give you a sense\Nof the best medical imaging Dialogue: 0,0:04:07.67,0:04:10.17,Default,,0000,0000,0000,,that's offered today\Nto brain cancer patients, Dialogue: 0,0:04:10.17,0:04:12.34,Default,,0000,0000,0000,,or actually generally\Nto all cancer patients, Dialogue: 0,0:04:12.35,0:04:14.29,Default,,0000,0000,0000,,take a look at this PET scan right here. Dialogue: 0,0:04:14.29,0:04:15.53,Default,,0000,0000,0000,,Let's see. There we go. Dialogue: 0,0:04:16.15,0:04:17.85,Default,,0000,0000,0000,,So this is a PET/CT scan, Dialogue: 0,0:04:17.87,0:04:20.32,Default,,0000,0000,0000,,and what you'll see in this PET/CT scan Dialogue: 0,0:04:20.35,0:04:23.57,Default,,0000,0000,0000,,is the CT scan will show you\Nwhere the bones are, Dialogue: 0,0:04:23.58,0:04:25.98,Default,,0000,0000,0000,,and the PET scan will show you\Nwhere tumors are. Dialogue: 0,0:04:26.34,0:04:28.56,Default,,0000,0000,0000,,Now, what you can see here Dialogue: 0,0:04:28.56,0:04:30.98,Default,,0000,0000,0000,,is essentially a sugar molecule Dialogue: 0,0:04:30.99,0:04:32.81,Default,,0000,0000,0000,,that was added a small little tag Dialogue: 0,0:04:32.81,0:04:34.91,Default,,0000,0000,0000,,that is signaling to us\Noutside of the body, Dialogue: 0,0:04:34.91,0:04:36.21,Default,,0000,0000,0000,,"Hey, I'm here." Dialogue: 0,0:04:36.23,0:04:40.05,Default,,0000,0000,0000,,And those sugar molecules are injected\Ninto these patients by the billions, Dialogue: 0,0:04:40.05,0:04:41.75,Default,,0000,0000,0000,,and they're going all over the body Dialogue: 0,0:04:41.75,0:04:43.83,Default,,0000,0000,0000,,looking for cells\Nthat are hungry for sugar. Dialogue: 0,0:04:44.73,0:04:47.39,Default,,0000,0000,0000,,You'll see that the heart,\Nfor example, lights up there. Dialogue: 0,0:04:47.39,0:04:49.61,Default,,0000,0000,0000,,That's because the heart\Nneeds a lot of sugar. Dialogue: 0,0:04:49.61,0:04:51.94,Default,,0000,0000,0000,,You'll also see that the bladder\Nlights up there. Dialogue: 0,0:04:51.94,0:04:54.56,Default,,0000,0000,0000,,That's because the bladder\Nis the thing that's clearing Dialogue: 0,0:04:54.56,0:04:55.96,Default,,0000,0000,0000,,the sugar away from our body. Dialogue: 0,0:04:56.83,0:04:58.83,Default,,0000,0000,0000,,And then you'll see a few other hot spots, Dialogue: 0,0:04:58.83,0:05:00.44,Default,,0000,0000,0000,,and these are in fact the tumors. Dialogue: 0,0:05:00.45,0:05:02.59,Default,,0000,0000,0000,,Now, this is a really\Na wonderful technology. Dialogue: 0,0:05:02.60,0:05:05.74,Default,,0000,0000,0000,,For the first time it allowed us\Nto look into someone's body Dialogue: 0,0:05:05.75,0:05:08.13,Default,,0000,0000,0000,,without picking up\Neach and every one of the cells Dialogue: 0,0:05:08.14,0:05:09.100,Default,,0000,0000,0000,,and putting them under the microscope, Dialogue: 0,0:05:09.100,0:05:13.01,Default,,0000,0000,0000,,but in a noninvasive way\Nallowing us to look into someone's body Dialogue: 0,0:05:13.02,0:05:15.16,Default,,0000,0000,0000,,and ask, "Hey,\Nhas the cancer metastasized? Dialogue: 0,0:05:15.16,0:05:16.37,Default,,0000,0000,0000,,Where is it?" Dialogue: 0,0:05:16.37,0:05:18.87,Default,,0000,0000,0000,,And the PET scans here\Nare showing you very clearly Dialogue: 0,0:05:18.87,0:05:21.15,Default,,0000,0000,0000,,where are these hot spots,\Nwhere is the tumor. Dialogue: 0,0:05:22.14,0:05:25.44,Default,,0000,0000,0000,,So as miraculous as this might seem, Dialogue: 0,0:05:25.46,0:05:28.34,Default,,0000,0000,0000,,unfortunately, well, it's not that great. Dialogue: 0,0:05:29.10,0:05:31.18,Default,,0000,0000,0000,,You see, those\Nsmall little hot spots there. Dialogue: 0,0:05:31.90,0:05:35.42,Default,,0000,0000,0000,,Can anyone guess how many cancer cells\Nare in any one of these tumors? Dialogue: 0,0:05:37.29,0:05:39.63,Default,,0000,0000,0000,,So it's about 100 million cancer cells, Dialogue: 0,0:05:39.64,0:05:42.34,Default,,0000,0000,0000,,and let me make sure\Nthat this number sunk in. Dialogue: 0,0:05:42.34,0:05:44.67,Default,,0000,0000,0000,,In each and every one\Nof these small little blips Dialogue: 0,0:05:44.69,0:05:46.27,Default,,0000,0000,0000,,that you're seeing on the image, Dialogue: 0,0:05:46.29,0:05:50.39,Default,,0000,0000,0000,,there needs to be\Nat least 100 million cancer cells Dialogue: 0,0:05:50.39,0:05:51.92,Default,,0000,0000,0000,,in order for it to be detected. Dialogue: 0,0:05:51.93,0:05:54.39,Default,,0000,0000,0000,,Now, if that seemed to you\Nlike a very large number, Dialogue: 0,0:05:54.41,0:05:56.09,Default,,0000,0000,0000,,it is a very large number. Dialogue: 0,0:05:57.28,0:05:59.34,Default,,0000,0000,0000,,This is in fact\Nan incredibly large number, Dialogue: 0,0:05:59.34,0:06:02.68,Default,,0000,0000,0000,,because what we really need\Nin order to pick up something early enough Dialogue: 0,0:06:02.68,0:06:05.61,Default,,0000,0000,0000,,to do something about it,\Nto do something meaningful about it, Dialogue: 0,0:06:05.63,0:06:08.77,Default,,0000,0000,0000,,well, we need to pick up tumors\Nthat are a thousand cells in size, Dialogue: 0,0:06:08.79,0:06:10.93,Default,,0000,0000,0000,,and ideally just\Na handful of cells in size. Dialogue: 0,0:06:10.95,0:06:12.97,Default,,0000,0000,0000,,So we're clearly\Npretty far away from this. Dialogue: 0,0:06:12.100,0:06:14.89,Default,,0000,0000,0000,,And I remember looking at these numbers Dialogue: 0,0:06:14.91,0:06:17.76,Default,,0000,0000,0000,,and being struck by the humonguos\Ndifference Dialogue: 0,0:06:17.78,0:06:20.58,Default,,0000,0000,0000,,between where we are today\Nand where we need to be. Dialogue: 0,0:06:20.60,0:06:23.79,Default,,0000,0000,0000,,And saying, I'm an engineer -\Nit was very early in my career - Dialogue: 0,0:06:23.82,0:06:26.74,Default,,0000,0000,0000,,I'm an engineer, let's see\Nif there's something I can do here. Dialogue: 0,0:06:26.86,0:06:30.34,Default,,0000,0000,0000,,I started talking to a lot of surgeons,\Nradiologists, Dialogue: 0,0:06:30.37,0:06:32.10,Default,,0000,0000,0000,,and other types of doctors Dialogue: 0,0:06:32.26,0:06:34.04,Default,,0000,0000,0000,,that deal with brain cancer patients, Dialogue: 0,0:06:34.06,0:06:36.77,Default,,0000,0000,0000,,because I was really\Npassionate about brain cancer. Dialogue: 0,0:06:36.85,0:06:40.98,Default,,0000,0000,0000,,And I remember talking to them,\Nand boy, I was just horrified Dialogue: 0,0:06:41.15,0:06:44.92,Default,,0000,0000,0000,,at how archaic medicine is today. Dialogue: 0,0:06:45.50,0:06:47.76,Default,,0000,0000,0000,,So we're going to play\Na little experiment here. Dialogue: 0,0:06:47.78,0:06:50.24,Default,,0000,0000,0000,,I'm going to ask each of you\Nto now play and imagine Dialogue: 0,0:06:50.26,0:06:51.62,Default,,0000,0000,0000,,that you are brain surgeons. Dialogue: 0,0:06:52.80,0:06:56.82,Default,,0000,0000,0000,,And you guys are now at an operating room, Dialogue: 0,0:06:56.84,0:06:58.86,Default,,0000,0000,0000,,and there's a patient in front of you, Dialogue: 0,0:06:58.88,0:07:02.60,Default,,0000,0000,0000,,and your task is to make sure\Nthat the tumor is out. Dialogue: 0,0:07:03.20,0:07:06.58,Default,,0000,0000,0000,,So you're looking down at the patient, Dialogue: 0,0:07:06.60,0:07:08.94,Default,,0000,0000,0000,,the skin and the skull\Nhave already been removed, Dialogue: 0,0:07:08.96,0:07:10.50,Default,,0000,0000,0000,,so you're looking at the brain. Dialogue: 0,0:07:10.52,0:07:12.22,Default,,0000,0000,0000,,And all you know about this patient Dialogue: 0,0:07:12.24,0:07:15.06,Default,,0000,0000,0000,,is that there's a tumor\Nabout the size of a golf ball or so Dialogue: 0,0:07:15.08,0:07:17.40,Default,,0000,0000,0000,,in the right frontal lobe\Nof this person's brain. Dialogue: 0,0:07:17.88,0:07:19.22,Default,,0000,0000,0000,,And that's more or less it. Dialogue: 0,0:07:19.24,0:07:22.46,Default,,0000,0000,0000,,So you're looking down, and unfortunately\Neverything looks the same, Dialogue: 0,0:07:22.48,0:07:25.58,Default,,0000,0000,0000,,because brain cancer tissue\Nand healthy brain tissue Dialogue: 0,0:07:25.60,0:07:27.18,Default,,0000,0000,0000,,really just look the same. Dialogue: 0,0:07:27.20,0:07:29.10,Default,,0000,0000,0000,,And so you're going in with your thumb, Dialogue: 0,0:07:29.12,0:07:31.46,Default,,0000,0000,0000,,and you start to press\Na little bit on the brain, Dialogue: 0,0:07:31.48,0:07:33.90,Default,,0000,0000,0000,,because tumors tend to be\Na little harder, stiffer, Dialogue: 0,0:07:33.92,0:07:36.54,Default,,0000,0000,0000,,and so you go in and go\Na little bit like this and say, Dialogue: 0,0:07:36.56,0:07:38.54,Default,,0000,0000,0000,,"It seems like the tumor is right there." Dialogue: 0,0:07:38.56,0:07:41.22,Default,,0000,0000,0000,,Then you take out your knife\Nand start cutting the tumor Dialogue: 0,0:07:41.24,0:07:42.50,Default,,0000,0000,0000,,piece by piece by piece, Dialogue: 0,0:07:42.52,0:07:44.22,Default,,0000,0000,0000,,and as you're taking the tumor out, Dialogue: 0,0:07:44.24,0:07:46.46,Default,,0000,0000,0000,,then you're getting\Nto a stage where you think, Dialogue: 0,0:07:46.48,0:07:48.62,Default,,0000,0000,0000,,"All right, I'm done.\NI took out everything." Dialogue: 0,0:07:48.64,0:07:50.18,Default,,0000,0000,0000,,And at this stage, if that's -- Dialogue: 0,0:07:50.20,0:07:52.90,Default,,0000,0000,0000,,so far everything sounded,\Nlike, pretty crazy -- Dialogue: 0,0:07:52.92,0:07:56.62,Default,,0000,0000,0000,,you're now about to face the most\Nchallenging decision of your life here. Dialogue: 0,0:07:56.64,0:07:58.18,Default,,0000,0000,0000,,Because now you need to decide, Dialogue: 0,0:07:58.20,0:08:00.90,Default,,0000,0000,0000,,should I stop here\Nand let this patient go, Dialogue: 0,0:08:00.92,0:08:03.86,Default,,0000,0000,0000,,risking that there might be\Nsome leftover cancer cells behind Dialogue: 0,0:08:03.88,0:08:05.74,Default,,0000,0000,0000,,that I just couldn't see, Dialogue: 0,0:08:05.76,0:08:08.42,Default,,0000,0000,0000,,or should I take away some extra margins, Dialogue: 0,0:08:08.44,0:08:11.30,Default,,0000,0000,0000,,typically about an inch or so\Naround the tumor Dialogue: 0,0:08:11.32,0:08:13.52,Default,,0000,0000,0000,,just to be sure that I removed everything? Dialogue: 0,0:08:15.20,0:08:19.04,Default,,0000,0000,0000,,So this is not a simple decision to make, Dialogue: 0,0:08:19.64,0:08:21.58,Default,,0000,0000,0000,,and unfortunately this is the decision Dialogue: 0,0:08:21.60,0:08:24.94,Default,,0000,0000,0000,,that brain cancer surgeons\Nhave to take every single day Dialogue: 0,0:08:24.96,0:08:26.56,Default,,0000,0000,0000,,as they're seeing their patients. Dialogue: 0,0:08:27.12,0:08:30.06,Default,,0000,0000,0000,,And so I remember talking\Nto a few friends of mine in the lab, Dialogue: 0,0:08:30.08,0:08:32.46,Default,,0000,0000,0000,,and we say, "Boy,\Nthere's got to be a better way." Dialogue: 0,0:08:32.48,0:08:35.90,Default,,0000,0000,0000,,But not just like you tell a friend\Nthat there's got to be a better way. Dialogue: 0,0:08:35.92,0:08:37.87,Default,,0000,0000,0000,,There's just got to be a better way here. Dialogue: 0,0:08:37.90,0:08:39.42,Default,,0000,0000,0000,,This is just incredible. Dialogue: 0,0:08:39.44,0:08:41.10,Default,,0000,0000,0000,,And so we looked back. Dialogue: 0,0:08:41.12,0:08:44.10,Default,,0000,0000,0000,,Remember those PET scans I told you about,\Nthe sugar and so on. Dialogue: 0,0:08:44.12,0:08:46.86,Default,,0000,0000,0000,,We said, hey, how about\Ninstead of using sugar molecules, Dialogue: 0,0:08:46.88,0:08:50.02,Default,,0000,0000,0000,,let's maybe take tiny, tiny\Nlittle particles made of gold Dialogue: 0,0:08:50.04,0:08:53.70,Default,,0000,0000,0000,,and let's program them with some\Ninteresting chemistry around them. Dialogue: 0,0:08:53.72,0:08:56.14,Default,,0000,0000,0000,,Let's program them\Nto look for cancer cells. Dialogue: 0,0:08:56.16,0:08:58.26,Default,,0000,0000,0000,,And then we will inject\Nthese gold particles Dialogue: 0,0:08:58.28,0:09:00.54,Default,,0000,0000,0000,,into these patients by the billions again, Dialogue: 0,0:09:00.56,0:09:02.54,Default,,0000,0000,0000,,and we'll have them go all over the body, Dialogue: 0,0:09:02.56,0:09:04.54,Default,,0000,0000,0000,,and just like secret agents, if you will, Dialogue: 0,0:09:04.56,0:09:07.38,Default,,0000,0000,0000,,go and walk by\Nevery single cell in our body Dialogue: 0,0:09:07.40,0:09:09.10,Default,,0000,0000,0000,,and knock on the door of that cell, Dialogue: 0,0:09:09.12,0:09:11.86,Default,,0000,0000,0000,,and ask, "Are you a cancer cell\Nor are you a healthy cell? Dialogue: 0,0:09:11.88,0:09:13.90,Default,,0000,0000,0000,,If you're a healthy cell, we're moving on. Dialogue: 0,0:09:13.92,0:09:16.66,Default,,0000,0000,0000,,If you're a cancer cell,\Nwe're sticking in and shining out Dialogue: 0,0:09:16.68,0:09:18.78,Default,,0000,0000,0000,,and telling us,\N"Hey, look at me, I'm here." Dialogue: 0,0:09:18.80,0:09:21.18,Default,,0000,0000,0000,,And they'll do it\Nthrough some interesting cameras Dialogue: 0,0:09:21.20,0:09:22.62,Default,,0000,0000,0000,,that we developed in the lab. Dialogue: 0,0:09:22.64,0:09:25.58,Default,,0000,0000,0000,,And once we see that,\Nmaybe we can guide brain cancer surgeons Dialogue: 0,0:09:25.60,0:09:29.00,Default,,0000,0000,0000,,towards taking only the tumor\Nand leaving the healthy brain alone. Dialogue: 0,0:09:29.52,0:09:32.58,Default,,0000,0000,0000,,And so we've tested that,\Nand boy, this works well. Dialogue: 0,0:09:32.60,0:09:34.58,Default,,0000,0000,0000,,So I'm going to show you an example now. Dialogue: 0,0:09:34.60,0:09:36.38,Default,,0000,0000,0000,,What you're looking at here Dialogue: 0,0:09:36.80,0:09:40.45,Default,,0000,0000,0000,,is an image of a mouse's brain. Dialogue: 0,0:09:40.48,0:09:43.52,Default,,0000,0000,0000,,The mouse is fully anestethized,\Nso it's not feeling anything - Dialogue: 0,0:09:43.56,0:09:46.04,Default,,0000,0000,0000,,and we've implanted\Ninto this mouse's brain Dialogue: 0,0:09:46.12,0:09:47.38,Default,,0000,0000,0000,,a small little tumor. Dialogue: 0,0:09:47.42,0:09:50.45,Default,,0000,0000,0000,,That tumor was taken from\Na brain cancer patient Dialogue: 0,0:09:50.51,0:09:52.13,Default,,0000,0000,0000,,who donated it. Dialogue: 0,0:09:52.80,0:09:55.42,Default,,0000,0000,0000,,And so this tumor is now\Ngrowing in this mouse's brain, Dialogue: 0,0:09:55.44,0:09:58.10,Default,,0000,0000,0000,,and then we've taken a doctor\Nand just asked this doctor Dialogue: 0,0:09:58.12,0:10:00.94,Default,,0000,0000,0000,,to please operate on the mouse\Nas if that was a patient, Dialogue: 0,0:10:00.96,0:10:03.38,Default,,0000,0000,0000,,and take out piece by piece\Nout of the tumor, Dialogue: 0,0:10:03.40,0:10:05.18,Default,,0000,0000,0000,,and while he's doing that, Dialogue: 0,0:10:05.20,0:10:08.18,Default,,0000,0000,0000,,we're going to take images\Nto see where the gold particles are. Dialogue: 0,0:10:08.20,0:10:09.82,Default,,0000,0000,0000,,And so we're going to first start Dialogue: 0,0:10:09.84,0:10:12.26,Default,,0000,0000,0000,,by injecting these gold particles\Ninto this mouse, Dialogue: 0,0:10:12.28,0:10:15.18,Default,,0000,0000,0000,,and we're going to see\Nright here at the very left there Dialogue: 0,0:10:15.20,0:10:16.46,Default,,0000,0000,0000,,that image at the bottom Dialogue: 0,0:10:16.48,0:10:18.98,Default,,0000,0000,0000,,is the image that shows\Nwhere the gold particles are. Dialogue: 0,0:10:19.00,0:10:21.06,Default,,0000,0000,0000,,The nice thing\Nis that these gold particles Dialogue: 0,0:10:21.08,0:10:23.10,Default,,0000,0000,0000,,actually made it all the way to the tumor, Dialogue: 0,0:10:23.12,0:10:26.78,Default,,0000,0000,0000,,and then they shine out and tell us,\N"Hey, we're here. Here's the tumor." Dialogue: 0,0:10:26.80,0:10:28.18,Default,,0000,0000,0000,,So now we can see the tumor, Dialogue: 0,0:10:28.20,0:10:30.34,Default,,0000,0000,0000,,but we're not showing this\Nto the doctor yet. Dialogue: 0,0:10:30.36,0:10:33.42,Default,,0000,0000,0000,,We're asking the doctor,\Nnow please start cutting away the tumor, Dialogue: 0,0:10:33.44,0:10:36.86,Default,,0000,0000,0000,,and you'll see here the doctor\Njust took the first quadrant of the tumor Dialogue: 0,0:10:36.88,0:10:39.10,Default,,0000,0000,0000,,and you see that first quadrant\Nis now missing. Dialogue: 0,0:10:39.12,0:10:41.58,Default,,0000,0000,0000,,The doctor then took\Nthe second quadrant, the third, Dialogue: 0,0:10:41.60,0:10:43.34,Default,,0000,0000,0000,,and now it appears to be everything. Dialogue: 0,0:10:43.36,0:10:46.10,Default,,0000,0000,0000,,And so at this stage,\Nthe doctor came back to us and said, Dialogue: 0,0:10:46.12,0:10:48.38,Default,,0000,0000,0000,,"All right, I'm done.\NWhat do you want me to do? Dialogue: 0,0:10:48.40,0:10:49.98,Default,,0000,0000,0000,,Should I keep things as they are Dialogue: 0,0:10:50.00,0:10:52.50,Default,,0000,0000,0000,,or do you want me to take\Nsome extra margins around?" Dialogue: 0,0:10:52.52,0:10:54.18,Default,,0000,0000,0000,,And then we said, "Well, hang on. Dialogue: 0,0:10:54.20,0:10:55.94,Default,,0000,0000,0000,,You've missed those two spots." Dialogue: 0,0:10:55.96,0:10:58.97,Default,,0000,0000,0000,,And it's extremely hard to see\Non the projector, but trust me - Dialogue: 0,0:10:59.03,0:11:00.86,Default,,0000,0000,0000,,it's there, some of you might notice - Dialogue: 0,0:11:00.88,0:11:03.15,Default,,0000,0000,0000,,there are two small red dots there Dialogue: 0,0:11:03.16,0:11:04.91,Default,,0000,0000,0000,,in that area there. Dialogue: 0,0:11:05.49,0:11:08.11,Default,,0000,0000,0000,,We told the doctor, "You've missed\Nthose two spots," Dialogue: 0,0:11:08.14,0:11:10.14,Default,,0000,0000,0000,,so rather than taking huge margins around, Dialogue: 0,0:11:10.16,0:11:11.100,Default,,0000,0000,0000,,only take out those tiny little areas. Dialogue: 0,0:11:12.02,0:11:14.04,Default,,0000,0000,0000,,Take them out,\Nand then let's take a look." Dialogue: 0,0:11:14.06,0:11:17.30,Default,,0000,0000,0000,,And so the doctor took them away,\Nand lo and behold, Dialogue: 0,0:11:17.54,0:11:19.56,Default,,0000,0000,0000,,the cancer is now completely gone. Dialogue: 0,0:11:20.38,0:11:21.76,Default,,0000,0000,0000,,Now, the important thing Dialogue: 0,0:11:21.78,0:11:24.40,Default,,0000,0000,0000,,is that it's not just\Nthat the cancer is completely gone Dialogue: 0,0:11:24.42,0:11:25.76,Default,,0000,0000,0000,,from this person's brain, Dialogue: 0,0:11:25.78,0:11:27.10,Default,,0000,0000,0000,,or from this mouse's brain. Dialogue: 0,0:11:27.86,0:11:29.12,Default,,0000,0000,0000,,The most important thing Dialogue: 0,0:11:29.14,0:11:32.04,Default,,0000,0000,0000,,is that we did not have to take\Nhuge amounts of healthy brain Dialogue: 0,0:11:32.06,0:11:33.28,Default,,0000,0000,0000,,in the process. Dialogue: 0,0:11:33.30,0:11:35.48,Default,,0000,0000,0000,,And so now we can actually imagine a world Dialogue: 0,0:11:35.50,0:11:39.40,Default,,0000,0000,0000,,where doctors and surgeons,\Nas they take away a tumor, Dialogue: 0,0:11:39.42,0:11:42.86,Default,,0000,0000,0000,,they actually know what to take out,\Nand they no longer have to guess. Dialogue: 0,0:11:44.22,0:11:48.16,Default,,0000,0000,0000,,Now, here's why it's extremely important\Nto take those tiny little leftover tumors. Dialogue: 0,0:11:48.18,0:11:51.04,Default,,0000,0000,0000,,Those leftover tumors,\Neven if it's just a handful of cells, Dialogue: 0,0:11:51.06,0:11:54.12,Default,,0000,0000,0000,,they will grow to recur the tumor, Dialogue: 0,0:11:54.14,0:11:55.80,Default,,0000,0000,0000,,for the tumor to come back. Dialogue: 0,0:11:55.82,0:11:57.76,Default,,0000,0000,0000,,In fact, the reason why 80 to 90 percent Dialogue: 0,0:11:57.78,0:11:59.100,Default,,0000,0000,0000,,of those brain cancer surgeries\Nultimately fail Dialogue: 0,0:12:00.02,0:12:03.80,Default,,0000,0000,0000,,is because of those small little\Nextra margins that were left positive, Dialogue: 0,0:12:03.82,0:12:06.50,Default,,0000,0000,0000,,those small little leftover tumors\Nthat were left there. Dialogue: 0,0:12:07.26,0:12:10.22,Default,,0000,0000,0000,,And I think,\Nwhere medical imaging is heading to, Dialogue: 0,0:12:10.24,0:12:12.52,Default,,0000,0000,0000,,is the ability to look\Ninto the human body Dialogue: 0,0:12:12.55,0:12:16.70,Default,,0000,0000,0000,,and actually see each\Nand every one of these cells separately. Dialogue: 0,0:12:16.78,0:12:18.83,Default,,0000,0000,0000,,The ability like this would allow us Dialogue: 0,0:12:18.86,0:12:21.37,Default,,0000,0000,0000,,to pick up tumors way early\Nin the process Dialogue: 0,0:12:21.38,0:12:23.86,Default,,0000,0000,0000,,way before it's a hundred million\Ncells in size, Dialogue: 0,0:12:23.87,0:12:25.92,Default,,0000,0000,0000,,so we can actually do something about it. Dialogue: 0,0:12:25.97,0:12:28.56,Default,,0000,0000,0000,,An ability to see each and every one\Nof the cells Dialogue: 0,0:12:28.57,0:12:30.89,Default,,0000,0000,0000,,might also allow us to ask\Ninsightful questions. Dialogue: 0,0:12:30.93,0:12:32.94,Default,,0000,0000,0000,,So in the lab,\Nwe're now getting to a point Dialogue: 0,0:12:33.01,0:12:36.22,Default,,0000,0000,0000,,where we can actually start asking\Nthese cancer cells real questions Dialogue: 0,0:12:36.24,0:12:39.97,Default,,0000,0000,0000,,like, for example, are you responding\Nto the treatment we're giving you or not? Dialogue: 0,0:12:39.100,0:12:42.93,Default,,0000,0000,0000,,If you're not, we will know\Nto stop the treatment right away - Dialogue: 0,0:12:42.97,0:12:45.10,Default,,0000,0000,0000,,days into the treatment,\Nnot three months. Dialogue: 0,0:12:46.23,0:12:48.10,Default,,0000,0000,0000,,Also for patients like Ehud, Dialogue: 0,0:12:48.44,0:12:52.11,Default,,0000,0000,0000,,that are going through these\Nnasty chemotherapy drugs. Dialogue: 0,0:12:52.82,0:12:56.90,Default,,0000,0000,0000,,For them not to suffer through\Nthose horendous side effects of the drugs, Dialogue: 0,0:12:56.98,0:12:59.73,Default,,0000,0000,0000,,when drugs are in fact\Nnot even helping them. Dialogue: 0,0:13:01.90,0:13:03.12,Default,,0000,0000,0000,,So to be frank here, Dialogue: 0,0:13:03.16,0:13:06.62,Default,,0000,0000,0000,,we're pretty far away\Nfrom winning the war against cancer, Dialogue: 0,0:13:06.64,0:13:07.90,Default,,0000,0000,0000,,just to be realistic. Dialogue: 0,0:13:07.92,0:13:09.82,Default,,0000,0000,0000,,But at least I am hopeful Dialogue: 0,0:13:09.84,0:13:13.98,Default,,0000,0000,0000,,that we should be able to fight this war\Nwith better medical imaging techniques Dialogue: 0,0:13:14.00,0:13:15.86,Default,,0000,0000,0000,,in the way that is not blind. Dialogue: 0,0:13:15.88,0:13:17.10,Default,,0000,0000,0000,,Thank you. Dialogue: 0,0:13:17.12,0:13:19.36,Default,,0000,0000,0000,,(Applause)