Research Assessment #2

Date: ​September 12, 2018

Subject: ​Oncology

MLA citation:

Soto, Jorge. “The Future of Early Cancer Detection?” ​TED: Ideas Worth Spreading​,

www.ted.com/talks/jorge_soto_the_future_of_early_cancer_detection?referrer=playlist-a
_cure_for_cancer.

Analysis:

Last week, I focused my research on the new types of treatment that were being
discovered in order to combat cancer. And while combating cancer is important, detecting it has
never been easy. And when the cancer is detected in patients, it mostly has already reached stage
3 or 4, making cancer treatment, no matter how efficient, very difficult. Thus, I decided to focus
my time researching new ways that cancer can be detected early so that treatments can begin
early and the chance of survival can be boosted considerably. When I found a TED talk by Jorge
Soto, called “The Future of Early Cancer Detection”, I knew this article would establish new
ideas as well increase my knowledge on the subject.
The author begins his Ted talk by challenging current knowledge of cancer detection with
the audience. He told them about how his aunt was an athletic person, ate healthy, never smoked
or ever drinked. By doing this, he established his aunt as of peak health to the audience and when
he then told them that she was diagnosed with stage 3 lung cancer, the audience’s assumption
about detection were challenged. This revelation that his aunt had stage 3 lung cancer while
being at the highest of health also surprised me. I had always thought that some of the early risk
factors and signs of detection for cancer was when a person was unhealthy and didn’t exercise.
This included smoking, drugs, alcohol, and obesity. But to learn a person who had neither of
those mentioned attributes but was still susceptible to stage 3 cancer astonished me. This was a
moment of learning for me as my previous knowledge of cancer was challenged a new thought
was introduced.
Next, the author talks about how we are living in a world where we are discovering 21st
century treatments through our innovations and technology but our detection of cancer is still in
the 20th century. We only detect cancer most times while the patient is in the 3rd or 4th stage of
cancer, which by then is almost already too late. He describes how in this time “biotech is
advancing at least six times faster than the growth rate of the processing power of computers”.
This information is very motivating for someone like me who is going into a field of research
and innovation where every small growth or advancement can make the treatment for patients
easier and more affordable. This statement also provides job security for an ISM student like me
who wants to research more into biotechnology such as CRISPR in order to make a treatment for
cancer that is less expensive and more effective for metastatic cancer.
Next, he finally goes into the research he has been conducting with his team on how to
detect cancer early. He talks about how he is able to find patterns using microRNA that can be
compared to microRNA patterns in patients with cancer. And because of how early microRNA
are present in bloodstreams, he believes with enough pattern recognition and data collection, he
can ensure that his system detects cancer as early as stage 1 every time. My only concern for a
genome database such as this is the intricate and length it will take to collect this data. For
example, the human genome took 15 years to map out and they mapped out the DNA. A object
like DNA is small, but it doesn't even begin to compare to the size of microRNA. Thus, while
there are only about 20,000 genomes to map for the human body, mapping microRNA can be up
to millions and that just for an organ or two. However, with the technology that Jorge Soto is
working with, he should be able to map out patterns for these microRNA even though he will not
be able to map the entirety of the microRNA database. This advancement in early detection is
truly important to the state of current cancer treatment. When perfected and a 100% mapped out,
this technology has the ability to increase the likelihood of survival in a manner never done
before. This information is very relevant to me when considering I want to become a oncologist
in the future and use ISM as a conduit for information and experience for the field. As an
oncologist, having the ability to detect cancer in a patient in early stages like 1 or 2 can be
absurdly important as it can allow the physician to cater treatments to the patient that are not as
painful and more efficient than they would be during stage 3 or 4.
In this age, cancer detection happens when symptoms begin to show. When they do begin
to show, it is already too late for the physician and the patient. It is not impossible to treat cancer
but it becomes more expensive, painful and difficult as time progresses. Having a technology
like that of Jorge Soto can make us finally grasp the idea that there will be a day when cancer is
treated easily because it can be routinely diagnosed at the very early stages. It will give us the
chance of detecting it early, understanding it better, and finding a cure. When going into this
article, even though I had hope for the future of oncology, there was always a dread in my
stomach that we would be too late to respond and that cancer will become a battle of time rather
than treatment. This article completely changed my perspective by informing me that countless
researchers are figuring out applicable ways to detect cancer early. It has given me hope and
helped me turn from the pessimistic person I was about cancer treatment to someone who is a
little bit more optimistic and ready to take on the world of oncology.

(Ted Talk begins on next page)

Ted Talk:

00:12
Almost a year ago, my aunt started suffering back pains. She went to see the doctor and they told
her it was a normal injury for someone who had been playing tennis for almost 30 years. They
recommended that she do some therapy, but after a while she wasn't feeling better, so the doctors
decided to do further tests. They did an x-ray and discovered an injury in her lungs, and at the
time they thought that the injury was a strain in the muscles and tendons between her ribs, but
after a few weeks of treatment, again her health wasn't getting any better. So finally, they
decided to do a biopsy, and two weeks later, the results of the biopsy came back. It was stage 3
lung cancer.
00:58
Her lifestyle was almost free of risk​. She never smoked a cigarette, she never drank alcohol, and
she had been playing sports for almost half her life.​ Perhaps, that is why it took them almost six
months to get her properly diagnosed.
01:14
My story might be, unfortunately, familiar to most of you​. One out of three people sitting in this
audience will be diagnosed with some type of cancer, and one out of four will die because of it.
Not only did that cancer diagnosis change the life of our family, but that process of going back
and forth with new tests, different doctors describing symptoms, discarding diseases over and
over, was stressful and frustrating, especially for my aunt. And that is the way cancer diagnosis
has been done since the beginning of history. ​We have 21st-century medical treatments and
drugs to treat cancer, but we still have 20th-century procedures and processes for diagnosis, if
any.
02:02
Today, most of us have to wait for symptoms to indicate that something is wrong. Today, the
majority of people still don't have access to early cancer detection methods, even though we
know that catching cancer early is basically the closest thing we have to a silver bullet cure
against it. We know that we can change this in our lifetime, and that is why my team and I have
decided to begin this journey, this journey to try to make cancer detection at the early stages and
monitoring the appropriate response at the molecular level easier, cheaper, smarter and more
accessible than ever before.
02:42
The context, of course, is that we're living at a time where technology is disrupting our present at
exponential rates, and the biological realm is no exception. It is said today that biotech is
advancing at least six times faster than the growth rate of the processing power of computers.
But progress in biotech is not only being accelerated, it is also being democratized. Just as
personal computers or the Internet or smartphones leveled the playing field for entrepreneurship,
politics or education, recent advances have leveled it up for biotech progress as well, and that is
allowing multidisciplinary teams like ours to try to tackle and look at these problems with new
approaches.
03:23
We are a team of scientists and technologists from Chile, Panama, Mexico, Israel and Greece,
and based on recent scientific discoveries, we believe that we have found a reliable and accurate
way of detecting several types of cancer at the very early stages through a blood sample. ​We do
it by detecting a set of very small molecules that circulate freely in our blood called microRNAs.
03:51
To explain what microRNAs are and their important role in cancer, I need to start with proteins,
because when cancer is present in our body, protein modification is observed in all cancerous
cells. As you might know, proteins are large biological molecules that perform different
functions within our body, like catalyzing metabolic reactions or responding to stimuli or
replicating DNA, but before a protein is expressed or produced, relevant parts of its genetic code
present in the DNA are copied into the messenger RNA, so this messenger RNA has instructions
on how to build a specific protein, and potentially it can build hundreds of proteins, but the one
that tells them ​when to build them and how many to build are microRNAs.​ So microRNAs are
small molecules that ​regulate gene expression. ​Unlike DNA, which is mainly fixed, microRNAs
can vary depending on internal and environmental conditions at any given time, telling us which
genes are actively expressed at that particular moment. And that is what makes microRNAs such
a promising ​biomarker​ for cancer,because as you know, cancer is a disease of altered gene
expression. It is the uncontrolled regulation of genes. Another important thing to consider is that
no two cancers are the same, ​but at the microRNA level, there are patterns. ​Several scientific
studies have shown that abnormal microRNA expression levels varies and creates a unique,
specific pattern for each type of cancer, even at the​ early stages, reflecting the progression of the
disease​, and whether it's responding to medication or in remission, making microRNAs a perfect,
highly sensitive biomarker.
05:38
However, the problem with microRNAs is that ​we cannot use existing DNA-based technology ​to
detect them in a reliable way, because they are very short sequences of nucleotides, much
smaller than DNA. And also, all microRNAs are very similar to each other, with just tiny
differences. So imagine trying to differentiate two molecules, extremely similar, extremely
small.
06:02
We believe that we have found a way to do so, and this is the first time that we've shown it in
public. Let me do a demonstration.Imagine that next time you go to your doctor and do your next
standard blood test, a lab technician extracts a total RNA, which is quite simple today, and puts it
in a standard 96-well plate like this one. Each well of these plates has specific biochemistry that
we assign,that is ​looking for a specific microRNA, acting like a trap that closes only when the
microRNA is present in the sample, and when it does, it will shine with green color.​ To run the
reaction, you put the plate inside a device like this one, and then you can put your smartphone on
top of it. If we can have a camera here so you can see my screen. A smartphone is a connected
computer and it's also a camera, good enough for our purpose. The smartphone is taking pictures,
and when the reaction is over, it will send the pictures to our online database for processing and
interpretation. This entire process lasts around 60 minutes, but when the process is over, wells
that shine are matched with the specific microRNAs and analyzed in terms of how much and
how fast they shine. And then, when this entire process is over, this is what happens. This chart
is showing the specific microRNAs present in this sample and how they reacted over time. Then,
if ​we take this specific pattern of microRNA of this person's samples and compare it with
existing scientific documentation that correlates microRNA patterns with a specific presence of a
disease, this is how pancreatic cancer looks like. This inside is a real sample where we just
detected pancreatic cancer.
07:55
(Applause)
08:04
Another important aspect of this approach is the gathering and mining of data in the cloud, so we
can get results in real time and analyze them with our contextual information. If we want to
better understand and decode diseases like cancer, we need to stop treating them as acute,
isolated episodes, and consider and measure everything that affects our health on a permanent
basis. This entire platform is a working prototype. It uses state-of-the-art molecular biology, a
low-cost, 3D-printed device, and data science to try to tackle one of humanity's toughest
challenges​. Since we believe early cancer detection should really be democratized, this entire
solution costs at least 50 times less than current available methods, and we know that the
community can help us accelerate this even more, so we're making the design of the device
open-source.
08:59
(Applause)
09:07
Let me say very clearly that we are at the very early stages, but so far, we have been able to
successfully identify the microRNA pattern of pancreatic cancer, lung cancer, breast cancer and
hepatic cancer. And currently, we're doing a clinical trial in collaboration with the German
Cancer Research Center with 200 women for breast cancer.
09:31
(Applause) ​This is the single non-invasive, accurate and affordable test that has the potential to
dramatically change how cancer procedures and diagnostics have been done.​ Since we're looking
for the microRNA patterns in your blood at any given time, you don't need to know which cancer
you're looking for. You don't need to have any symptoms. You only need one milliliter of blood
and a relatively simple array of tools.
10:01
Today, cancer detection happens mainly when symptoms appear. That is, at stage 3 or 4, and I
believe that is too late. It is too expensive for our families. It is too expensive for humanity. We
cannot lose the war against cancer. It not only costs us billions of dollars, but it also costs us the
people we love. ​Today, my aunt, she's fighting bravely and going through this process with a
very positive attitude. However, I want fights like this to become very rare. I want to see the day
when cancer is treated easily because it can be routinely diagnosed at the very early stages, and
I'm certain that in the very near future, because of this and other breakthroughs that we are seeing
every day in the life sciences, the way we see cancer will radically change. It will give us the
chance of detecting it early, understanding it better, and finding a cure.
10:58
Thank you very much.
11:00
END.