I got my mind set on you…

Cancer research and testing

Whilst I would never want to be ignorant, the burden of knowing that I have the BRCA2 gene mutation weighs heavy on my mind. The decision that I am making about whether… or when to have a bilateral salpingo-oophrectomy is one that only a few years ago I probably wouldn’t have been faced with, simply because nobody even knew about the BRCA gene.

The first, BRCA1 (for BReast CAncer gene), was discovered in 1994, and the second, BRCA2, in 1995. At least 7 other genes have been identified as possible contributors to hereditary breast–ovarian cancer syndrome. 45% of cases are still either unidentified or multiple genes seem to be a cause. The search for other genes continues.

There are lots of dedicated scientists out there, mapping the human genome. A lot of pharma companies developing tests for cancer detection. Only this week the Baylor Research Institute announced it is showing very promising results for finding cancer-related microRNA in the blood before a tumor develops in the colon. However, depending on the type of test it will vary in accuracy, and depending which pharma company develops it, it will cost a lot and might be beyond the reach of most GPs’ budgets.

When your DNA sustains damage, at some point it’s going to send something in you a bit haywire. Common sense, really. Too much sun? You might get skin cancer. Pumping lots of chemicals into your body? You might trigger off a hormone reaction that can no longer stop itself. So it’s a question of whether your genes, an accident or something else gets you. If you are one of the lucky ones who live to a ripe old age, statistically the older our population gets as a whole the more likely it is that one of the things you’ll get is cancer. The lifetime risk is now 50%.

Would you want to know?

That being the case, would you want genetic testing to be able to tell you which cancer is most likely? Would you want to know?

In the case of ovarian cancer, where survivability is not as high as with breast cancer, hell yes I’d certainly love early detection so I can do something about it.

A new test for pancreatic, ovarian and lung cancer

Whilst there isn’t yet a cheap, quick, simple test for ovarian and pancreatic cancer on the market, there is hope that there will be one soon – hopefully in the next few years… because a rather clever and determined teenager is getting ready to have his work published in medical journals about his development of a test for pancreatic, ovarian and lung cancer.

His name is Jack Andraka.

“I got my mind set on you”

At the age of 13, after a close family friend died of pancreatic cancer, Jack decided he wanted to find out everything he could about the disease – he felt it was unacceptable that so many people were dying because it wasn’t detected early enough. 85% of all pancreatic cancers are diagnosed too late in the disease progression, at the point when a person has less than a 2% chance of survival. Fewer than 4% of people diagnosed are still alive after 5 years.

Currently, the test in use for detecting pancreatic cancer costs $800, and because it’s so expensive, it is only used to confirm a diagnosis that is already suspected. Even then, the test being used is 60 years old and inaccurate – it misses 30% of cases.

Jack knew he had to find a better way. A rapid, sensitive, accurate test.

“Its gonna take plenty of money”

The first challenge Jack faced was the number of paywalls in front of valuable scientific research. Scientists would publish their work, and then the publications would put an overhead on even students being able to access it.

Jack’s mum ended up spending a lot of money to give him access to the research he needed to be able to develop his test, and Jack believes strongly that this shouldn’t be the case, because it’s potentially stifling thousands of ideas.

“A whole lotta precious time”

Jack set his mind to the problem and never gave up. He spent many months trawling through papers and analysing results. If it weren’t for his youthful enthusiasm and perseverance, he would probably not have found the answer he needed.

He managed to find a list of EIGHT THOUSAND possible protein markers that might give an indication for pancreatic cancer, and decided to work through each one in turn to try to find one that would allow him to detect cancer. That kind of single-mindedness and focus is rare in anyone, let alone a teenager! It was on his four thousandth attempt that he found a possible candidate – a biomarker protein called mesothelin.

Levels of mesothelin in the blood are normally pretty consistent – but they rise to a level of 10 ng/mL at the very earliest stages of pancreatic cancer – a stage when the potential survival rate is 100% if action is taken.

“Its gonna take patience and time”

So Jack had a possible protein he could test for, but no test. How could he develop a simple, cheap enough test?

To create his test, Jack had an epiphany. He was reading an article about carbon nanotubes under his school desk whilst his Science teacher was teaching his class about antibodies. Carbon nanotubes are pretty new in technology terms – about 10 years old as a discovery.

Jack realised that if he mixed human mesothelin-specific antibodies with single-walled carbon nanotubes in solution and used it to coat strips of ordinary filter paper, the paper would become conductive and when there were higher levels of mesothelin proteins, they would bind to the antibodies and that would affect the conductivity of the nanotube-soaked paper.

The next challenge? Finding a lab that would take him seriously… and would let a child conduct research. Jack Andraka’s mentor, Professor Anirban Maitra, said: “I have been delighted and honoured to have him in my lab.” [4] – but he was the only one out of 200 professors who actually replied to Jack and took him seriously enough to say “maybe” to his lab and research plans.

“To do it, to do it right”

The test is administered like a dipstick for pregnancy or diabetes testing and 10 tests can be performed per strip, taking 5 minutes each. The cost to develop the test? 3 pence or 5 cents. “It’s 168 times faster, over 26,000 times less expensive, and over 400 times more sensitive than our current methods of diagnosis,” Jack says.

Jack’s test won the $75,000 Grand Jury prize at the Intel International Science and Engineering Fair in 2012 and this year, along with various speaking engagements he is managing to keep up with his school work and only attends about 4 days a month.

Having lost a number of loved ones to cancer, cancer research has always been a cause I’ve supported. One of my heroes, Steve Jobs, died of pancreatic cancer. And… I first heard of Jack Andraka from the TED website when I read about him last year whilst I was having my own chemo treatments. So his research, any groundbreaking cancer research, is something that means a lot to me.

When I found out Jack would be one of the speakers at TEDxHoP event at the Houses of Parliament in London, on Friday 14th June I booked a ticket. I wanted to find out more about this surprising young man. I wasn’t disappointed.

It was a truly awe-inspiring day from start to finish, with a whole bunch of very clever, witty people talking about democratisation of information and ideas, the dangers of misinformation and lack of fact-checking, society and equality…

Jack’s speech was both funny and moving and he got a standing ovation at the end of it.

I met him that evening, and was pretty chuffed to be able to say “Thanks” in person to this 16 year old for everything he’s already achieved.

“I know if I put my mind to it…”

“So what’s next?” I asked him.

He’s been working on ironing out all the gaps in his method that he realised once he started working in the lab. My understanding is that to get the accuracy he’s after there is still some work to do, but his method of using carbon nanotubes is one that a lot of scientists hadn’t tried before even though they had already tried to use the same types of proteins to detect the cancers.

AND he’s already working on his next challenge: the Tricorder XPRIZE, a competition in which he and a team of teens will compete against adult teams and big corporations for a $10 million prize – the goal being development of a medical tricorder device the size of a smartphone or smaller – that uses light and can scan through your skin to detect disease.

His take on how he was able to overcome challenges that other people were not? “Fresh pairs of eyes are more likely to solve problems in new ways”.

He said “I do a lot of math competitions and my math coaches always tell us that although you can use brute force to solve a problem that looks really complex you should think about other tools and figure out a more elegant way to solve it. My math heroes can reduce a really difficult proof to a few elegant lines.” [2]

You can see a version of his talk here: “My 3 cents on cancer: Jack Andraka at TEDxSanJoseCAWomen”

I got my mind set on you, I got my mind set on you.
I got my mind set on you, I got my mind set on you.

But it’s gonna take money, a whole lotta spending money.
Its gonna take plenty of money, to do it right child.
Its gonna take time, a whole lot of precious time
Its gonna take patience and time, to do it, to do it, to do it, to do it, to do it, to do it right, child.

I got my mind set on you, I got my mind set on you.
I got my mind set on you, I got my mind set on you.
And this time I know it’s for real, the feelings that I feel
I know if I put my mind to it, I know that I really can do it…

Lyrics by Rudy Clark
(original song recorded by James Ray in 1962 and more recently by George Harrison in 1987)

Sources of statistics and information:

[1] National Human Genome Research Institute – BRCA1 and BRCA2 Gene Study 

[2] Forbes article January 2013 – Cancer innovation and a boy named Jack

[3] JackAndraka.net

[4] The Independent – The first early test for pancreatic cancer – devised by 15-year-old Jack Andraka