TEDxStanford
Adam de la Zerda: We can start winning the war against cancer
Adam de la Zerda: Môžeme začať vyhrávať vojnu proti rakovine
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Dozviete sa o najnovších pokrokoch vo vojne proti rakovine od výskumníka Adama de la Zerdu zo Stanfordu, ktorý pracuje na vývoji prelomových technológii. Použitím výnimočnej zobrazovacej technológie, ktorá vďaka luminescencii čiastočiek zlata vpichnutých do tela zviditeľnuje rakovinu, v Zerdovom laboratóriu dúfajú, že osvetlia cestu chirurgom, aby odstránili aj najmenšiu stopu po smrtiacich nádoroch.
Adam de la Zerda - Biologist, electrical engineer
Adam de la Zerda develops new medical imaging technologies to detect and destroy cancer. Full bio
Adam de la Zerda develops new medical imaging technologies to detect and destroy cancer. Full bio
Double-click the English transcript below to play the video.
00:12
"We're declaring war against cancer,
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„Vyhlasujeme vojnu proti rakovine
00:14
and we will win this war by 2015."
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a vyhráme ju do roku 2015.“
00:18
This is what the US Congress
and the National Cancer Institute declared
and the National Cancer Institute declared
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Toto vyhlásili Americký kongres
a Národný inštitút pre rakovinu
a Národný inštitút pre rakovinu
00:22
just a few years ago, in 2003.
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len pred pár rokmi, v roku 2003.
00:25
Now, I don't know about you,
but I don't buy that.
but I don't buy that.
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Neviem ako vy, ale ja tomu neverím.
00:28
I don't think we quite won this war yet,
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Nemyslím si, že sme túto vojnu už vyhrali,
00:30
and I don't think
anyone here will question that.
anyone here will question that.
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a nemyslím si, že niekto o tom pochybuje.
00:33
Now, I will argue that a primary reason
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Teraz sa pokúsim dokázať,
že hlavný dôvod,
že hlavný dôvod,
00:36
why we're not winning
this war against cancer
this war against cancer
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prečo túto vojnu proti rakovine
nevyhrávame,
nevyhrávame,
00:38
is because we're fighting blindly.
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je, že bojujeme naslepo.
00:40
I'm going to start by sharing with you
a story about a good friend of mine.
a story about a good friend of mine.
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Začnem tým, že vám rozpoviem
príbeh môjho dobrého priateľa.
príbeh môjho dobrého priateľa.
00:44
His name is Ehud,
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Jeho meno je Ehud
00:45
and a few years ago,
Ehud was diagnosed with brain cancer.
Ehud was diagnosed with brain cancer.
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a pred pár rokmi mu diagnostikovali
rakovinu mozgu.
rakovinu mozgu.
00:48
And not just any type of brain cancer:
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A nielen tak hocijaký typ rakoviny mozgu:
00:50
he was diagnosed with one
of the most deadly forms of brain cancer.
of the most deadly forms of brain cancer.
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diagnostikovali mu jednu
z najsmrteľnejších foriem rakoviny mozgu.
z najsmrteľnejších foriem rakoviny mozgu.
00:53
In fact, it was so deadly
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Vlastne, bolo to až také zlé,
00:55
that the doctors told him
that they only have 12 months,
that they only have 12 months,
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že mu doktori povedali,
že mu ostáva len 12 mesiacov
že mu ostáva len 12 mesiacov
00:57
and during those 12 months,
they have to find a treatment.
they have to find a treatment.
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a počas týchto 12 mesiacov
musia nájsť liečbu.
musia nájsť liečbu.
01:01
They have to find a cure,
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Musia nájsť liek
01:02
and if they cannot
find a cure, he will die.
find a cure, he will die.
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a ak nenájdu liek, zomrie.
01:05
Now, the good news, they said,
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Dobrou správou je, povedali,
01:07
is that there are tons
of different treatments to choose from,
of different treatments to choose from,
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že je na výber množstvo liečebných metód,
01:10
but the bad news is
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ale zlou správou je,
01:11
that in order for them to tell
if a treatment is even working or not,
if a treatment is even working or not,
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že na to aby zistili,
či liečba funguje alebo nie,
či liečba funguje alebo nie,
01:15
well, that takes them
about three months or so.
about three months or so.
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potrebujú približne 3 mesiace.
01:17
So they cannot try that many things.
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Takže nemôžu vyskúšať veľa vecí.
01:19
Well, Ehud is now going
into his first treatment,
into his first treatment,
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Teda, Ehud podstupuje svoju prvú liečbu
01:23
and during that first treatment,
just a few days into that treatment,
just a few days into that treatment,
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a počas nej,
len pár dní pred jej začiatkom,
len pár dní pred jej začiatkom,
01:26
I'm meeting with him, and he tells me,
"Adam, I think this is working.
"Adam, I think this is working.
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sa s ním stretávam, a on mi vraví:
„Adam, myslím že to bude fungovať.
„Adam, myslím že to bude fungovať.
01:29
I think we really lucked out here.
Something is happening."
Something is happening."
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Myslím, že sme mali skutočne šťastie.
Niečo sa deje.“
Niečo sa deje.“
01:32
And I ask him, "Really?
How do you know that, Ehud?"
How do you know that, Ehud?"
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Pýtam sa ho: „Naozaj?
Ako to vieš, Ehud?“
Ako to vieš, Ehud?“
01:35
And he says, "Well,
I feel so terrible inside.
I feel so terrible inside.
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A on vraví: „Nuž,
vo vnútri sa cítim úplne zle.
vo vnútri sa cítim úplne zle.
01:37
Something's gotta be working up there.
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Niečo tam vo vnútri musí pracovať.
01:39
It just has to."
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Proste musí.“
01:40
Well, unfortunately, three months later,
we got the news, it didn't work.
we got the news, it didn't work.
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Nuž, nanešťastie, o 3 mesiace neskôr,
prišli správy, že to nezabralo.
prišli správy, že to nezabralo.
01:45
And so Ehud goes
into his second treatment.
into his second treatment.
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A tak Ehud podstúpil svoju druhú liečbu.
01:47
And again, the same story.
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A znovu, rovnaký príbeh.
01:48
"It feels so bad, something's
gotta be working there."
gotta be working there."
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„Cítim sa tak zle,
že niečo tam musí pracovať.“
že niečo tam musí pracovať.“
01:51
And then three months later,
again we get bad news.
again we get bad news.
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A po 3 mesiacoch, znovu zlé správy.
01:54
Ehud is going into his third treatment,
and then his fourth treatment.
and then his fourth treatment.
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Ehud ide na svoju tretiu liečbu
a potom na štvrtú.
a potom na štvrtú.
01:58
And then, as predicted, Ehud dies.
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A potom, podľa predovedí, Ehud zomiera.
02:01
Now, when someone really close to you
is going through such a huge struggle,
is going through such a huge struggle,
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Ak niekto, kto je vám skutočne blízky,
prechádza takýmto veľkým bojom,
prechádza takýmto veľkým bojom,
02:06
you get really swamped with emotions.
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vašimi emóciami to skutočne zamáva.
02:08
A lot of things
are going through your head.
are going through your head.
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Hlavou vám prejde veľa myšlienok.
02:10
For me, it was mostly outrage.
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U mňa to bolo hlavne rozhorčenie.
02:11
I was just outraged that, how come
this is the best that we can offer?
this is the best that we can offer?
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Bol som rozhorčený, ako je možné, že
toto je to najlepšie, čo môžeme ponúknuť?
toto je to najlepšie, čo môžeme ponúknuť?
02:16
And I started looking
more and more into this.
more and more into this.
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A začal som sa tomu venovať viac a viac.
02:18
As it turns out, this is not just
the best that doctors could offer Ehud.
the best that doctors could offer Ehud.
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Ukázalo sa, že to nebolo to najlepšie,
čo lekári mohli ponúknuť Ehudovi.
čo lekári mohli ponúknuť Ehudovi.
02:22
It's not just the best doctors could offer
patients with brain cancer generally.
patients with brain cancer generally.
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Nie je to to najlepšie, čo lekári ponúkajú
pacientom s rakovinou mozgu všeobecne.
pacientom s rakovinou mozgu všeobecne.
02:26
We're actually not doing that well
all across the board with cancer.
all across the board with cancer.
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Vlastne sa nám nedarí dosť dobre
naprieč celou oblasťou rakoviny.
naprieč celou oblasťou rakoviny.
02:30
I picked up one of those statistics,
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Vybral som jednu z tých štatistík
02:32
and I'm sure some of you
have seen those statistics before.
have seen those statistics before.
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a som si istý,
že niektorí z vás ich už videli.
že niektorí z vás ich už videli.
02:34
This is going to show you here
how many patients actually died of cancer,
how many patients actually died of cancer,
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Táto vám ukáže, koľko pacientov
už vlastne zomrelo na rakovinu,
už vlastne zomrelo na rakovinu,
02:38
in this case females in the United States,
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v tomto prípade ženy v USA
02:40
ever since the 1930s.
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od roku 1930.
02:41
You'll notice that there aren't
that many things that have changed.
that many things that have changed.
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Všimnite si, že sa toho
až tak veľa nezmenilo.
až tak veľa nezmenilo.
02:44
It's still a huge issue.
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Stále je to obrovský problém.
02:46
You'll see a few changes, though.
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Hoci sú tam aj malé zmeny.
02:48
You'll see lung cancer,
for example, on the rise.
for example, on the rise.
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Napríklad môžete vidieť,
že pľúcna rakovina rastie.
že pľúcna rakovina rastie.
02:50
Thank you, cigarettes.
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Vďaka vám, cigarety.
02:52
And you'll also see that,
for example, stomach cancer
for example, stomach cancer
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A môžete tiež vidieť,
že rakovina žalúdka,
že rakovina žalúdka,
02:54
once used to be one
of the biggest killers of all cancers,
of the biggest killers of all cancers,
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ktorá bývala jedným z najväčších zabijakov
zo všetkých rakovín,
zo všetkých rakovín,
02:58
is essentially eliminated.
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je v podstate eliminovaná.
03:00
Now, why is that?
Anyone knows, by the way?
Anyone knows, by the way?
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Prečo je to tak?
Mimochodom, vie to niekto?
Mimochodom, vie to niekto?
03:02
Why is it that humanity is no longer
struck by stomach cancer?
struck by stomach cancer?
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Prečo ľudstvo už viac nie je postihnuté
rakovinou žalúdka?
rakovinou žalúdka?
03:05
What was the huge, huge
medical technology breakthrough
medical technology breakthrough
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Čo bol veľký, obrovský medicínsky
technologický prelom,
technologický prelom,
03:10
that came to our world
that saved humanity from stomach cancer?
that saved humanity from stomach cancer?
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ktorý prišiel na svet a zachránil ľudstvo
od rakoviny žalúdka?
od rakoviny žalúdka?
03:15
Was it maybe a new drug,
or a better diagnostic?
or a better diagnostic?
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Možno to boli nové lieky
alebo lepšia diagnostika?
alebo lepšia diagnostika?
03:19
You guys are right, yeah.
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Máte pravdu, správne.
03:20
It's the invention of the refrigerator,
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Je to vynájdenie chladničky
03:23
and the fact that we're
no longer eating spoiled meats.
no longer eating spoiled meats.
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a fakt, že už viac nejeme pokazené mäso.
03:25
So the best thing
that happened to us so far
that happened to us so far
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Takže najlepšia vec,
čo sa nám dosiaľ prihodila
čo sa nám dosiaľ prihodila
03:28
in the medical arena in cancer research
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v medicíne, vo výskume rakoviny,
03:29
is the fact that
the refrigerator was invented.
the refrigerator was invented.
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je fakt, že bola vynájdená chladnička.
03:32
(Laughter)
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(smiech)
03:33
And so -- yeah, I know.
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A tak – áno, viem.
03:34
We're not doing so well here.
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Nedarí sa nám až tak dobre.
03:36
I don't want to miniaturize the progress
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Nechcem bagatelizovať pokrok
03:38
and everything that's been done
in cancer research.
in cancer research.
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a všetko, čo bolo urobené
vo výskume rakoviny.
vo výskume rakoviny.
03:41
Look, there is like 50-plus years
of good cancer research
of good cancer research
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Pozrite sa, je za nami viac ako 50 rokov
dobrého výskumu rakoviny,
dobrého výskumu rakoviny,
03:45
that discovered major, major things
that taught us about cancer.
that taught us about cancer.
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ktorý objavil závažné veci
a naučil nás veľa o rakovine.
a naučil nás veľa o rakovine.
03:48
But all that said,
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Ale toto všetko nám ukazuje,
03:50
we have a lot of heavy lifting
to still do ahead of us.
to still do ahead of us.
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že máme pred sebou ešte veľa ťažkých úloh.
03:54
Again, I will argue that the primary
reason why this is the case,
reason why this is the case,
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Opäť sa pokúsim ukázať, že základným
dôvodom prečo je to tak,
dôvodom prečo je to tak,
03:58
why we have not done that remarkably well,
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prečo sa nám nedarí tak pozoruhodne dobre,
04:00
is really we're fighting blindly here.
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je, že bojujeme tak trochu naslepo.
04:01
And this is where
medical imaging comes in.
medical imaging comes in.
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A tu do toho vstupuje
medicínske zobrazovanie.
medicínske zobrazovanie.
04:04
This is where my own work comes in.
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To je oblasť mojej práce.
04:06
And so to give you a sense
of the best medical imaging
of the best medical imaging
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Pre predstavu najlepšieho
medicínskeho zobrazovania,
medicínskeho zobrazovania,
04:09
that's offered today
to brain cancer patients,
to brain cancer patients,
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ktoré sa dnes používa u pacientov
s rakovinou mozgu,
s rakovinou mozgu,
04:11
or actually generally
to all cancer patients,
to all cancer patients,
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alebo všeobecne
pre pacientov s rakovinou,
pre pacientov s rakovinou,
04:13
take a look at this PET scan right here.
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pozrite sem na tento PET sken.
04:15
Let's see. There we go.
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Pozrite, tu je.
04:17
So this is a PET/CT scan,
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Takže toto je PET/CT sken,
04:19
and what you'll see in this PET/CT scan
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a na tomto PET/CT skene vidíte
04:21
is the CT scan will show you
where the bones are,
where the bones are,
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CT sken, ktorý vám ukáže, kde sú kosti,
04:25
and the PET scan will show you
where tumors are.
where tumors are.
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a PET sken ktorý ukáže, kde sú nádory.
04:27
Now, what you can see here
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To, čo tu môžete vidieť,
04:30
is essentially a sugar molecule
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sú vlastne molekuly cukru,
04:32
that was added a small little tag
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ktorým bol pridaný malý štítok,
04:34
that is signaling to us
outside of the body,
outside of the body,
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ktorý nám signalizuje:
04:36
"Hey, I'm here."
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„Aha, tu som.“
04:37
And those sugar molecules are injected
into these patients by the billions,
into these patients by the billions,
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A tieto molekuly cukru sú vpichnuté
pacientom po miliardách,
pacientom po miliardách,
04:41
and they're going all over the body
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rozptýlia sa do celého tela,
04:43
looking for cells
that are hungry for sugar.
that are hungry for sugar.
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hľadajúc bunky, ktoré potrebujú cukor.
04:46
You'll see that the heart,
for example, lights up there.
for example, lights up there.
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Tu vidíte napríklad srdce, rozžiarené.
04:49
That's because the heart
needs a lot of sugar.
needs a lot of sugar.
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Je to preto, lebo srdce
potrebuje veľa cukru.
potrebuje veľa cukru.
04:51
You'll also see that the bladder
lights up there.
lights up there.
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Tu vidíte rozžiarený mechúr.
04:53
That's because the bladder
is the thing that's clearing
is the thing that's clearing
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Je to preto, lebo mechúr je
tá vec, ktorá čistí
tá vec, ktorá čistí
04:56
the sugar away from our body.
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cukor z vášho tela.
04:58
And then you'll see a few other hot spots,
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Potom vidíte zopár ďalších hot-spotov
05:00
and these are in fact the tumors.
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a to sú v skutočnosti nádory.
05:01
Now, this is a really
a wonderful technology.
a wonderful technology.
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Takže toto je skutočne skvelá technológia.
05:03
For the first time it allowed us
to look into someone's body
to look into someone's body
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Po prvýkrát nám umožnila
pozrieť sa do nejakého tela
pozrieť sa do nejakého tela
05:07
without picking up
each and every one of the cells
each and every one of the cells
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bez vybratia každej jednej bunky
05:09
and putting them under the microscope,
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a položenia pod mikroskop,
05:11
but in a noninvasive way
allowing us to look into someone's body
allowing us to look into someone's body
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ale neinvazívnym spôsobom
nám umožňuje pozrieť sa do tela
nám umožňuje pozrieť sa do tela
05:14
and ask, "Hey,
has the cancer metastasized?
has the cancer metastasized?
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a pýtať sa: „Hej, metastázuje rakovina?
05:16
Where is it?"
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Kde je?“
05:17
And the PET scans here
are showing you very clearly
are showing you very clearly
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A PET sken tu ukazuje veľmi jasne,
05:20
where are these hot spots,
where is the tumor.
where is the tumor.
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kde sú tie miesta, kde sú tie nádory.
05:23
So as miraculous as this might seem,
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Môže sa to zdať úžasné,
05:26
unfortunately, well, it's not that great.
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avšak, nanešťastie,
nie je to až také dobré.
nie je to až také dobré.
05:30
You see, those
small little hot spots there.
small little hot spots there.
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Pozrite, tieto malé miestočká tu.
05:33
Can anyone guess how many cancer cells
are in any one of these tumors?
are in any one of these tumors?
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Vie niekto uhádnuť koľko rakovinových
buniek je v jednom z týchto nádorov?
buniek je v jednom z týchto nádorov?
Takže, je to okolo 100 miliónov
rakovinových buniek
rakovinových buniek
05:38
So it's about 100 million cancer cells,
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05:40
and let me make sure
that this number sunk in.
that this number sunk in.
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a uisťujem vás,
je ich je tam naozaj toľko.
je ich je tam naozaj toľko.
05:43
In each and every one
of these small little blips
of these small little blips
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V každom jednom z týchto malých bodov,
05:46
that you're seeing on the image,
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ktoré vidíte na obrázku,
05:47
there needs to be
at least 100 million cancer cells
at least 100 million cancer cells
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musí byť najmenej 100 miliónov
rakovinových buniek,
rakovinových buniek,
05:51
in order for it to be detected.
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na to, aby sa dali detekovať.
05:53
Now, if that seemed to you
like a very large number,
like a very large number,
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Takže to, čo sa vám zdá
ako veľmi veľké číslo,
ako veľmi veľké číslo,
05:55
it is a very large number.
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je veľmi veľké číslo.
Je to v skutočnosti
neuveriteľne veľké číslo,
neuveriteľne veľké číslo,
05:58
This is in fact
an incredibly large number,
an incredibly large number,
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06:00
because what we really need
in order to pick up something early enough
in order to pick up something early enough
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pretože to, čo naozaj potrebujeme,
aby sme mohli niečo vybrať von včas,
aby sme mohli niečo vybrať von včas,
06:04
to do something about it,
to do something meaningful about it,
to do something meaningful about it,
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robiť s tým niečo,
robiť s tým niečo zmysluplné,
robiť s tým niečo zmysluplné,
06:07
well, we need to pick up tumors
that are a thousand cells in size,
that are a thousand cells in size,
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potrebujeme vybrať von nádory
vo veľkosti tisícov buniek,
vo veľkosti tisícov buniek,
06:10
and ideally just
a handful of cells in size.
a handful of cells in size.
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ideálne len hŕstku buniek.
06:12
So we're clearly
pretty far away from this.
pretty far away from this.
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Takže sme od toho pekne ďaleko.
06:14
So we're going to play
a little experiment here.
a little experiment here.
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Teraz si zahráme malý experiment.
06:16
I'm going to ask each of you
to now play and imagine
to now play and imagine
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Poprosím každého z vás,
aby hral a predstavil si,
aby hral a predstavil si,
06:19
that you are brain surgeons.
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že je mozgový chirurg.
06:21
And you guys are now at an operating room,
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A teraz ste v operačnej sále
06:25
and there's a patient in front of you,
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a pred vami leží pacient
06:27
and your task is to make sure
that the tumor is out.
that the tumor is out.
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a vašou úlohou je uistiť sa,
že nádor je vonku.
že nádor je vonku.
06:31
So you're looking down at the patient,
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Takže sa pozeráte na pacienta,
06:34
the skin and the skull
have already been removed,
have already been removed,
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koža a lebka už boli odstránené,
06:37
so you're looking at the brain.
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takže pozeráte sa na mozog.
06:38
And all you know about this patient
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A všetko čo viete o pacientovi, je,
06:40
is that there's a tumor
about the size of a golf ball or so
about the size of a golf ball or so
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že je tam nádor približne
o veľkosti golfovej loptičky
o veľkosti golfovej loptičky
06:43
in the right frontal lobe
of this person's brain.
of this person's brain.
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v pravom prednom laloku jeho mozgu.
06:46
And that's more or less it.
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A to je viac-menej všetko.
06:47
So you're looking down, and unfortunately
everything looks the same,
everything looks the same,
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Takže pozeráte dolu a nanešťastie
všetko vyzerá rovnako,
všetko vyzerá rovnako,
06:50
because brain cancer tissue
and healthy brain tissue
and healthy brain tissue
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pretože rakovinové mozgové tkanivo
a zdravé mozgové tkanivo
a zdravé mozgové tkanivo
06:53
really just look the same.
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proste vyzerajú rovnako.
06:55
And so you're going in with your thumb,
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Tak vopcháte dnu svoj palec
06:57
and you start to press
a little bit on the brain,
a little bit on the brain,
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a začnete trošku stláčať mozog,
06:59
because tumors tend to be
a little harder, stiffer,
a little harder, stiffer,
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pretože nádory zvyknú byť
trochu tvrdšie, tuhšie,
trochu tvrdšie, tuhšie,
07:02
and so you go in and go
a little bit like this and say,
a little bit like this and say,
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teda idete dnu a trochu skúšate a vravíte,
07:04
"It seems like the tumor is right there."
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„Zdá sa, že nádor je priamo tu.“
07:06
Then you take out your knife
and start cutting the tumor
and start cutting the tumor
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Potom vezmete nôž
a začnete nádor odrezávať
a začnete nádor odrezávať
07:09
piece by piece by piece.
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kúsok po kúsku.
07:10
And as you're taking the tumor out,
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A tak, keď ho vyberiete von,
07:12
then you're getting
to a stage where you think,
to a stage where you think,
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dostávate sa do štádia, keď si myslíte
07:14
"Alright, I'm done.
I took out everything."
I took out everything."
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„Dobre, mám to. Vybral som všetko.“
07:16
And at this stage, if that's --
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A v tomto štádiu –
07:18
so far everything sounded,
like, pretty crazy --
like, pretty crazy --
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doteraz všetko znelo, dosť bláznivo –
07:21
you're now about to face the most
challenging decision of your life here.
challenging decision of your life here.
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práve čelíte jednému z najnáročnejších
rozhodnutí vo svojom živote.
rozhodnutí vo svojom živote.
07:24
Because now you need to decide,
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Pretože sa práve musíte rozhodnúť,
07:26
should I stop here
and let this patient go,
and let this patient go,
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či máte prestať a nechať pacienta ísť,
07:29
risking that there might be
some leftover cancer cells behind
some leftover cancer cells behind
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riskujúc, že možno ešte nejaké
rakovinové bunky zostali,
rakovinové bunky zostali,
07:32
that I just couldn't see,
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len ich nevidíte,
07:33
or should I take away some extra margins,
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alebo či odobrať ešte nejaké extra okraje,
07:36
typically about an inch or so
around the tumor
around the tumor
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typicky tak 2 cm okolo nádoru,
07:39
just to be sure that I removed everything?
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pre istotu, aby bolo všetko odstránené.
07:43
So this is not a simple decision to make,
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Nuž, toto nie je ľahké rozhodnutie
07:47
and unfortunately this is the decision
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a nanešťastie je to rozhodnutie,
07:49
that brain cancer surgeons
have to take every single day
have to take every single day
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ktoré chirurgovia pri nádoroch mozgu
musia robiť každý deň,
musia robiť každý deň,
07:53
as they're seeing their patients.
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keď vidia svojich pacientov.
07:55
And so I remember talking
to a few friends of mine in the lab,
to a few friends of mine in the lab,
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Spomínam si na rozhovor niekoľkých
mojich priateľov v labáku,
mojich priateľov v labáku,
07:58
and we say, "Boy,
there's got to be a better way."
there's got to be a better way."
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vravíme, „Človeče,
musí tu byť lepší spôsob.“
musí tu byť lepší spôsob.“
08:00
But not just like you tell a friend
that there's got to be a better way.
that there's got to be a better way.
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Ale nie tak, ako poviete priateľovi,
že tu musí byť lepší spôsob.
že tu musí byť lepší spôsob.
08:04
There's just got to be a better way here.
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Ale tak, že tu musí byť lepší spôsob.
08:06
This is just incredible.
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Toto je proste neskutočné.
08:07
And so we looked back.
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A tak sme sa vrátili spať.
08:09
Remember those PET scans I told you about,
the sugar and so on.
the sugar and so on.
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Spomínate si na PET skeny,
o ktorých som hovoril, a o cukre.
o ktorých som hovoril, a o cukre.
08:12
We said, hey, how about
instead of using sugar molecules,
instead of using sugar molecules,
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Hej, vravíme, čo keby sme
namiesto molekúl cukru,
namiesto molekúl cukru,
08:15
let's maybe take tiny, tiny
little particles made of gold,
little particles made of gold,
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vzali také malé, malilinké čiastočky zlata
08:18
and let's program them with some
interesting chemistry around them.
interesting chemistry around them.
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a naprogramovali ich pomocou nejakých
zaujímavých chemických vzťahov.
zaujímavých chemických vzťahov.
08:21
Let's program them
to look for cancer cells.
to look for cancer cells.
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Naprogramujeme ich,
aby hľadali rakovinové bunky.
aby hľadali rakovinové bunky.
08:24
And then we will inject
these gold particles
these gold particles
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A potom vpichneme tieto zlaté čiastočky
08:26
into these patients by the billions again,
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do pacientov, opäť v miliónoch,
08:28
and we'll have them go all over the body,
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1976
necháme ich cestovať naprieč celým telom,
08:30
and just like secret agents, if you will,
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1976
presne ako tajných agentov,
08:32
go and walk by
every single cell in our body
every single cell in our body
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necháme ich ísť a prejsť
každú jednu bunku v našom tele,
každú jednu bunku v našom tele,
08:35
and knock on the door of that cell,
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zaklopať na dvere tej bunky
08:37
and ask, "Are you a cancer cell
or are you a healthy cell?
or are you a healthy cell?
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a spýtať sa: „Si rakovinová bunka,
alebo si zdravá bunka?
alebo si zdravá bunka?
08:40
If you're a healthy cell, we're moving on.
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Ak si zdravá bunka, ideme ďalej.
Ak si rakovinová bunka,
prilepíme sa a vysvietime ťa,“
prilepíme sa a vysvietime ťa,“
08:42
If you're a cancer cell,
we're sticking in and shining out
we're sticking in and shining out
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08:44
and telling us,
"Hey, look at me, I'm here."
"Hey, look at me, I'm here."
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a to nám povie:
„Hej, pozrite, tu som.“
„Hej, pozrite, tu som.“
08:47
And they'll do it
through some interesting cameras
through some interesting cameras
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A to urobia cez špeciálne kamery,
08:49
that we developed in the lab.
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ktoré sme vyvinuli v labáku.
08:50
And once we see that,
maybe we can guide brain cancer surgeons
maybe we can guide brain cancer surgeons
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Ak ich budeme vidieť, možno vieme
navádzať mozgových chirurgov,
navádzať mozgových chirurgov,
08:53
towards taking only the tumor
and leaving the healthy brain alone.
and leaving the healthy brain alone.
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aby odobrali len nádor
a ponechali zdravý mozog.
a ponechali zdravý mozog.
08:57
And so we've tested that,
and boy, this works well.
and boy, this works well.
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A tak sme to začali testovať
a ide to dobre.
a ide to dobre.
09:00
So I'm going to show you an example now.
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Teraz vám ukážem jeden príklad.
09:02
What you're looking at here
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To, na čo sa pozeráte,
09:04
is an image of a mouse's brain,
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priamo tu, je obrázok mozgu myši,
09:08
and we've implanted
into this mouse's brain
into this mouse's brain
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ktorej sme implantovali do mozgu
09:11
a small little tumor.
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veľmi malý nádor.
09:13
And so this tumor is now
growing in this mouse's brain,
growing in this mouse's brain,
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Teraz tento nádor rastie v myšacom mozgu.
09:15
and then we've taken a doctor
and asked the doctor
and asked the doctor
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Potom sme myš zobrali k lekárovi
a požiadali ho,
a požiadali ho,
09:18
to please operate on the mouse
as if that was a patient,
as if that was a patient,
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aby ju operoval ako svojho pacienta
09:21
and take out piece by piece
out of the tumor.
out of the tumor.
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a vybral nádor kúsok po kúsku.
09:23
And while he's doing that,
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A kým na tom pracuje,
09:25
we're going to take images
to see where the gold particles are.
to see where the gold particles are.
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robíme snímky, aby sme videli,
kde sú zlaté čiastočky.
kde sú zlaté čiastočky.
09:28
And so we're going to first start
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Začíname najprv vpichom
09:30
by injecting these gold particles
into this mouse,
into this mouse,
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zlatých čiastočiek do myši
09:32
and we're going to see
right here at the very left there
right here at the very left there
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a vidíme práve tu, úplne vľavo,
09:35
that image at the bottom
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spodný obrázok,
09:36
is the image that shows
where the gold particles are.
where the gold particles are.
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je snímka, ktorá ukazuje,
kde sú zlaté čiastočky.
kde sú zlaté čiastočky.
09:39
The nice thing
is that these gold particles
is that these gold particles
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Pekné je, že tieto zlaté čiastočky,
09:41
actually made it all the way to the tumor,
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vlastne prešli celú cestu až k nádoru
09:43
and then they shine out and tell us,
"Hey, we're here. Here's the tumor."
"Hey, we're here. Here's the tumor."
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a potom na nás zažiarili a povedali,
„Hej, tu sme. Tu je nádor.“
„Hej, tu sme. Tu je nádor.“
09:47
So now we can see the tumor,
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Takže teraz vidíme nádor,
09:48
but we're not showing this
to the doctor yet.
to the doctor yet.
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ale zatiaľ to ešte neukážeme lekárovi.
09:50
We're asking the doctor,
now please start cutting away the tumor,
now please start cutting away the tumor,
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Žiadame lekára, aby začal vyberať nádor,
09:53
and you'll see here the doctor
just took the first quadrant of the tumor
just took the first quadrant of the tumor
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a teraz uvidíte že lekár práve odobral
prvú štvrtinu nádoru,
prvú štvrtinu nádoru,
09:57
and you see that first quadrant
is now missing.
is now missing.
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vidíte, že prvá štvrtina už chýba.
09:59
The doctor then took
the second quadrant, the third,
the second quadrant, the third,
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Doktor potom zobral
druhú štvrtinu, tretiu,
druhú štvrtinu, tretiu,
10:01
and now it appears to be everything.
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a teraz sa zdá, že je preč všetko.
10:03
And so at this stage,
the doctor came back to us and said,
the doctor came back to us and said,
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V tomto štádiu, k nám lekár príde a vraví:
„Ok, som hotový.
Čo chcete, aby som urobil?
Čo chcete, aby som urobil?
10:06
"Alright, I'm done.
What do you want me to do?
What do you want me to do?
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10:08
Should I keep things as they are
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Mám to nechať tak, ako to je,
10:10
or do you want me to take
some extra margins around?"
some extra margins around?"
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alebo chcete, aby som zobral
nejaký extra okraj?“
nejaký extra okraj?“
A vtedy hovoríme, „Počkaj, zadrž.“
10:12
And then we said, "Well, hang on."
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10:14
We told the doctor,
"You've missed those two spots,
"You've missed those two spots,
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Vravíme lekárovi,
„Zostali tam dve malé miesta,
„Zostali tam dve malé miesta,
10:16
so rather than taking huge margins around,
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takže radšej ako odobrať celý extra okraj,
10:18
only take out those tiny little areas.
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vyber von len tie malé plochy.
10:20
Take them out,
and then let's take a look."
and then let's take a look."
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Vyber ich von a pozrieme sa na to.“
10:22
And so the doctor took them away,
and lo and behold,
and lo and behold,
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A tak ich doktor vyberá a ajhľa,
10:25
the cancer is now completely gone.
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rakovina je kompletne preč.
10:27
Now, the important thing
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Dôležitá vec je,
10:29
is that it's not just
that the cancer is completely gone
that the cancer is completely gone
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že to nie je len rakovina,
ktorá je úplne preč
ktorá je úplne preč
10:31
from this person's brain,
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z mozgu tejto osoby,
10:33
or from this mouse's brain.
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alebo z mozgu tejto myši.
10:35
The most important thing
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Najdôležitejšia vec je,
10:36
is that we did not have to take
huge amounts of healthy brain
huge amounts of healthy brain
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že sme nemuseli odobrať
obrovský počet zdravých buniek
obrovský počet zdravých buniek
10:39
in the process.
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počas operácie.
10:40
And so now we can actually imagine a world
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A tak si teraz vieme predstaviť svet,
10:42
where doctors and surgeons,
as they take away a tumor,
as they take away a tumor,
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v ktorom lekári a chirurgovia,
ktorí vyberajú nádor,
ktorí vyberajú nádor,
10:46
they actually know what to take out,
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vedia, čo je potrebné vybrať,
10:48
and they no longer
have to guess with their thumb.
have to guess with their thumb.
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a už to nemusia odhadovať pomocou palca.
10:51
Now, here's why it's extremely important
to take those tiny little leftover tumors.
to take those tiny little leftover tumors.
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Poďme k tomu, prečo je extrémne dôležité
vybrať všetky maličké zostatky nádorov.
vybrať všetky maličké zostatky nádorov.
10:55
Those leftover tumors,
even if it's just a handful of cells,
even if it's just a handful of cells,
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Maličké zvyšky,
dokonca aj hŕstka buniek,
dokonca aj hŕstka buniek,
10:58
they will grow to recur the tumor,
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budú znovu rásť
11:01
for the tumor to come back.
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a obnovia nádor.
11:03
In fact, the reason why 80 to 90 percent
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V skutočnosti, dôvod prečo 80 až 90 %
11:05
of those brain cancer surgeries
ultimately fail
ultimately fail
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z týchto operácií mozgu nakoniec neuspeje
11:07
is because of those small little
extra margins that were left positive,
extra margins that were left positive,
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je to, že niektorý z týchto malých extra
okrajov bol pozitívny,
okrajov bol pozitívny,
11:11
those small little leftover tumors
that were left there.
that were left there.
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zostal tam malý zvyšok nádoru.
11:15
So this is clearly very nice,
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Takže toto je veľmi pekné,
11:17
but what I really want to share with you
is where I think we're heading from here.
is where I think we're heading from here.
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ale chcem vám povedať, kam si myslím,
že budeme smerovať.
že budeme smerovať.
11:21
And so in my lab at Stanford,
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V mojom laboratóriu v Stanforde
11:23
my students and I are asking,
what should we be working on now?
what should we be working on now?
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sa ja a moji študenti pýtame,
na čom budeme pracovať teraz?
na čom budeme pracovať teraz?
11:29
And I think where
medical imaging is heading to
medical imaging is heading to
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Myslím si, že medicínske
zobrazovanie smeruje
zobrazovanie smeruje
11:32
is the ability to look into the human body
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k schopnosti pozrieť sa do ľudského tela
11:34
and actually see each and every one
of these cells separately.
of these cells separately.
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a vidieť každý jednu
z týchto buniek samostatne.
z týchto buniek samostatne.
11:39
The ability like this would allow us
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Takáto schopnosť by nám dovolila
11:40
to actually pick up tumors
way, way earlier in the process,
way, way earlier in the process,
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vybrať nádory oveľa, oveľa skôr,
11:43
way before it's 100 million cells inside,
so we can actually do something about it.
so we can actually do something about it.
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skôr ako tam je 100 miliónov buniek,
teda by sme s tým mohli niečo robiť.
teda by sme s tým mohli niečo robiť.
11:48
An ability to see each and every one
of the cells might also allow us
of the cells might also allow us
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Schopnosť pozrieť sa
na každú jednu bunku nám umožní
na každú jednu bunku nám umožní
11:51
to ask insightful questions.
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pýtať sa zmysluplné otázky.
11:53
So in the lab,
we are now getting to a point
we are now getting to a point
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V laboratóriu sa teraz dostávame do bodu,
11:55
where we can actually start asking
these cancer cells real questions,
these cancer cells real questions,
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keď môžeme začať klásť skutočné otázky
rakovinovým bunkám,
rakovinovým bunkám,
11:58
like, for example, are you responding
to the treatment we are giving you or not?
to the treatment we are giving you or not?
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ako napríklad: zaberá alebo nezaberá
liečba, ktorú vám dávame?
liečba, ktorú vám dávame?
Ak nezaberá, budeme vedieť, že túto
liečbu musíme zastaviť, hneď teraz,
liečbu musíme zastaviť, hneď teraz,
12:02
So if you're not responding, we'll know
to stop the treatment right away,
to stop the treatment right away,
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12:05
days into the treatment, not three months.
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po dňoch liečby, nie po 3 mesiacoch.
12:08
And so also for patients like Ehud
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A tiež pre pacientov ako Ehud,
12:10
that are going through these
nasty, nasty chemotherapy drugs,
nasty, nasty chemotherapy drugs,
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ktorí prechádzajú
touto hnusnou chemoterapiou,
touto hnusnou chemoterapiou,
12:15
for them not to suffer
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nemusia trpieť
12:16
through those horrendous
side effects of the drugs
side effects of the drugs
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príšernými vedľajšími efektmi liekov,
12:19
when the drugs are
in fact not even helping them.
in fact not even helping them.
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ak im tie lieky v skutočnosti nepomáhajú.
12:22
So to be frank here,
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Aby som bol úprimný,
12:24
we're pretty far away
from winning the war against cancer,
from winning the war against cancer,
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sme ďaleko od toho, aby sme vyhrali vojnu
nad rakovinou,
nad rakovinou,
12:28
just to be realistic.
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buďme realisti.
12:29
But at least I am hopeful
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Ale aspoň dúfam,
12:31
that we should be able to fight this war
with better medical imaging techniques
with better medical imaging techniques
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že bude ľahšie bojovať s pomocou lepších
medicínskych zobrazovacích techník,
medicínskych zobrazovacích techník,
12:35
in the way that is not blind.
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ako naslepo.
12:37
Thank you.
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Ďakujem vám.
12:38
(Applause)
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(potlesk)
ABOUT THE SPEAKER
Adam de la Zerda - Biologist, electrical engineerAdam de la Zerda develops new medical imaging technologies to detect and destroy cancer.
Why you should listen
Adam de la Zerda is an assistant professor at the Departments of Structural Biology and Electrical Engineering (courtesy) at Stanford University – School of Medicine. He completed his undergraduate degree in computer engineering and physics from the Technion – Israel Institute of Technology in 2005 Summa Cum Laude. He received his Ph.D. in Electrical Engineering from Stanford University in 2011, where he developed the Photoacoustic Molecular Imaging technique with Sanjiv Sam Gambhir. He was then a postdoctoral fellow at the lab of Carolyn Bertozzi at UC Berkeley – Chemistry Department, before joining the Stanford faculty in 2012.
de la Zerda's research interests span the broad field of molecular imaging. His lab focuses on developing new optical imaging instrumentation and chemistry tools to study the complex spatiotemporal behavior of biomolecules in living subjects. The lab uses animal models for cancer and ophthalmic diseases such as age-related macular degeneration. His research efforts span both basic science and clinically translatable work.
de la Zerda has received many awards and honors for his work, including the Pew-Stewart Scholar for Cancer Research, the AFOSR Young Investigator Award, Baxter Faculty Scholar Award, Dale F. Frey Award, Forbes Magazine 30 Under 30 in Science and Healthcare for 2012 and 2014, NIH Director’s Early Independence Award, Damon Runyon Cancer Research Foundation Postdoctoral Fellowship, Era of Hope Distinguished Predoctoral Poster Award, Best Poster Presentation at SPIE Photonics West, the Young Investigator Award at the World Molecular Imaging Congress, the Department of Defense Breast Cancer Research Program Award for Predoctoral researchers, the Bio-X Graduate Student Fellowship and first place at the Bay Area Entrepreneurship Contest. He has published papers in leading journals including Nature Medicine, Nature Nanotechnology and PNAS. He holds a number of patents and is the founder of a medical device company, Click Diagnostics.
Adam de la Zerda | Speaker | TED.com