TEDxStanford
Adam de la Zerda: We can start winning the war against cancer
亞當 德拉澤: 我們怎樣能個夠開始贏得與癌癥的戰爭的勝利
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從斯坦福研究人員亞當 德拉澤拉那兒了解與癌癥之間戰爭的最新發現。亞當正在研究最新的技術——壹種超前的影像技術，使用尋找癌細胞的金粒子並註射入體內。德拉澤拉的實驗室希望能夠幫助手術醫師移除甚至微小的致命的腫瘤。
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.
“我們已經和癌癥宣布戰爭了，
00:12
"We're declaring war against cancer,
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00:14
and we will win this war by 2015."
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而且我們能在2015年前贏得這場戰爭。”
00:18
This is what the US Congress
and the National Cancer Institute declared
and the National Cancer Institute declared
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這是美國國會和國家癌癥協會聲稱的
00:22
just a few years ago, in 2003.
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就在幾年前，2003年。
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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現在，我不知道妳，
但是我並不相信。
但是我並不相信。
00:28
I don't think we quite won this war yet,
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我不認我們已經贏得場戰鬥了，
00:30
and I don't think
anyone here will question that.
anyone here will question that.
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而且我不認為在場的人會質疑我。
00:33
Now, I will argue that a primary reason
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現在我會告訴妳們壹個最基本的原因，
00:36
why we're not winning
this war against cancer
this war against cancer
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為什麽我們不會贏得和癌癥的戰爭，
00:38
is because we're fighting blindly.
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是因為我們盲目地鬥爭。
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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我要給妳們分享壹個我的好朋友的故事。
他的名字是埃胡德，
00:44
His name is Ehud,
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00:45
and a few years ago,
Ehud was diagnosed with brain cancer.
Ehud was diagnosed with brain cancer.
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幾年前，他被診斷出有腦癌。
00:48
And not just any type of brain cancer:
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而且還不是普通的腦癌，
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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他被診斷出患有最致命的腦癌。
事實上，這個癌癥致命到
00:53
In fact, it was so deadly
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00:55
that the doctors told him
that they only have 12 months,
that they only have 12 months,
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醫生告訴他，他只有12個月，
00:57
and during those 12 months,
they have to find a treatment.
they have to find a treatment.
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而且在這個12個月裏，
他們還要找到壹個治療的方法。
他們還要找到壹個治療的方法。
01:01
They have to find a cure,
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他們壹定要找到壹個治療方法，
01:02
and if they cannot
find a cure, he will die.
find a cure, he will die.
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而且如果找不到，他將會死亡。
01:05
Now, the good news, they said,
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現在，好消息是，他們說，
01:07
is that there are tons
of different treatments to choose from,
of different treatments to choose from,
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有無數種治療方法可以選擇，
01:10
but the bad news is
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但是壞消息是，
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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如果要檢測治療是否有效果，
01:15
well, that takes them
about three months or so.
about three months or so.
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好吧，需要大約三個月的時間。
01:17
So they cannot try that many things.
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所以他們嘗試不了那麽多療程。
01:19
Well, Ehud is now going
into his first treatment,
into his first treatment,
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好吧，
埃胡德正在準備進行他的第壹次治療，
埃胡德正在準備進行他的第壹次治療，
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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在第壹次治療開始幾天的時候，
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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我見到他，他告訴我
“亞當，我覺得療程有效果。
“亞當，我覺得療程有效果。
01:29
I think we really lucked out here.
Something is happening."
Something is happening."
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我覺得我們還是挺走運的。
事情正在改變。”
事情正在改變。”
01:32
And I ask him, "Really?
How do you know that, Ehud?"
How do you know that, Ehud?"
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我問他：
“真的嗎，妳是怎麽知道，埃胡德？”
“真的嗎，妳是怎麽知道，埃胡德？”
01:35
And he says, "Well,
I feel so terrible inside.
I feel so terrible inside.
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他說，
“好吧，我感覺身體很難受。
“好吧，我感覺身體很難受。
01:37
Something's gotta be working up there.
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壹定有什麽東西在裏面運作，
01:39
It just has to."
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壹定是的。”
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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好吧，不幸的是，三個月後，
我們得到消息，療程沒有起效果。
我們得到消息，療程沒有起效果。
01:45
And so Ehud goes
into his second treatment.
into his second treatment.
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所以埃胡德進入第二次治療。
01:47
And again, the same story.
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事情的發展又和上次壹樣。
01:48
"It feels so bad, something's
gotta be working there."
gotta be working there."
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“我感覺很糟，
壹定有什麽東西在裏面運作。”
壹定有什麽東西在裏面運作。”
01:51
And then three months later,
again we get bad news.
again we get bad news.
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三個月後，我們又接到了壞消息。
01:54
Ehud is going into his third treatment,
and then his fourth treatment.
and then his fourth treatment.
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埃胡德接受了第三次和第四次的治療。
01:58
And then, as predicted, Ehud dies.
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正如預測的壹樣，埃胡德去世了。
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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當身邊親近的人飽受巨大的折磨，
02:06
you get really swamped with emotions.
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妳的內心五味雜陳。
02:08
A lot of things
are going through your head.
are going through your head.
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妳的腦海中充斥著雜亂的事情。
02:10
For me, it was mostly outrage.
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對於我來說，
這是最大的暴行。
這是最大的暴行。
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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我只是憤怒，
為什麽這些是我們最大能夠提供的？
為什麽這些是我們最大能夠提供的？
謝謝。
02:16
And I started looking
more and more into this.
more and more into this.
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然後我開始研究這件事，
（鼓掌）
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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結果是，這不僅僅是醫生能夠
提供給埃胡德最好的，
提供給埃胡德最好的，
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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而且這是醫生能夠提供給所有
腦癌病人最好的。
腦癌病人最好的。
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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我們其實並沒有在
解決癌癥上做的很好。
解決癌癥上做的很好。
02:30
I picked up one of those statistics,
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我挑選了那些調查數據之壹， ¶
02:32
and I'm sure some of you
have seen those statistics before.
have seen those statistics before.
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我保證妳們中的壹些人曾經
看過這些數據。
看過這些數據。
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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這將要告訴妳多少人真的死於癌癥，
02:38
in this case females in the United States,
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多少美國女性，
02:40
ever since the 1930s.
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自從20世紀30年代。
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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妳會發現並沒有什麽改變。
02:44
It's still a huge issue.
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這依舊是壹個巨大的問題。
02:46
You'll see a few changes, though.
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即使妳能看到壹些改變，
02:48
You'll see lung cancer,
for example, on the rise.
for example, on the rise.
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妳會發現，比如，肺癌在升高。
02:50
Thank you, cigarettes.
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感謝香煙。
02:52
And you'll also see that,
for example, stomach cancer
for example, stomach cancer
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而且妳還能看到，比如說，胃癌，
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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曾經癌癥中最大的殺手之壹，
02:58
is essentially eliminated.
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已經大大地減少。
03:00
Now, why is that?
Anyone knows, by the way?
Anyone knows, by the way?
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好，為什麽會這樣？
有人知道嗎？
有人知道嗎？
03:02
Why is it that humanity is no longer
struck by stomach cancer?
struck by stomach cancer?
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為什麽人類不再受胃癌折磨？
03:05
What was the huge, huge
medical technology breakthrough
medical technology breakthrough
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是哪個巨大的醫療技術突破
03:10
that came to our world
that saved humanity from stomach cancer?
that saved humanity from stomach cancer?
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誕生在世界上，從胃癌中拯救人類？
03:15
Was it maybe a new drug,
or a better diagnostic?
or a better diagnostic?
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可能是壹種新藥或者
是壹種更好的診斷方式？
是壹種更好的診斷方式？
03:19
You guys are right, yeah.
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妳們是對的。
03:20
It's the invention of the refrigerator,
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是冰箱的發明，
03:23
and the fact that we're
no longer eating spoiled meats.
no longer eating spoiled meats.
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還有我們不在吃腐爛的食物的事實。
03:25
So the best thing
that happened to us so far
that happened to us so far
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所以至今發生最好的事情，
03:28
in the medical arena in cancer research
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在癌癥研究的醫療領域，
03:29
is the fact that
the refrigerator was invented.
the refrigerator was invented.
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是冰箱的發明。
03:32
(Laughter)
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（笑聲）
03:33
And so -- yeah, I know.
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我知道。
03:34
We're not doing so well here.
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我們並沒有做的很好。
03:36
I don't want to miniaturize the progress
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我不想貶低
我們在癌癥研究方面的付出。
03:38
and everything that's been done
in cancer research.
in cancer research.
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03:41
Look, there is like 50-plus years
of good cancer research
of good cancer research
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聽著，
有五十多年很有成效的癌癥研究，
有五十多年很有成效的癌癥研究，
03:45
that discovered major, major things
that taught us about cancer.
that taught us about cancer.
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發現了有關癌癥的重要的東西。
03:48
But all that said,
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但是，盡管這樣，
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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我們還有很多重要的事情需要解決。
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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我會闡述為什麽事情會發展成這樣，
03:58
why we have not done that remarkably well,
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為什麽我們沒有做的非常好，
是因為我們在盲目地鬥爭。
04:00
is really we're fighting blindly here.
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04:01
And this is where
medical imaging comes in.
medical imaging comes in.
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這和醫療影像有關，
04:04
This is where my own work comes in.
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這就是為什麽我成果的誕生。
04:06
And so to give you a sense
of the best medical imaging
of the best medical imaging
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為了告訴妳們什麽是最好的
04:09
that's offered today
to brain cancer patients,
to brain cancer patients,
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能夠提供給腦癌患者的醫療影像，
04:11
or actually generally
to all cancer patients,
to all cancer patients,
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或者給所有癌癥患者的，
04:13
take a look at this PET scan right here.
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看壹看這個PET掃描，
04:15
Let's see. There we go.
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04:17
So this is a PET/CT scan,
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好，這是壹個PETCT掃描，
04:19
and what you'll see in this PET/CT scan
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妳能從這個PET／CT掃描中看出，
04:21
is the CT scan will show you
where the bones are,
where the bones are,
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CT掃描能夠告訴妳骨頭的位置，
04:25
and the PET scan will show you
where tumors are.
where tumors are.
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PET掃描能夠告訴妳腫瘤的位置。
04:27
Now, what you can see here
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現在，妳可以看到，
04:30
is essentially a sugar molecule
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壹個糖分子
04:32
that was added a small little tag
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被添加了壹個小小的標簽，
04:34
that is signaling to us
outside of the body,
outside of the body,
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並給在體外的我們打信號，
04:36
"Hey, I'm here."
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“嘿，我在這。”
04:37
And those sugar molecules are injected
into these patients by the billions,
into these patients by the billions,
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而且上億那樣的糖分子被
註射進病人體內，
註射進病人體內，
04:41
and they're going all over the body
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並散布至全身，
04:43
looking for cells
that are hungry for sugar.
that are hungry for sugar.
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尋找需要糖分的細胞。
04:46
You'll see that the heart,
for example, lights up there.
for example, lights up there.
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妳會發現，比如說，
心臟部位是亮的，
心臟部位是亮的，
04:49
That's because the heart
needs a lot of sugar.
needs a lot of sugar.
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那是因為心臟需要很多糖分。
04:51
You'll also see that the bladder
lights up there.
lights up there.
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妳還會發現膀胱也是亮的。
04:53
That's because the bladder
is the thing that's clearing
is the thing that's clearing
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那是因為膀胱負責清除
04:56
the sugar away from our body.
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體內的糖分。
04:58
And then you'll see a few other hot spots,
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而且妳會發現其他亮點，
05:00
and these are in fact the tumors.
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這些事實上都是腫瘤。
05:01
Now, this is a really
a wonderful technology.
a wonderful technology.
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現在，這是壹個很棒的科技。
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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第壹次能夠讓我們觀察人體內部，
05:07
without picking up
each and every one of the cells
each and every one of the cells
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不需要挑出其中的細胞，
05:09
and putting them under the microscope,
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並把它們放在顯微鏡下，
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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而且無侵入性地讓我們觀察人體內部，
05:14
and ask, "Hey,
has the cancer metastasized?
has the cancer metastasized?
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並問，“嘿，癌癥有擴散嗎？
05:16
Where is it?"
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它在哪裏？”
05:17
And the PET scans here
are showing you very clearly
are showing you very clearly
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而且PET掃描很清晰的展示
05:20
where are these hot spots,
where is the tumor.
where is the tumor.
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這些亮點在哪裏，
那些腫瘤在哪裏。
那些腫瘤在哪裏。
05:23
So as miraculous as this might seem,
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這看起來很奇妙，
05:26
unfortunately, well, it's not that great.
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不幸的是，這並沒有那麽棒。
05:30
You see, those
small little hot spots there.
small little hot spots there.
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那些小小的亮點，
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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有人能猜猜在其中壹個腫瘤裏
有多少癌細胞嗎？
有多少癌細胞嗎？
05:38
So it's about 100 million cancer cells,
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大概有1億個癌細胞，
05:40
and let me make sure
that this number sunk in.
that this number sunk in.
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讓我解釋這個數據的真實性。
05:43
In each and every one
of these small little blips
of these small little blips
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每壹個小小的亮點，
05:46
that you're seeing on the image,
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妳能在圖片中看到的，
05:47
there needs to be
at least 100 million cancer cells
at least 100 million cancer cells
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都需要至少1億個癌細胞
05:51
in order for it to be detected.
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才能被檢測到。
05:53
Now, if that seemed to you
like a very large number,
like a very large number,
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如果那對妳來說是個很大的數字，
05:55
it is a very large number.
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沒錯，那就是壹個很大的數字。
05:58
This is in fact
an incredibly large number,
an incredibly large number,
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事實上，
這就是壹個非常龐大的數據，
這就是壹個非常龐大的數據，
因為為了能夠盡早發現壹些東西，
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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並能夠采取有意義的行動，
06:04
to do something about it,
to do something meaningful about it,
to do something meaningful about it,
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我們需要有壹千個癌細胞大小的腫瘤，
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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但是理想來說，
只需要很少癌細胞的腫瘤，
只需要很少癌細胞的腫瘤，
06:10
and ideally just
a handful of cells in size.
a handful of cells in size.
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所以我們很明顯離這個還很遠。
06:12
So we're clearly
pretty far away from this.
pretty far away from this.
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所以我們要做壹個小實驗。
06:14
So we're going to play
a little experiment here.
a little experiment here.
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06:16
I'm going to ask each of you
to now play and imagine
to now play and imagine
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我要妳們每壹個人扮演和想象
06:19
that you are brain surgeons.
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我要妳們每壹個人扮演和想象
06:21
And you guys are now at an operating room,
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妳們現在在壹間手術室裏，
06:25
and there's a patient in front of you,
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面前有壹個病人，
06:27
and your task is to make sure
that the tumor is out.
that the tumor is out.
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妳的任務就是保證清除腫瘤。
06:31
So you're looking down at the patient,
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所以妳低頭看著病人，
06:34
the skin and the skull
have already been removed,
have already been removed,
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皮膚和頭骨都已經被拆除了，
06:37
so you're looking at the brain.
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所以妳正在看著大腦。
06:38
And all you know about this patient
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妳知道的所有關於這個病人的，
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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就是有壹個大概高爾夫球大小的腫瘤
06:43
in the right frontal lobe
of this person's brain.
of this person's brain.
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在這個病人的右額葉。
06:46
And that's more or less it.
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情景大概就是這樣。
06:47
So you're looking down, and unfortunately
everything looks the same,
everything looks the same,
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所以妳往下看，不幸的是，
所有東西都看起來是壹樣的，
所有東西都看起來是壹樣的，
06:50
because brain cancer tissue
and healthy brain tissue
and healthy brain tissue
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因為腦癌組織和健康的腦組織
06:53
really just look the same.
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看起來是壹樣的。
06:55
And so you're going in with your thumb,
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所以妳要用妳的拇指，
06:57
and you start to press
a little bit on the brain,
a little bit on the brain,
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開始輕輕地在大腦上按壓，
06:59
because tumors tend to be
a little harder, stiffer,
a little harder, stiffer,
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因為腫瘤相對更硬，
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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所以妳壹遍壹遍做這樣的事情，
07:04
"It seems like the tumor is right there."
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“看起來腫瘤在這。”
07:06
Then you take out your knife
and start cutting the tumor
and start cutting the tumor
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然後妳拿出刀，開始切割腫瘤，
07:09
piece by piece by piece.
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壹塊壹塊地，
07:10
And as you're taking the tumor out,
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當妳正在摘除腫瘤的時候，
07:12
then you're getting
to a stage where you think,
to a stage where you think,
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然後妳會想，
07:14
"Alright, I'm done.
I took out everything."
I took out everything."
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“好，我把所有的腫瘤都拿出來了。”
07:16
And at this stage, if that's --
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到了這個時候，
07:18
so far everything sounded,
like, pretty crazy --
like, pretty crazy --
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壹切看起來都有點瘋狂，
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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妳現在要面臨人生中最具挑戰的決定，
07:24
Because now you need to decide,
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因為妳要決定
07:26
should I stop here
and let this patient go,
and let this patient go,
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我應該停下，讓病人出院，
07:29
risking that there might be
some leftover cancer cells behind
some leftover cancer cells behind
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承擔有遺留癌細胞的風險，
07:32
that I just couldn't see,
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因為妳看不出來，
07:33
or should I take away some extra margins,
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或者我應該多摘除壹些邊緣物質，
07:36
typically about an inch or so
around the tumor
around the tumor
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經常是腫瘤邊緣壹英寸，
07:39
just to be sure that I removed everything?
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為了保證移除了所有腫瘤？
07:43
So this is not a simple decision to make,
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所以這不是壹個簡單的決定，
07:47
and unfortunately this is the decision
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而且不幸的是，這個決定
07:49
that brain cancer surgeons
have to take every single day
have to take every single day
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腦癌手術醫師每天都要做，
07:53
as they're seeing their patients.
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因為他們要見到病人。
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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所以我記得我跟
我的幾個朋友在實驗室聊天，
我的幾個朋友在實驗室聊天，
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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“朋友們，總有更好的方式。”
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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但是不像是妳安慰別人的方式，
08:04
There's just got to be a better way here.
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真的，總有壹個更好的方式。
08:06
This is just incredible.
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這太不可思議了。
08:07
And so we looked back.
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所以我們回頭看，
08:09
Remember those PET scans I told you about,
the sugar and so on.
the sugar and so on.
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想起了我告訴妳們的那個PET掃描，
糖分子啊等等。
糖分子啊等等。
08:12
We said, hey, how about
instead of using sugar molecules,
instead of using sugar molecules,
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我們說，嘿，如果不用糖分子，
08:15
let's maybe take tiny, tiny
little particles made of gold,
little particles made of gold,
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我們可以用很小很小的由金構成的粒子，
08:18
and let's program them with some
interesting chemistry around them.
interesting chemistry around them.
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然後在它們旁邊附上壹些
有趣的化學物質，
有趣的化學物質，
08:21
Let's program them
to look for cancer cells.
to look for cancer cells.
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讓它們去尋找癌細胞。
08:24
And then we will inject
these gold particles
these gold particles
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然後我們會註射這些金粒子，
08:26
into these patients by the billions again,
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以上十億的數量註入病人體內，
08:28
and we'll have them go all over the body,
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1976
讓它們散布全身，
08:30
and just like secret agents, if you will,
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1976
妳可以把他們想象成特工，
08:32
go and walk by
every single cell in our body
every single cell in our body
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潛伏在我們體內的每壹個細胞，
08:35
and knock on the door of that cell,
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並敲開細胞的門，
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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並問：
“妳是壹個癌細胞，還是健康的細胞？”
“妳是壹個癌細胞，還是健康的細胞？”
如果妳是壹個健康的細胞，那就繼續，
08:40
If you're a healthy cell, we're moving on.
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2016
如果妳是壹個癌細胞，
我們就原地不動，並發出亮光，
我們就原地不動，並發出亮光，
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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並跟我們說，
“嘿，看看我，我在這。”
“嘿，看看我，我在這。”
08:44
and telling us,
"Hey, look at me, I'm here."
"Hey, look at me, I'm here."
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通過壹些特殊的攝像頭，
08:47
And they'll do it
through some interesting cameras
through some interesting cameras
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是我們在實驗室裏研究出來的，
08:49
that we developed in the lab.
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壹旦我們看到癌細胞，
可能我們可以帶領腦癌手術醫師，
可能我們可以帶領腦癌手術醫師，
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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只摘除腫瘤，留下健康的腦細胞。
08:53
towards taking only the tumor
and leaving the healthy brain alone.
and leaving the healthy brain alone.
203
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3401
08:57
And so we've tested that,
and boy, this works well.
and boy, this works well.
204
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所以我們檢測了這個主意，
它的運作很成功。
它的運作很成功。
09:00
So I'm going to show you an example now.
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我現在要給妳們展示壹個實驗，
妳現在看到的，
09:02
What you're looking at here
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09:04
is an image of a mouse's brain,
207
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是壹張老鼠大腦的照片，
09:08
and we've implanted
into this mouse's brain
into this mouse's brain
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我們已經在這只老鼠的大腦裏，
種植了壹個小腫瘤。
09:11
a small little tumor.
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09:13
And so this tumor is now
growing in this mouse's brain,
growing in this mouse's brain,
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所以這個腫瘤現在正在老鼠大腦裏擴散，
我們已經請求過壹個醫生，
09:15
and then we've taken a doctor
and asked the doctor
and asked the doctor
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讓他來這只“病人”老鼠動手術，
09:18
to please operate on the mouse
as if that was a patient,
as if that was a patient,
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2816
09:21
and take out piece by piece
out of the tumor.
out of the tumor.
213
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壹片壹片地取出腫瘤。
09:23
And while he's doing that,
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當他在做這個的時候，
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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我們準備給金粒子的位置拍照，
09:28
And so we're going to first start
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所以首先我們要
給這只老鼠註射金粒子，
09:30
by injecting these gold particles
into this mouse,
into this mouse,
217
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2416
09:32
and we're going to see
right here at the very left there
right here at the very left there
218
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所以我們可以看到，在最左邊，
底部的那張圖片，
09:35
that image at the bottom
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09:36
is the image that shows
where the gold particles are.
where the gold particles are.
220
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展示金粒子的位置，
金粒子的好處就是
09:39
The nice thing
is that these gold particles
is that these gold particles
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它們能夠成功找到腫瘤，
09:41
actually made it all the way to the tumor,
222
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2016
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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發光，並告訴我們
“嘿，我們在這兒，腫瘤在這兒。”
“嘿，我們在這兒，腫瘤在這兒。”
所以我們可以看到腫瘤，
09:47
So now we can see the tumor,
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但是我們還沒有把這個展示給醫生。
09:48
but we're not showing this
to the doctor yet.
to the doctor yet.
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我們要求醫生開始切除腫瘤，
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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妳能看到四分之壹的腫瘤
已經被醫生摘除了，
已經被醫生摘除了，
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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妳已經看不到四分之壹的腫瘤了。
09:57
and you see that first quadrant
is now missing.
is now missing.
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醫生然後移除了第二個和
第三個四分之壹，
第三個四分之壹，
09:59
The doctor then took
the second quadrant, the third,
the second quadrant, the third,
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現在看起來腫瘤已經被清除幹凈了，
10:01
and now it appears to be everything.
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到了這個階段，
醫生告訴我們說：
醫生告訴我們說：
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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“好了，我做完了。
現在妳們要我幹什麽？
現在妳們要我幹什麽？
10:06
"Alright, I'm done.
What do you want me to do?
What do you want me to do?
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留下剩下的不動，
10:08
Should I keep things as they are
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還是要我摘除多余的邊緣？”
10:10
or do you want me to take
some extra margins around?"
some extra margins around?"
234
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然後我們說：”等等。”
10:12
And then we said, "Well, hang on."
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我們告訴醫生
“妳已經遺漏了這兩處，
“妳已經遺漏了這兩處，
10:14
We told the doctor,
"You've missed those two spots,
"You've missed those two spots,
236
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2416
與其要切除大量的邊緣，
10:16
so rather than taking huge margins around,
237
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2000
還不如把這些小型的部分切除。
10:18
only take out those tiny little areas.
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把它們摘除，然後我們再看看。“
10:20
Take them out,
and then let's take a look."
and then let's take a look."
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2016
然後醫生把它們摘除了，
10:22
And so the doctor took them away,
and lo and behold,
and lo and behold,
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10:25
the cancer is now completely gone.
241
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2016
癌細胞現在是完全的沒了。
10:27
Now, the important thing
242
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現在，重要的不僅僅是
10:29
is that it's not just
that the cancer is completely gone
that the cancer is completely gone
243
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癌癥細胞已經從這個人或者
是老鼠的大腦裏摘除了，
是老鼠的大腦裏摘除了，
10:31
from this person's brain,
244
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10:33
or from this mouse's brain.
245
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10:35
The most important thing
246
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最重要的是，
10:36
is that we did not have to take
huge amounts of healthy brain
huge amounts of healthy brain
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我不需要摘除大量的健康腦細胞，
在手術過程中。
10:39
in the process.
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10:40
And so now we can actually imagine a world
249
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所以現在我們可以想象壹個世界，
10:42
where doctors and surgeons,
as they take away a tumor,
as they take away a tumor,
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醫生和手術醫師在摘除腫瘤的時候，
他们知道什麽是應該摘除了，
10:46
they actually know what to take out,
251
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10:48
and they no longer
have to guess with their thumb.
have to guess with their thumb.
252
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2110
他們不再需要用拇指來猜測。
現在，這是為什麽取出那些
剩余少量的腫瘤那麽重要，
剩余少量的腫瘤那麽重要，
10:51
Now, here's why it's extremely important
to take those tiny little leftover tumors.
to take those tiny little leftover tumors.
253
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那些剩下的腫瘤，
即使只有壹點點細胞，
即使只有壹點點細胞，
10:55
Those leftover tumors,
even if it's just a handful of cells,
even if it's just a handful of cells,
254
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它們會復發，
10:58
they will grow to recur the tumor,
255
646360
3056
重新長成腫瘤。
11:01
for the tumor to come back.
256
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11:03
In fact, the reason why 80 to 90 percent
257
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事實上，
這就是為什麽80%到90%的
這就是為什麽80%到90%的
11:05
of those brain cancer surgeries
ultimately fail
ultimately fail
258
653080
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腦癌手術醫師最終都會失敗，
11:07
is because of those small little
extra margins that were left positive,
extra margins that were left positive,
259
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是因為那些我們樂觀地
留下少量的邊緣物質，
留下少量的邊緣物質，
11:11
those small little leftover tumors
that were left there.
that were left there.
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那些我們留下的少量的剩余物質。
11:15
So this is clearly very nice,
261
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這看起來很好，
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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我想分享給妳們的是
我們該怎麽從這裏開始，
我們該怎麽從這裏開始，
11:21
And so in my lab at Stanford,
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所以我在斯坦福的實驗室，
11:23
my students and I are asking,
what should we be working on now?
what should we be working on now?
264
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我的學生和我在問，
現在該研究什麽？
現在該研究什麽？
我認為醫療影像的未來
11:29
And I think where
medical imaging is heading to
medical imaging is heading to
265
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是查看人體的內部，
11:32
is the ability to look into the human body
266
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2336
並能夠分別查看每壹個細胞。
11:34
and actually see each and every one
of these cells separately.
of these cells separately.
267
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像這樣的能力，能夠讓我們
11:39
The ability like this would allow us
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11:40
to actually pick up tumors
way, way earlier in the process,
way, way earlier in the process,
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在早期移除腫瘤，
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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遠遠在1億個細胞之前，
所以我們可以采取行動。
所以我們可以采取行動。
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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壹種能夠查看單個細胞的能力，
能夠讓我們
11:51
to ask insightful questions.
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提出深刻的問題。
11:53
So in the lab,
we are now getting to a point
we are now getting to a point
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所以在實驗室裏，
我們達到了壹個臨界點，
我們達到了壹個臨界點，
11:55
where we can actually start asking
these cancer cells real questions,
these cancer cells real questions,
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我們可以開始提出關於癌細胞的問題，
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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比如說，我們給妳的治療有效果嗎？
如果沒有效果，
我們就會知道要立即停止治療
我們就會知道要立即停止治療
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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在治療開始幾天，不是三個月。
12:05
days into the treatment, not three months.
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12:08
And so also for patients like Ehud
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像埃胡德這樣的病人，
正在經受這些殘酷治療的，
12:10
that are going through these
nasty, nasty chemotherapy drugs,
nasty, nasty chemotherapy drugs,
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讓他們免受可怕的藥物副作用，
12:15
for them not to suffer
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12:16
through those horrendous
side effects of the drugs
side effects of the drugs
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當藥物並不會幫助他們的時候。
12:19
when the drugs are
in fact not even helping them.
in fact not even helping them.
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12:22
So to be frank here,
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但是坦白來說，
12:24
we're pretty far away
from winning the war against cancer,
from winning the war against cancer,
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我們距離贏得與癌癥的鬥爭還很遠，
這就是現實。
12:28
just to be realistic.
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但是，至少我是樂觀的，
12:29
But at least I am hopeful
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我們能夠用更好的醫療影像來做鬥爭，
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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12:35
in the way that is not blind.
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那樣，我們就不會盲目了。
謝謝。
12:37
Thank you.
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（鼓掌）
12:38
(Applause)
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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