How new tech is changing the way we see, treat and beat cancer

Nothing prepares you for a cancer diagnosis. I didn’t even have any symptoms when I got mine.

A sonographer, routinely checking on the health of my carotid arteries with a mobile ultrasound cart, noticed an enlarged thyroid on the periphery of her screen. A few clumps of cells had turned against me and started to multiply.

Years ago, nobody would have been able to discover my problem until the disease had spread. And to diagnose me, they would’ve had to perform an invasive biopsy that itself carries risks. But thanks to that little diagnostic machine, I began on a treatment path that has left me cancer-free for nearly a year now.

I’m lucky to be one of millions of cancer survivors with a positive story to share. Deaths from cancer are on the decline thanks to better detection methods, more early screenings, behavior changes like quitting smoking, and rapidly advancing treatments. The latest data show that since 1991, the cancer death rate has fallen by 29% in the US, and from 2016 to 2017, it dropped by 2.2% — the largest single-year decline ever.

But there are still sobering statistics to temper the good news. In 2020, the American Cancer Society estimates doctors will diagnose 1.8 million people with cancer in the US alone, where it’s still the second leading cause of death after heart disease. More than 600,000 Americans die from cancer every year, and millions must endure grueling treatments.

From more powerful diagnostic imaging to genetic testing to immunotherapy innovations, new and emerging technologies will play a key role in accelerating the fight against cancer and potentially help reduce the mortality rate even further.

“There’s a sense of tremendous advances in treating cancers that would otherwise have killed the patient very quickly,” says Joel Saltz, a pathologist and Stony Brook Medicine’s vice president for clinical informatics. “People are having months or years of symptom-free life.”

Smarter detection through AI

Not long ago, detecting cancer required a biopsy, which a pathologist would examine through a microscope to determine if cells had turned malignant. Then, a couple of years ago, providers started taking digital images of diseased tissue, and researchers built repositories of imaged tumors from different patients. A new world came into view, aided by algorithms that let computers make predictions about which cells appear cancerous and which don’t.

“Computing power has grown by a factor of a million in the last 25 years, which really impacts how long it takes to do computations,” Saltz says. “The AI performs complex statistical analysis that can circle cancer in imaging after you teach it the general rules of what tumor cells look like.”

Now, AI systems wielding a powerful form of machine learning called deep learning are improving the predictive assistance they can offer, allowing researchers like Saltz to connect image analysis to patient-specific biochemical profiles.

“We’re going from an information-poor to an information-rich scenario,” Saltz says. “Soon, patients will get a much more precise set of suggestions based on personal genetics, the specifics of their immune system and other factors.”

Seeing tumors from every angle

Strapping on virtual reality (VR) headsets like HP’s Reverb Pro Edition, doctors can now virtually fly through representations of muscles, bones and blood vessels, exploring the specific dimensions of the tumor they must attack from every angle. 

Companies such as Immersive Touch and Surgical Theater let surgeons feed traditional CT and MRI scans into a medical visualization platform, which then builds a VR representation. This view offers an unprecedented way to navigate through the tumor and nearby anatomy for study, surgical planning and testing a procedure using virtual instruments. It also allows specialists anywhere in the world to virtually collaborate on the best treatment plan for difficult cases.

“You can do things you can’t do in the real world like blow up a tumor’s size and stand inside of it,” says MaryKate Mahoney, HP’s healthcare VR global lead. “You can segment and color-code different tissue to get a better picture of what you’re attacking.” 

Mahoney says HP is one of the organizations pushing the VR envelope in healthcare, with new hardware capabilities set to roll out later this year, including personalized surgical planning aids and enhanced spatial audio that lets a wearer hear sound in three dimensions. She predicts a future in which technology merges the virtual and real worlds in the operating room, where doctors will use augmented reality glasses while performing surgery, and computers will overlay their field of vision with critical data like a patient’s vital signs and AI-powered visual aids to guide procedures.

More precise, personalized treatments

Molecular information is also at the heart of treatments scientists are developing to target a patient’s unique disease.

Clinicians now routinely perform DNA sequencing on biopsies to understand a cancer cell’s genetic blueprint, informing therapies that can target specific molecules on the surface of, or within, a patient’s cancer cells. These selective pharmaceuticals can stop gene expression in particular cancer cells or tell them to self-destruct, unlike older medicines, which lay waste to all fast-replicating cells, whether they’re cancerous or not. 

Researchers are also excited about an approach called immunotherapy, which trains a patient’s immune system to recognize and destroy cancer cells. In one example, a company called Precision BioSciences edits the DNA in one kind of white blood cells so they can recognize specific diseases. Doctors then infuse these altered cells back into the patient to fight the disease.

“Old chemotherapies were generic, not specifically targeted and very toxic,” Saltz says. “Targeted therapies are remarkably effective, and their effects can last for years.”

Less invasive “liquid” biopsies 

With today’s precision treatments tuned to work at the cellular level, scientists and doctors need an even clearer view of the tumors they’re treating. Enter the world of microfluidics, the science of fluid flow at microscopic scales using tiny pumps, tubes and other components.

At HP’s Print Adjacencies and Microfluidics Lab, a team led by chief researcher Viktor Shkolnikov is working on a solution that will help solve the challenging problem of manipulating individual cells, using technology based on HP’s decades of expertise in inkjets, which precisely control fluid flow and electric field, temperature and pressure.

“You’re trying to identify and isolate 10 cancer cells out of a billion other cells in the blood based on specific properties the cancer cells share,” says Shkolnikov. 

This technology will become critical for personalized therapy and detecting if there are cancer cells post-treatment through so-called liquid biopsies, which can identify circulating tumor cells in blood samples instead of tissue removed via invasive biopsies. 

Shkolnikov expects the first commercial version to be available in the next few years, primarily for use by researchers and pharmaceutical companies conducting clinical trials of new drugs. “They’ll be able to grab cells after a drug is administered and see what the molecule is doing to them,” he says. “There’s no other way of attaining that information, that frequently, through traditional methods.”

Within the decade, he says microfluidic diagnostics will make their way into the clinic, offering more targeted detection and eliminating the risk of complications that arise in about 20% of biopsies conducted today. Microfluidic instruments will also let doctors assess how effective a treatment is through ongoing monitoring via simple blood draws and regular, more accurate surveillance once a patient achieves remission. 

Taken together, advances in AI, VR, precision medicine, microfluidics and other lines of inquiry provide hope for earlier detection, more effective treatment and lasting remission. For an increasing number of cancer patients, the future is filled with stories of survival like mine.

“The potential of these technologies isn’t sci-fi anymore,” says Mahoney. “More resources are being poured into development while more incredible things are coming out of it.”

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