Medical diagnostics are a subject close to my heart, and not simply because it we have a medical diagnostics company under the Cientifica umbrella. I have an elder brother who died last month as a result of undiagnosed cancer metastasizing until by the time symptoms appeared there were no treatment options left. My father, currently in the last stages of his fight, had a chance diagnosis sixteen years ago, something which gave him fifteen years that he would not have had otherwise.
There is unanimity from the medical world that the sooner you diagnose a disease the more treatment options you have, and therefore the higher the survival rate can be. The problem lies in obtaining that early diagnosis, especially in disease such as pancreatic cancer where symptoms do not show until there are limited treatment options.
It is not an insoluble problem using current technology, and there is a growing trend towards screening rather than waiting until symptoms present. While it is unfeasible to give everyone a regular colonoscopy to check for bowel cancer, the fecal occult blood test (FOBT) does at least give an indication of whether further tests are required, and routine blood tests can give early indications of a variety of conditions.
While a blood test may sound simple, the analysis is rather more complex. Samples must be taken using someone with medical training, shipped off to a lab, analysed and then the results transmitted back to the physician and eventually the diagnosis relayed to the patient. During this process the samples have to be labelled and tracked to ensure they do not get mixed up, and an audit trail with data security to protect patient confidentiality needs to be set up. As a result, a test that may seem simple to the patient requires a huge amount of time and effort, and a tiny bit of science, which results in long turnaround times and huge expense.
Most of the tests I have had involved a trip to the local doctor, a referral to a specialist consultant, an appointment with the consultant, some diagnostics, and another meeting with the consultant to discuss the results which may result in further tests etc. It is a system that is inconvenient for patients, and expensive for health care providers, so better diagnostic tools could make a huge difference.
So if we wanted to design a perfect diagnostic test what would it look like?
- Cheap: if want to screen for diseases the overall test has to be cheap, hundreds of dollars is way too much, so it needs to be in single figures.
- Fast: Cutting down all the data security and need for follow up visits further reduces the cost of testing. Getting the results within 7 minutes is the target for a 15 minute doctor’s appointment.
- Portable: Severing the link between the lab full of reagents and the patient is crucial if diagnostics are to be used in developing areas with little healthcare infrastructure, where the nearest lab could be hours of days away.
- Sensitive: Higher sensitivity is essential for locating small amounts of disease markers, reducing the volumes of fluid needed to be sampled and detecting disease early.
Combining all these attributes into a single test sounds like pure fantasy, but while compiling our report ‘Nanotechnology for Medical Diagnostics’ we came across dozens of examples of diagnostic tests under development that are faster, cheaper and more sensitive, not just by a few percent, but by orders of magnitude.
The implications of this are staggering, and the impact will be felt first in the research community, with products following once the various regulatory hurdles have been past. In the first wave of applications we will see hospital able to screen for drug allergies, cardiac markers and cytokine on admission. This will soon translate to physicians being able to run a whole battery of tests while you wait, dramatically cutting the time between presenting with symptoms and starting treatment.
But the overall trend is to make the majority of doctors visits completely unnecessary. Picking up a device that will take a pinprick of blood, run a test and transmit the results back to the physician will become increasingly possible, and as technologies such as organic electronics progress, reducing production costs by orders of magnitude, mass screening at an affordable price becomes possible.
So while the diagnostics enabled by nanotechnologies may become a $50 billion market within ten years, on a personal level, I’d like to make sure that the good fortune of an early diagnosis that allowed my father to enjoy my children growing up becomes less about luck, and more a matter of fact. After all, isn’t a longer and higher quality life worth so much more than a mere $50 billion.