Gambhir: We pay a price for shying away

It’s the year 2100. As you go about your morning routine, the implanted device inside your upper arm initiates its daily blood test. Your smart watch checks your heart and breathing rates. And the screen on your toilet signals your sample is clear.

This is not a scene from Hollywood’s next sci-fi epic. It is Dr. Sanjiv S. Gambhir’s compelling vision for the future of health care and early cancer detection.

“To really detect cancer early, we have to move toward monitoring the human body all the time,” he explained. “Our current therapies are pretty good, but they are applied far too late.”

GAMBHIR

GAMBHIR

For this visionary approach to cancer diagnostics, Gambhir, a renowned clinician-scientist from Stanford University, was named the 2015 recipient of the J. Allyn Taylor International Prize in Medicine, presented by Robarts Research Institute. He will present his research Nov. 18 at Western.

With his research, Gambhir is shifting the conversation around health care to include the concept of precision health.

He points to airplane engines as an illustration. Monitored by hundreds of sensors, an engine’s status is recorded while on the ground and in flight. If a problem exists, it is fixed immediately.

Compare aviation’s standard engine checks with the current approach to disease treatment and prevention. “In the health world, we check in once a year, if even that,” Gambhir said. “We detect problems when they already exist and we usually detect them very late in the game.”

Constant monitoring of the body will require the combined efforts of wearable devices, implanted devices and household appliances that people use frequently, such as the toilet bowl or sink. All with the purpose of raising red flags on potential health issues or diseases.

It’s certainly advantageous for those who avoid the doctor. “People won’t actually have to do anything different or change their behaviour,” Gambhir explained. “We can go about our normal business and be monitored in the background.”

Gambhir and his team are developing such devices, as well as additional technology that forces cancer cells to reveal themselves by producing biomarkers. One example is DNA-ring technology that may one day result in patients taking a pill which will cause cancerous cells to excrete a unique biomarker, indicating the type and stage of the tumour at an earlier point in the disease.

Another tactic is scaring tumours into revealing themselves by applying sound.

“We yell at the tumours, which causes them to release these biomarkers,” Gambhir said.

High-resolution imaging also remains an important complement to the bigger picture of precision health and early detection, as it will continue to verify the existence of cancer and locate the site of the disease.

Despite these promising advances, the issue of early detection stirs up anger and frustration for Gambhir.

“As a society, we’ve failed our patients – and not just the medical community, but insurers, governments, pharmaceutical companies, imaging companies,” he said. “Instead of tackling the real problem, which is prevention and early detection, we’ve focused all our energies on the tail end of the problem.”

A devastating personal tragedy put this failure front and centre for the researcher. Six months ago, he lost his 16-year-old son, Milan, to an aggressive brain tumour.

“Had he been born at a different time – 50 or 100 years from now – probably some element of precision health would have been in place and we would have a better chance at catching the disease early,” Gambhir said. “My anger, my frustration is only amplified by what happened to Milan. We continue to pay a price for shying away from the harder problem.”

The Taylor Prize is significant to him for this reason. While personally honoured, he also considers the prize to be recognition for the field of early detection.

“We’ve now trained a whole host of scientists that are all over the world tackling this problem,” he said. “I am grateful that the field is getting profile and attention, because people are realizing early detection is something that has major significance.”

The Robarts community will present Gambhir with his prize at the Leaders in Innovation Dinner on Nov. 18.

“Dr. Gambhir is a globally recognized pioneer in the field of molecular imaging,” said Arthur Brown, Robarts scientist and chair of the Taylor Prize committee. “His work has revolutionized our ability to diagnose cancer and other diseases, and to develop and optimize the therapies of tomorrow.”

During his visit, Gambhir will also spend the day at Robarts and take part in the Taylor Symposium and Cancer Imaging Public Forum. Members of the public are invited to attend the Public Forum, a free event, to learn about cancer research breakthroughs and imaging advances from local and international researchers.