Within Reach

Over the past several years, my wife and I have committed a ton of time and money to fund cancer research. Increasingly these days, I get asked why.

Let’s start with the obvious – cancer is a miserable, vicious disease that is responsible for over 20% of all deaths in America. You eradicate cancer and instantly save one out of every five people that die each year.

Cancer is also a drain on our national and global resources. The U.S. government spends over $80 billion subsidizing cancer treatment and the estimated cost to our economy is well over half a trillion dollars annually. Cancer is literally clogging up our health care system and draining our economy.

As someone who has spent the last 16 years (with my partner Brad) applying technology to antiquated industries, I believe there is no greater white space than healthcare and no singular opportunity as promising as molecular engineering with regard to cancer treatment.

The process of diagnosing and treating cancer has remained largely the same over the past 50 years and is deeply rooted in anatomical biology. There are almost no 0s and 1s, just good old-fashioned chemistry and biology at work.

The process today goes as follows: a patient feels a lump, or has an unexplained pain that won’t go away, or some other symptom that prompts them to seek medical advice. Their doctor performs a biopsy and sends a small sample of their tissue to a pathologist who examines their cells under a microscope. Within a few days, a pathology report is returned to their doctor telling them if cancer was detected. The report is very brief and describes three things: tumor size, point of origin and whether or not it’s metastasized; something like – “the patient has metastatic stage 4 bone cancer with a tumor measuring 4 cm wide that has spread to their left lung.”

At that point, an oncologist determines a course of treatment, likely to consist of surgery, chemotherapy or radiation (the same course of treatment that’s existed for 50 years).

A patient could go through the entire process (from diagnosis to treatment), following a statistically validated pharmacological regimen without anyone looking into their molecular composition or the mutations that are prevalent in “their” cancer.

The human genome was decoded in 2003, giving us our first view into a human’s complete molecular composition. For over 12 years, we have had the recipe book of our anatomy and yet today less than 10% of cancer patients receive any form of genetic testing. And when patients are tested, the process is slow and narrowly focused on a few mutations for which there are known targeted treatments.

Why?

First, healthcare has been slow to adopt certain technologies that most other industries have embraced (big data, open source, mobile, etc.), due in part to the fact that their core practice is deeply entrenched in science – chemistry, biology, physics, etc. As a result, in order for technologists to build solutions that address the needs of oncologists, they have to first understand medicine, essentially getting a ‘mini-medical degree.’

Second, the entire healthcare ecosystem is wrapped up in a seemingly endless bundle of regulation – insurance, pharma, the FDA, state and federal law, HIPAA, and so on. What should take a month, takes a year. What should take a year, takes a decade.

Third, until recently, the cost of sequencing patients has been prohibitive. And even if you could afford to sequence a patient’s genome, or exome, or transcriptome, the cost of storage and analysis was equally problematic.

Yet this last point has been turned upside down as the cost of sequencing has dropped dramatically, creating what I believe is the most unique technological paradigm shift I have ever seen (a pretty bold statement coming from someone who has lived through the creation and proliferation of the personal computer, the Internet, and the smart phone).

Now that the toll you have to pay to look inside someone’s body is affordable, a world of new opportunity is emerging before our very eyes. Every day there is a new breakthrough. Every day new hope.

We are on the verge of extending life in ways that just a decade ago seemed unimaginable.

We are on the verge of personalized medicine and of engineering medicinal cocktails that are specific to each patient and his or her disease.

For the first time, it’s within reach.