7 ms·

Bikanta’s (YC S14) Tiny Diamonds Find Cancer Before It Spreads

179 points by paul 12y ago

bcjordan 12y ago
From the article: > these nanodiamonds can detect molecular abnormalities at a much earlier stage, essentially stopping cancer from spreading any further > Current methods are unable to detect small tumors or breakaway tumor cells that lead to something called micrometastatic tumors, which can go undetected at the source and lead to the spread of cancer throughout other areas of the body. From pg's essay Frighteningly Ambitious Startup Ideas[1]: > It will seem preposterous to future generations that we wait till patients have physical symptoms to be diagnosed with cancer. Cancer will show up on some sort of radar screen immediately. > (Of course, what shows up on the radar screen may be different from what we think of now as cancer. I wouldn't be surprised if at any given time we have ten or even hundreds of microcancers going at once, none of which normally amount to anything.) [1]: http://www.paulgraham.com/ambitious.html http://www.paulgraham.com/ambitious.html
- deleted 12y ago
  [deleted]
- salgernon 12y ago
  As someone that has just been diagnosed with stage iv colon cancer, I'm a bit dismayed that a blood test done after the diagnosis (via colonoscopy and ct scan) shows an abnormal result - but that simple blood test was never performed before. If it correlates with the cancer, why isn't it done as a matter of course during routine health checkups? If there a dozen such tests for a dozen different cancers, I'm willing to give a liter of blood per year for testing. The test in question is CEA, carcinoembryonic antigen, where a standard range is 0.0 to 2.5ng/mL and mine is 8.0. What if I had had this test a year ago?
  - nostromo 12y ago
    The false positive paradox is often used when answering the question, "why not test everyone for everything?" http://en.wikipedia.org/wiki/False_positive_paradox http://en.wikipedia.org/wiki/False_positive_paradox (I get the statistics, but personally I would still happily sign up to be tested for everything possible.)
  - zrail 12y ago
    I had a similar situation. I was diagnosed with stage ii testicular cancer after an ultrasound and a blood test, which consisted of a simple blood test for a particular female pregnancy hormone. I would have gladly paid for that test every year, hell every month, if they could have detected it earlier. All that said, good luck with your treatment. That's a much tougher diagnosis than mine was.
    - copperx 12y ago
      You can just pee on a pregnancy test. If it's positive, you've got cancer. Pregnancy tests are cheap.
      - zrail 12y ago
        I never actually thought about that. Of course you can do that!
  - seesomesense 12y ago
    The CEA is useful for prognosis, staging and follow up. It is useless for diagnosis. "The CEA test has a specificity of between 30-80% and it is not recommended by the National Institute for Health and Clinical Excellence (NICE) for the diagnosis of early colorectal cancer" http://www.patient.co.uk/doctor/carcinoembryonic-antigen-cea http://www.patient.co.uk/doctor/carcinoembryonic-antigen-cea Causes of false postive CEA include but are not confined to: "Inflammatory Bowel Disease. Pancreatitis. Liver disease. Tobacco use can lead to elevated CEA levels. (CEA is elevated in 19% of smokers and only 3% of the non-smoking healthy population.) Diverticulitis. Hepatitis. Peptic ulcers. Hypothyroidism. Cirrhosis of the liver. COPD. Lung infection. Pleural effusions. Biliary obstruction. Treatment with oral 5-FU. High serum glutamic-pyruvic transaminase (sGPT) levels. Non-malignant liver disease, including cirrhosis, chronic active hepatitis.[6] Chronic kidney disease. Pancreatic disease.[7] Inflammatory bowel disease, diverticulitis, irritable bowel syndrome. Respiratory diseases, eg pleural inflammation, pneumonia. Smoking. Ageing.[8] Atherosclerosis "http://www.kantrowitz.com/cancerpoints/tumormarkerfalsepositives.html http://www.kantrowitz.com/cancerpoints/tumormarkerfalseposit...
    - clarkevans 12y ago
      Gosh : many of these are just as scary. Wouldn't it still be useful to have the screen taken, compare it with previous years, and see if anything changed? If you've got a change, then, you could start asking why?
      - salgernon 12y ago
        This was my thinking exactly. These are data points and while the test itself in isolation may not be conclusive, when combined with other factors that may be measured, inferred or analyzed as trends over time, this may have had me tested years ago. Standard for colonoscopy screening is to start at age 50. I'm 44.
  - mailshanx 12y ago
    Hey, here is wishing you all the very best in your treatment. I really hope you will come out stronger!
    - IgorPartola 12y ago
      I second this. My grandfather died from colon cancer a few years ago. He refused to go see a doctor even when he knew something was very wrong. Hope you get the treatment you need.
rgejman 12y ago
I am very pessimistic about the likelihood of this being a non-toxic visualization strategy in mice or men. These "microdiamonds" are unlikely to clear the kidneys, leading to kidney toxicity. This is the problem with all ≥ nanoscale molecules, with the exception of very long ones such as nanotubes which can pass longitudinally through the kidney slit diaphragms. Many a great drug (and visualization agent) has failed because of kidney toxicity. It's surprising that there are no MDs on the team.
- dbcooper 12y ago
  Non-invasive circulating cancer cell (CTC) screening from blood samples seems to have the most promise. (disclaimer: I run a project in this area)
  - Bikanta 12y ago
    that is actually one area of applications we are exploring! I'd love to have a chat with you about it.
    - dbcooper 12y ago
      Sounds great! I will have to try to contact you/Bikanta when I return from vacation.
  - ihodes 12y ago
    Which project? CTC screening is fascinating. Could you please point me to some good introductory papers/reading?
    - dbcooper 12y ago
      I am on vacation right now, without my literature archive in arms reach, but from recent publications you may be interested in the whole-exome single cell sequencing work from Lohr et al. http://www.nature.com/nbt/journal/v32/n5/abs/nbt.2892.html http://www.nature.com/nbt/journal/v32/n5/abs/nbt.2892.html There is also an overview editorial in that issue of Nature Biotechnology. http://www.nature.com/nbt/journal/v32/n5/full/nbt.2897.html http://www.nature.com/nbt/journal/v32/n5/full/nbt.2897.html I remember seeing reviews in Lab Chip and Nat Rev Clinical Oncology recently. http://pubs.rsc.org/en/Content/ArticleLanding/2014/LC/C3LC50644D#!divAbstract http://pubs.rsc.org/en/Content/ArticleLanding/2014/LC/C3LC50... http://www.nature.com/nrclinonc/journal/v11/n3/full/nrclinonc.2013.253.html http://www.nature.com/nrclinonc/journal/v11/n3/full/nrclinon... The introduction sections of those papers should give you plenty of references to read. It's a good idea to look into the devices/methods used to enrich CTCs from blood prior to screening; Toner's devices based (in part) on EPCAM expression, and the CellScreen device (size/morphology), in particular.
Bikanta 12y ago
Hi everyone! I'm Ambika, one of the founders of Bikanta and inventors of this technology. I'd love to answer any questions that you may have. Here is also a link to our website: www.bikanta.com Thanks for the share from PG's article. We are definite believers that it is possible to detect cancer significantly before symptoms begin to appear!
- dbcooper 12y ago
  Do you intend to use your probes for in vivo imaging, or for histological study of tissue biopsies?
  - Bikanta 12y ago
    both, also for areas such as single molecule imaging
- negrit 12y ago
  Is the technology going to be affordable ? I'm a big believer of free/affordable health care and such technology could have a big impact around the world.
  - Bikanta 12y ago
    These nanodiamonds are cheaper to synthesize than what you find current optical imaging agents on the market for.
- dnautics 12y ago
  what exactly is the mechanism of bioaccumulation in cancer cells specifically? Or is this merely an imaging method that will have to be conjugated to, say a cancer-marker antibody?
  - Bikanta 12y ago
    you are correct, this is primarily targeted to disease states with ligands such as antibodies, aptamers, fab fragments, etc.
WhitneyLand 12y ago
Don't see how this pays off. Hard to imagine nanodiamonds being added to someone's body if there is not an unusual risk. If there is an unusual risk it's worth doing blood and tissue work. What scenario am I missing?
- adamnemecek 12y ago
  > Hard to imagine nanodiamonds being added to someone's body if there is not an unusual risk. Why is it hard to imagine?
  - mbreese 12y ago
    Because you don't treat someone for a disease that they haven't been diagnosed for. The idea that you'd prophylactically give someone these nanodiamonds is a big stretch at this point... especially when the PR is that "It’s like having a flashlight inside your body that basically lasts forever." You really want to have a method for turning off the flashlight when you don't need it. Now, if you have a patient that has been already diagnosed with cancer, and the nanodiamonds are used to monitor tumor progression or watch for metastasis, then that's a different story. Note: these aren't the same as vaccines, since cancer isn't a communicable disease (largely).
ph0rque 12y ago
The song I've been listening to lately has strangely appropriate lyrics, in a literal way: Your love is like radiant diamonds bursting inside us...
- Bikanta 12y ago
  :-) Thanks for that share!
mikexstudios 12y ago
Interesting! The article was weak on the science so I found some papers about the "nanodiamonds": http://pubs.acs.org/doi/full/10.1021/ja0567081 http://pubs.acs.org/doi/full/10.1021/ja0567081 http://pubs.acs.org/doi/abs/10.1021/ja4016815 http://pubs.acs.org/doi/abs/10.1021/ja4016815 https://www.opticsinfobase.org/boe/abstract.cfm?uri=boe-5-4-1190 https://www.opticsinfobase.org/boe/abstract.cfm?uri=boe-5-4-... Question (I know almost nothing about medicine/biology): I can see how nanodiamonds are useful for general imaging, but how will it help differentiate cancer cells from regular cells? Do the nanodiamonds bind to anything or is it just a emission light source? Thanks.
- Bikanta 12y ago
  It's an emission light source or probe that can be directed to specific cells with targeting agents. On our website (www.bikanta.com) you can find links to some of our publications and if you would like more literature and information about nanodiamonds, we'd love to share with you. Email us at info@bikanta.com
mikkom 12y ago
How safe is it to "insert" these nanodiamonds to your body? Can it be guaranteed that don't cause some kind of internal damage?
obvious_throw 12y ago
Ok, I've read the article twice and I am missing something here. I get how these can be used to help imaging, but I'm not clear on how exactly they target cancerous cells in particular. Are they attached to antibodies that seek out specific antigen markers of cancerous cells?
nicholas73 12y ago
How do the microdiamonds highlight abnormalities, and not just whatever it rests on? That is, wouldn't you simply get the same signal to noise ratio as before? Not only that, wouldn't the signal strength be a function of blood supply to that area? Thus, how big does the abnormality have to be before its conclusive using this technology?

179 points by paul 12y ago

From the article: > these nanodiamonds can detect molecular abnormalities at a much earlier stage, essentially stopping cancer from spreading any further > Current methods are unable to detect small tumors or breakaway tumor cells that lead to something called micrometastatic tumors, which can go undetected at the source and lead to the spread of cancer throughout other areas of the body. From pg's essay Frighteningly Ambitious Startup Ideas[1]: > It will seem preposterous to future generations that we wait till patients have physical symptoms to be diagnosed with cancer. Cancer will show up on some sort of radar screen immediately. > (Of course, what shows up on the radar screen may be different from what we think of now as cancer. I wouldn't be surprised if at any given time we have ten or even hundreds of microcancers going at once, none of which normally amount to anything.) [1]: http://www.paulgraham.com/ambitious.html http://www.paulgraham.com/ambitious.html

deleted 12y ago
[deleted]
salgernon 12y ago
As someone that has just been diagnosed with stage iv colon cancer, I'm a bit dismayed that a blood test done after the diagnosis (via colonoscopy and ct scan) shows an abnormal result - but that simple blood test was never performed before. If it correlates with the cancer, why isn't it done as a matter of course during routine health checkups? If there a dozen such tests for a dozen different cancers, I'm willing to give a liter of blood per year for testing. The test in question is CEA, carcinoembryonic antigen, where a standard range is 0.0 to 2.5ng/mL and mine is 8.0. What if I had had this test a year ago?
- nostromo 12y ago
  The false positive paradox is often used when answering the question, "why not test everyone for everything?" http://en.wikipedia.org/wiki/False_positive_paradox http://en.wikipedia.org/wiki/False_positive_paradox (I get the statistics, but personally I would still happily sign up to be tested for everything possible.)
- zrail 12y ago
  I had a similar situation. I was diagnosed with stage ii testicular cancer after an ultrasound and a blood test, which consisted of a simple blood test for a particular female pregnancy hormone. I would have gladly paid for that test every year, hell every month, if they could have detected it earlier. All that said, good luck with your treatment. That's a much tougher diagnosis than mine was.
  - copperx 12y ago
    You can just pee on a pregnancy test. If it's positive, you've got cancer. Pregnancy tests are cheap.
    - zrail 12y ago
      I never actually thought about that. Of course you can do that!
- seesomesense 12y ago
  The CEA is useful for prognosis, staging and follow up. It is useless for diagnosis. "The CEA test has a specificity of between 30-80% and it is not recommended by the National Institute for Health and Clinical Excellence (NICE) for the diagnosis of early colorectal cancer" http://www.patient.co.uk/doctor/carcinoembryonic-antigen-cea http://www.patient.co.uk/doctor/carcinoembryonic-antigen-cea Causes of false postive CEA include but are not confined to: "Inflammatory Bowel Disease. Pancreatitis. Liver disease. Tobacco use can lead to elevated CEA levels. (CEA is elevated in 19% of smokers and only 3% of the non-smoking healthy population.) Diverticulitis. Hepatitis. Peptic ulcers. Hypothyroidism. Cirrhosis of the liver. COPD. Lung infection. Pleural effusions. Biliary obstruction. Treatment with oral 5-FU. High serum glutamic-pyruvic transaminase (sGPT) levels. Non-malignant liver disease, including cirrhosis, chronic active hepatitis.[6] Chronic kidney disease. Pancreatic disease.[7] Inflammatory bowel disease, diverticulitis, irritable bowel syndrome. Respiratory diseases, eg pleural inflammation, pneumonia. Smoking. Ageing.[8] Atherosclerosis "http://www.kantrowitz.com/cancerpoints/tumormarkerfalsepositives.html http://www.kantrowitz.com/cancerpoints/tumormarkerfalseposit...
  - clarkevans 12y ago
    Gosh : many of these are just as scary. Wouldn't it still be useful to have the screen taken, compare it with previous years, and see if anything changed? If you've got a change, then, you could start asking why?
    - salgernon 12y ago
      This was my thinking exactly. These are data points and while the test itself in isolation may not be conclusive, when combined with other factors that may be measured, inferred or analyzed as trends over time, this may have had me tested years ago. Standard for colonoscopy screening is to start at age 50. I'm 44.
- mailshanx 12y ago
  Hey, here is wishing you all the very best in your treatment. I really hope you will come out stronger!
  - IgorPartola 12y ago
    I second this. My grandfather died from colon cancer a few years ago. He refused to go see a doctor even when he knew something was very wrong. Hope you get the treatment you need.

rgejman 12y ago

I am very pessimistic about the likelihood of this being a non-toxic visualization strategy in mice or men. These "microdiamonds" are unlikely to clear the kidneys, leading to kidney toxicity. This is the problem with all ≥ nanoscale molecules, with the exception of very long ones such as nanotubes which can pass longitudinally through the kidney slit diaphragms. Many a great drug (and visualization agent) has failed because of kidney toxicity. It's surprising that there are no MDs on the team.

dbcooper 12y ago
Non-invasive circulating cancer cell (CTC) screening from blood samples seems to have the most promise. (disclaimer: I run a project in this area)
- Bikanta 12y ago
  that is actually one area of applications we are exploring! I'd love to have a chat with you about it.
  - dbcooper 12y ago
    Sounds great! I will have to try to contact you/Bikanta when I return from vacation.
- ihodes 12y ago
  Which project? CTC screening is fascinating. Could you please point me to some good introductory papers/reading?
  - dbcooper 12y ago
    I am on vacation right now, without my literature archive in arms reach, but from recent publications you may be interested in the whole-exome single cell sequencing work from Lohr et al. http://www.nature.com/nbt/journal/v32/n5/abs/nbt.2892.html http://www.nature.com/nbt/journal/v32/n5/abs/nbt.2892.html There is also an overview editorial in that issue of Nature Biotechnology. http://www.nature.com/nbt/journal/v32/n5/full/nbt.2897.html http://www.nature.com/nbt/journal/v32/n5/full/nbt.2897.html I remember seeing reviews in Lab Chip and Nat Rev Clinical Oncology recently. http://pubs.rsc.org/en/Content/ArticleLanding/2014/LC/C3LC50644D#!divAbstract http://pubs.rsc.org/en/Content/ArticleLanding/2014/LC/C3LC50... http://www.nature.com/nrclinonc/journal/v11/n3/full/nrclinonc.2013.253.html http://www.nature.com/nrclinonc/journal/v11/n3/full/nrclinon... The introduction sections of those papers should give you plenty of references to read. It's a good idea to look into the devices/methods used to enrich CTCs from blood prior to screening; Toner's devices based (in part) on EPCAM expression, and the CellScreen device (size/morphology), in particular.

Bikanta 12y ago

Hi everyone! I'm Ambika, one of the founders of Bikanta and inventors of this technology. I'd love to answer any questions that you may have. Here is also a link to our website: www.bikanta.com Thanks for the share from PG's article. We are definite believers that it is possible to detect cancer significantly before symptoms begin to appear!

dbcooper 12y ago
Do you intend to use your probes for in vivo imaging, or for histological study of tissue biopsies?
- Bikanta 12y ago
  both, also for areas such as single molecule imaging
negrit 12y ago
Is the technology going to be affordable ? I'm a big believer of free/affordable health care and such technology could have a big impact around the world.
- Bikanta 12y ago
  These nanodiamonds are cheaper to synthesize than what you find current optical imaging agents on the market for.
dnautics 12y ago
what exactly is the mechanism of bioaccumulation in cancer cells specifically? Or is this merely an imaging method that will have to be conjugated to, say a cancer-marker antibody?
- Bikanta 12y ago
  you are correct, this is primarily targeted to disease states with ligands such as antibodies, aptamers, fab fragments, etc.

WhitneyLand 12y ago

Don't see how this pays off. Hard to imagine nanodiamonds being added to someone's body if there is not an unusual risk. If there is an unusual risk it's worth doing blood and tissue work. What scenario am I missing?

adamnemecek 12y ago
> Hard to imagine nanodiamonds being added to someone's body if there is not an unusual risk. Why is it hard to imagine?
- mbreese 12y ago
  Because you don't treat someone for a disease that they haven't been diagnosed for. The idea that you'd prophylactically give someone these nanodiamonds is a big stretch at this point... especially when the PR is that "It’s like having a flashlight inside your body that basically lasts forever." You really want to have a method for turning off the flashlight when you don't need it. Now, if you have a patient that has been already diagnosed with cancer, and the nanodiamonds are used to monitor tumor progression or watch for metastasis, then that's a different story. Note: these aren't the same as vaccines, since cancer isn't a communicable disease (largely).

ph0rque 12y ago

The song I've been listening to lately has strangely appropriate lyrics, in a literal way: Your love is like radiant diamonds bursting inside us...

Bikanta 12y ago
:-) Thanks for that share!

mikexstudios 12y ago

Interesting! The article was weak on the science so I found some papers about the "nanodiamonds": http://pubs.acs.org/doi/full/10.1021/ja0567081 http://pubs.acs.org/doi/full/10.1021/ja0567081 http://pubs.acs.org/doi/abs/10.1021/ja4016815 http://pubs.acs.org/doi/abs/10.1021/ja4016815 https://www.opticsinfobase.org/boe/abstract.cfm?uri=boe-5-4-1190 https://www.opticsinfobase.org/boe/abstract.cfm?uri=boe-5-4-... Question (I know almost nothing about medicine/biology): I can see how nanodiamonds are useful for general imaging, but how will it help differentiate cancer cells from regular cells? Do the nanodiamonds bind to anything or is it just a emission light source? Thanks.

Bikanta 12y ago
It's an emission light source or probe that can be directed to specific cells with targeting agents. On our website (www.bikanta.com) you can find links to some of our publications and if you would like more literature and information about nanodiamonds, we'd love to share with you. Email us at info@bikanta.com

mikkom 12y ago

How safe is it to "insert" these nanodiamonds to your body? Can it be guaranteed that don't cause some kind of internal damage?

obvious_throw 12y ago

Ok, I've read the article twice and I am missing something here. I get how these can be used to help imaging, but I'm not clear on how exactly they target cancerous cells in particular. Are they attached to antibodies that seek out specific antigen markers of cancerous cells?

nicholas73 12y ago

How do the microdiamonds highlight abnormalities, and not just whatever it rests on? That is, wouldn't you simply get the same signal to noise ratio as before? Not only that, wouldn't the signal strength be a function of blood supply to that area? Thus, how big does the abnormality have to be before its conclusive using this technology?