Revolutionizing Cancer Diagnostics with Sumit Rai

Welcome, synergy listeners. We are so excited to have you here today for this awesome conversation around a topic that I think you're all going to be very interested. So meet Sumit, the visionary leader revolutionizing cancer diagnostics. As the founder, CEO and chairman of Cancer Check Labs, Sumit is pioneering advanced circulating tumor cells, CTC capturing technology in his relentless pursuit of a cure. His mission is deeply personal, fueled by the loss of his younger sister to cancer. Since 2012, Sumit has been the driving force behind Curesonia, a nonprofit funding research at top institutions like Stanford and usc. Not only does Curesonia provide financial support to families in need, but it also registered over 10,000 donors through bone marrow drives. Sumit's groundbreaking work earned him a nomination for the National Board of Leukemia and lymphoma society in 2022. Before transforming oncology, he founded a mobile advertising exchange acquired by Velti and Telefonica. With over 20 years in venture capital and private equity, Sumit is a seasoned angel investor and board member for companies like Fastbite and music. He's also a mentor and speaker, inspiring future entrepreneurs at Stanford and UC Berkeley. Join us as we explore Sumit's journey of innovation and resilience in the fight against cancer. Get ready to be inspired. We have an amazing opportunity today to talk about a topic that I think is near and dear to many people's hearts. We just welcome you, Sumit, to this conversation today. Thank you for being here.

Thank you for having me. I very much appreciate it.

Absolutely. So listen, tough topic today, cancer, and I know it's near and dear to your heart. So tell us a little bit about what even got you into anything related to cancer.

Yeah. So 14 years ago, my only sibling, my younger sister, got diagnosed with cancer and a year and a half later passed away. And that's really what got me into cancer. I had nothing to do with cancer. Prior to that, I was a Silicon Valley tech venture capital entrepreneur doing things unrelated to cancer. And so after my sister got ill and then unfortunately passed, I became very obsessed with learning everything I could possibly learn about cancer. And that's primarily what I've done over the last 14 years. And so to that end, I wanted to find a way to make a massive difference in an impact in the cancer world because it's such an important thing for humanity at large given how pervasive it's become in the population, with over 40% of the population now being expected to be diagnosed with cancer. And so spent the last 14 years developing a technology essentially that has Some profound implications because it gives rise to previously inconceivable diagnostic and therapeutic applications. Now, when you think about cancer, especially solid tumors, which include things like breast cancer, lung cancer, prostate, colorectal, pancreatic, liver, bladder, gastric, brain, skin, all the organ tumors from which 100 million people a year suffer across the globe annually, the primary tumor itself generally does not kill you. What kills you is the tumor sheds tumor cells that circulate through your bloodstream, known as circulating tumor cells, or ctcs, the acronym for short and. The CTCs spread the cancer in your body in a as metastasis. And the metastatic effects are fatal. And that's generally how you die from cancer, not from this lump. So a lot is known about CTCs, which I believe is the key to unlocking the Cure to cancer. CTCs have been extensively and exhaustively studied over the past 30 years. A simple Google search on CTCs would reveal thousands and thousands of papers on them. Number one, CTCs are known to be the drivers behind metastasis, the spread of cancer in the body. Number two, CTCs are known to be homologous, meaning similar to the primary tumor, because they are literally cells of the primary tumor. They have the same DNA, the same genome. They are micromodels, they are mini mes in transit through the bloodstream. Number three, CTCs are known to be prognostic, meaning predictive of outcome. High CTC count, bad outcome, lower CTC count, Relatively speaking, better outcome. And that's correlative, not causative. What's causative is high underlying tumor, high CTC count, bad outcome, lower underlying tumor mass, lower CTC count, Relatively speaking, better outcome, because it's a function of tumor burden. Number four, CTCs are known to have the same response to drugs as the primary tumor because CTCs are cells of the primary tumor and much, much more. All of this research that's been done over the past three plus decades has been done by about a dozen technologies that exist today that are very well understood. There are competitive analyses in medical journal. Depending on which of those technologies we're talking about, they can process anywhere from half a milliliter of blood to 9 ML of blood. Typically, no one's really crossed 10. And to put that in perspective, 9 ML of blood is about 2 teaspoons. The human body has 5,000 ML of blood, plus or minus, typically 4,600 to 6,400 ML, depending on body weight. And so that's fine for the research realm, but when you're sub 10ml of blood, a couple of teaspoons. It really does relegate you to the research realm. In order to go into the clinical and commercial realm, you need much more statistical significance and much more sample size. And so what we did over the past 14 years was invest about $80 million into building a proprietary filter that can process over 10,000 milliliters of blood to extract CTCs circulating tumor cells. That is a 1000x3 order of magnitude disruptive breakthrough in it has profound implications because it gives rise to previously inconceivable diagnostic and therapeutic applications. For example, the presence or absence of CTCs in your blood is indicative of cancer. If you do not have an underlying tumor, there should not be something sloughing off and shooting tumor cells into your bloodstream. They need to come from somewhere. They need a source, they need origin. As a result, if you could take a statistically significant sample that is 40 milliliters, not 4, and you could det the presence or absence of CTCs in that sample, you could screen the entire population for cancer. And that is the basis of our first test that we just released at cancer check labs.

And you're speaking specifically to solid tumor cancers, correct?

Correct.

Yeah. So not specifically leukemia so much. Right. But more solid.

Yes. And so leukemia is something that's near and dear to my heart, unfortunately, because that's what my sister passed away from. But the thing about that is when you want to move the needle on cancer, 90, 95% of all cancers are solid tumors. And det for things like leukemia are not really the problem, because in things like leukemia will show up in basic blood counts. They'll mess up your white blood counts, your platelet counts, so often they'll catch that they become very symptomatic very quickly at times. And so where you really have difficulty is when you have these latent solid tumors, tissue organ tumors in the body that don't show up in your blood counts, you don't start to see those types of things in the biochemistry immediately. And so they become very difficult to detect, which is why a lot of these tumors, unfortunately, detected so late, which results in mortality. You know, a good example of that is something like pancreatic cancer. Pancreatic cancer is often a presumed death sentence. Pancreatic cancer is not a death sentence. Stage 4 pancreatic cancer is probably a death sentence. However, stage 1 pancreatic cancer is curable. You'll just never find it. There's previously been no screen. There's no symptoms, there's no easy diagnostic. The Only way they discover something like that is they're doing a procedure in an adjacent organ, let's say the liver, and they notice an abnormality, and then they biopsy it and they go, oh, we found pancreatic cancer. But when they do, which is rare, it happens on occasion. At stage 1, pancreatic cancer is broken into 1a and 1b. Survival at 1b is 85%. Survival at 1a is 92%. CTCs begin to disseminate and shed from a primary tumor as early as stage zero. If you construct to detect that at stage zero, survival will be north of 99%. You will practically eradicate mortality from cancer, right?

Yep, yep. So once you get a positive CTC test.

Yes.

Like, what is the workup beyond that? Like, we know we've got circulating cancer cells, but we don't know where those circulating cancer cells are coming from. Is that right?

That's. That's correct. So. So first thing is, we have to remember that, you know, generally speaking, mortality is not caused by the primary tumor. It's caused by metastasis.

Right.

So the presence of CTC is important in the blood is really where you have to start to get concerned. Now, if you detect CTCs in the blood, then the next step would be to go back to your practitioner. It's important whether that result is a positive or a negative, to work with someone that can walk you through what that means. If it's a negative, that's obviously what we always want to see. And in that case, you should continue to do what you're doing, your lifestyle habits, your functional protocols, whatever optimization you can do around that. And you should screen regularly to ensure that it remains negative. If, unfortunately, you detect a positive, then you need to basically go to the next step. It is possible to look at CTCs and start to derive their probable tissue of origin, but it's probable. And so that happens today in classic oncology, traditionally, because 3 to 5% of all cancer diagnoses today are what are known as cup, which is an acronym that stands for cancer of unknown primary. The way that occurs clinically is they find cancer in the lymphatic system, in the tissue. They know that that's a metastatic mass. They know that it's not a primary. It's been spread from somewhere, and they have to trace it back. And so sometimes they're able to trace it back, sometimes they're not. And so what ends up happening is they look at the markers on those cells, and so certain CTCs and cells will have certain markers for example, they have a marker for, er, estrogen receptor. Well, if it's estrogen receptor positive, that means it's probably breast, but could also be ovarian. However, the issue becomes that let's say it's estrogen receptor negative, it doesn't mean it's not breast cancer. It might be triple negative breast cancer, right? It would be er, positive PR, positive progesterone and so on and so forth. And so you can start to look at the CTCs to try to figure out where they're coming from, but you will only get a probable result thereby. I don't think that trying to identify the tissue of origin is actually what's as important. Inevitably what will happen is once you have that positive result, they will probably put you into imaging to try to find it, because that's how the protocols are written today. And so after they do imaging, the practitioner will then apply their treatment protocol. And that protocol could include everything from traditional oncology to functional medicine, to lifestyle changes, to naturopathic to homeopathic to ayurvedic to combinations of such. And that just depends on who your clinician is and what they choose to do with you as a patient, given your particular circumstances, which is why it is so important to have a clinician there. And then once they complete that protocol, the next thing that they want to do is know, did it work? Are the CTCs gone? And that's why in all of our positive draws, we also include a complimentary second draw to do a recheck. And that can be done anytime within 12 months. So whether they want to check at 2 months, 3 months, 6 months, 9 months, whatever the case might be, we will check and see if there are still CTCs present. Now if we don't find them, great, that's what we want to see. If we do find them, then what that means is the protocol either needs to be extended or it needs to be adjusted, or both. The goal is when you find a positive by doing regular screening is typically to find that positive. And then when you go to imaging, the hope is the home run is you don't see anything, right? Because that means you caught it at the cellular level. And it's so early that at that point you can likely make functional lifestyle type of changes that are non toxic and your immune system can immunopotentiate, which means become stronger and effectively gobble it up. Because that's what your immune system's naturally supposed to do. It's just that sometimes, and that's what.

Your testing is Going after is really that early, early, early pickup of those changes long before a scan would pick that up, Right?

Correct.

Yeah. And Timmit, when you're doing sequential testing, are you able to quantify that? Say they started out with a low count and the count got lower or the count got higher to know which direction they're moving within their treatment protocol.

So the short answer is yes, it can be quantified that sometime something called enumeration, that's another application that we're developing right now that we're going to release in the future. And so at that point, what you want to do is you want to be able to check response. Right. And you want to see is it declining generally? Does it decline and stabilize? It's also important to enumerate for other reasons, not just that treatment protocol. Often what will happen is, and this gets a little bit more nuanced, but you'll have a primary tumor. Let's say you have lung cancer. And they will go and they will treat the lung cancer. They may even do surgical resection. They may do functional. They may do radiation ablation, chemo, whatever the case might be after they treat, even if the primary is completely gone, which they verify by following you for five years, which, by the way, is an arbitrary number, there's no reason there's any magic to five years biologically. But if they figure out that that's gone, what they don't figure out is, do you have a secondary or tertiary tumor at times. And so you need to look for those CTCs, because even if you get rid of the primary, that doesn't mean that you've gotten rid of the secondary and tertiary metastatic sites that those CTCs already created. So often what happens is people get the primary treated, but unfortunately, they die from the secondary and tertiary tumors. One of the issues that's come up in oncology, and this is more recent, people are starting to realize, which I've been saying for a little while, is primary tumors secrete a certain chemical. It's something called spc. It's essentially a suppression chemical. What happens is, when you have a primary tumor, CTCs and tumors can talk to each other. They signal each other with protein expression, essentially proteomics. The mechanisms of that are not completely understood yet, but it is understood that they do signal and communicate with each other. So what ends up happening is the primary tumor secretes this essentially spc, which tells the secondary and tertiary tumors in the body stand down so they don't flare up and start metastasizing themselves. Now, when they go in and they treat just the primary, and they eradicate the primary. They also eradicate the secretion of spc, the suppression chemical, at which point the secondary and tertiary tumors flare up and begin metastasizing out of control. It's sort of like if you kill the king in a village, the village will go wild. That's effectively what you've done. And so in that type of instance, you need to be able to check, are there CTCs, and even if they're growing, because you will see this flare up occur from secondary tertiary tumors post treatment of the primary.

Yeah. Within what period of time would testing, after removal of something like that, a tumor, would it be most valuable to do, like in the initial couple weeks? Or is that something that you need to let things kind of simmer a little bit before you repeat?

You want to let things kind of settle down a little bit? I think before you test. First of all, the protocol will probably take more than a couple weeks that the clinician will apply. So you have to finish their treatment protocol, and then I think you want to give it a little bit of time. So, for example, in traditional oncology, you know, we have a constraint where if you want to get tested, you could not have had chemo in the last 90 days.

Okay. Okay.

Because if you have chemo in the last 90 days, you will temporarily kill all the CTCs and tumor cells, and you will return a potential false negative. And so you don't want to do that. The reason we pick 90 days is because cellular cycles, depending on what type of cell you're dealing with, typically will be 30 days, 45 days, 60 days, 90 days. So we need a full turn of cellular cycles because there's chemo as an example here. Chemo, what does it do? It's an indiscriminate way that kills all your cells. I think it's a barbaric way to treat cancer. I think issues with chemo, and we can talk about that. One of the issues with chemo is whether you have one gram of tumor mass or one kilogram of tumor mass. They will dose you the same because it's based on body weight. To me, that doesn't make a lot of sense. I don't think you should have the same level of toxicity, nephrotoxicity to your kidney, hepatoxicity, your liver, immunocompromization for a tumor that's one gram versus a kilogram, which is 1,000 times that size. Chemo should be dosed, in my opinion, based on tumor Burden, which is also where enumeration can become valuable, because enumeration will be a direct effect of how much underlying tumor mass you have. And so once you can look at that, that could create alternate ways to consider staging the tumor and consider dosing protocols as you go along with it.

Are there things besides chemo, are you incorporating radiation would be the same, chemo would be the same, or are they different?

So they have all different kinds of issues. Similar issues. So there are different protocols. Right now, for traditional oncology, you're gonna deal with, you're gonna have chemotherapy, you're gonna have radiation ablation, you're gonna have surgical resection, and you're gonna have immunotherapy or some combination thereof.

So how do each of those affect the repeat draw, though? So with chemo, you need to wait at least. You said 90 days.

90 days, right?

What about the others? Yes.

So with chemo you would wanna wait. With immunotherapy, you may also wanna wait a little bit for the same sort of reasons. Right. When radiation ablation, I don't think you have to wait to the same degree because it's very. It's usually focal, unless it's full body and they're doing the spots. The problem with focal radiation is they have to make sure that when they image you, they find all the secondary tertiary spots. So they can do focal radiation everywhere. That's kind of the balance and trade off. Nobody wants to go through full body radiation exposure if they don't have to. So if you need radiation to ablate a tumor, you want to do that spot specific with focal radiation, if possible. But the counterpart to that is you have to make sure you catch all the spots. Sometimes you can't catch all the spots because tumors today don't really get diagnosed until they can be imaged. Because if they can't image it, they can't biopsy it. And if they can't biopsy it, they can't stain it. For a pathologist to look at the tissue and diagnose it, that is one of the things that is why when we do this, we are looking to detect at the cellular level. The problem with imaging today is you cannot detect at the cellular level. There are literally not enough pixels in the resolution. Even a 5T PET scan does not have enough pixels to detect at the cellular level. You have billions and of cells. You do not have billions and billions of pixels in the resolution of the image. And so now, as far as surgery is concerned, surgery could have some interesting effects. I don't Think you have to wait 90 days? I do think you should wait a little bit. We actually have a 90 day restriction on surgery. Not so much because of surgical resection on the tumor, but more if you have trauma, let's say you had bone surgery. There are certain cells that if you had bone surgery, you could release a cell that's called a megalaryocyte that is not normally in your blood. But if you had bone trauma, a megakaryocyte could get into your blood. Now a megakaryocyte can look like a tumor cell. It's really large. So tumor cells look very different than healthy cells.

Sure.

So tumor cells will be very big. They'll be like 30, 40 microns for example, instead of 8 or 10. Tumor cells will have multiple nuclei. They'll be multi headed, 5, 6 nuclei rather than 1. Tumor cells will have a very high what's known as NC nuclear to cytoplasmic ratio, which basically means the nuclei will take up 85, 90% instead of 15 or 20. They will be hyperchromatic, which means they have too much DNA because they have too much nuclei. And so these features of these tumor cells are very specific to them. So you don't want to introduce something into the bloodstream that may look like a tumor cell because of some aberrant event like a surgery. And that's why you have to be careful with those restrictions and for various reasons.

And we don't want false positive, you know, so, you know, being clinicians like ourselves, helping patients make decisions, taking all of those things into consideration is extremely important.

So Sumit, you take 40ml of blood, you run it through your proprietary filter, you measure the CTCs if they're there. Right. Are you calling this a liquid biopsy?

We are not calling it a liquid biopsy. You know, there's a whole world of tests that are in liquid biopsy. And liquid biopsy is a highly liquid space in terms of capital, just like, excuse the pun, because there's just tens to maybe $100 billion going into the space. And there's all these companies that are developing all these liquid biopsy and liquid being blood biopsy tests to develop to detect cancer.

Okay.

The problem is they generally don't work. And the reason they don't work is because they are either using some small set of biomarkers or scraps of what is known as CTDNA, CT DNA is circulating tumor DNA. Circulating tumor DNA are scra of the genome, the DNA sequence in the cell, which itself is just a scrap of the cell. So Taking these little bits and pieces of one piece of the cell and they are trying to extrapolate in some black box using AI, machine learning, next generation sequencing, ngs, computational processing to guess, do we have a tumor cell? Now, some guesses are better than others and we can sit and debate the quality of those algorithms. However, fundamentally, they are all guesses. We don't guess. You cannot guess when you need accuracy. What we do is we extract the whole intact tumor cell from the blood sample such that we can physically place it onto a glass slide, just like a tissue biopsy. We can stain it just like a tissue biopsy. We can put it in the palm of a pathologist to examine under a microscope, just like a tissue biopsy, so that the pathologist can then output a board certified pathology report, just like a tissue biopsy biopsy. In that it is important because one of the things they are doing is they are looking at the morphology of the cell. The features we just discussed, are they big, are they aberrant, are they multinucleated, do they have high nuclear cytoplasmic ratios, are they hypochromatic? And we will actually, on our positive reports, have physical pictures of the tumor cells in the report, should we find them. So any clinician or physician would be able to look at that and say, okay, that is an aberrant, unusual cell that should not be in the blood and it has all the characteristics of a tumor cell.

So lending itself to more credibility. Right, Correct.

And more accuracy.

Because that's what they're used to, inaccuracy. And that's what, you know, oncologists are used to looking at too, I would say, or pathologist. Right.

How is this technology being embraced by oncologists? I'm just curious, now that you've had this up and going for some time, the interface between your company and actual oncologists are in the clinic every day.

It's interesting. You know, we started by going into more of the primary market, essentially where you're dealing with a presumed healthy population for the purposes of screening them. Now what we're seeing is oncologists starting to reach out to us, wanting to use it to measure disease recurrence, wanting to measure what's known as mrd, minimum residual disease. Because again, a lot of times they don't have a way to measure that accurately. They take care of the primary, they don't know if it's all gone. So let's look at surgery. For example, let's say that you had a tumor, a lung tumor, Tumor, for instance, a solid tumor, what are they going to do? They're going to image it. After they image it on the 2D plane, they're going to cut and they're going to cut something known as margin. Margin is excess healthy tissue around the tumor because they don't know where it ends. Literally. Tumors have tentacles. They go in, they don't know where it ends. So they cut that extra space, hoping, cross your fingers, that they got it. The way they decide the success or failure of that particular modality is by tracking you for five years. And if five years later you're alive and well, they go, great, it worked. And if you know five, if anything happens to you before that, they go, sorry, we will try again. I guess it didn't work. To me, that's a horrific way to measure the success or failure of a treatment modality. And to make matters worse, when they image the 2D plane, they also cannot image accurately in the 3D because you cannot accurately image a tumor in the vasculature. So they are literally cutting broader, scooping deeper, just hoping they got it without knowing. Instead, if you could measure the CTCs beforehand, then you would do your treatment protocol, whether that is chemo, surgical radiation, ablation, immunotherapy, and then post that you want to measure if there are CTCs again, because if you have residual CTCs after that, you still have underlying tumor mass. Otherwise, where are they coming from? So we're seeing oncology have an interest in that. We're also seeing a very high interest in adoption because of the nature of the workflow that is providing this board certified pathology report. In everything else, you're asking the clinician to trust a black box with a bunch of algorithms. And that's where people get really obsessed with clinical trials and data, data, data, data, data. Because you're saying, hey, I have this black box box, it's going to kick out some result and you clinicians should now trust it. And that's a really, really big jump to ask them to trust it. In this case, you are looking at physical tissue. That is how every single solid tumor and subtype today is diagnosed. The difference is they get the tissue from surgical biopsy rather than extracting it from the blood sample. And so physical tissue is the gold standard for diagnosis in cancer. Now we are simply screening at this point, but we are doing it again with physical tissue, which makes adoption for the clinicians much easier because they already trust that. Because you cannot practice medicine without trusting tissue biopsy.

And I think that's what really drew us to talking to you more. We got the unique privilege of meeting you at the biohacking conference this year, as did I.

Likewise.

Yes. And honestly, it was the first table we stopped at, and we stayed there forever. But. But just intrigued by just the amount of time, energy, I'm sure capital that has gone into exploring this as an opportunity to help. To help people. But the question. Cause both of us came home and we got an opportunity to try the testing as many of the people that attended there. Right.

Yeah.

I remember going around my office. Cause I was thrilled of many things that I learned at the biohacking conference about doing this test. And I remember one of my team members just saying to me, are you sure you want to know? And now I have a history of breast cancer. And quickly I said, well, of course I want to know. But it got me thinking. I believe that that's probably what some of our patients will say.

Absolutely it is.

I'm sure. You know, do you want to know? So I wanted to talk about that a little bit.

Yeah. So my motivation for doing the test. I have a congenital defect in my pancreas, and I have high risk for pancreatic cancer. So I travel once a year to the University of Indiana. I have a very specialized mri. And every year I deep breath of relief when it's normal. Right. But there's all that anxiety leading up to. There's travel associated with. And I thought, well, if I could do a blood test, you know, and not necessarily have to go every year for that MRI and avoid some of the dyes that they have to use to accomplish that mri, then that would be, I think, a better option for me. And so I was like, you too? I had to question myself, like, do I really want to know? And the answer is yes, because I'm traveling to do the mri. Obviously, I want to know, to your point, pancreatic cancer that's diagnosed early is treatable, and it's also very preventable. And I do a lot of things to prevent. But it was kind of exciting for me to have a test that I could do in my own community and send off and have a result come back relatively quickly. But there's an emotionality to it. Right? A huge emotionality to it. And I would want. The first question I want to ask you about that is, what are you seeing in the rates of positive. Like, how often are you seeing a positive.

So it varies. It varies depending on the sample set you look at. So first of all, the general incidence of cancer today in the Population that's measured is about 2.1%. Let's start there. Now, in our testing, we see a higher incidence. There's a couple reasons for that and we should see a higher incidence. Number one, we are detecting at the cellular level so we will detect earlier. That itself will raise the incidence. Because today if they can't detect it until it's grown enough, you know, to be photographed, imaged and then biopsied and such, they're not going to. They're going to have a lower incidence. Right. So the first jump in incidence occurs because we are seeing cellular detection and we have had cases where we have been able to detect it at the cellular level. And it is pre imaging, which is effectively stage zero, which is the goal. The second thing we're seeing is a slight bump because there's sample bias. A lot of people that take the test, first of all, there's an age bias. They tend to be a little bit older.

They're higher risk.

Yes, they're higher risk. Maybe they're smokers, maybe they have occupational hazard or firefighter. They work at a nuclear power plant. They have a genetic history or a family history. Mom, dad, brother, sister. They have some concern around cancer because it is a cash pay test today. And so if someone's going to go out of pocket and invest in this test for their health, which they should, then basically they probably have some reason for concern that's a little bit more than the average person, which raises the incidence again. So depending on what kind of sample set we look at from that perspective, the incidence can vary. But to give you a more straightforward answer, what we see, depending on the sample set, typically is going to be anywhere between about 4 to 7%.

Okay. Yeah.

Well, and I think, you know, as functional medicine, integrative, regenerative, you know, providers of care who really want to help people catch things early and move them to a lower risk of that taking their life. Right. I think we talk about that in every aspect of what we treat. Hypertension, high cholesterol, diabetes, whatever it is. Because really it's that gap between being healthy, which most people think they're healthy. Right. They don't even know that they're sick. But it's that healthy to disease. Right. But it's that dis. Ease in between where the body metabolically is. Something's wrong. Right. And I think that my response to her was clearly yes, for all of those reasons you mentioned. But I do think that if people understood that there's so much we can do.

Right?

Right. There's so much we can do. Change what you eat, what you drink, how you sleep, how you move, how you think. There's so many protocols that help really target those aberrant cells. Is that proper to use that aberrant cells?

Yeah. And we have some really cool oncologists that focus on prevention and focus on the up and coming strategies for cancer treatment. So it doesn't always have to be a toxic therapy to work, especially if you're catching it at stage zero or stage one. So. And I loved what you said earlier about, you know, the patients that undergo surgery, they go undergo excision and then they're watched for five years. And I think, Lori, that was your story, right? You had surgery and then they monitor you every year for five years. And I would have to believe there's a lot of anxiety within that five years, right?

Oh, yes.

I mean, the waiting and the speaking from.

It's almost like PTSD just waiting for the other shoe to drop. Because cancer is sneaky. And having a tool like this, I think in our toolbox to help alleviate some of that anxiety. And if it is those circulating cancer cells are there, it can be taken care of. There are things that can be done, protocols and strategies that can be implemented to help reduce that. Yeah.

And I wanted to say. Go ahead. Sorry.

No, no, please. And sometimes a false sense of security because. Just because you're clear at five years.

Oh, yeah, yeah, yeah.

Actually clear. Like hopefully you are. And statistically you probably are, which is why they use that cutoff. But it's not definitive by any means. You know, more and more they're learning. Tumors are slow and indolent and they do not grow fast. This is typically not something that develops overnight like an acute affection.

No. Right.

This is something that is slow. And that is why, if you can intervene early. Right. You can actually do these changes to try to treat the tumor without introducing toxicity. Toxicity is a big problem in cancer. Right. Treatment is really harsh. When you talk about surgery and radiation and chemo, you are talking about cutting, burning and poisoning someone in order to treat the tumor. That's very harsh. There is a need for additional therapeutic modalities that are non toxic. Earlier I mentioned that we built this filter that can process over 10,000 milliliters of blood. But then I told you we're screening using a 40 milliliter sample. Well, what's the disconnect there? The reason is once you get past sort of 10 milliliters, you start entering the statistical realm. You can unlock all these applications. So for example, one of the other applications that we're developing right now, which we'll bring to market in the next couple years, is a medical device. That device will go through the FDA and that device actually is essentially cancer dialysis. If CTCs are known to be the drivers of metastasis through the bloodstream, why not take the blood out, filter it, what's known as plasma aphoresis, remove the aberrant CTCs and return the clean blood back in. Now you've created a therapeutic that should just mathematically probabilistically slow down and inhibit the progression of metastatic cancer. Cancer, because you have less CTCs. Now that is a non toxic modality that does not introduce any drugs, that does not introduce any chemo, that does not introduce any radiation, that does not introduce any surgery that uses your own blood autologously, which comes out of you and back into you. So you don't have compatibility issues like HLA typing on tissue for human level antigens, Rh factor issues, all of that goes away. And so there's a need to develop these additional modalities in cancer that are non toxic and give patients a better method and an additional chance to be able to resolve their underlying tumor burden.

That's incredible. That's exciting stuff. It's very exciting stuff.

We will definitely be having you back. This conversation is to be continued because you're not stopping, right? You're continuing to develop and develop and we, we certainly appreciate that. And I know the whole medical community appreciates that because cancer, to your point earlier, you know, 40 to 50% by the course of their life will have developed some type of cancer. And so our treatment strategies need to be non toxic and life giving.

Yeah, and you know, 40%. I mean, look, you can argue that cancer is possibly one of, if not the most significant threat to humanity. I mean last year alone there were 10 million recorded deaths in cancer. Now they're obviously more unrecorded. But at that rate, without even accounting for population growth or the incidence of cancer rising so rapidly in the younger population, which is disturbing. Just at 10 million people per year over 100 years, that is 100 times 10 million, which is 1 billion lives lost. You are talking about double digit percentages of global population, not even lives lost.

But think about the time and energy and distraction. And I hate to say that cancer is a distraction, but it takes away your joy. You know, all of the.

It's a billion lives lost in just a hundred years. And to put that in perspective in the history of the world, if you were to add up all known casualties from all known wars. The best historians put it at 350, 400 million people in all of human history. History, you're talking about a loss of life in just 100 years. That's two and a half times that size. And it's not just those patients. Other people are affected by cancer. Your mom, your dad, your siblings, your husband, your wife, your kids, like all those people are affected. It's not just a billion lives lost. It touches everyone. Unfortunately, it is far too pervasive and something needs to be done to slow it down.

And economically, it's. To speak of expensive. It's super expensive on many levels, right?

Yes.

Many, many levels.

Yeah.

So, so grateful for just your pioneering, your commitment to this. Obviously, you're very, very committed to this cause. And it was such a pleasure to meet you at the biohacking conference. To Kelly's point, this conversation will absolutely continue because there's more to come. And I also want to thank you for your philanthropy. I know that you've got quite a bit that's going on in that realm, and I just want to real quickly have you mention what you're doing in the area of firefighters?

Sure, sure. So I run two 501c3 organizations. I started the first one 12 years ago when my sister passed away. That's called Kirisonia in honor of my sister. And so there we fund cancer research, have and continue to at MD Anderson, Stanford, usc, City of Hope. We do financial assistance for underprivileged families that cannot pay for their cancer care. We are one of the largest registrars of bone marrow donors in the world. I've registered over 10,000 people in 300 drives across 60 cities. I was nominated for the board of LLS for my contributions to combating cancer. As I mentioned, leukemia is near dear to my heart. For that reason, separate from that, to your question, I just started a second nonprofit. It's actually launching on Monday. It's another 501C3 for the firefighters. And what we're going to do there is we're going to screen all the firefighters across the country for free for cancer, because unfortunately, firefighters have three times the incidence of cancer of the normal population because of the service that they provide to the community as first responders, which exposes them to a lot of hazards. Smoke, asbestos, pollutants, chemicals, carcinogens, et cetera. Firefighters do not die from fires and collapsing buildings. Generally, they die from cancer 72% of the time. It is the number one cause of line of duty occupational death. So we're launching that next week. We're going to start by screening the Dallas Fire Department, because we're based here in Medical district in Dallas. We're going to contribute about two and a half million dollars worth of tests to get that started. And we should be holding our first event for the firefighters, hopefully in October, to do our first fundraiser and grow it across the country.

That's exciting stuff. Exciting stuff. I did want to make sure that we talked about real quickly the how to order a test. And so there's two different ways to order a test, Right. One of them is through clinicians who order. Or they can go through their clinician. Right. Who offer this test. But you also offer an online option too, correct?

We do. So we have a standing order in all 50 states. And so obviously, as I mentioned earlier, we offer right now in 44 or 48 Continental. So you can go online and you can buy the kit and the kit will be sent to you. And in that kit, what you will find is essentially a box which has five test tubes. Those test tubes will each pull 8 milliliters of blood. Roughly, that's how you get 40 milliliters. And in the 40 milliliters of blood, there's also a temperature logger. And then there's a little ice, which is like a box with a lid on it. You press a button, it causes a chemical reaction to keep the sample between 2 to 8 degrees Celsius to preserve it during transport. What that does is it simplifies things because you don't have to deal with dry ice, you don't have to deal with freezing ice packs. These are generally busy people. They're going to forget the night before, they're going to freeze it an hour before. So we want to take all that friction and headache out of it. So basically, once you receive that kit kit, it'll have the tubes, it'll have the logger, it'll have this device. It will also have a FedEx priority overnight label, which will enable you to actually return it back overnight to our medical district lab where it will be processed. Now, in terms of getting your blood draw, there's three options. If you directly order the kit, you can do option number one. We have partnerships with mobile phlebotomists. We have over 4,000 mobile phlebotomists available to us across the country. They will come to your doorstep at your home and office and pull the blood, in which case they will take the kit with them and they will drop it off at FedEx for you. So it'll Just take you a few minutes. Option number two, some people prefer to walk into a physical place. And so we have a partnership with any labs across the country. You can walk into one of their 230ish locations and they will pull the blood, they will keep the kit and they will ship it on our behalf. And option three is you can go to your clinician and they can pull the blood and they can ship it to us, or you can take and ship it to us. That's on the direct to consumer side. On the clinician side, we also work with practices such as yourselves, where we can send you kits to your clinics if you want that. And then when a patient comes in, you can pull their blood in the kit, package it exactly the Same way, have FedEx pick it up and it will be overnight into our lab where it will be processed. Typically, the sample will be processed the next day when it arrives at the lab. After that, it simply awaits a pathology review, which takes, you know, a week or two, depending on the backlog of the pathologist.

Perfect. Well, it sounds like you've mastered it. We're super happy that you are here today. Thank you so much, much for your time.

Thank you. I appreciate you having me and the opportunity to share more.

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