42: Catch Cancer at Stage ZERO – The Most Advanced Early Detection Test You’ve Never Heard Of with Sumit Rai

I'm so excited to share today's episode with you. I think you will find it fascinating and captivating. It is with Sumit Rai, who is the founder of Cancer Check Labs, where his innovative approach to circulating tumor cell capture is transforming cancer cell technology. Driven by the loss of his younger sister, he's dedicated to the fight against the disease. Since 2012, he has served as president of Curasonia, with, which funds cancer research at top centers like Stanford, USC and MD Anderson, and provides financial assistance to families in need. He also recently launched Save a Firefighter, offering early detection for firefighters who face triple the cancer risk due to their occupation. In 2022, Mr. Rai was nominated for the National Board of Leukemia and Lymphoma Society. Before his work in cancer research, Mr. Rye spent 20 years in venture capital, private equity and hedge funds, as well as founding a mobile ad exchan Change, with a notable exit. Incredible human, incredible technology. Let's dig in. Welcome to Modern Thyroid and Wellness, the podcast that explores the intricate dance between health, wellness and thyroid, unraveling the threads that weave our vitality together. I'm your host, McCall McPherson, and I'm so thrilled to guide you on this journey to optimal wellness. Friends, I am here today and I am so excited to share this conversation with you with Sumit Rai from Cancer Check Labs. I very randomly ran across this company at Dave Asprey's biohacking conference this year and was immediately struck by what they offer and what they do. In fact, I spent more time probably talking with them and pursuing an interest in their technology over everyone else. So I am thrilled to be able to share this with you. I think it can be be life changing and life saving. Tell us first a little bit, Sumit, about what Cancer Check Labs is in general and what made you decide to kind of focus on this and garnered your interest in the cancer sector specifically.

Yeah. So Cancer Check Labs has developed a blood test that enables us to detect solid tumors as early as stage zero. And a solid tumor is any type of organ tumor, breast cancer, variant, uterine, cervical, lung, pancreatic, liver, bladder, thyroid, adrenal brain, skin, so on and so forth. And the significance of that is when you can detect as early as stage zero, survival is 99%. So you, you practically eradicate mortality from cancer at that stage. And so the reason I got into this personally was unfortunate. I had my only sibling, my younger sister, get diagnosed with cancer 15 years ago and a year and a half later pass away. And so that's why and how I got into this and that's why I built this technology over the last 15 years and brought it to market.

That's incredible. And I'm so, so sorry for your loss. And what a pain to purpose story that is. Right. Which is so much of the biggest impact in medicine, I feel like starts that way from pain and then they take that pain and they convert it into something that can change the world and change lives. So fascinating, Fascinating. I personally did this, so before I decided to have you guys on the podcast, I was like, I want to experience and I want you to tell us a little bit about. Well, first of all, how is it tested? Like what is the mechanism of testing? Like, is it blood, urine, what a body scan? And then tell us why it is unique. Like, what is different about cancer check labs because it is unique. So I'd love for you to kind of share with listeners a little bit of that information.

So it's a blood test, so we draw 40 milliliters of blood. And you know why it's unique is because of the mechanism by which we do the analysis. So what ends up happening is there's a whole bunch of cancer screening tests and modalities that are developing today. If you have a solid tumor, like we talked about earlier, let's say breast cancer as an example, the primary tumor itself, this lump, generally does not kill you. What kills you is the tumor sheds tumor cells that circulate through your bloodstream. And those are known as circulating tumor cells, or ctcs, the acronym for short and. The ctcs spread the cancer in your body in a process known as metastasis. And the metastatic effects are fatal because they make your other biolog organs dysfunctional, shut down the entire. And so today what we are able to do, the technology that we developed enables us to extract those C's, those circulating tumor cells, from a blood sample, whole and intact, such that we can place them physically, tangibly on a glass slide, just like tissue, because it is cellular tissue. We can stain it just like tissue because once again, it is tissue. And we can hand it to a human board certified pathologist, which is a physician that looks at tissue biopsies to look at the stained tissue and determine whether or not it is cancerous. And so that's how the test works today. Other tests in the market don't do that. They don't get reviewed by board certified pathologists. They're not extracting whole intact circulating tumor cell. You have different categories of tests. You have one category which are basically biomarker tests and looking for EXAMP genes for Example, so in the context of breast cancer, that would be something like BRCA1 BRCA2. Now that's fine, except if you're BRCA1 BRCA 2 positive, what do you do with that information? That doesn't mean you have cancer. It doesn't even mean you'll ever develop cancer. It simply means that your risk of developing cancer is slightly elevated. And so you could do something very extreme like Angelina Jolie and you could get a double mastectomy because of it. And. But I don't falter for that. Cancer is a scary thing. She's afraid of getting stage three, stage four cancer, or it could be terminal. But that's a very extreme intervention for someone who does not have cancer and may never develop it. Instead, if you could screen regularly with something that can detect as early as stage zero, then you would never do that. You would just screen more routinely where survival is 99% and try to detect it early to stay on top of it. So these biomarker tests that give you these little signals, they don't tend to be that great because they're not very actionable. Then you have a second category of tests which use little scripts and scraps of DNA. And those are called ctdna, circulating tumor DNA or cfdna, cell free DNA. And what that is is when you have a circulating tumor cell, a whole cell, a cell has all the components of a cell, and one of those components is a genome which has the DNA sequence. And when that cell is dislodged into the bloodstream, it's either going to go through programmed cell death or it's going to get eaten by your white blood cells, your macrophages, your immune system will gobble it up, or it's going to traverse your capillaries where the shear forces are going to blow the cell apart. When any of these events occur, the cell and all of its components, including the genome, the DNA sequence, explode and get dispersed into your bloodstream. Little incomplete scripts and scraps of DNA. So the second category of tests that are trying to do this are basically taking these little scripts and scraps of DNA incomplete bits and pieces and then putting them into some kind of black box. And in that black box, running sets of magical algorithms, AI, artificial intelligence, ML, machine learning, ngs, next year, sequencing, heavy computational processing to extrapolate and guess whether or not they have a tumor cell. The problem with that is it's a guess. And that guess is highly erroneous. Some of These tests generate 56.9% false positive rates, at which point you would be better off flipping a coin. You will only be wrong 50% of the time, not 57. Some of these tests, because they're using these little scripts and scraps of DNA, they have no signal and so they can't really detect. Their detection rates are very, very low. And so this category of tests with these guessing games, it's not a very good modality. And the third thing you have are these imaging machines like full body MRIs that are becoming popular. But there's a few problems with that. Number one, imaging cannot detect cancer at a cellular level. It's not possible. You have billions of cells, you don't have billions of pixels in the image, so simply can't see it at that resolution. And so the second problem is a lot of these machines are very, very sensitive on soft tissue. And as we age, our bodies change. We develop bumps, lumps, cysts, lipomas. All of that's going to show up on that image. And when it does, you don't know whether or not it's cancer. So you're going to come out of this tube after an hour and it's going to say you have 17 lumps and bumps. What are you going to do with that? Your physician is not going to chop you open and do 17 biopsies. And so you're just going to get anxiety. And so it doesn't really work that well. And by the way, for in that modality, for something that purports to detect cancer, it doesn't actually tell you whether or not you have cancer, Just tells you that you have bumps and lumps. So these things are proxies that people have been using, but they don't actually solve the problem. At the end of the day, tissue is the gold standard in medicine. And that's why extracting these cells whole and intact such that you can actually look at them is so important.

Tell me, like in medicine, so much of what we look at as far as testing is measured in value in like sensitivity and specificity. And usually there's this give, take relationship of either of those. Sensitivity means how like is it that cancer track labs will pick up a cancer cell. And then specificity is how specific can we get on the diagnosis? Or how positive are we that that positive is actually what it says it is. Can you tell me a little bit about the rankings of those that you guys have? Even rough estimates? I know you didn't probably prep for this question, but I'm just curious.

Sure. So. So specificity for our test is near perfect. The reason it's near perfect is because we're actually looking at the tumor cell. So tumor cells look very, very different than healthy cells. They are typically larger, 35, 40 microns instead of 8 or 10. They are multi headed, meaning multinucleated. They'll have 5, 6 nuclei like mutants. Instead of 1 or 2. They will be hyperchromatic, which means too much DNA. And so they experience what's called hypochromatism, which is just too much DNA because of all the nuclei, they will have high NC ratios, nuclear cytoplasmic ratios, where because they're multinucleated, the nuclei can comprise 85% of the cell instead of 15% of the cell. These features are so pronounced that my 7 year old daughter could look at that and tell you it's weird. I board certified pathologist that spends their entire life learning how to examine these types of tissues and cells is not going to mistake very rare to mistake some giant multinucleated, weird looking cell for like a healthy white blood cell or a red blood cell. And so as a result, when they see a positive, they see a positive like these cells, very, very aberrant and atypical. So that's why the specificity of the test is near perfect sensitivity. I'll give you an example. Let's say you have one gram of tumor mass in the breast. One gram of mass in the breast kicks off up to about 3.2 million CTCs a day at stage zero.

Wow.

So there are millions and millions of these cells floating around your bloodstream right when the tumor is born, which is what makes them very detectable, which is why we pick up stage zero cancers, which is why we have very high sensitivity. See, tumors must shed to spread. You cannot go from stage zero to stage one, or one to two, or two to three, through so on and so forth without shedding. And that's, that's my definition what happens. And so these tumors begin to shed right when they're born. I mean, you can think of it sort of like this, the first tumor that's born right when it's initiated, that initial base camp that is essentially an alien civilization that has started inside your body. These are mutated cells, literally. Now once that is created, it wants to expand its terr. And what it does is it sends its Little Vikings, these CTCs, out to sea. And your bloodstream is that sea. And those Vikings, those CTC circling tumor cells, go and look for more land and territory to raid, pillage and plunder. And that territory are your other organs. And they go There, and they set up shop and they build camp and they expand their civilization. And those are what are metastases? Secondary tertiary metastases, the spread of the tumor through the body. This process begins as soon as the tumor is born. I mean, when you look at colonoscopies in colorectal cancers, it is known today that CTCs are dispersed from colorectal tumors well before they're detectable on imaging.

Wow. Before they're detectable on colonoscopy.

Yeah.

Wow.

They had data that came out from Johns Hopkins, I think, about a month ago, maybe three weeks ago, that just very recent data that's showing that they had tumor signals that were detected, detectable three years before they could detect it with standard processes. So tumors typically are not born overnight. I mean, you can have some really rare aggressive mutation, but these things are slow and they're indolent, and they start years and years before we start seeing them or the symptoms. And so there are these cells floating around there. Is that tumor there quite early. And that's the power of being able to detect it at a cellular level. You can pick it up pre imaging. We've had instances where we had a positive. Someone went and did a PET ct. The PET CT right after the positive was negative. There's nothing on it. Wow. Six months later, they had. Did another PET CT and they had two lumps in their throat. And so you pick them up very early, and if you pick them up that early, they're much easier to resolve. And this is where I think you're going to see a big rise in functional medicine, because traditional medicine is very reactive. Traditional medicine is all about give me a disease, give me a condition, give me a symptom, and then I will treat it. You know, functional, on the other hand, is very preventative and trying to be preemptive. And so they will get more involved. And we've had cases, some of our functional medicine partners, where they've had positives. They've put the patients through various protocols over a period of some number of months, five to eight months, and then they've retested negative. Like we've seen that. And I think part of the reason that happens is because your immune system fundamentally knows how to kill tumors. So one of the questions that people often ask with this test is, well, doesn't everyone have tumor cells?

I was going to literally ask that question.

Yeah. So that comes up. So that's a. That's a very nuanced question. So the short answer is yes, but not circulating. And here. Here's why? So our bodies are living biological organisms. As living biological organisms, we constantly have cellular turnover. All cells die, new cells are formed. All cells die, new cells are formed. This process goes on as long as we're alive in making trillions and trillions of replications. Unfortunately, our body does make mistake. It creates erroneous, mutated precancerous cells. Fortunately, however, our immune system knows how to destroy them. And that's why everyone on the planet is not dead from cancer today. Literally. Now, what happens once in a while is one of those replications that is mutated either evades the immune system or the immune system may be compromised and it fails to kill it, or it's overloaded. When that happens, that erroneous cell gets a chance to multiply and grow. And that's when the tumor is born. And so once that tumor is born, then it does what we discussed earlier. It sends out this little Vikings, it's soldiers out to sea to expand. And that's when you can start to detect it in the blood.

Interesting. Okay. And in cancer, early detection is everything, right? Like, I mean, the earlier you find out that you have cancer, the higher the survival rate, the serious, often the treatments are. And before we got on this, before I started recording, you called me, quote, reason, kind of young or something like that, which I love. Thank you for that. But this is something like, as even a 42 year old, I find incredible value in, even if I was 32, still incredible value in this. Because the reality is cancer is on the rise in young people in our country, probably even the world, but at least certainly the staff in America are. This is becoming a concerning issue at a younger and younger age. I'm curious why you think that is and what are some of the mechanisms that are creating those, this construct for us.

Yeah. Cancer rates are rising rapidly in the younger population. I mean, colorectal cancer incidence has doubled in the younger population under 50 in the last 30 years. Breast cancer rates are increasing. We're seeing a lot of this and there's many reasons for it. One reason is lifestyle. We are very sedentary. We don't move. For the vast majority of human existence, we didn't have desk jobs. We moved around, right? We moved. We're hunters, we're gatherers. We went and looked for food. We, we moved a lot. And that's really important because when you're very sedentary, that lends itself to metabolic disease. And metabolic disease causes inflammation. Inflammation creates a breeding ground for cells to be erroneously replicated, I. E. Creation of More mutated pre cancerous cells. And if you keep doing that, at some point your immune system is going to fail to kill all of them. And that's when a tumor can be born. The second reason is we eat too often. We, we don't fast.

Amen.

The human body was not built to eat breakfast, lunch and dinner. That is a commercial construct that was introduced about 100 years ago, I think, the first one being grocery stores, Piggly Wiggly in 1914, Tennessee. And so that was introduced to sell cereal boxes and food and later on bars and microwave meals and this and that. For the vast majority of human civilization, we lived in periods of feast and famine. Famine is important. Famine is important because during famine your body kicks off processes like autophagy, which means self feeding, auto itself, faggies eating in Greek. And so what that is is your body's internal recycling cellular system. And when those processes occur, it cleans up sort of mutated cells, pre cancerous cells, dis dysfunctional cells. And, and that is an important process and set of processes that we inhibit and interrupt by constantly feeding ourselves. And that also lends itself to cancer. And the third is we just have a lot of exposure. The things that we eat, the things that we put in our bodies, the things we put on our bodies. Like for example, there's a, you know, Red 5 was banned recently, a few months ago. This is a. But it's interesting. It was banned as a food additive. Red 5 has been banned in the United States for 30 years as a lipstick coloring. Like they know it causes cancer. So this is.

But they were letting us eat it.

They're letting us eat it. You can put it in Skittles or something like that, but you can't put it on lipstick. So they. There's a lot of these things that make it through the cracks that shouldn't. Like if you look at Europe, for instance, there's 600 approved additives. If you look at the United States, we used to have 600. Now we have over 10,000. And so there's a lot of these things that are not good for us that we consume. There are products in the US that are bad for us. For example, I mentioned here earlier the acne stuff, like these household products, like for example, Estee Lauder, Clinique, Target, up and up, Clearasil, you know, that people use for acne. Well, the problem with that is the active ingredient in that is benzoyl peroxide. That's fine, except benzoyl peroxide is not heat stable. So because it's not heat stable. It turns into something known as benzene. Benzene is a highly toxic known carcinogenic. In fact, it is so toxic that the acceptable levels of benzene, depending on the environmental standard, are between one to four parts per million. When these products were being tested in independent labs, they were generating several hundred to several thousand parts per million. So now, to make matters worse, who uses these products?

Women.

Women. And when do they use the most?

When they're teenagers.

Yeah, Puberty. And so, and they're breaking out. And what happens during puberty? Your body surges with growth hormone. So they're taking a product that is extremely carcinogenic, known to cause cancer, applying it thousands of times the concentration they stood onto their skin, which then goes into your body and again creates a breeding ground and cellular damage and precancerous mutated cells while your body is surging with growth hormone. And what does growth hormone do? It makes things grow. Good cells, bad cells, cancer cells, non cancer cells. It's indiscriminate. And so there's a lot of these factors that compound on each other that are causing cancer rates to decrease. I mean, today, if you look at the statistics, it's frightening that 40% of the population will be diagnosed with cancer in their lifetime. It just went up from 39 and a half to 40.5 per the National Cancer Institute. It has overtaken heart disease as the number one cause of mortality in several high income developed countries. That data came out in the Lancet in 2019, six years ago. And so it's going to overtake heart disease globally as the number one cause of mortality. And if you're hitting 40% of the population, I mean that's a massive number. Last year alone we had 10 million recorded deaths in cancer and 10 million recorded deaths in cancer in one year. And that's not counting population population growth or the incidence rising of the younger population, as we just discussed. But even at that rate, in the course of a hundred years, that's one billion lives lost. I mean, to put that in perspective, if you were to add up all fatalities and all casualties from all known wars in human history, the total is about 350 million. You're talking about a lost life. That's three times of that in just 100 years. I mean, there are not many things on the planet that actively threatened double digit percentages of global population. It is massive. Now, if you can detect at stage zero, as we can, we have, then you're talking about potentially saving almost a billion lives in just 100 years. And the impact is just immeasurable.

It's immeasurable. And even economically speaking, I mean, those are lives, that's patients, I mean, not patients, but people's quality of life, disability, et cetera. But even economically speaking, treating cancer at stage zero, stage one is so different than stage three, stage four. The impact on people's physiology, if they can have a lumpectomy versus lumpectomy, chemo, radiation, their quality of life during that whole process, not even to mention survival rates, they change dramatically. Even thyroid cancer. Right. I mean, thyroid nodules, thyroid cancer is something that largely, often doesn't get found until it's enormous and almost visible to the naked eye. And medicine just doesn't really routinely screen these people outside of feeling with their hands, which is a very, very terrible way to screen for thyroid cancer. Do you think there's a better path, more proactive way to look and screen for thyroid cancer? Obviously this could be a great way.

Yes. Take the test. I mean, right. If you have a tumor, thyroid tumor is no different than any other tumor. It's going to look to spread, immune metastasize.

And if it's a question, like follow up question, because nodules are so common. Right. Like 70% of adults have thyroid nodules. Less than 5% of those are actually cancer. So if someone has a thyroid nodule and they're like, oh, do I get a thyroidectomy? What do I do? We're not sure if it's cancer. They didn't get a good biopsy. Could cancer check labs be a great way to differentiate a non cancerous nodule from a cancerous? I know that's probably nuanced.

Yeah. So potentially, I mean, I won't claim it as a diagnostic right now. So that's a little bit of a step in the medical world. We want to be cautious. We claim as a screen, but yes. I mean, if there are, if there are tumor cells floating around the blood they came from, whether they were your thyroid or somewhere else, I mean there's, there's likely an underlying problem because healthy blood composition does not have circulating tumor cells. That is known. And they spontaneously appear. That is also known. So anytime you find them in a blood sample, they have to have a source and origin that is an underlying tumor. Now if you have that data combined with the data that there's nodules, then there's probably reason for concern.

Yeah. And you know, my results, to let everybody know, my results came back negative, thankfully. It was a little bit of a long wait for, I think it was like 10 days or two weeks or so. At first I'm like, oh my gosh, I just want these results to come back in. And then you forget about it, and then all of a sudden it shows up in your inbox. I made my husband, okay, open it for me. But what does it look like if someone has a positive result? Is it just a general. Yes. You have circulating tumor cells.

Yeah. So there's, there's a whole package that'll go out. So it's. First of all, they'll have the pathology report that will say it's positive. It will explain what stains were used, what immunohistochemistry, what systology was applied to the cells in order to determine that there will be images of the positive tumor cells on the robot report. It'll be accompanied by sort of, what can you do with the positive result? An overview of CTCs, how to interpret the results, things like that. So all of that's available if, if there is a positive and, and if need be, you know, our team can connect you with a physician. If you don't have one, they can connect you to a functional medicine provider, a naturopath, a primary care, traditional allopathic, whatever the case might be.

And so essentially, it's with all of those stains, histology, et cetera, it take, it's like a funnel. Like, it sort of narrows the potential of what be to give a little direction of where to go. Is that correct?

Yes. So t tumors and tumor cells express certain markers that healthy cells don't. And so you, you differentiate using those stains. That's exactly what happens with surgical tissue biopsy today. When they go, they take a tissue biopsy, they think that put on a slide, and they stain it with certain histology stains and immunohistochemistry stains. And then the pathologist looks at it and they tell you whether or not it's lighting up for those stains or whether or not it has the morphological features of, of a tumor. And so what we essentially are doing here is effectively a whole body tissue biopsy without surgical cutting. Right. That's what this is. Because we're getting tissue. Right. And we're getting tissue and we're putting it on slide just like we would from cutting. But you can't do that with the whole body unless you cut everywhere. But because again, all tumors must shed to spread, you're going to pick them up indiscriminately, these CTCs, irrespective of where they're coming from.

Fascinating. And who do you think makes a good candidate for Cancer check labs, like, for your own family member, for you personally. When would you start screening? What would make you want to start screening?

I think younger is better. Look, my sister was 24 when she was diagnosed.

Oh, wow.

Cancer can happen when you're fairly young. I've had a lot of people ask us if we can do pediatrics because there are pediatric cancer.

Can you?

We don't today. We likely can. It just becomes a question of validating that with the blood sample size. Because you can't pull the same amount of blood depending on their body weight. You have to be a little cautious. So we need them at a certain body weight before we can actually do it to ensure that we have a representative large enough blood sample. So that's. That's the rubber that we have to work through. But in the future, we do intend to do pediatrics. The mechanism is exactly the same. There's nothing different. It's just a matter of how small can you get that blood sample and still make sure you have reliable results? I mean, in that same vein, the other kind of vector that we get a lot, which is really interesting, is people asking if we can do their pet. That comes up a lot, too. And we're looking at that. That's kind of an interesting one. I've had several people say, I don't know if I'll take the test, but I would buy it for my dog, which is really interesting.

There is, like. There's a sense of anxiety about it. You have to, like, commit. Right. And so many people have this health anxiety. Admittedly, me too. I went for a pernuvo that took weeks. I waited two weeks for this. And it is unnerving. But, gosh, once you have that information back, you're so empowered. And the reality is, is I've known people who have done these sorts of screenings and found positive results, and because of that, they're still alive and thriving and doing well. As difficult as those two weeks are, you don't want to just sit and wait. And I think what's really cool about cancer check labs is especially for. I am worried about colorectal cancer because it is a big deal in young people. And I don't want to go have a colonoscopy because it's invasive, it's uncomfortable. Naturally, people don't want to do that. And so that's one thing that I'm like, you know what? I'm not ready to commit to that yet. So this being able to almost complement if you need a colonoscopy and you're at that age or supplement if you're before it is is such a powerful tool that's less invasive, less vulnerable for people.

Yes, it is. And it's interesting you mentioned pernuvo. So the next step after a positive for us is imaging. Now normally they'll do a CT with contrast from base of skull to top of thigh. Some people will ask can we narrow that down to a region? And the answer is always no. Why would you do that? Kind of breast cancer or lung cancer, it may have spread. You want to see that. You don't, you don't want to limit it to just that region.

Tell me this too. Like for me example, for someone else who pursues cancer, check labs. I have a negative. Right. How often do you think people should get follow up screenings?

So complex question. The short answer to that is going to be annual. They're 12 to 12 months. The reason I say annual is because of behavioral training. People are trained to do annual physicals, annual checkups, annual exams. There's nothing biologically magical about 365 days versus 192 versus 586. This is a random number now so, but, but the short answer, because of the behavioral training and the psychology, tends to be annual. The slightly extended answer is unless you have risk factors, then every six months, if you are a smoker, you have a genetic history, you have family history, you have occupational hazards, you, you're a firefighter, you have exposure, you work in a nuclear power plant, things like that. So 12 months, if you're just generally healthy in the normal gen pop, so to speak, six months if you have risk factors. The real nuanced answer, which I don't give generally because people will think I'm just trying to sell tests, is every 90 days. And the reason for that is, if you remember earlier we talked about cellular turnover, that 90 days is about the cycle where all the cells turn over. So if you're negative today and you have cellular turnover, you could have an erroneous replication that starts 90 days later. Right. Interesting. Now what is the likelihood that that replication is going to take off into some aggressive tumor in the next three months? Very low. Like unlikely. Talked about earlier, mostly things start years before, they're slow and they're indolent. But from the science side you would, you would look at it from 90 days. But the, from a practical side, I would just say every time 12 months and maybe six if you have risk.

Factors or like a history of cancer. Like if you, if you had a breast cancer that was removed five years ago, and you want to just make sure it doesn't return, would you say every six months?

Yes, that. So there's, we've talked about this in the context of sort of presumed healthy population screening. On the other side of the fence post treatment, there's, there's an application and it's, it's basically looking for two things. One is something called mrd, which is a minimum residual disease, and the second is recurrence. So let's say that you had a tumor and they got rid of it, so they cut it out. How do you know it's all gone? Like one of the, like surgical resection, for example. Like if you have a tumor, they will image you. And typically they will image on the 2D plane. You cannot accurately image a tumor in the 3D plane inside the vasculature. So when cut, they cut what's known as margin. Margin is excess healthy tissue around the tumor. And they, that because tumors have tentacles, they don't exactly know where it ends. They do that in the hope, cross your fingers, that they got it all. So they're cutting broader and scooping deeper, hoping they got it. They don't know. And the way they determine whether or not they got it all, they track you for five years. And if five years later you're alive and well, they say, great. Which by the way, is arbitrary too. And if anything happens to you before five years, they say, sorry, we can try again or try again something else. And that's a fairly horrific way to measure the success or failure of a treatment or therapeutic modality. You know, Instead, what you could do is after the tumor's been cut out, wait a little bit and take the test. Because if all the tumor mass is gone, you should have a clean screen. There should be nothing remaining to shoot off tumor cells into your bloodstream because again, they're not part of healthy blood composition. They don't spontaneously appear. They have to come from somewhere, a source in origin. So one thing you're doing is you're seeing is there any residual disease, any residual tumor mass. And, and that also compounds because sometimes what will happen is they get the primary, but they miss a secondary or tertiary tumor, a metastasis, and then those start to out, and they don't know. So you're looking for residual disease, one, and then two. Even if they got it all, this person has a propensity to develop cancer. It can recur. So you're looking for recurrence as well. So it sort of screens for those two things.

That's fascinating. And yeah, I mean, intervention post surgical resection of cancer and medicine waits until it's visible again, until they pick it up on imaging and then they'll go and remove that. But again, we're dealing with a late intervention at that point. And if we can back up that clock, that's a powerful, powerful tool. Well, I know that we have a discount code for listeners and I'll share that, of course. But I want you to tell people a little bit about pricing, about if you guys accept HSA, FSA, etc. All of that.

So we, we do accept HSA, FSA, that the test is 1995 retail. I know you have a discount code and that's $2,000. Not, not $20. I get asked that actually quite often.

So that would be amazing. If it was $20, I don't think you guys would stay in business.

But yeah, no, no, you can't have a pathologist look at it for $20. But. Right, you can't even pay for the FedEx. I mean, the way the test works, can't pay for the FedEx label. But basically when someone buys the test, they can buy it on our website. We're available right now in 47 of 48 continental United States. We don't do Alaska and Hawaii and there are six states. We need state licenses. We have all of them except New York where we're in the final steps. I anticipate we may have that by the end of summer. Last step now, but every state except New York, it's available today on the website. And if you buy a kit will be drop shipped ship to your doorstep and everything you need will be in that kit. And that kit will have the vials to do the blood draw. We'll talk about that in a second. That kit has a little cooling engine where once the blood is drawn, you put it in there, you close the lid and you hit a button. And that keeps the sample cool for transport. You don't have to do any refrigeration. You don't have to freeze any ice packs the night before. You don't have to handle any dry ice. Literally just blood in the box. It has a prepaid priority overnight FedEx label that will ship the kit the next morning morning to our lab in Medical district in Dallas where it'll be processed to slides. And then it'll just await a human pathologist to review those slides and images. And so for the blood draw, there's three options. Option A is we have partnerships with 4,000 mobile phlebotomists across the country. They will come to your doorstep, they will pull your blood, they will pack it up, they will take it with them, they will drop it off at FedEx. You don't have to do any of that. It'll take you five minutes. Option B, if you don't want someone to come to your doorstep, you can go to an any lab test. Now, we have a partnership with them. They have about 230 locations across the US you can walk in, they'll pull your blood, they'll pack it up, they'll ship it to us. And option C, you can obviously go to your provider, your doctor, your nurse practitioner, whatever the case might be, and.

They can pull your blood and then ship it off. It takes a couple weeks to get back.

Yeah. Typically about 10 business days.

Awesome. And if you guys want the discount code, it is TNR500. It's 500 off, which is very generous. Thank you so much for providing that for my people. I had one follow up question too. I want you to tell people where they can find you all, where they can track your work and connect.

Yeah. So our website is cancerchecklabs.com. we'll start there. You can follow us on Instagram, Facebook, at Cancer Check labs. It's the same handle, so please do that. Take a look. Sumitri Cancer, which is a little hard to spell, but S U, M, I, T, R, A I cancer. And there's tips about cancer prevention and stuff like that.

I was gonna say, like, you guys totally need to. I download that list right now. For my daughter, for the things that we should and shouldn't do for her, to protect her as she moves through adolescence. Well, thank you so much for your work. And I don't say this lightly. I truly believe that you can possibly change the cancer trajectory of medicine forever. So thank you for taking the time to do all of this work, to invest in the lives of people that you'll probably never even meet. And I think it truly can make history.

I appreciate having me.