Science Friday - How Blind Women In India Detect Early Breast Cancer | Web-Slinging Silk Becomes Real

Episode Date: December 19, 2024

A program trains women as tactile medical examiners to identify tumors before they show up on imaging scans. And, in a materials science discovery, scientists made a liquid silk solution that hardens and picks up objects—not unlike Spider-Man’s web.How Blind Women In India Are Detecting Early Breast CancerBreast cancer is the second most common cancer worldwide, just behind lung cancer. And the earlier a breast tumor is found, the more likely it is that the person survives their diagnosis.An international program called Discovering Hands trains blind women to detect even the smallest lumps and bumps through breast exams. The idea is to leverage the blind examiners’ sense of touch, which may be more acute than sighted people’s, to feel for breast abnormalities and, hopefully, catch cancer in an early stage.Discovering Hands has a cohort in India, a country where only around one in every two people diagnosed with breast cancer survive, and imaging equipment can be expensive or hard to come by.SciFri producer Rasha Aridi talks with science journalist Kamala Thiagarajan, who reported on Discovering Hands’ program in India for NPR’s global health blog, Goats and Soda.Accidental Breakthrough Makes Web-Slinging Silk A RealityWe’re all familiar with Spider-Man—the red-suited hero who swings through New York using spider silk that shoots from his hands. While Peter Parker has a radioactive spider to thank for his shooting webs, scientists at Tufts University have made their own version of liquid silk that solidifies and can pick up objects.This discovery was made accidentally, says biomedical engineer Dr. Marco Lo Presti of the Tufts University Silklab. Lo Presti found that combining silk from a silkworm with dopamine and acetone made the silk change from a flexible liquid to a hardened fiber that attaches to objects.Lo Presti joins guest host Kathleen Davis to talk about the possibilities of liquid silk adhesives, and the advancements he’d like to see to make the technology better.Transcripts for each segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

Everyone knows Spider-Man, the red-suited hero who uses webs to swing across New York. Well, scientists have put us one step closer to his technology really existing. So far, the only application of this was done through CGI. It's Thursday, December 19th, better known as Science Friday. I'm SciFri producer Charles Bergquist. Silk's a really interesting fiber, and at Tufts University, the Silk Lab is working on all sorts of applications for it. One recent breakthrough is a liquid silk that can shoot out of a needle, stick to an object, and then harden it. Then, just like Spider-Man, that object can be picked up using the silk solution.

We'll get to that story in just a bit, but first, here's Cyfry producer Rasha Reedy to tell us about a public health project to detect cancer in India. To learn more about the Discovering Hands program in India, I spoke with science journalist Kamala Thiegeraghan, based in Monterey in southern India. She reported on this for NPR's global health blog, Goats and Soda. Kamala, welcome to Science Friday. Thank you so much for having me on. So Kamala, what is Discovering Hands? And where did it start? The Discovering Hands program started in Germany.

And it was founded by a German gynecologist, Dr. Frank Hoffman. And he just wanted to set up the program as a means of helping doctors out and doctors who were having really crowded waiting rooms and didn't have time to do thorough breast examination. So he wanted to train women to be able to do it for them, to someone to help them out. So that's how it started. The intention was to kind of catch breast cancer cases early. Right.

So why does this program train blind women specifically to detect breast cancers? So Dr. Hoffman was wondering why he was seeing so many women come in with stage three breast cancer. And at a time when, you know, he couldn't really help them. I think that weighed heavily on him. So when I spoke to him, he told me that doctors needed help because, you know, it was a failure of the health care system that they were catching women so late in the day when they couldn't really help them. And so what he wanted to do was train people to help these doctors catch these cases early.

And when he was wondering whom he should train, he remembered, like, there were so many studies that said that blind people had a heightened sense of perception. And so he thought, well, you know, maybe I could. use that heightened sense of perception and train these women to kind of catch breast cancer early. And so that's how the idea started. Very cool. So basically, there's some research that suggests blind people might be more in tune with their other senses like touch than sighted people because that's how they navigate the world. So the idea is to put that to use in medicine through giving breast exams. Absolutely. So how do the examiners conduct the breast exams? They use skin-friendly

braille tape and they tape it on the chest and then they divide the breast into zones. They use their fingertips and kind of probe and try to find, you know, if there are any small lumps that need to be brought to a doctor's attention. And so if they find something that needs more attention, then they flagged that. So the examinations take about an average of 45 minutes. And this is the kind of time that doctors don't have today to give to their patients. But these women have been really, really successful in finding even the smallest of tumors. Yeah, so how good are they at detecting lumps and bumps? They have been surprisingly really good at detecting lumps that medical practitioners and patients

themselves miss. They can find bumps 30% better than doctors, even before it shows up on imaging scans. So these are really, really tiny lumps. And it's thanks to their perception that they're able to detect it so early. And there were doctors who spoke to me for this project, and they said that, you know, once they're sure that the medical tactile examiners, as they're called, once they give it the all clear and they go ahead. And then they said, there's absolutely nothing more that we can do. We're very satisfied that they've been thoroughly checked. So it seems like a win-win across the board then for doctors and patients. Oh, yes, it's absolutely a win-win. And also for the women themselves, you know, visually impaired

women in India struggle to find jobs. So this is one area where they can excel and it gives them a lot of dignity. Yeah, on that note, you spoke with some of the women in this program. What did they share about their experiences? I mean, why do they choose to do this kind of work? They said that they were very scared at the outset of being responsible for a woman's life this way or woman's health. But then they finally found that, you know, with time and with the training, they were confident enough to do it. The very first thing that they had to learn was mobility training because usually in India, in a visually impaired women, don't navigate things alone. There's always someone to help. So they said that the National Association of the Blind here that coordinates this program,

it gave them mobility training first, and that was really helpful. So now they can walk to their hospitals where they're working with a cane, and that gives them a lot of independence. And then the fact that they're helping save lives, the practitioner that I spoke, too said that, you know, it's giving them a lot of joy. That's beautiful. I want to go back to some of the research that's been done. Do we know if the tactile examiner's work has led to better survival outcomes? It has definitely led to better survival outcomes, but I think that a lot of the work in India

still needs to be examined. It still needs to be, you know, recorded. The program is just starting out in hospitals in India. So we should, in the years to come, be able to have a. clearer picture of how much it's helping. But at this point, we have about 75,000 deaths a year thanks to breast cancer in India. And a lot of this breast cancer is being caught in the later stages. So I think that just the very fact that they can catch tumors early will be saving lives. Right. And on that note, in your reporting, you write that in India, only about one in two people

survive breast cancer. Why is that rate so high? Well, for one thing, we have a short of mammograms. And for another, like, you know, especially in a rural center, is if you want to go to a hospital that has a mammogram, it has to be a multi-specialty hospital. And that might involve considerable travel. And also the woman involved, they're deeply conservative. You know, they may not agree or may not like or be comfortable with someone checking their breasts. And so in this way, the program has also helped because the women who are patients here who are being checked have shown greater, like, you know, trust in these medical tactile examiners, they feel less shame in being able to get checked up. As you said, so this program, you know, isn't a substitute for

having imaging equipment and trained physicians, but it's more so just another tool to help catch cancer early, right? That's right. It's not a substitute. What I think it does is that it saves time for doctors, and it ensures that women are caught at the earlier stages, rather than when it's too late when nobody can do anything about it because that's just so heartbreaking. One of the reasons that doctors were seeing cancer at such a late stage was that, you know, women are self-reliant, right? So they check out their own breasts. That's what we've been asked to do. But then you can't often rely on that. So the fact that this program provides you with that support, someone who's trained in the anatomy of the breast, someone who would be able to identify it,

who has a heightened sense of perception, I think in many ways that's a better deal. So yes, the idea would be, yes, we should have more equipment, but it just practically not possible. So Kamala, what are you hoping that readers and our listeners take away from your reporting? I'm hoping that readers take away the importance of preventative health care. You know, it's so important, not just to put out a fire, but to prevent it from happening in the first place. And, you know, I hope that they'll be more aware of their bodies because that could save us a lot of grief and pain and time at the end of the day. Kamala, thank you so much for your reporting and for talking to me today. Thank you so much for having me on.

We have to take a quick break, but when we come back, we'll meet a scientist working on making Spider-Man's liquid silk a reality. This is Science Friday. I'm Kathleen Davis. We're all familiar with Spider-Man, the red-suited hero who swings through New York. In the original comic book, our hero, the young Peter Parker, invents a device that lets him shoot webs of spider silk from his wrists. Now more than 60 years after that fictional invention, scientists have made their own version of liquid silk that solidifies and can pick up objects. Joining me to talk about this is my guest, Dr. Marco Lopresti, biomedical engineer in the Tufts University Silk Lab, based in Medford, Massachusetts. Welcome to Science Friday. Hello, everyone. So tell me a little bit about

the Silk Lab that you work in. There is a lot of things going on in Silk Lab. There are a lot of researchers studying on sensors, on solar cells, on hybrid biological microprocessor. And there's me that I work mainly on adhesives. The name Silk Club, of course, we are focusing the creation of most of the material. We're creating here out of silk protein, silk fibroid protein, which is the protein extracted from a bombixmory cocoon. For my specific field, the adhesive, the protein is very appealing because it is well known for its stiffness.

It's a very stiff protein with high mechanical properties. And also on the chemical point of view, is like a detergent, acts like a soap, so it can wet easily any kind of material. And if you think about a material that is very strong and has nice wetability, is an amazing starting point for, creating an adhesive. I created, together with all my colleagues here in Silk Club, different formulation of adhesive, mimicking muscle, mimicking many different natural organism, and why not? Also mimicking some superheroes inspired by some superheroes. We created this formulation, which is indeed inspired by Spider-Man. It is the very first example of a solution, a liquid solution, that undergoing to a transition creating a fiber that

can attach on a distant object, and so you can remotely capture a distant object with this material. Help me imagine this. So I'm assuming you're not shooting this out of your hands like Spider-Man does, but how are you actually making this happen? So this started with a bit of serendipity, This started while trying of developing underwater adhesive. Washing the vials with acetone with noticing this transition into a web-like material. And again, inspired by pop culture, we started thinking about adding a bit of engineering on this chemistry and creating a material just also to find it out if it was possible to create such kind of material. because so far the only application of this was done through CGI, but nothing physical.

And so with a lot of engineering, there is a lot of processing of the solution and a lot of chemistry to make this transition happen with the right timing to have the transition maintaining, of course, the fiber sticky. The transition from liquid to solid is something like, when your super glue cures, when it cures is not ad-easym anymore. Just a quick note, this is Science Friday from WNYC Studios. If you're just joining us, I'm talking about real-life Spider-Man science with my guest, Marco Lopresti.

So what is the component that is making it have those unique properties? What is being combined with the silk? The component to make this happen is a molecule which is very, popular in the chemistry of underwater ad-easy. The molecule is dopamine. It's very popular because the chemistry is mimicking the one of muscles. There is also something about muscles in this process. Even if the molecule is the same, the process is very, very different

because in muscles, dopamine polymerized into a polymer to ensure cross-linking into the material. In our case, dopamine is helping washing away the water from the silk fibroin solution and accelerating its transition into fiber, similar to what the silkworm does for creating, for spinning the cocoon, but with the addition of some havesive properties. And is this the same dopamine that is, you know, going on in our brains and that makes us feel good? Is the same dopamine exactly the same neurotransmitter that, that we use to feel happy indeed.

And, you know, in a natural system, usually natural system, use every time same chemistry or similar molecules. You will be surprised that this same molecule that you can find in muscle for creating underwater adhesive is also chemically the base for creating melanins, which add colors to our hair or our skin. Wow, that is so fascinating. So tell me how much weight can this silk solution actually hold once it's solidified?

So after improvement of how the silk transition into a fiber, we managed to reach 2 megapascal of tensile strength, where 2 megapascal means that a fiber with the diameter of 1 millimeter can potentially pull up up to 160 grams. The maximum weight that we managed to lift was 5 grams up to a 15 centimeter of distance. So give me a couple real world examples of items that you've actually been able to pick up. So using a needle and creating a single fiber, we lifted some different object. The weight was every time around between 5 grams and 10 grams. We tried different situations, different environments. We tried, for example, small plastic vials floating on the water. So even if a material has a wet surface can be recovered. We tried some stainless steel nuts partially buried into a sand bath and the solution can infiltrate,

can percolate into the sand, creating a hole and you can lift all the, all the steel nuts with the sand. We tried also with a glass vial of 10mm, a very smooth surface, and also that's very easy. I would say that the solution can lift heavier object when the material is absorbing and it's porous because it allows the solution to be firstly absorbed, rooting into the material,

and so increasing the surface area where it forms connection to the material. So this seems like a really fun thing to play with in the lab, but are there future applications that you see this for? Are there future applications? So far, I would say the material is not ready for an application. Usually in the academic world, a publication also useful to share your findings with the other scientific community. And someone can think, hey, this technology might be very, very useful. to solve this specific problem, we can address specific problem.

Thank you so much for your time. It was great speaking to you about all this. Thank you, Kathleen. Dr. Marco Lopresti, biomedical engineer in the Tufts University Silk Lab, based in Medford, Massachusetts. And if you want to see videos of this technology, you can do so on our website, Sciencefriday.com slash silk science. That's it for this episode. Next time, we'll bring you. bring you some of the biggest science stories of the week, and we'll talk to a drone expert about what she thinks is happening with all those sightings on the East Coast. Lots of folks help make

the show happen this week, including Jordan Smudjik, Shoshana Buxbaum, Santiago Flores, Diana Plasker, and many more. I'm SciFri producer Charles Berkwist. Thanks so much for listening. We'll see you soon.