Tresias: Low hangin fruit

"Patience is bitter, but its fruit is sweet."

Jean-Jacques Rousseau

My friends,

Things remain quiet. Quietness and inaction raise doubts. It brings out speculation, both positive and negative. Tiresias has been around. He has seen. But in this apparent inaction Tiresias foresees great action.

To return to the recent announcement on the completion of the breast study. Our company seemed not to except much from the completion of patient recruitment for the breast study. Tiresias, though, could have said a lot, also said little. He could have said more, much more. There is actually quite a lot that can be said on this. The breast cancer study is an Ex-Vivo Digital Real-Rime Confocal Laser Histopathology. Although Tiresias too must await the publication of the results, Tiresias has no doubt that it will be positive. It will confirm that Optiscan CLE makes frozen section biopsy, in all its current applications obsolete. It will show that it is time to change, from the 120-year-old technology of frozen section to digital real time confocal laser microscopy. Once shown, there will be no more excuses and pathology and histopathologists and cytopathologists everywhere, in every field of cancer, will have to start upgrading. Frozen section is obsolete. Surgery and pathology are changed!

But there is more to this small study. Though it is difficult to ever be sure or to even understand and the opaque and arcane rules of that corrupted bureaucracy, the FDA, as far as Tiresias understands, because this is ex-vivo, it should not require FDA approval. Of course, when it comes to medical regulations and the FDA, to paraphrase Schiller, “…even the gods immortal contend in vain.” In other words, if as Tiresias anticipates, this study is positive, there should be a scramble to replace frozen section around the world in all cancer surgery with CLE. We therefore await, wait with patience but rising excitement for this result.

Apart from the possibility of bypassing FDA and fast track replacement of frozen section, Tiresias is also hoping that Optiscan’s management can see this and is able execute. It seemed to Tiresias, from the recent report of the completion of recruitment, that OIL report was framed as merely foreshadowing the definitive breast-cancer trial of the next step in in vivo application of the technology. Tiresias understands the current reporting rules of the ASX and will put the less than expansive report to that and not to any lack of vision or ambition. Thus, this apparently small study now completed and being analysed, opens two avenues that are already viable and can be travelled simultaneously. The one; replace frozen section biopsy in all cancer surgery, and two; whilst progress to in-vivo real-time intra operative cellular digital pathology in breast cancer and then in other cancers, with oral cancer, head neck cancer, malignant brain tumour simultaneously or quick succession.

But there is still more just waiting, waiting. Gastrointestinal! All the work has been done. The technology is done. The trials were completed 10 years ago. It simply requires the re-engagement with an endoscope manufacturer to bring in vivo histopathology into this huge field. Surely, after the long pause, the management can reengage with an endoscope maker.

To close, Tiresias would like to remind his friends of Dale Carnegie who said

“Trees that are slow to grow bear the best fruit.”