Tiresias- In Real-Time

"For the times they are a changing”

Bob Dylan

My friends,

Pathology results after surgery is as useful to the operating surgeon as a post-mortem is to a deceased patient. This is what Optiscan is all about. Providing real time and timely pathology, to the operating cancer surgeon, to modify the surgery accordingly, to improve survival, and not providing it a week after, when it is too late. This is just what real-time histopathology for cancer surgery is all about. And it is the new world. And it is coming.

The current answer to this problem, is frozen section biopsy. Instituted in 1905, flawed as it is, it is still “the state of the art”. This is one of the reasons that brain tumour mortality has not changed in the last 60 years, despite all the extraordinary advances in neuro-imaging and operative technology. Not one percent improvement. All of no more benefit to the patient with a brain tumour, or as much benefit as a post-mortem. This now is about to change.

What about breast cancer? Second only to skin cancer, the lifetime risk of breast cancer is 13%. The incidence of breast biopsy is roughly 5 times the actual incidence of breast cancer. Approximately 30% of patients with breast cancer have inadequate resections on the first surgery and have to have repeat surgery with all that the medical and psychological problems that that engenders. Optiscan changes all that.

The current most advanced application of Optiscan Imaging Confocal Laser Endomicroscopy is the CONVIVO. This is interesting to Tiresias. Carl Zeiss, as we all know is the optical instrument and microscope technology giant. It is also interesting how that they are developing a histopathology hub to “support” real-time neurohistopathology. “Support” or building a trojan horse to take on the fat sleepy lucrative pathology business. It is also interesting, but not surprising, that pathology companies have not, as yet, looked at Optiscan. What does this remind Tiresias of? Kodak. Classified advertisements of newspaper. Bookstores! Everything else that has shifted and is shifting into digital real-time and online.

Pathology companies currently make large profits. Much of their business is actually commoditised, depending on huge and overinflated throughputs, operating wafer thin and ever shrinking margins. This is why the pathology industry is constantly consolidating with companies having to get bigger or get out. Certain other tests like histopathology are growing and are very lucrative. Pathology companies imagine that the world of tomorrow will be like the world of today, as did Kodak, as did Polaroid, as did Xerox, as did IBM personal computers. Carl Zeiss sees an opportunity for online centralised expert digital real-time pathology. They have started with the hardest field, brain tumour in vivo real-time histopathology. To support this, they have developed a hub and as they deploy it frozen section biopsy will be obsolete. The pathology companies don't see it at all. But, of course they wouldn't. They are too busy scrambling for thin margins and mergers and acquisitions to make their paper profits for this year look a bit better. Some pathology company somewhere will shortly wake up. Tiresias looks forward to this their "Kodak realisation moment" and then for us, Optiscan shareholders, “I told you so” smile.