Tiresias is ebullient

“The wonders of yesterday are today common occurrences."

Nikola Tesla

My friends,

Last week Tiresias was pleased with the developments in Optiscan. This week, Tiresias is positively ebullient. The ebullience comes, yet again, from the gift that keeps on giving Memorial Sloan Kettering Cancer (MSK), and PARTi-FL molecular cancer marker. Out of MSK, published in the JNM, a world leading journal of nuclear medicine, molecular imaging and theranostics. Tiresias, who is not easily impressed, is thrilled by this paper, not just because it confirms yet another predicted application of Optiscan real-time endomicroscopic pathology. This application is “low hanging fruit” which should have virtually no barriers to entry and will transform the lives of millions of women around the world. There is no other technology now available or in the pipeline that can possibly compete. Tiresias must admit a slight disappointment, that, as usual, Optiscan itself is not mentioned in the report and hardly gets a mention in the original JNM paper, even though our equipment is critical to the whole study. This is of course to be expected given that MSK is the developer of PARP1 fluorescent marker, (PARPi-FL). Tiresias hopes, that the progress in Optiscan management can take off the gloves and tell, no better still show, to the world what they have here.

With apologies to those who have already studied the report, Tiresias will presume to explain a little more deeply just what this means. Though cervical cancer is a major health problem world-wide, and HPV detection and vaccination will not solve the problem in most of the world, this is not just about cervical cancer. Teresa's would like to foreground a number of very important facts about just how revolutionary and important this technology is.

We, the followers of CLE, have understood how Optiscan technology will enable in-vivo real time histopathology. This article demonstrates “molecular imaging based in vivo non-invasive safe real-time painless cancer diagnosis” in cervical cancer. Important as this is, it is but a tiny fraction of the potential benefits and application of this technology. Tiresias sees, what Fred Hollows instituted for eye disease clinics in the third world; ambulatory women’s clinics, in villages around the world, not needing doctors but just a technician with an Optiscan probe, screening millions of women, digitally linked with expert systems and experts giving instant results. But that's just for cervical cancer. The really exciting prospect and one only hinted at in the paper, is that Parp1 ubiquitous molecule expressed by many cancers, and therefore available for many other cancers. Furthermore, this is just one marker. There is a race on to find and label others, and Tiresias anticipates there will be thousands. As a brief aside, one case in this paper, which piqued Tiresias’s interest, was an image vulvar skin lesion, of squamous cell carcinoma imaged with expressing PARP1 and imaged with PARPi-FL. This is actually a squamous cell skin cancer. So what, you might say. How many skin clinics are there around Australia staffed by, shall we say “non-experts" who should be using this technology on the skin. With topical application PARPi-FL even the local beautician will be able to diagnose malignancy.

But there is more, much more, and even bigger. The really exciting and breakthrough prospect is the application of this topical molecular imaging cancer marker in GI; Gastrointestinal cancers, specifically oesophageal cancer, stomach cancer colon and rectal cancer. You will recall that Optiscan already has FDA approval for GI endoscopic application. This approval was with fluorescein, which needs to be given intravenously. It was shown to be beneficial, but, didn’t go ahead because Pentax ran into problems due to the GFC. Fluorescein labelling, though quite good, is not as specific, and does not compare with a topical application of a specific molecular cancer marker imaged in real time. Gastrointestinal cancer screening is now on notice. The new world has arrived. There will be many fewer biopsies. There will be better screening and greatly reduced pathology costs. This will revolutionise pathology and Tiresias trusts that the big anatomical pathology providers, like Sonic and Healthscope, through their subsidiaries such as CliniPath and ClinicalLabs, are aware of this technology. They will either ignore it like Kodak ignored digital photography or will embrace it with Optiscan for mutual benefit. It has not escaped Tiresias notice that the current chairman of Optiscan was the managing director of Healthscope which owns clinical laboratories. It has also not escaped Tiresias’s notice that one of the new directors of Optiscan, Professor Camile Farah, has been awarded a 2.2million grant by Future fund to develop molecular biomarkers for head and neck cancer. Furthermore, it has not escaped Tiresias’s notice that Professor Farah is also on staff as an oral histopathologist with ClinicalLabs.

Tiresias, uses many methods of augury, including ex-avibus, ex-caelo, hepatoscopy and scapuloscopy. He also relies on and keeps up with the journals. His favourite is of course the movement of the stars. Tiresias sees the stars aligning. The fifty percent correction has happened. The downside is small. The upside beckons. Tiresias is reaching into his temple treasure, taking some of his dusty silver Tetra-drachma, deposited for him eons ago for a rainy day. Tiresias feels that it is time to put some more of his Tetra-Drachma, into Optiscan, now.