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

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.

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• 0:00Ira Flatow?

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• 1:06Speaker 02

  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.

• 1:16Speaker 03

  So far, the only application of this was done through CGI.

• 1:21Speaker 02

  It's Thursday, December 19th, better known as Science Friday.

• 1:29Speaker 02

  I'm Sci-Fry producer Charles Burquist. 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. 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 Sci-Fry producer Rasha Aaridi to tell us about a public health project to detect cancer in India.

• 1:59Speaker 04

  To learn more about the Discovering Hands program in India, I spoke with science journalist Kamala Theegarajan, based in Madurai in southern India. She reported on this for NPR's global health blog, Goats and Soda. Kamala, welcome to Science Friday.

• 2:15Speaker 05

  Thank you so much for having me on.

• 2:17Speaker 04

  So Kamala, what is Discovering Hands? And where did it start?

• 2:21Speaker 05

  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 examinations. 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.

• 2:50Speaker 04

  Right. So why does this program train blind women specifically to detect breast cancers?

• 2:56Speaker 05

  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. And 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 healthcare 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

• 3:39Speaker 05

  and train these women to kind of catch breast cancer early. And so that's how the idea started.

• 3:44Speaker 04

  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?

• 3:59Speaker 05

  Absolutely.

• 4:00Speaker 04

  So how do the examiners conduct the breast exams?

• 4:05Speaker 05

  They use a 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 flag that. So the examinations take about an average of forty five minutes. And this is the kind of time that doctors don't have today to give to their patients. But uh these women have been really, really successful in finding even the smallest of tumors.

• 4:40Speaker 04

  Yeah, so how good are they at detecting lumps and bumps?

• 4:44Speaker 05

  They have been surprisingly really good at detecting um lumps that medical practitioners and patients themselves miss. They can find bumps thirty percent better than doctors, even before it shows up on imaging scans. So these are really, really tiny lumps. And it's thanks to their, you know, 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 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 there's they've been thoroughly checked.

• 5:23Speaker 04

  Hmm, so it seems like a win-win across the board then for doctors and patients.

• 5:28Speaker 05

  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.

• 5:41Speaker 04

  Yeah, on that note, um 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?

• 5:51Speaker 05

  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 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, you know, 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 um 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 to said that, you know, it's giving them a lot of joy.

• 6:35Speaker 04

  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?

• 6:47Speaker 05

  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 seventy five thousand 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.

• 7:20Speaker 04

  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?

• 7:31Speaker 05

  Well, for one thing, we have a shortage of mammograms. And for another, like, you know, especially in our rural centers, 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 women 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.

• 8:11Speaker 04

  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?

• 8:22Speaker 05

  That's right. It's not, 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 and 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, they check out their own breasts. That's what we're 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,

• 9:05Speaker 05

  but it's just practically not possible.

• 9:08Speaker 04

  So Kamala, what are you hoping that readers and our listeners take away from your reporting?

• 9:14Speaker 05

  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.

• 9:32Speaker 04

  Kamala, thank you so much for your reporting and for talking to me today.

• 9:35Speaker 05

  Thank you so much for having me on.

• 9:39Speaker 02

  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.

• 9:52Speaker 06

  I'm Kevin Roos.

• 9:53Speaker 07

  And I'm Casey Newton.

• 9:54Speaker 06

  And together, we've been tech journalists for decades. Now, we're your hosts of Machine Gods, a new podcast from NPR that makes sense of what AI means for your work, your life, and all of our futures.

• 10:05Speaker 07

  Twice a week, we'll be exploring the biggest moves in tech and give you unmatched access to the real titans of industry.

• 10:11Speaker 06

  Listen to Machine Gods from NPR on the NPR app or wherever you get your podcasts.

• 10:21Speaker 05

  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.

• 11:00Speaker 03

  Hello, everyone.

• 11:01Speaker 05

  So tell me a little bit about the Silk Lab that you work in.

• 11:05Speaker 03

  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 Lab, of course, we are focusing the creation of most of the material we're creating here out of silk protein, silk fibroin protein, which is the protein extracted from a Bombix Mori 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.

• 11:48Speaker 03

  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 wet ability is an amazing starting point for creating an adhesive. I created, together with all my colleagues here in Silk Lab, 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.

• 12:32Speaker 03

  It is the very first example of a solution, a liquid solution that undergoing to transition, creating a fiber that can attach on a distant object. And so you can remotely capture distant object with this material.

• 12:52Speaker 05

  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?

• 13:01Speaker 03

  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.

• 13:40Speaker 03

  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, it's not adhesive anymore.

• 14:08Speaker 05

  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 La Presti. So what is the component that is making it have those unique properties? What is being combined with the silk?

• 14:28Speaker 03

  The component to make this happen is a molecule which is very popular in the chemistry of underwater adhesive. 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

• 15:10Speaker 03

  and accelerating its transition into fiber, similar to what the silkworm does for spinning the cocoon, but with the addition of some adhesive properties.

• 15:22Speaker 05

  And is this the same dopamine that is, you know, going on in our brains and that makes us feel good?

• 15:27Speaker 03

  Is the same dopamine, exactly the same neurotransmitter that we use to to feel happy indeed. And you know, in the 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.

• 15:59Speaker 05

  Wow, that is so fascinating. So tell me, how much weight can this silk solution actually hold once it's solidified?

• 16:08Speaker 03

  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 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 15 centimeter of distance.

• 16:42Speaker 05

  So give me a couple of real world examples of items that you've actually been able to pick up.

• 16:47Speaker 03

  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 situation, different environment. 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.

• 17:31Speaker 03

  Still not with the with the sand. We tried also with a glass vial of 10 milliliter, 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, routing into the material, and so increasing the surface area where it forms connection to the material.

• 18:01Speaker 05

  So this seems like a really fun thing to play with in the lab. But are there future applications that you see this for?

• 18:08Speaker 03

  Are there future application? 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.

• 18:37Speaker 05

  Thank you so much for your time. It was great speaking to you about all this.

• 18:40Speaker 03

  Thank you, Kathleen.

• 18:41Speaker 05

  Dr. Marco La Presti, 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/silcscience.

• 19:00Speaker 02

  That's it for this episode. Next time, we'll 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 helped make the show happen this week, including Jordan Smudgic.

• 19:14Speaker 07

  Shishana Buxbaum. Santiago Flores.

• 19:17Speaker 05

  Diana Plasker.

• 19:18Speaker 02

  And many more. I'm Sci-Fry producer Charles Berkquist. Thanks so much for listening. We'll see you soon.