Picture this: A group of childhood friends reunite after decades in Bengaluru. These friends consist of an engineer with two decades of work in IT and a passion for mathematics and two doctors who specialize in neuroscience research. As with any Bangalorean, we need a dosa and filter coffee to have a good time. Over dosa, these friends relive their school and graduation days. As in Bengaluru, conversations with good food and friends lead to interesting topics. The focal of the conversation was an article in Nature Research (www.nature.com) about a test for cancer with high sensitivity from just a drop of urine. Of course, in a lighter vein the rise and fall of Theranos was also discussed.

The thought of the possible detection of cancer using a non-invasive methodology with a high sensitivity was curious enough for the group of friends to explore the science behind this. The more we started to read articles on non-invasive methodology it became evident to us that this topic had far-reaching benefits to mankind to help identify possible risk to cancer in stage -1. The fact that a nematode, a worm that is abundant on earth with millions of species (though only a few thousand have been named), can have the potential to sniff out cancer cells was interesting. One of these species, Caenorhabditis Elegans (c.elegans), has gained fame as a research model.

Cancer tissues exude volatile compounds and animals perceive volatile molecules as odors. This is how a dog is trained to sniff and track. C.elegans is a transparent and blind nematode with low long-range receptors such as vision/sound but very efficient short-range receptors – olfactory system (smell). Every adult c.elegan grows up to 1 mm in length with exactly 959 somatic nuclei and replicates organ systems of complex organisms. With their transparent body, and efficient olfactory system, c.elegans are a good choice for cancer detection.

When c.elegans are placed in a prepared petri dish with control sample and analysis sample, it is determined that c.elegans move towards analysis sample if there are volatile compounds indicating cancer. The behaviour of c.elegans moving towards the suspected cancer sample can be analyzed by its displacement, head thrustings and the analysis of the activity of AWC neurons. This is classic image analysis which is a relatively matured area in AI and can bracketed as a classification problem.

Urine contains signatures of the metabolic breakdown of food, contaminants, drugs, and endogenous and bacterial by-products. These signatures help us to identify the health of an individual by analyzing their urine sample.

Now imagine that as part of your regular health check-up, you provide your blood and urine sample for analysis either at home or in a hospital premises. In addition to your regular blood parameters and urine analysis, you get a risk score for cancer based on your urine analysis with help from c.elegans coupled with faster analysis using AI. Would this not be a scalable diagnostic tool that is population-inclusive?

To develop a cancer testing kit on commercial terms using a body fluid and c.elegans, there has to be a seamless integration of Nematology, Cellular Biology, Bioinformatics and Artificial Intelligence.

Over a dosa, filter coffee and good conversations, we have kindled desire within ourselves to know more on the topic of non-invasive methodology for cancer screening and evaluate its feasibility on commercial scale.

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