From exploring distant stars to satellite communications, the technology developed for space is being brought down to Earth for the NHS.
Feature article for the UK Space Agency’s magazine, SPACE:UK - ISSUE 51.
Every two minutes someone in the UK is diagnosed with cancer. Our body is made up of trillions of healthy cells that grow, divide and adapt to our needs. But with cancer, it’s a different story. Damaged or abnormal cells grow, surviving when they should die, and new cells develop when they are not needed. Symptoms include rapid weight loss, night sweats and fatigue. But diagnosis can be difficult.
“You can miss things if you’re just taking a medical history in the setting of a GP surgery – someone could be tired for a range of reasons,” says Christina Mackaill, an emergency care specialist at Queen Elizabeth University Hospital in Glasgow.
“Sometimes cancer doesn’t even have symptoms at the beginning. But the aim of the game is earlier detection, that’s what the NHS and the space industry are trying to achieve.”
As part of last year’s 70th anniversary celebrations of the founding of the NHS, the UK Space Agency and NHS announced a £5 million fund to adapt space technology for patient care. One of the winners of this open competition was space imaging company Adaptix. Based at the Rutherford Appleton Laboratory at Harwell near Oxford, it’s using x-ray detection technology originally designed to spot exploding stars and black holes.
Adaptix’s device consists of two vertical flat panels, both the size of a pizza box, that move in parallel as the patient stands in between them. One is made up of small X-ray emitters, which fire off X-rays in multiple directions. These travel through the patient to reach a detecting panel and produce a detailed 3D image. The technique not only avoids the traditional (and drawn-out) need to physically move the X-ray source to create an image but the patient receives a fraction of the radiation dose of a CT scan.
“Cancers can go undetected with 2D X-rays,” says Mackaill. “The potential benefit of this technology is that it could be used more quickly than a CT machine and therefore spot cancer sooner, without waiting for a hospital appointment.”
There is a long history of adapting space technology to benefit human health. In 1983, for example, NASA Space Shuttle engineer David Saucier suffered a heart attack. He was given a transplant by world-renowned heart surgeon Michael DeBakey. Later, the two realised that artificial heart pumps and Shuttle fuel pumps were similar but the heart pumps available to patients awaiting transplant left a lot to be desired. The result? A new mechanical pump that assisted the heart. The technology has become a vital, live-saving procedure for patients awaiting heart surgery.
Today, digital technology is finding new applications in medicine. Another of the winners from the UK Space Agency’s initiative is using Artificial Intelligence (AI) and satellite communications systems to target bowel cancer.
“Bowel cancer is the second most common cause of cancer-related deaths in the UK and it’s growing,” says CEO of Odin Vision, Peter Mountney.
People with suspected bowel cancer are sent for a colonoscopy. The test uses a narrow, flexible, camera to look at the lining of the large bowel. Cancer specialists are looking for small pieces of abnormal tissue, called polyps, which could develop into cancer.
“The problem is that finding them is extremely difficult and there are lots of studies to show doctors miss over 20% of these polyps,” Mountney says. “Our software is using artificial intelligence and space communications technology to help detect and diagnose cancer during the procedure, it’s like having a second pair of eyes to spot areas of abnormal tissue.”
The technology is similar to the Video Assistant Referee in football. As the doctor carries out the colonoscopy, a live video feed is sent to a cloud database via a fast and reliable data connection originally designed for high-speed satellite communication. The system, Early diAgnosis Real-Time Healthcare System for CANcer (EARTH SCAN), then uses AI to analyse the colonoscopy and identify whether or not a patient has cancer.
The AI technique at the heart of EARTH SCAN has learnt to identify cancerous tissue by comparing images of healthy bowels with signs of cancer. And there are numerous benefits. The speed of the technology means patients can receive a diagnosis straightaway, rather than having to wait for up to a month. Plus, because it’s a cloud-based system, EARTH SCAN can be accessed anywhere in the World.
“Better early detection and diagnosis, especially with bowel cancer, leads to much better outcomes for patients,” says Mountney. “Survival rate for early detection can be 90% and the cost of treating early polyps is very cost-effective compared to treating late stage cancer.” The technology will be progressing through clinical trials in the next year.
As we live longer, the NHS is under increasing pressure to treat a wide-range of age-related diseases. More than a third of all cancer cases in the UK, for example, are diagnosed in people aged 75 and over. By 2034, almost a quarter of the UK population, some 15 million people will be over 65.
“There are more and more old people, because of demographic changes which are associated with lifespan and development,” says Malcolm Jackson from the University of Liverpool’s Institute of Ageing and Chronic Disease. Jackson is leading a project called MicroAge, investigating the loss of muscle mass as we age, which is also an issue astronauts encounter when living in space.
On Earth, our muscles are constantly working against Earth’s gravity. In the weightlessness of space, however, astronauts have to exercise at least two hours a day to prevent bone and muscle loss. During his mission to the International Space Station (ISS), British ESA astronaut Tim Peake investigated this impact of the environment on his body. He had muscles samples taken before and after the mission for analysis, with MRI scans comparing the state of his tissue.
“We were struck by the fact that by trying to ameliorate the changes that go on in space, astronauts now do very large amounts of exercise on a treadmill or resistance training,” says Jackson. “Despite that, when they return to Earth they can’t walk initially – almost by definition they are not responding to exercise.”
The MicroAge team plan to send cultures of muscle tissue up to the ISS in 2021. These will be kept at ambient conditions in a special incubator, developed by Kayser Space Limited. In microgravity, the muscle samples will receive electrical stimulation to contract. Scientists will then analyse the synthesis of new muscle proteins. The same experiment will be taking place on the ground, enabling scientists to build-up a better understanding of the effects of microgravity on muscle synthesis.
If all goes well, this could be the beginning for drug-development studies that attempt to identify loss of muscle mass in elderly individuals, helping them to lead a more active life and reduce the strain on the NHS.
“We’re trying to address how we can keep people mobile and relatively healthy,” says Jackson. “A lot of that is around lifestyle and exercise and there’s potential for some selective pharmacology within that.”
Over the coming years, the benefits of space technology, communication and AI could make a significant difference to NHS care and all our lives here on Earth.
“It’s essential to have access to healthcare” says Mackaill. “These advances in technology mean that we can detect diseases earlier and more easily”.