India reports 77,000 cases of oral cancer every year. An estimated five people die from the disease every hour. This accounts for one-fourth of global incidences and these numbers have only increased over time.
One major reason for the high mortality rate is a late diagnosis. This can be due to many reasons – patients live in rural areas with only primary healthcare centres, or cannot afford diagnosis and treatment, or are in denial about their symptoms.
To make the diagnosis simple and accessible to everyone, 18-year-old Nikhiya Samsher, a resident of Bengaluru and a graduate of Greenwood High International School, has innovated ‘QuitPuff’.
“This is an early risk detection device which can show if a person is at risk of developing oral cancer or if they already have it. It takes 15 minutes to show results and is priced as low as Rs 38,” says Nikhiya, in an interview with The Better India.
In 2015, when Nikihiya was in class 8, she was part of a programme named ‘Compassionate Clowns’. Students would dress up as different characters and visit paediatric wards of various hospitals to cheer up young patients.
“During one of these visits, as I was leaving the hospital, I saw a man whose face was wrapped in bandages. After another glance, I noticed that his jaw had been removed. I immediately asked the nurse accompanying us what had happened to him. She explained that he was in the later stages of oral cancer,” says Nikhiya, adding that the nurse explained how he was one of the lucky patients, since most don’t get a chance to survive.
This prompted Nikhiya to understand why the disease was so cruel.
Through research on the internet, she understood late diagnosis makes the patient’s condition worse and does not give them a fighting chance.
“On looking up the methods for early diagnosis, I noticed that the tests were either too expensive or available only at certain hospitals. The testing techniques were a long process and required lab facilities,” says Nikhiya.
She decided to understand more about the topic and innovate a solution of her own for the detection of oral cancer.
Mentors and research
In 2016, Nikhiya began reading several scientific research papers published on the internet about diagnosis methods for oral cancer. Being in class 9, she had a tough time understanding many of the medical concepts but would take help from her parents – who are dermatologists.
Through them, she also got connected with Tania Das, a senior research fellow at ICAR- National Bureau of Animal Genetic Resources. Tania eventually became her mentor.
“With her help, I was able to understand the concepts behind the diagnosis methods for oral cancer,” says Nikhiya.
Tania further connected Nikhiya with her second mentor, Chaitanya Prabhu, a scientific analyst. With her help, she understood the chemical compositions for diagnostic materials, how to source those chemicals and work with them.
“After six months of doing the research work from my home and coordinating with my mentors. I formulated a reagent that would help detect oral cancer using saliva. Once it was approved by my mentor, I sourced the necessary chemicals from a pharmaceutical supplier and began the tests in my house,” says Nikhiya.
The reagent is made using three kinds of chemicals. This includes thiobarbituric acid, trichloro-acetic acid, and ortho-phosphoric acid, to detect the presence of malondialdehyde, a biomarker that indicates the presence of cancer-causing cells.
To test her composition, Nikhiya also procured malondialdehyde acid. In a test tube, she added water, added the reagent and heated the mixture. There was no reaction and the liquid’s colour remained the same. However, when the water was mixed with malondialdehyde and the reagent was added, its colour would change.
“The intensity of the colour change depended on the amount of malondialdehyde that was present in the water. It would range from a light yellow indicating early cancer stages to a dark brown indicating late stages of cancer,” says Nikhiya.
By 2018, once Nikhiya was sure of her ‘QuitPuff’ reagent, she priced it at Rs 38 and approached Victoria Hospital in Bengaluru to conduct random trials on smokers and non-smokers visiting the facility.
“The request for using the device was approved. Between June 2018 to February 2019, tests were conducted on 500 people using their saliva samples, and the method showed 96% accuracy,” says Nikhiya, adding that the accuracy was determined after the hospital also conducted their usual tests.
Using the findings, Nikhiya and Chaitanya wrote a research paper regarding ‘QuitPuff’. The same was approved and published in 2020.
Now, Nikhiya has still not released the product for commercial use as she is in the process of improving it. Since the process takes 15 minutes to give results and requires heating, it is not easy to use for everyone. So she is working on a solution that will be paper-based.
“In the future, I hope to provide this piece of paper as part of tobacco boxes, so that people can test themselves for free and stay vigilant about their health,” says Nikhiya.
(Edited by Vinayak Hegde)