 Welcome to Much More on Medicine on the ThinkTech live streaming network series broadcasting from our downtown studio at Pioneer Plaza in downtown Honolulu. I'm your host, Catherine Noor. Much More on Medicine is an opportunity to learn about all aspects of health care. I talk with guests about medical and alternative care treatment, insurance, medication, surgery, rehabilitation, prevention, and much more. Joining me in the studio is Dr. David Samsami. Talk about his invention, a do-it-yourself pap smear. Dr. Samsami is board certified by the American Board of Family Physicians and the American Board of Disability Analysts. He earned his medical degree from the Carol Linska Institutes.com in Sweden. He served his residency and family practice at the UC Davis affiliated program in Merced, California. Dr. Samsami has been a community family physician in Hawaii since 2004. He has volunteered as an assistant clinical professor at University of Hawaii John A. Burns School of Medicine, Department of Family Medicine. Dr. Samsami, welcome. Thank you. It's great to have you here today. It's an honor to be here. Okay, so this do-it-yourself pap smear. What is the technical name for it? The technical name for this is a cervical tissue sample device that it takes samples of the cells from the cervix. Okay, and so can you explain how this is done? Well, it's, in reality, in concept, it's very simple. So it's a sort of syringe that has been designed in a way that once you push it in, so it opens up a shroud that there is a brush inside there. So the woman can do this at home on their own privacy. Okay. And the instruction is a very simple. Okay, so why don't we take a look at it? Okay, let's bring up the side view. Okay, okay. The closed one. The closed side view. Okay, yeah, there we go. Okay, so what is this? What are we looking at? This one is just a syringe that usually, you know, we use it in a daily using in health care. And that is designed now in a way that I put a cap on the syringe that has fluid inside it. And it is locked by aluminum foil or something that can hold the fluid inside the cap. Then that is the body of the syringe. And inside the body, when we push in the plunger, the bottom part of the thing, it pushes out inside the chamber of the syringe. Okay, so let's look at the open front view. Please are sure. Okay, so what what are we looking at? This one is now that once we push in the plunger inside push it out, then it opens up on the top of the syringe. It opens up like a reverse umbrella. So it opens up. And then there is a brush that takes the sample cells, it will appear inside the shrouds. Okay, and then let's look at the open side view. Okay, and what how does what is this show? Yeah, this one, if we say that, okay, now it has opened up. And the upper part with the shroud that is covering the brush inside. So once this inserted inside, so with a little push automatically will align with the tip of the surface. Okay, and so doctor, you're a family physician. And this seems to be something that what a gynecologist would do in your work as a family physician. Do you actually conduct pap smears on patients? Yeah, well, it's a big part of the family physician is women's health. So I mean, it all depends on how much a family physician is engaging. But in my practice, it has been everything, you know, as a pediatric to geriatrics and gynecology is some portion of it. Okay, and so we know that a lot of inventions have inspirations. And so tell us about your inspiration that caused you to invent this. Right, I mean, beside hearing all the time that, okay, this position or this test is embarrassing. These comments, I was inspired mostly because one of my patients delayed incoming and doing the test that you were supposed to do repeatedly and it went a couple of years and finally when the test was done, unfortunately, it was invasive cervical cancer. And that gave me an idea that okay, why don't we find a easier way for women to be able to do it themselves. So in this way, you know, we will avoid. Okay, so essentially, this device allows a woman to insert that that what we should we saw. And they do that at home. And by doing that, they extract cells. And then what do they do after they complete that procedure? Well, the thing is that first we target which group, you know, because this one is designed for those people that are, you know, underserved community or hard to reach people. So we say that with these people that you're not not coming for some reason. And so how can we reach them? Then we mail this device home to them. And, you know, then the instruction and I say that okay, now, can you at least do this, you know, it would be anything better than nothing. So if you do this, then send it back to a lab. So instruction they read it. So it's very discreet when it goes home in a mail, then they open it and then do according to instruction, collect the cells and then mail it to the lab. And the doctor will get the result. Okay, so let's just say this procrastinating woman who doesn't have time to come in to see you and they get the they get this in the mail to do it and they do it and then they forget to mail it out. But how long will it last before it's spoiled? Well, I mean, I cannot say exactly the time wise. But basically, if it is a shorter period of time, I don't believe that, you know, because this preservative met it preserves the cells. And just looking it on their microscope to see whether the cells are pathologically or no normal. I don't believe that it would be. But the goal here is and I don't believe that any person that would do the test would delay in mailing it. You know, they don't want to have any samples of anything left over. But in case if they forget, I still think it's good to mail it and see what the lab would say. Okay. And can any laboratory analyze the cells? Those that they are, I mean, a standard laboratory that the laboratory that they do this stuff, yes, they would be able to do it. Is it difficult to use this device at home? Not really, because they're already a lot of patients we prescribe medicine that they use the same sorts of applicator to treat other bacteria, as you know, says stuff like that. So if they follow the instruction, it is very simple. Okay. And does it collect cells from multiple parts of the cervix? Yes. Well, this is designed that the brush inside the thing, if we look at another picture from above that we can see the brush. That one, the middle part of the brush is longer than the sides of the brush. So the middle part goes into in the cervical area. And the outer part is gets the cervical area. And any purpose we should have both endocervical and peripheral. Okay. So how important is early detection of cervical cancer? Well, early detection of any disease is very important. And especially if it comes to a cancer form, that's almost life saving. And prevention is almost everything in medicine. So if we prevent it, we would never end up with the disease and would not cost so much, both, you know, economically and also emotionally. So if the test is positive for pre cancerous cells, are there things that doctors can do? Absolutely. I mean, the test, it does not need to be positive for pre cancerous. It can just say that they are normal cell or inflammatory. That just is a source of light that you know, say, okay, now, you really need to go and get checked. And then now when they do the check again, and it is pathologically or or has changed. So of course, early intervention, preserve life. Okay, fantastic. So this kind of reminds me of something like 23 and me or a home pregnancy test. Is that kind of the what this is about doing something at home rather than going to a clinic to do it? Yeah, exactly. The home devices are designed to do that, that patient would be able to do it on their own privacy of the home. And pretty much, that's the same. Okay, and so and I also understand that they have tests that you can determine like for, for problems with the colon and issues, where they you could do a home sample. That's right. Yeah, those, those like polo guard or stool samples and stuff, they're similar, but of different type of the test. Yes, patients does it at home and send it. Okay. So now, this is an important question. What other benefits are there to this test? Is it capture any other cells? Or absolutely, they capture is almost all sexually transmitted infections, as they call it STI. So as I mean, they are going to re HPV, more virus, and they're also found on the infection bacteria of vaginosis, trichomonas, anything that could be captured this one. So I think that sounds like a wonderful thing for people that are kind of embarrassed about going to a doctor. Absolutely, absolutely, because they especially younger generation that, you know, if they want to do this, and then, you know, so it stops the spreading. And then also it gives them a source of idea. Now I have to go to the doctor and get treatment. Okay. So now, how prevalent is this problem of cervical cancer in the world? It is. I mean, there's a quite large number of women that, you know, yearly worldwide, you know, be offered to this disease and die of the disease, is a great number of people and somewhere around, let's say, 6%. And so that they develop cervical cancer that leads to death. Okay. All right. So doctor, now, is a device difficult to use? I mean, we know, I mean, if they really read the instruction properly, like any other, as I mentioned, maybe prescribe medicine with applicator, if they have to really that, okay, how is it do that? It's not difficult at all. Following the instruction is very simple and safe. Okay. Fantastic. This is Catherine Norr, much more on medicine with Dr. Samsami. Aloha, this is Rob Hack. My show is exporting from Hawaii every other Thursday from 12 to 12 30pm, where I bring in people involved in the entire exporting infrastructure in Hawaii, including government, academia and manufacturers and shippers themselves. Please join me every other Thursday, 12 to 12 30pm and exporting from Hawaii. Mahalo. Aloha, I'm Mellie James, host of Let's Mana Up, Tuesdays, every other Tuesday, from 11 to 11 30. This show is meant to dive into stories of local product entrepreneurs and how they're growing their companies from right here in Hawaii. I'm so thrilled to have our show kicked off. And so please join us on Tuesdays at 11 o'clock as we talk to local entrepreneurs and hear their stories. We're back. We're live. I'm Catherine Norr. And this is much more on medicine on the Think Tech live streaming network series. And we're talking with Dr. David Samsami about his new invention of a do it yourself pap smear. Dr, do you have a patent? Yes. This one is US patents recently. That's been patented. That's big news. And it sounds like it's just going to be an amazing product for many populations. Yes, that's the hope that that we can reach those that are very difficult to reach. And then we would save lives. That's the whole idea behind. Okay, so the type of populations that would benefit. Those are people in rural areas and what other types of populations? I mean, any population can use this as we mentioned also, some people due to privacy, you know, or religion reason, they don't want to go to their doctors and stuff. So those will be identified and then they can request. So, you know, a device will be sent home to them, at least to get it done. Now, of course, we don't say that this would replace the doctor's examination. We still say that that would be the best if somebody can go be examined by the doctor. Okay, so I think this might lead to some cost savings. Is that correct? Absolutely. Absolutely. I mean, one of the good benefit of this device is the cost. But saving lives is priceless. So we cannot say that, okay, just because it's cheaper, we got to go, you know, to do that. But no, in today's society, we need to have a low cost healthcare, the best source of service. And so that one is a fraction of the price of pap smear. But still, we won't say that, just because of that, that for this reason, we are going to introduce this. No, we want to introduce it in order to get more people to get tested. Okay. So in this way. And you know, one thing that I didn't ask you, and I think this is important, what is a pap smear? Yeah, a pap smear is a sort of test that before was yearly that women need to do it. Then nowadays, they say that if it has been normal, so it is a test that the ladies go to their doctor and the doctor take the same method that we're doing with the brush, take tests from the cervical area, and then send it for analysis and see that, you know, whether it's normal or abnormal, or if it is an infection, or that's what the pap smear means. Okay. And how often do women normally get a pap smear? Before, yeah, before was recommended to be done yearly. Then as years went by, so now they recommend that, you know, every two to three years, three years, that would be the maximum if the pap smear consequently is normal. Okay. But if the patient somehow would like to get it done yearly, still, they wouldn't say no, they would recommend it to do. Okay. So if now, before your invention, people would have to go to their doctor and have this done. How much would a doctor's office visit cost? Well, I would estimate that in the office pap smear does even you charge the insurance and some pay somewhere around $180. That would be the cost of the office visit and the service that the doctor is doing. Then, of course, this one is not embedded the lab cost in it, you know, lab I have absolutely no idea how much they would charge to do with the charge insurances. And so it would be a quite big difference between get it done privately or get it done at all. Okay. So and then the cost of this device about like, if let's just say an insurance company was paying for it, what would be the range? Well, it is, of course, you know, I would guess I'm not professionally making manufacturing this, but it shouldn't be expensive. I would guess I'm around $15 to $20 would cost so it would be around one fifths of the price of there. Okay. So we're looking at the difference between a cost of like $180 office visit and a 10 to $15 test that someone could do in the privacy of their own home that would not only perform a pap smear, get those cells to be tested for cervical cancer, but also could detect the STIs. Okay, that's right. Okay. So that seems like a huge benefit. Absolutely. Okay. So when I when I kind of think about the potential advantages of this, I think about all these countries that like such as Africa, or, for example, Africa, lots of remote areas, not served, potentially by doctors, is that correct? No, absolutely. In Africa, it's not the need to be remote, you know, even in their cities, every house, they don't have that much of a doctor's pair in a population that they should serve. There's a lot of underserved people that that that could be targeted and safe. And then when I think about the Middle East or parts of Asia, I think about the need for privacy. Absolutely. Okay, where some populations, they can't see a male doctor. Absolutely. The cultural set, there are a lot of cultures that women don't like to be, you know, examined by a male. And so in this way, I don't believe that they would mind to do it themselves. And any woman would like to be tested by a, you know, female examiner or male examiner. Still, they would say that I would prefer, if I can do it myself, I would prefer to do it myself. Okay, and then we even have populations like in the North, for example, I know you went to school in Stockholm. That's right. Yeah. When I look at those countries, Scandinavian countries, they have a lot of really remote areas. Yes, absolutely. You know, there are some places in Sweden or Norway or Finland that is about four or five hours to the closest facility. So this would be a lot easier. Absolutely. I think that they would be very much interested in because they usually invest in preventive medicine. Okay, fantastic. Okay. And so and then when I look at countries like the UK or Canada, they try to provide care to all of their citizens. And so this would probably benefit them as well. Absolutely. I mean, now if we we shouldn't go that far to UK or so in the United States now, almost everywhere, every state, their goal is to give the best health care and lowest cost. All insurance companies, you know, encourage doctors that, you know, to bring in people for annual health examination, just to prevent. So even in the United States, it would be very much benefited. Yeah, and especially Hawaii where we have islands, right? Absolutely. Yeah, and we even have islands that don't have many doctors. Absolutely. Sure. Yeah. That is that that was the whole goal to target those people. Okay. Fantastic. Okay. So does the using the cervical tissue sample device, does that mean that a patient doesn't have to see a gynecologist? No, exactly. As I mentioned, we even recommend the very hard nothing can replace a doctor's examination. So that's why we encourage them. This is just that for some reason, if they cannot do it, so it will not take two years, three years after, you know, whatever test has shown that it become like so late like the other patient I mentioned that. So this says, okay, now if you cannot do it, you can or you have no possibility to go to doctor. So we send it home to you, you get it done. At least, you know, it gives us some idea very in time that person is. So it really doesn't replace that hands on visit with the doctor who checks other health issues like like breast health and other. Absolutely. Absolutely not. Absolutely not. Nothing in reality can replace doctors visit test. Sure. Yeah. Even even now if they send a test for colon cancer, steel colonoscopy is a gold standard that needs to be done. But of course, it prevents a lot of time, you know, for earliest age. So they find out that yes, okay, there was a blood in a stool, or there was this and was that. So it captures it, you know, earlier. So if there is a, let's just say that there's a positive finding and the lab comes back with a positive finding, does that go back go? Does the test go to their physician? Yes, they they it is that way since they are sent home from the physician to those targeted patients. So the result will go to to doctor and the doctor, you know, will write a letter or stating that okay, was this so come, you know, for for a real more thorough examination. Okay. And so if it's positive, then they'll probably have a repeat in the office? Yes, absolutely. Yeah, then it's like any other tests, even we do Pap smear and it becomes in the office setting positive. Then we say that okay, if what the stage it is, then whether in six months or one year, you have to repeat the test, but it is on alert that something is wrong. Okay, so the the person who has always had negative pap smears or hasn't had one yet, they could probably do this. But once it starts being positive, then we're really shifting into actual hands on medicine. Absolutely, absolutely. And so but the younger generation, of course, we recommend to do these tests and not just for the purpose purposes, just for the STI, you know, because a lot of them go silent. Sure. And spreading in a community and so and so it not only is a good thing in relation to cervical cancer, but also could could help prevent the spread of absolutely. Yes. Okay, well, doctor, it's been fantastic talking with you today. And I'm so excited about your about your invention. Well, thank you for having me. And so well, I just want to say we really appreciate it. And so we're out of time today, but we'll have to and we'll have to wrap this up. I'm Catherine Norr. This is much more on medicine on the ThinkTech live streaming network series. We've been talking with Dr. David Samsami about his invention of a do it yourself pap smear. And thank you for joining us today, Dr. And thanks for our broadcast engineer, our floor manager, and to J. Fidel, our executive producer, who puts it all together. Please join us for future ThinkTech productions. Thank you.