In terms of ‘Founders Who Are Killing It!’, one of the last sessions of talks at Inspirefest 2018, Surbhi Sarna topped the bill in more ways than one.
Sarna is the woman behind nVision Medical, the medtech company that was recently snapped up by Boston Scientific in a deal worth $275m. Her start-up journey is like a storybook tale but, like most great stories, it began with a struggle. At 13 years old, she was struck by a sharp pain in her side that was so intense she blacked out. She woke up in hospital, the start of what would become many visits with medical practitioners to deal with a complex ovarian cyst.
With complex ovarian cysts, Sarna explained, it is difficult for physicians to determine if they are cancerous without risky invasive surgery. A transvaginal ultrasound can merely allow the doctor to evaluate the cyst, not confirm if it is cancerous. A CA 125 blood test, Sarna said, is “no better than flipping a coin” because both its false positive and false negative rates are so high.
What this leads to is both unnecessary surgeries and undetected cancers in women. It also means that women such as actress Angelina Jolie, who discover that they are genetically predisposed to ovarian or breast cancer, might make a drastic pre-emptive decision to remove those organs that pose the risk.
“In the US alone, there are 20,000 cases of ovarian cancer diagnosed each year. There are 300,000 procedures to remove ovaries,” said Sarna, describing the “dire situation” of limited options in women’s healthcare.
A tool for early diagnosis could change this situation dramatically. The American Cancer Society confirms that only 15pc of all ovarian cancers are found at the earliest stages, when the five-year survival rate is 92pc.
And so, nVision Medical set about developing a non-invasive test that could improve early detection of ovarian cancer. Capitalising on new research indicating that many ovarian cancers may actually begin in the fallopian tube, nVision’s solution is a self-navigating balloon catheter that picks up cells on its surface as it distends the fallopian tube. With this device, a test can be conducted in a doctor’s office while the patient is awake, much like a pap smear.
The product received FDA clearance for collecting cells and the company raised more than $16m in Series A and B funding from Catalyst Health Ventures, Astia Angels, Draper Associates and others. Then came the mega-deal from Boston Scientific: a $150m upfront acquisition payment and another $125m provided certain milestones are hit in the coming four years. Sarna is confident this legacy medical company will do a great job commercialising the product, and indeed Boston Scientific has identified an annual market opportunity of $500m to $2bn for the device.
That’s the personal journey that brought Sarna to a $275m exit, but the ‘patient to impatient entrepreneur’ story she shared had more to it than simply having a good idea that sold. First, she had to sell that idea to investors. This meant pitching rooms of male VCs who sometimes recoiled at the frequent but necessary use of the word “vagina”.
Reading these rooms, Sarna amended her language. “Transvaginal” diffused the discomfort and allowed the male VCs to relax in a conversation that was medically focused.
Being the founder and CEO of an evidently skyrocketing start-up, Sarna attracted media attention early on, which taught her another valuable lesson. “[Be] careful on what you’re saying to the press,” she advised, as you could end up being the star of an ‘editor’s choice’ story headlined: To Pitch VCs, Just Don’t Say ‘Vagina’.
Signing off with one final lesson learned on her founder journey, Sarna warned that founders who are later seen to be ‘killing it’ don’t always feel that way as it’s all taking shape, though she’s clearly hopeful that things can work out for others as it did for her.
Counting herself lucky that her medical scare didn’t lead to her ovaries being removed, Sarna’s husband (Reflektive CEO Rajeev Behera) and child joined her on stage for her final words. “There are so many women that don’t have the same luck,” she said. “This [situation] upset me so much but instead of staying angry, I decided to do something and work on it. And it ended up being a really good exit for my investors as well.”
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