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Can we eat to starve cancer ?

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Good afternoon. There’s a medical revolution happening all around us, and it’s the one who is going to help us conquer some of society’s more dreaded conditions including cancer. And the revolution is called angiogenesis and it’s based on the process that our bodies use to grow blood vessels. So why should we care about blood vessels? Well the human body is literally packed with them. 60,000 miles worth in a typical adult, end to end that would form a line that will circle the Earth twice. The smallest blood vessels are called capillaries. We’ve got 19 billion of them in our bodies and these are the vessels of life and, as I’ll show you, they can also be the vessels of death. The remarkable thing about blood vessels is that they have the ability to adapt to whatever environment they are growing in. For example, in the Liver the form channels to detoxify the blood. In the Lung they line air sacs for gas exchange. In the Muscle they corkscrew so the Muscles can contract without cutting off the circulation, and in Nerves they course along like power lines keeping those nerves alive. And we get most of these blood vessels when we’re actually still in the womb and what that mean is that, as adults, blood vessels don’t normally grow, except in a few exceptional circumstances: in women, blood vessels grow every month to built the lining of the uterus; during pregnancy, they form the placenta which connects mom and baby, and after injury, blood vessels, actually, have to grow under the scab in order to heal wounds. And this is actually what it looks like hundreds of blood vessels all growing towards the center of the wound. So the body has the ability to regulate the amount of blood vessels that are present at any given time, and it does this through an elaborate and elegant system of checks and balances, stimulators and inhibitors of angiogenesis, such that when we need a brief burst of blood vessels the body can do this by releasing stimulators – proteins called angiogenic factors - that act as natural fertilizers and stimulate new blood vessels to sprout. And when those excess vessels are no longer needed the body prunes them back to baseline using naturally occurring inhibitors of angiogenesis. There are other situations when we start beneath the baseline we need to grow more blood vessels just to get back to normal levels. For example after injury, the body can do that too, but only to normal level, that set point. But what we now know is that for a number of diseases, there are defects in the system, where the body can’t prune back extra blood vessels or can’t grow enough new ones in the right place at the right time, and in these situation angiogenesis is out of balance and when angiogenesis is out of balance a myriad of diseases result. For example, insufficient angiogenesis, not enough blood vessels, leads to wounds that don’t heal, heart attacks, legs without circulation, death from stroke, nerve damage, and on the other hand, excessive angiogenesis, too many blood vessels, drives disease and we see this in cancer, blindness, arthritis, obesity, Alzheimer’s disease. In total there are more than 70 mayor diseases affecting more than a billion people world wide, that all look on the surface to be different to one another, but all actually share abnormal angiogenesis as their common denominator. And this realization is allowing us to reconceptualize the way we actually approach these diseases: by controlling angiogenesis. Now I’m going to focus on cancer because angiogenesis is a hallmark of cancer, every type of cancer. So here we go. This is a tumor: a dark, grey ominous mass growing inside a brain and under the microscope you can see hundred of theses brown staining blood vessels, capillaries, that are feeding cancer cells, bringing oxygen and nutrients. But cancers don’t start out like this, and in fact, cancers don’t start out with a blood supply. They start out as a small microscopic nest of cells that can only grow to ½ cubic millimeters in size, that’s a tip of a ball point pen, then they can’t get any larger because they don’t have a blood supply, so they don’t have enough oxygen or nutrients. And in fact, we’re probably forming these microscopic cancers all the time in our bodies. Autopsy studies from people who died in car accidents have shown that about 40% of women, between the ages of 40 and 50, actually have microscopic cancers in their breasts; about 50% of men in their 50`s and 60`s have microscopic prostate cancers, and virtually a 100% of us by the time we reach our 70`s will have microscopic cancers growing in our thyroid. Yet without a blood supply most of these cancers will never become dangerous. Dr. Judah Folkman who was my mentor and who was the pioneer of the angiogenesis field once called this “cancer without disease.” So the body’s ability to balance angiogenesis, when it’s working properly, prevents blood vessels from feeding cancer and this turns out to be one of our most important defense mechanisms against cancer. In fact, if you actually block angiogenesis and prevent blood vessels from ever reaching cells, tumors simply can’t grow up. But once angiogenesis occurs cancers can grow exponentially, and this is actually how a cancer goes from being harmless to deadly, cancer cells mutate and they gain the ability to release lots of those angiogenic factors, natural fertilizers that tip the balance in favor of blood vessels invading the cancer. Once those vessels invade the cancer, it can expand, it can invade local tissues and the same vessels that are feeding tumors allow cancer cells to exit into the circulation as metastases. And unfortunately, this late stage of cancer is the one at which it’s most likely to be diagnosed, when angiogenesis has already turned on and cancer cells are growing like wild. So, if angiogenesis is a tipping point between a harmless cancer and a harmful one, then one major part of the angiogenesis revolution is a new approach to treating cancer by cutting off the blood supply. We call this antiangiogenic therapy and it’s completely different from chemotherapy because it selectively aims at the blood vessels that are feeding the cancers. And we can do this because tumor blood vessels are unlike normal healthy vessels that we see in other places of the body. They’re abnormal, they’re very poorly constructed and because of that they’re highly vulnerable to treatments that target them. In effect, when we give cancer patients antiangiogenic therapy here: an experimental drug for a glioma, which is a type of brain tumor, you can see that there are dramatic changes that occur when a tumor is being starved. Here is a woman with a breast cancer being treated with the antiangiogenic drug called Avastin, which is FDA approved, and you can see that the halo of blood flow disappears after treatment. Well I’ve just shown you 2 very different types of cancer that both responded to antiangiogenic therapy, so a few years ago I asked myself “Can we take this one step further and treat other cancers even in other species” So here is a 9 year- old boxer named Milo who had a very aggressive tumor called a malignant neurofibroma growing on his shoulder and invaded into his lungs, his veterinarian only gave him 3 months to live, so we created a cocktail of antiangiogenic drugs that could be mixed into his dog food, as well as an antiangiogenic cream that could be applied on the surface of the tumor and within a few weeks of treatment, we were able to slow down that cancer’s growth such that we were ultimately able to extend Milo’s survival to six times what the veterinarian had initially predicted, all with a very good quality of life. And we subsequently treated more than a 600 dogs, we have about a 60% response rate and improved survival for these pets that were about to be euthanized. So let me show you a couple of even more interesting examples: this is a 20 year-old dolphin living in Florida and she had these lesions in her mouth that over the course of 3 years developed into invasive squamous cell cancers. So we created an antiangiogenic paste, we had it paint it on top of the cancer 3 times a week and over the course of seven months the cancers completely disappeared and the biopsies came back as normal. Here is a cancer growing on the lip of a quarter horse named Guinness; it’s a very, very deadly type of cancer called an Angiosarcoma and it had already spread into his lymph nodes so we used an antiangiogenic skin cream for the lip and an oral cocktail so we could treat from the inside as well as the outside, and over the course of 6 months he experienced a complete remission. And here he is 6 years later: Guinness with his very happy owner. Now obviously, antiangiogenic therapy could be used for a wide range of cancers and in fact, the first pioneering treatments for people, as well as dogs, are already becoming available; there’re 12 different drugs, 11 different cancer types. But the real question is: how well do these work in practice? So here is actually the patient survival data from 8 different types of cancer and the bars represent survival time taken from the era in which there was only chemotherapy or surgery radiation available. But starting in 2004 when the antiangiogenic therapies first became available you can see that there has been a 70 to a 100% improvement in survival for people with kidney cancer, multiple myeloma, colorectal cancer and gastrointestinal stromal tumors, that’s impressive. But for other tumors and cancers types the improvements have only been modest. So I started asking myself: why haven’t we been able to do better? And the answer to me is obvious, we’re treating cancer too late in the game, when it’s already established, and often times it’s already spread or metastasized and, as a doctor, I know that once a disease progresses to an advanced stage, achieving a cure can be difficult if not impossible. So I went back to the biology of angiogenesis and started thinking: “could the answer to cancer be preventing angiogenesis, beating cancer at its own game so the cancers could never become dangerous?” This could help healthy people, as well as people who have already beaten cancer once or twice, and want to find the way to keep it from coming back. So to look for a way to prevent angiogenesis in cancer I went back to look at cancer’s causes, and what really intrigued me was when I saw that diet accounts for 30 to 35% of environmentally caused cancer, now the obvious thing is to think about what we could remove from our diet, what to strip out, take away, but I actually took a completely opposite approach and began asking "what could be adding to our diet, that’s naturally antiangiogenic that could boost the body defense system and beat back those blood vessels that are feeding cancers?” In other words, can we eat to starve cancer? The answer is yes, and I`m going to show you how. and our search for this has taken us to the market, the farm and to the spice cabinet because what we’ve discovered is that mother nature has laced a large number of foods and beverages and herbs with naturally occurring inhibitors of angiogenesis. So here’s the test system we developed. At the center is a ring from which hundreds of blood vessels are growing out in a star burst fashion. And we can use this system to test dietary factors at concentrations that are attainable by eating. So let me show you what happens when we put in an extract from red grapes. The active ingredient is resveratrol; its also found in the red wine. This inhibits abnormal angiogenesis by 60 %. Here’s what happens when we add an extract from strawberries. It potently inhibits angiogenesis. An extract from soy beans. And here’s a growing list of our antiangiogenic foods and beverages that we are interested in studying. And for each food type, we believe there is different potencies within different strains and varietals. And we want to measure this because, well, while you are eating a strawberry or drinking tea, why not select the one that is most potent for preventing cancer. So here are 4 different teas that we have tested. They are all common ones: Chinese jasmine, Japanese sencha, Earl grey and a special blend that we prepared. And you can see clearly that the teas vary in their potency from less potent to more potent. But what’s very cool is when we combined the 2 less potent teas together, the combination, the blend, is more potent than either one alone. This means there is food synergy. Here’s more data from our testing. Now, in the lab we can simulate tumor angiogenesis represented here in a black bar. And using this system we can test the potency of cancer drugs. So the shorter the bar…less angiogenesis, that’s good. And here are some common drugs that had been associated with reducing the risk of cancer in people: Statins, nonsteroidal anti inflammatory drugs and a few others, they inhibit angiogenesis, too. And here are the dietary factors going head to head against these drugs, you can see they clearly hold their own and in some cases they’re more potent than the actual drugs. Soy, parsley, garlic, grapes, berries. I could go home and cook a tasty meal using these ingredients. So imagine if we could create the world’s first rating system, in which we could score foods according to their antiangiogenic cancer preventative properties. And that’s what we’re doing right now. Now, I’ve shown you a bunch of lab data, so the real question is: what is the evidence, in people, that eating certain foods can reduce angiogenesis in cancer? Well, the best example I know is a study of 79.000 men followed over 20 years, in which it was found that men who consumed cooked tomatoes 2 to 3 times a week had up to a 50 % reduction in their risk of developing prostate cancer. Now, we know that tomatoes are a good source of lycopene and lycopene is antiangiogenic. But what’s even more interesting from this study is that in those men who did develop prostate cancer, those who ate more servings of tomato sauce actually had fewer blood vessels feeding their cancer. So this human study is a prime example of how antiangiogenic substances present in food and consumed in practical levels can impact on cancer. And we are now studying the role of a healthy diet, with Dean Ornish at UCSF and Tufts University, and the role of this healthy diet on markers of angiogenesis that we can find in the blood stream. Now obviously, what I’ve shared with you has some far ranging implications even beyond cancer research. Because if we are right, it could impact on consumer education, food services, public health and even the insurance industry. And in fact, some insurance companies are already beginning to think along these lines. Check out this ad from Blue Cross Blue Shield of Minnesota. And for many people around the world, dietary cancer prevention may be the only practical solution because not everybody can afford expensive end stage cancer treatments, every body could benefit from a healthy diet based on local, sustainable antiangiogenic crops. Now, finally, I’ve talked to you about food and I’ve talked to you about cancer, so there’s just one more disease that I have to tell you about and that’s obesity. Because it turns out that adipose tissue, fat, is highly angiogenesis dependent. Like a tumor, fat grows when blood vessels grow. So the question is: can we shrink fat by cutting off its blood supply? So the top curve shows the body weight of a genetically obese mouse that eats non stop until it turns fat like this furry tennis ball. And the bottom curve is the weight of a normal mouse. If you take the obese mouse and give it an angiogenesis inhibitor it loses weight; stop the treatment… gains the weight back; restart the treatment… loses the weight again; stop the treatment… gains the weight back, and in fact, you can cycle the weight up and down simply by inhibiting angiogenesis. So this approach that we are taking for cancer prevention may also have an application for obesity. The really and truly interesting about this is that we can’t take these obese mice and make them lose more weight than what a normal mouse weight is supposed to be. in other words, we can’t create supermodel mice. And this speaks to the role of angiogenesis in regulating healthy set points. Albert Szent-Gyorgi once said that “discovery consists of seeing what everyone has seen, and thinking what no body has thought”. I hope I’ve convinced you that for diseases like cancer, obesity and other conditions that there may be a great power in attacking their common denominator: angiogenesis. And that is what I think the world needs now. Thank you. So the drugs aren’t exactly… they are not exactly in main stream of cancer treatments right now. For anyone out there who has cancer, what would you recommend? Do you recommend pursuing this treatment now for most cancer patients? So there are antiangiogenic treatments that are FDA approved, if you are a cancer patient ... ... The Angiogenesis Foundation is working with almost 300 companies; there are about 100 more drugs in the pipeline. Consider the approved ones, look for clinical trials, but then between what the doctor can do for you, we need to start asking: what can we do for ourselves? This is one of the themes that I’m talking about, we can empower ourselves to do things that doctors can’t do for us. Which is to use knowledge and take action and if mother nature has given us some clues we think that might be a new future in the value of how we eat. And what we eat is really our chemotherapy 3 times a day. Along those lines, for people who might have risk factors for cancer, would you recommend pursuing any treatment sort of prophylactically or simple pursuing a right diet with a lot of tomato sauce? Well you know... there is abundant epidemiological evidence and I think in the information age it doesn’t take long to go to a credible source like PodMed the National Library of Medicine, to look for epidemiological studies for cancer risk reduction based on diet and based on common medication and that is certainly something that anybody can look into. Ok. Thanks you so much. Transcripted by Mauro Leiva, Chile.

Video Details

Duration: 24 minutes and 10 seconds
Country: Chile
Language: English
Views: 155
Posted by: mauro88 on Jul 8, 2010

William Li presents a new way to think about cancer treatment: angiogenesis.

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