Can we eat to starve cancer William Li

good afternoon there’s a medical

revolution happening all around us and

it’s one that’s going to help us conquer

some of society’s most 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 and the end that would form a line

that would 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 now the remarkable

thing about blood vessels is that they

have this ability to adapt to whatever

environment they’re growing in for

example in the liver they form channels

to detoxify the blood in the lung they

line air sacs for gas exchange in muscle

they corkscrew so that muscles can

contract without cutting off 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 means is that as adults

blood vessels don’t normally grow except

in a few special circumstances in women

blood vessels grow every month to build

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 a wound

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

fertilizer 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 now there are

other situations where we start beneath

the baseline and we need to grow more

blood vessels just to get back to normal

levels for example after an injury and a

body can do that too but only to that

normal level that’s setpoint 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 a right place at the right time

and in these situations 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 major diseases

affecting more than a billion people

worldwide that all look on the surface

to be different from one another but all

actually share abnormal angiogenesis as

their common denominator in this

realization is allowing us to

reconceptualize the way that we actually

approach these diseases by controlling

and your genesis 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 dark grey ominous mass

growing inside a brain and under the

microscope you can see hundreds of these

brown staining blood vessels capillaries

that are feeding cancer cells bringing

oxygen and nutrients but cancers don’t

start out like this and if that cancers

don’t start out with a blood supply they

start out as small microscopic nests of

cells that can only grow to one half a

cubic millimeter in size that’s the tip

of a ballpoint 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 body 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 50s

and 60s have microscopic prostate

cancers and all virtually a hundred

percent of us by the time we reach our

70s 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

cancers 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 cancer 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 fertilizer

that tipped the balance in favor of

blood vessels invading the cancer and

once those vessels invade the cancer it

can expand it can invade local tissues

in 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 Evandro Genesis 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 anti-angiogenic therapy and it’s

completely different from chemotherapy

because it’s selectively aims at the

blood vessels that are feeding the

cancers and we can do this because

tomber blood vessels are unlike normal

healthy vessels we see in other places

of the body they’re abnormal they are

very poorly constructed and because of

that they’re highly vulnerable to

treatments that target them in fact when

we give cancer patients anti-angiogenic

therapy here an experimental drug for a

glioma which is a type of a brain tumor

you can see that there are dramatic

changes that occur when the tumor is

being starved here’s a woman with a

breast cancer being treated with the

anti-angiogenic drug called Avastin

which is fda-approved and you can see

that the halo of blood flow disappears

after treatment

now I’ve just shown you two very

different types of cancer that both

responded to anti-angiogenic 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 nine-year-old boxer named Milo

who had a very aggressive tumor called a

malignant neurofibroma growing in his

shoulder and invaded to his lungs his

veterinarian only gave him three months

to live so we created a cocktail of

anti-angiogenic drugs that could be

mixed into his dog food as well as an

anti-angiogenic 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 cancers growth

such that we were ultimately able to

extend Milo’s survival to six times what

the veterinarian had initially predicted

all with the very good quality of life

and we’ve subsequently treated more than

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 three years developed into

invasive squamous cell cancers so we

created an anti-angiogenic paste we had

it painted on top of the cancer three

times a week and over the course of

seven months the cancer has completely

disappeared and the biopsies came back

as normal here’s a cancer growing on the

lip of a quarter horse named

it’s a very very deadly type of cancer

called an angiosarcoma had already

spread to his lymph nodes so we used an

anti-angiogenic skin cream for the lip

and the oral cocktail so we could treat

from the inside as well as the outside

and over the course of six months he

experienced a complete remission and

here he is

six years later guinness with his very

happy owner

now obviously antigenic therapy could be

used for a wide range of cancers in fact

the first pioneered treatments for

people as well as dogs already becoming

available there’s 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 or

radiation available but starting in 2004

when anti-angiogenic therapies first

became available you can see that there

has been a 70 to 100 percent improvement

in survival for people with kidney

cancer multiple myeloma colorectal

cancer and gastrointestinal stromal

tumors that’s impressive

but for other tumors and cancer 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 oftentimes it’s already

spread or metastasize 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 Andrew Genesis

beating cancer 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 a way to

keep it from coming

back so to look for a way to prevent

angiogenesis in cancer I went back to

look at cancerous causes and what really

intrigued me was when I saw that diet

accounts for 30 to 35 percent of

environmentally caused cancers 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 it began

asking what could we be adding to our

diet that’s naturally anti-angiogenic

that could boost the body’s defense

system and beat back those blood vessels

that are feeding cancers in other words

can we eat to starve cancer well 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 a

test system we developed at the center

as a ring from which hundreds of blood

vessels are growing out in a starburst

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 resveratrol it’s also found

in red wine this inhibits abnormal

angiogenesis by 60 percent here’s what

happens when we add an extract from

strawberries it potently inhibits

angiogenesis an extract from soybeans

and here is a growing list of our

anti-angiogenic foods and beverages that

we’re interested in studying and for

each food type we believe that there’s

different potencies within different

strains and varietals and we want to

measure this because well while you’re

eating a strawberry or drinking tea why

not select the one that’s most potent

for preventing cancer so here are four

different teas that we’ve tested they’re

all common ones Chinese Jasmine Japanese

Sencha Earl Grey and a special blend

that we prepared and you can see clearly

that the tea’s vary in their potency

from less potent

to more potent but what’s very cool is

when we actually combine the two less

potent teas together the combination the

blend is more potent than either one

alone this means there’s food synergy

here’s some more data from our testing

now in the lab we can simulate tumor

angiogenesis represented here in a black

bar and using the system we can test a

potency of cancer drugs so the shorter

the bar less angiogenesis that’s good

and here are some common drugs that have

been associated with reducing the risk

of cancer in people statins

non-steroidal anti-inflammatory drugs

and a few others they inhibit

angiogenesis - 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 anti-angiogenic cancer

preventative properties and that’s what

we’re doing right now now I’ve shown you

a bunch of lab data and 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 the study of 79

thousand men followed over 20 years in

which it was found that men who consumed

cooked tomatoes two to three times a

week at 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

anti-angiogenic 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

anti-angiogenic substances present food

and consumed impractical levels can

impact on cancer and we’re now studying

the role

of a healthy diet with Dean Ornish at

UCSF and Tufts University on the role of

this healthy diet on markers of

angiogenesis that we can find in the

bloodstream now obviously what I’ve

shared with you has some far ranging

implications even beyond cancer research

because if we’re 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 but everybody could

benefit from a healthy diet based on

local sustainable anti-angiogenic 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 turns out that adipose

tissue fat is highly angiogenesis

dependent and 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 away back in fact you

can cycle the weight up and down simply

by inhibiting Andra Genesis so this

approach that we’re taking for cancer

prevention may also have an application

for obesity the really truly interesting

thing about this is that we can’t take

these obese mice and make them lose more

weight than what the normal Mouse is

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 setpoints albertson

Georgie once said that discovery

consists of seeing what everybody is

seen and thinking what nobody is 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’s what

I think the world needs now thank

so these drugs aren’t exactly they’re

not exactly in mainstream cancer

treatments right now for anyone out here

who has cancer what would you recommend

do you recommend pursuing these

treatments now for most cancer patients

so there are anti energetic treatments

that are you should ask

there are many clinical trials the in

geneticist foundation respond almost 300

companies 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 and this is one of the

themes that I’m talking about is we can

empower ourselves to do the things that

doctors can’t do for us which is a use

knowledge of take action and if Mother

Nature has given us some clues we think

that there might be some new future in

the value of how we eat and what we eat

is really our chemotherapy three times a

day right and along those lines for

people who might have risk factors for

cancer would you recommend pursuing any

treatment sort of prophylactically or

simply pursuing the right diet with lots

of tomato sauce well you know there’s a

abundant epidemiological evidence and I

think an Information Age it doesn’t take

long to go to a credible source like

PubMed the National Library of Medicine

to look for epidemiological studies for

cancer risk reduction based on diet and

based on common medications and that’s

certainly something that anybody can

look into okay well thank you so much

you