Can we eat to starve cancer? | William Li

Prevodilac: Ivana Korom Lektor: Sandra Gojic

Good afternoon.

Dobar dan.

There's a medical revolution happening all around us,

Svuda oko nas se dešava jedna medicinska revolucija,

and it's one that's going to help us conquer

a to je ona koja će nam pomoći da pobedimo

some of society's most dreaded conditions,

neka od stanja kojih se najviše bojimo,

including cancer.

uključujući rak.

The revolution is called angiogenesis,

Ta revolucija se naziva angiogeneza

and it's based on the process that our bodies use to grow blood vessels.

i zasnovana je na procesu

koji naša tela koriste da proizvode krvne sudove.

So why should we care about blood vessels?

Dakle, zašto bismo brinuli o krvnim sudovima?

Well, the human body is literally packed with them --

Pa, ljudsko telo je bukvalno njima pretrpano,

60,000 miles worth in a typical adult.

u tipičnom odraslom telu ih ima oko 96000km.

End to end, that would form a line that would circle the earth twice.

Od jednog do drugog kraja, to bi formiralo liniju

koja bi obišla oko Zemlje dva puta.

The smallest blood vessels are called capillaries.

Najmanji krvni sudovi nazivaju se kapilari.

We've got 19 billion of them in our bodies.

U telu ih imamo 19 milijardi.

And these are the vessels of life,

Ovo su krvni sudovi života i

and as I'll show you, they can also be the vessels of death.

kao što ću vam pokazati,

mogu takođe biti i krvni sudovi smrti.

Now, the remarkable thing about blood vessels

Izvanredna stvar u vezi s krvnim sudovima

is that they have this ability

jeste njihova sposobnost

to adapt to whatever environment they're growing in.

da se prilagode bilo kakvom okruženju u kom se razvijaju.

Na primer, u jetri formiraju kanale

For example, in the liver, they form channels to detoxify the blood;

da prečiste krv.

in the lungs, they line air sacs for gas exchange.

U plućima, okružuju kesice sa vazduhom za razmehu kiseonika.

In muscle, they corkscrew,

U mišićima krivudaju, tako da mišići mogu da se stežu,

so that muscles can contract without cutting off circulation.

a da ne prekinu cirkulaciju.

And in nerves, they course along like power lines,

A u nervima, oni se protežu kao strujni kablovi,

keeping those nerves alive.

održavajući te nerve živim.

We get most of these blood vessels

I većinu ovih krvnih sudova dobijemo

when we're actually still in the womb.

dok smo još u materici.

A to znači da, kod odraslih,

And what that means is that as adults,

blood vessels don't normally grow.

ne nastaju novi krvni sudovi,

Except in a few special circumstances.

osim u nekoliko posebnih slučajeva.

In women, blood vessels grow every month,

Kod žena, krvni sudovi nastaju svakog meseca

to build the lining of the uterus.

da ograde matericu.

During pregnancy, they form the placenta,

Tokom trudnoće, oni formiraju palcentu,

which connects mom and baby.

koja povezuje majku i bebu.

And after injury, blood vessels actually have to grow under the scab

A posle povrede, krvni sudovi

zapravo moraju da nastaju ispod kraste

in order to heal a wound.

kako bi zalečili ranu.

And this is actually what it looks like,

To ovako izgleda.

hundreds of blood vessels, all growing toward the center of the wound.

Stotine krvnih sudova

koji se formiraju ka centru rane.

So the body has the ability to regulate

Znači telo je sposobno da kontroliše

the amount of blood vessels that are present at any given time.

količinu krvnih sudova koji postoje u bilo kom trenutku.

It does this through an elaborate and elegant system of checks and balances,

A to čini jednim složenim

i elegantnim sistemom podele moći,

stimulators and inhibitors of angiogenesis,

stimulatorima i inhibitorima angiogeneze,

such that, when we need a brief burst of blood vessels,

tako da, kada su nam brzo potrebni krvni sudovi,

the body can do this by releasing stimulators,

telo to može da učini otpuštajući stimulatore,

proteins called angiogenic factors,

proteine koji se zovu angiogenski faktori

that act as natural fertilizer, and stimulate new blood vessels to sprout.

koji se ponašaju kao prirodno đubrivo

i stimulišu cvetanje novih krvnih sudova.

When those excess vessels are no longer needed,

I kada ti dodatni sudovi nisu više potrebni,

the body prunes them back to baseline,

telo ih smanji na osnovni nivo,

using naturally-occurring inhibitors of angiogenesis.

koristeći prirodne inhibitore angiogeneze.

There are other situations where we start beneath the baseline,

Postoje druge situacije kada polazimo ispod osnovnog nivoa,

kada nam je potrebno da proizvedemo više krvnih sudova da bismo se vratili na normalni nivo.

and we need to grow more blood vessels, just to get back to normal levels --

Na primer, posle povrede.

for example, after an injury --

Telo može i to da uradi,

and the body can do that too, but only to that normal level,

ali samo do normalnog nivoa,

that set point.

te određene tačke.

But what we now know, is that for a number of diseases,

Ali sada znamo da, kod nekih bolesti,

there are defects in the system,

postoje greške u sistemu,

where the body can't prune back extra blood vessels,

kada telo ne može da smanji višak krvnih sudova

or can't grow enough new ones in the right place at the right time.

ili ne može da proizvede nove

u pravo vreme na pravom mestu.

And in these situations, angiogenesis is out of balance.

U tim situacijama, angiogeneza

nije u ravnoteži.

And when angiogenesis is out of balance,

A kada je angiogeneza u neravnoteži,

a myriad of diseases result.

može se javiti bezbroj bolesti.

For example, insufficient angiogenesis -- not enough blood vessels --

Na primer, nedovoljna angiogeneza,

nedovoljno krvnih sudova,

leads to wounds that don't heal, heart attacks,

vodi do rana koje ne zarastaju, do srčanih udara,

legs without circulation, death from stroke,

nogu bez cirkulacije, smrti od moždanog udara,

nerve damage.

oštećenja nerava.

And on the other end, excessive angiogenesis --

S druge strane, preterana angiogeneza,

previše krvnih sudova, podstiče bolesti.

too many blood vessels -- drives disease,

and we see this in cancer, blindness,

To vidimo kod raka, slepila,

arthritis, obesity, Alzheimer's disease.

artritisa, gojaznosti,

Alchajmerove bolesti.

In total, there are more than 70 major diseases

Sve ukupno, postoji preko 70 ozbiljnih oboljenja

affecting more than a billion people worldwide,

koja muče više od milijardu ljudi širom sveta,

that all look on the surface to be different from one another,

koja na površini izgledaju kao da se razlikuju

ali zapravo im je

but all actually share abnormal angiogenesis

abnormalna angiogeneza

as their common denominator.

zajednički imenitelj.

And this realization is allowing us to re-conceptualize

I ovo otkriće nam omogućava

da preispitamo

the way that we actually approach these diseases,

način na koji prilazimo ovim bolestima,

by controlling angiogenesis.

tako što kontrolišemo angiogenezu.

Now, I'm going to focus on cancer,

Sad ću se koncentrisati na rak,

because angiogenesis is a hallmark of cancer --

jer angiogeneza je obeležje raka,

every type of cancer.

svakog tipa raka.

So here we go.

Dakle, evo.

This is a tumor: dark, gray, ominous mass growing inside a brain.

Ovo je tumor, tamna, siva, zlokobna masa

koja raste u jednom mozgu.

And under the microscope,

I pod mikroskopom možete videti

you can see hundreds of these brown-stained blood vessels,

stotine ovih braon krvnih sudova,

capillaries that are feeding cancer cells,

kapilara koji hrane ćelije raka,

bringing oxygen and nutrients.

donoseći kiseonik i hranljive materije.

But cancers don't start out like this,

Ali rak ne počinje na ovaj način.

and in fact, cancers don't start out with a blood supply.

Ustvari, rak ne počinje

dotokom krvi.

They start out as small, microscopic nests of cells,

Počinje kao mala, mikroskopska mreža ćelija

that can only grow to one half a cubic millimeter in size.

koja može da naraste do

veličine od samo pola kubnog milimetra.

That's the tip of a ballpoint pen.

To je vrh hemijske olovke.

Then they can't get any larger because they don't have a blood supply,

Onda ne može da naraste jer se ne snabdeva krvlju,

pa nema dovoljno kiseonika i hranljivih materija.

so they don't have enough oxygen or nutrients.

In fact, we're probably forming these microscopic cancers

Ustvari, verovatno svo vreme proizvodimo

ove mikroskopske rakove u našim telima.

all the time in our body.

Autopsy studies from people who died in car accidents

Izveštaji sa autopsija ljudi koji su poginuli u saobraćajnim nesrećama

have shown that about 40 percent of women between the ages of 40 and 50

pokazuju da oko 40 procenata žena

između 40 i 50 godina starosti

actually have microscopic cancers in their breasts.

zapravo ima mikroskopske

rakove u svojim grudima.

About 50 percent of men in their 50s and 60s

Oko 50% muškaraca u pedesetim i šezdesetim

have microscopic prostate cancers,

godinama ima mikroskopske rakove prostate.

and virtually 100 percent of us, by the time we reach our 70s,

I praktično 100% nas,

do vremena kada dođe u sedamdesete,

will have microscopic cancers growing in our thyroid.

imaće mikroskopske rakove u tiroidnoj žlezdi.

Yet, without a blood supply,

Ipak, bez snabdevanja krvlju,

most of these cancers will never become dangerous.

većina ovih tumora

nikada neće postati opasna.

Dr. Judah Folkman, who was my mentor

Dr Juda Folkman, koji je bio moj mentor

and who was the pioneer of the angiogenesis field,

i koji je pionir na polju angiogeneze,

once called this "cancer without disease."

jednom je ovo nazvao "rak bez bolesti".

So the body's ability to balance angiogenesis,

Znači sposobnost tela da balansira angiogenezu,

when it's working properly,

kada funkcioniše ispravno,

prevents blood vessels from feeding cancers.

sprečava krvne sudove da hrane rak.

And this turns out to be

Ispostavlja se da je ovo

one of our most important defense mechanisms

jedan od najvažnijih odbrambenih mehanizama

against cancer.

protiv raka.

In fact, if you actually block angiogenesis

Ustvari, ako blokirate angiogenezu

and prevent blood vessels from ever reaching cancer cells,

i sprečite krvne sudove da stignu do ćelija raka,

tumori jednostavno ne mogu da rastu.

tumors simply can't grow up.

But once angiogenesis occurs,

Ali kada nastane angiogeneza,

cancers can grow exponentially.

tumori mogu eksponencijalno da rastu.

And this is actually how a cancer goes from being harmless,

Ovo je način na koji

jedan rak od bezopasnog

to being deadly.

postaje smrtonosan.

Cancer cells mutate,

Ćelije raka mutiraju

and they gain the ability to release lots of those angiogenic factors,

i stiču sposobnost da otpuštaju

mnoge od ovih angiogenskih faktora, prirodnog đubriva,

natural fertilizer,

that tip the balance in favor of blood vessels invading the cancer.

koji remete ravnotežu u korist krvnih sudova

prodirući u rak.

And once those vessels invade the cancer,

I kada ti sudovi prodru u rak,

it can expand, it can invade local tissues,

on se širi i može da prodre u okolna tkiva.

and the same vessels that are feeding tumors

I isti krvni sudovi koji hrane tumore

allow cancer cells to exit into the circulation as metastases.

omogućavaju ćelijama raka da uđu u cirkulaciju

kao metastaze.

And unfortunately, this late stage of cancer

I nažalost, u ovoj kasnoj fazi raka

is the one at which it's most likely to be diagnosed,

se on najčešće

dijagnostikuje,

when angiogenesis is already turned on,

kada je angiogeneza uključena

and cancer cells are growing like wild.

i ćelije raka rastu kao lude.

So, if angiogenesis is a tipping point

Dakle, ako je angiogeneza

granica između

between a harmless cancer and a harmful one,

bezopasnog i opasnog raka,

then one major part of the angiogenesis revolution

onda je jedan veliki deo u revoluciji angiogeneze

is a new approach to treating cancer

novi pristup tretmanu raka,

by cutting off the blood supply.

prekidanjem snabdevanja krvlju.

We call this antiangiogenic therapy,

Ovo nazivamo terapijom antiangiogenezom

and it's completely different from chemotherapy,

i to je potpuno drugačije od hemoterapije

because it selectively aims

jer selektivno cilja

at the blood vessels that are feeding the cancers.

krvne sudove koji hrane rak.

We can do this because tumor blood vessels are unlike normal, healthy vessels

Ovo možemo da uradimo jer se

krvni sudovi tumora razlikuju od normalnih, zdravih

sudova koje vidimo na drugim mestima u telu.

we see in other places of the body --

they're abnormal, they're very poorly constructed,

Oni su abnormalni;

vrlo su slabo napravljeni

and because of that, they're highly vulnerable

i zbog toga su veoma osetljivi

to treatments that target them.

na tretmane koji ih ciljaju.

In effect, when we give cancer patients antiangiogenic therapy --

Kao rezultat toga, kada obolelima od raka

damo ovakvu terapiju -

here, an experimental drug for a glioma,

ovde, eksperimentalni lek za gliom,

which is a type of brain tumor --

koji je vrsta tumora na mozgu -

you can see that there are dramatic changes that occur

možete videti da se javljaju ozbiljne promene

when the tumor is being starved.

kada se tumor izgladnjuje.

Here's a woman with a breast cancer,

Ova žena ima rak dojke

being treated with the antiangiogenic drug called Avastin,

koji se tretira antiangiogenetskim lekom Avastinom,

which is FDA approved.

koji je odobrila administracija za hranu i lekove.

And you can see that the halo of blood flow

I možete videti da je oreol toka krvi

disappears after treatment.

nestao posle tretmana.

Well, I've just shown you two very different types of cancer

Dakle, upravo sam vam pokazao

dva veoma različita tipa raka

that both responded to antiangiogenic therapy.

koji su reagovali na antiangiogenetsku terapiju.

So a few years ago, I asked myself,

Pre nekoliko godina sam se zapitao,

"Can we take this one step further and treat other cancers,

"Možemo li ovo da odvedemo korak dalje,

i lečimo druge tumore,

even in other species?"

čak i kod drugih vrsta?"

So here is a nine year-old boxer named Milo,

Ovde je devetogodišnji bokser po imenu Majlo

who had a very aggressive tumor

koji je imao veoma agresivni tumor

called a malignant neurofibroma growing on his shoulder.

po imenu maligni neurofibrom, koji je rastao na njegovom ramenu.

It invaded into his lungs.

Prešao mu je na pluća.

His veterinarian only gave him three months to live.

Njegov veterinar mu je dao tri meseca života.

So we created a cocktail of antiangiogenic drugs

Mi smo napravili koktel antiangiogenetskih lekova

that could be mixed into his dog food,

koji mogu da se pomešaju s njegovom hranom,

as well as an antiangiogenic cream,

kao i antiangiogenetsku kremu

that could be applied on the surface of the tumor.

koja se može namazati na površinu tumora.

And within a few weeks of treatment,

I u okviru nekoliko nedelja tretmana

we were able to slow down that cancer's growth,

uspeli smo da usporimo rast tog raka

such that we were ultimately able to extend Milo’s survival

tako da smo na kraju mogli da produžimo Majlov život

to six times what the veterinarian had initially predicted,

za šest puta u odnosu na veterinarevu prognozu,

all with a very good quality of life.

i to uz veoma dobar kvalitet života.

And we've subsequently treated more than 600 dogs.

Nakon toga smo lečili više od 600 pasa.

We have about a 60 percent response rate,

Imamo oko 60% učinka

and improved survival for these pets

i poboljšanog opstanka ovih ljubimaca

that were about to be euthanized.

koji bi bili uspavani.

So let me show you a couple of even more interesting examples.

Pokazaću vam dva

još interesantnija primera.

This is 20-year-old dolphin living in Florida,

Ovo je dvadesetogodišnji delfin koji živi na Floridi,

and she had these lesions in her mouth

i ona je imala ove lezije u ustima

that, over the course of three years,

koje su se, tokom tri godine

developed into invasive squamous cell cancers.

razvile u invazivne, slojevite ćelije raka.

So we created an antiangiogenic paste.

Napravili smo antiangiogenetsku pastu.

We had it painted on top of the cancer three times a week.

Tri puta nedeljno smo je

nanosili na rak.

And over the course of seven months,

Tokom sedam meseci

the cancers completely disappeared,

rak je u potpunosti nestao,

and the biopsies came back as normal.

a rezultati biopsije bili su normalni.

Here's a cancer growing on the lip

Ovde je rak koji raste na usni

of a Quarter Horse named Guinness.

jednog trkačkog konja koji se zove Ginis.

It's a very, very deadly type of cancer called an angiosarcoma.

To je veoma, veoma smrtonosna vrsta raka po imenu angiosarkom.

It had already spread to his lymph nodes,

Već se proširio na njegove limfne čvorove,

so we used an antiangiogenic skin cream for the lip,

tako da smo koristili kremu za usnu,

and the oral cocktail, so we could treat from the inside as well as the outside.

kao i koktel, kako bismo ga lečili iznutra

i spolja.

And over the course of six months,

I u roku od šest meseci

he experienced a complete remission.

potpuno se oporavio.

And here he is six years later,

A evo ga šest godina posle,

Guinness, with his very happy owner.

Ginis, sa svojim srećnim vlasnikom.

(Applause)

(aplauz)

Now obviously, antiangiogenic therapy could be used for a wide range of cancers.

Očigledno da se antiangiogenetska terapija

može koristiti za razne vrste tumora.

And in fact, the first pioneering treatments

Ustvari, prva pionirska lečenja,

for people as well as dogs,

namenjena ljudima kao i životinjama,

are already becoming available.

već postaju dostupna.

There are 12 different drugs, 11 different cancer types.

Postoji 12 različitih lekova, 11 različitih vrsta raka,

But the real question is:

ali pravo pitanje je:

How well do these work in practice?

koliko su oni dobri u praksi?

So here's actually the patient survival data

Evo podataka o izlečenim pacijentima

from eight different types of cancer.

od osam različitih vrsta raka.

The bars represent survival time

Ovi podaci predstavljaju vreme preživljavanja

taken from the era in which there was only chemotherapy,

koje je uzeto iz ere

kada su bile dostupne samo

or surgery, or radiation available.

hemoterapija ili operacija ili radijacija.

But starting in 2004,

Ali počevši od 2004.

when antiangiogenic therapies first became available,

kada su prve antioangiogenetske terapije postale dostupne,

možete videti da je

you can see that there has been a 70 to 100 percent improvement in survival

za 70 do 100 procenata

povećano preživljavanje

for people with kidney cancer, multiple myeloma,

za ljude sa rakom bubrega, višestrukim mijelomima,

colorectal cancer, and gastrointestinal stromal tumors.

kolorektalnim rakom i gastrointestinalnim stromalnim tumorom.

That's impressive.

To je impresivno.

But for other tumors and cancer types,

Ali za druge tumore i vrste raka

the improvements have only been modest.

poboljšanja su skromna.

So I started asking myself,

Tako sam se zapitao,

"Why haven't we been able to do better?"

"Zašto nismo uspeli da postignemo više?"

And the answer, to me, is obvious:

A odgovor je, po meni, očigledan;

we're treating cancer too late in the game,

lečimo rak prekasno,

when it's already established,

kada se već smesti

and oftentimes, it's already spread or metastasized.

i često, već se i raširio i metastazirao.

And as a doctor,

I kao doktor, ja znam da,

I know that once a disease progresses to an advanced stage,

kada bolest uznapreduje,

achieving a cure can be difficult, if not impossible.

postizanje izlečenja

može biti teško, ako ne i nemoguće.

So I went back to the biology of angiogenesis, and started thinking:

Onda sam se vratio na biologiju

angiogeneze

i počeo da razmišljam:

Could the answer to cancer be preventing angiogenesis,

da li bi lek za rak

mogla da bude prevencija angiogeneze,

beating cancer at its own game,

pobeda raka u njegovoj igri

so the cancers could never become dangerous?

tako da rak nikada ne postane opasan?

This could help healthy people,

Ovo bi moglo da pomogne zdravim ljudima

as well as people who've already beaten cancer once or twice,

kao i onima koji su već pobedili rak

jednom ili dva puta

and want to find a way to keep it from coming back.

i žele da nađu način da se on ne vrati.

So to look for a way to prevent angiogenesis in cancer,

Dakle, da bih pronašao način da sprečim angiogenezu kod raka,

I went back to look at cancer's causes.

vratio sam se na uzroke raka.

And what really intrigued me,

I ono što me je stvarno kopkalo,

was when I saw that diet accounts for 30 to 35 percent

je kad sam video da ishrana

učestvuje sa 30 do 35%

of environmentally-caused cancers.

u rakovima koji uzrok imaju u okruženju.

Now the obvious thing is to think about what we could remove from our diet,

Sad, očigledno bi bilo da razmišljamo

o tome šta bismo mogli da izbacimo iz ishrane, da smanjimo.

what to strip out, take away.

But I actually took a completely opposite approach,

Ali ja sam imao potpuno suprotan pristup

and began asking: What could we be adding to our diet

i počeo da pitam: šta bismo mogli da dodamo našoj ishrani

that's naturally antiangiogenic,

što je prirodno antiangiogenetsko,

and that could boost the body's defense system,

što bi moglo da ojača odbrambeni sistem tela

and beat back those blood vessels that are feeding cancers?

i pobedi te krvne sudove koji hrane rak?

In other words, can we eat to starve cancer?

Drugim rečima, možemo li da jedemo da bismo izgladneli rak?

(Laughter)

Pa, odgovor je da.

Well, the answer is yes, and I'm going to show you how.

I pokazaću vam kako.

And our search for this has taken us to the market,

Naše istraživanje ovoga

odvelo nas je na pijacu, na farmu i među začine,

the farm and to the spice cabinet,

because what we've discovered

jer otkrili smo

is that Mother Nature has laced a large number

da nam je majka priroda podarila veliki broj

of foods and beverages and herbs

hrane i pića i bilja

with naturally-occurring inhibitors of angiogenesis.

koja sadrže prirodne inhibitore

angiogeneze.

Here's a test system we developed.

Evo sistema za test koji smo razvili.

At the center is a ring

U centru je krug iz kog stotine krvnih sudova

from which hundreds of blood vessels are growing out in a starburst fashion.

polaze u obliku zvezde.

Možemo koristiti ovaj sistem

And we can use this system to test dietary factors

za testiranje hranljivih faktora

at concentrations that are obtainable by eating.

u koncentracijama koje se dobijaju putem jela.

Let me show you what happens

Pokazaću vam šta se dešava kada stavimo

when we put in an extract from red grapes.

ekstrakt crnog grožđa.

The active ingredient is resveratrol,

Aktivni sastojak je resveratrol.

it's also found in red wine.

Može se naći i u crnom vinu.

This inhibits abnormal angiogenesis,

Ovo inhibira abnormalnu angiogenezu

by 60 percent.

za 60 procenata.

Here's what happens when we added an extract from strawberries.

Evo šta se dešava kada dodamo ekstrakt jagoda.

It potently inhibits angiogenesis.

To veoma moćno inhibira angiogenezu.

And extract from soybeans.

I ekstrakt soje.

And here is a growing list

A evo i naše rastuće liste

of antiangiogenic foods and beverages that we're interested in studying.

antiangiogenetskih pića i hrane

koje želimo da proučimo.

For each food type,

I mislimo da za svaku vrstu

we believe that there are different potencies

hrane postoje različite snage

within different strains and varietals.

u okviru različitih vrsta i varijacija.

And we want to measure this because,

I ovo želimo da merimo jer,

well, while you're eating a strawberry

pa, kad jedete jagode

or drinking tea,

ili pijete čaj,

why not select the one that's most potent

zašto ne biste izabrali onaj koji je najjači

for preventing cancer?

u prevenciji raka.

So here are four different teas that we've tested.

Evo četiri različita čaja koja smo testirali.

They're all common ones: Chinese jasmine, Japanese sencha,

Oni su svi uobičajeni,

kineski jasmin, vrsta japanskog zelenog čaja,

Earl Grey and a special blend that we prepared,

Earl Grey i posebna mešavina koju smo mi pripremili.

and you can see clearly that the teas vary in their potency,

I jasno možete videti

da čajevi varijaju u snazi

from less potent to more potent.

od manje snažnog do snažnijeg.

Ali ono što je super

But what's very cool

is when we combine the two less potent teas together,

je kad smo pomešali dva

manje snažna čaja,

the combination, the blend, is more potent than either one alone.

ta kombinacija, mešavina,

snažnija je od oba čaja posebno.

This means there's food synergy.

To znači da postoji sinergija hrane.

Here's some more data from our testing.

Evo još nekih podataka iz naših testiranja.

Now in the lab, we can simulate tumor angiogenesis,

E sad, u laboratoriji simuliramo angiogenezu tumora,

represented here in a black bar.

što je prikazano crnim stupcem.

And using this system, we can test the potency of cancer drugs.

Koristeći ovaj sistem možemo da testiramo snagu lekova protiv raka.

So the shorter the bar,

Dakle, kraći stubac,

the less angiogenesis -- that's good.

manje angiogeneze, to je dobro.

And here are some common drugs

A evo i nekih uobičajenih lekova

that have been associated with reducing the risk of cancer in people.

za koje se smatra da smanjuju rizik

od raka kod ljudi.

Statins, nonsteroidal anti-inflammatory drugs,

Statini, antizapaljenski lekovi bez steroida,

i još neki,

and a few others -- they inhibit angiogenesis, too.

oni takođe inhibiraju angiogenezu.

And here are the dietary factors

A evo i faktora ishrane

going head-to-head against these drugs.

koji idu rame uz rame sa ovim lekovima.

You can see they clearly hold their own,

Možete videti da oni očigledno imaju svoje,

and in some cases, they're more potent than the actual drugs.

a u nekim slučajevima su i jači

od običnih lekova.

Soy, parsley, garlic, grapes, berries.

Soja, peršun, beli luk,

grožđe, bobice,

I could go home and cook a tasty meal using these ingredients.

mogao bih da odem kući i skuvam ukusan

obrok sa ovim sastojcima.

Imagine if we could create the world's first rating system,

Zamislite da možemo da napravimo

prvi sistem da ocenjivanje hrane

in which we could score foods

gde bismo mogli da bodujemo hranu

according to their antiangiogenic, cancer-preventative properties.

prema tome kolika su im antiangiogenetska

i svojstva koja preveniraju rak.

And that's what we're doing right now.

I to ćemo upravo sada da uradimo.

Now, I've shown you a bunch of lab data,

Sad, pokazao sam vam gomilu podataka iz laboratorije,

and so the real question is:

a pravo pitanje je:

What is the evidence in people

kakvi su dokazi na ljudima,

that eating certain foods can reduce angiogenesis in cancer?

da konzumiranje određene hrane može smanjiti

angiogenezu kod raka?

Well, the best example I know

Pa, najbolji primer koji znam

is a study of 79,000 men followed over 20 years,

je studija o 79.000 muškaraca

koji su praćeni preko 20 godina,

in which it was found that men who consumed cooked tomatoes

u kojoj je utvrđeno da je muškarcima koji

su konzumirali kuvani paradajz dva do tri

two to three times a week,

had up to a 50 percent reduction

puta nedeljno, rizik od razvijanja raka

in their risk of developing prostate cancer.

prostate bio smanjen za 50%.

Now, we know that tomatoes are a good source of lycopene,

Sad, znamo da je paradajz dobar izvor likopena,

and lycopene is antiangiogenic.

a likopen je antiangiogenetski.

But what's even more interesting from this study,

Ali ono što je iz ove studije još interesantnije

is that in those men who did develop prostate cancer,

je da oni muškarci kod kojih se ipak razvio rak prostate,

those who ate more servings of tomato sauce,

oni koji su jeli više porcija paradajz sosa,

actually had fewer blood vessels feeding their cancer.

oni su imali manje krvnih sudova

koji su hranili rak.

So this human study is a prime example

Dakle ova ljudska studija je glavni primer

of how antiangiogenic substances present in food and consumed at practical levels,

toga kakav uticaj antiangiogenetske supstance,

koje su prisutne u hrani i konzumiraju se u praktičnim količinama,

can have an impact on cancer.

mogu imati na rak.

And we're now studying the role of a healthy diet --

A sada proučavamo

ulogu zdrave ishrane

with Dean Ornish at UCSF and Tufts University --

sa Dinom Ornišem i kalifornijskim i Tufts univerzitetom,

the role of this healthy diet on markers of angiogenesis

ulogu ove zdrave ishrane na markere angiogeneze

that we can find in the bloodstream.

koje možemo da pronađemo u krvotoku.

Obviously, what I've shared with you has some far-ranging implications,

Sad, očigledno da ovo što sam podelio s vama ima neke široke implikacije,

even beyond cancer research.

čak i dalje od proučavanja raka.

Because if we're right, it could impact consumer education,

Jer ako smo u pravu, to bi moglo uticati na obrazovanje potrošača,

food services, public health

restorane, javno zdravlje,

and even the insurance industry.

čak i na industriju osiguranja.

And in fact, some insurance companies

Zapravo, neke osiguravajuće kompanije

are already beginning to think along these lines.

već počinju da razmišljaju u skladu sa ovim.

Check out this ad from BlueCross BlueShield of Minnesota.

Pogledajte ovaj oglas iz Blue Cross Blue Shield iz Minesote.

For many people around the world,

I za mnoge ljude širom sveta

dietary cancer prevention may be the only practical solution,

prevencija raka ishranom

može biti jedino praktično rešenje

because not everybody can afford expensive end-stage cancer treatments,

jer ne mogu svi da priušte skupa lečenja

but everybody could benefit from a healthy diet

ali svi mogu imati koristi od

zdrave ishrane koja se zasniva na lokalnim, održivim

based on local, sustainable, antiangiogenic crops.

antiangiogenetskim usevima.

Now, finally,

Sada, konačno,

I've talked to you about food,

pričam o hrani,

and I've talked to you about cancer,

pričam vam i o raku,

so there's just one more disease that I have to tell you about,

ali ima još samo jedna bolest o kojoj moram da vam ispričam,

and that's obesity.

a to je gojaznost.

Because it turns out that adipose tissue -- fat --

Ispostavlja se da

masno tkivo, salo,

is highly angiogenesis-dependent.

veoma zavisi od angiogeneze.

And like a tumor, fat grows when blood vessels grow.

I kao i tumor, salo se širi kad se krvni sudovi množe.

So the question is:

Znači pitanje je: možemo li da smanjimo salo

Can we shrink fat by cutting off its blood supply?

tako što ćemo mu prekinuti dotok krvi?

The top curve shows the body weight of a genetically obese mouse

Gornja krivulja pokazuje telesnu masu

genetski gojaznog miša

that eats nonstop until it turns fat,

koji neprekidno jede,

dok se ne pretvori u ovakvu krznenu tenisku lopticu.

like this furry tennis ball.

(Laughter)

And the bottom curve is the weight of a normal mouse.

A donja krivulja je težina normalnog miša.

If you take the obese mouse

Ako uzmete gojaznog miša i date mu

and give it an angiogenesis inhibitor, it loses weight.

inhibitor antiangiogeneze, on izgubi na težini.

Stop the treatment, gains the weight back. Restart the treatment, loses the weight.

Prekinete tretman, opet se ugoji.

Ponovo počnete tretman, opet izgubi na težini.

Stop the treatment, it gains the weight back.

Prekinete tretman, opet se ugoji.

And, in fact, you can cycle the weight up and down

I ustvari, možete da menjate težinu gore dole

samo inhibiranjem angiogeneze.

simply by inhibiting angiogenesis.

So this approach that we're taking for cancer prevention

Znači ovaj pristup koji imamo za prevenciju raka

may also have an application for obesity.

možda može da se primeni

i na gojaznost.

The truly interesting thing about this

Stvarno veoma interesantna stvar u vezi s ovim

is that we can't take these obese mice

je da ne možemo gojaznom mišu

and make them lose more weight

smanjiti težinu više

than what the normal mouse's weight is supposed to be.

nego što bi trebala da bude težina normalnog miša.

In other words, we can't create supermodel mice.

Drugim rečima, ne možemo napraviti miševe super modele.

(smeh)

(Laughter)

And this speaks to the role of angiogenesis

I to govori o ulozi angiogeneze

in regulating healthy set points.

u regulaciji zdravih vrednosti.

Albert Szent-Györgi once said,

Albert Snet-Đerđ je jednom rekao da se

"Discovery consists of seeing what everyone has seen,

"Otkriće sastoji u tome da vidimo ono što svi vide,

and thinking what no one has thought."

i da mislimo da ono što niko nije mislio."

I hope I've convinced you

Nadam se da sam vas ubedio

that for diseases like cancer, obesity and other conditions,

da, kod bolesti kao što su rak, gojaznost i neke druge,

there may be a great power

može biti veoma moćno

in attacking their common denominator: angiogenesis.

da se napadne njihov zajednički imenitelj, angiogeneza.

And that's what I think the world needs now.

I to je ono što ja mislim da je svetu potrebno sada. Hvala.

Thank you.

(Applause)

(aplauz)

June Cohen: I have a quick question for you.

Džun Koen: Dakle ovi lekovi nisu -

JC: So these drugs aren't exactly in mainstream cancer treatments right now.

oni nisu deo rasprostranjenog lečenja raka u ovom trenutku.

For anyone out here who has cancer, what would you recommend?

Za nekoga ko ima rak,

šta biste preporučili?

Do you recommend pursuing these treatments now, for most cancer patients?

Da li preporučujete, većini obolelih od raka, da traže ove tretmane?

Vilijam Li: Postoje antiangiogenetski lekovi

William Li: There are antiangiogenic treatments

koje je odobrila administracija za lekove.

that are FDA approved,

and if you're a cancer patient,

I ako ste oboleli od raka,

or working for one or advocating for one, you should ask about them.

ili radite za nekog ili zastupate nekog ko jetse,

trebalo bi da ih tražite.

And there are many clinical trials.

Postoji i mnogo kliničkih proba.

The Angiogenesis Foundation is following almost 300 companies,

Fondacija Angiogeneze prati skoro 3000 kompanija,

and there are about 100 more drugs in that pipeline.

a postoji još oko 100

lekova u najavi.

So, consider the approved ones,

Dakle razmislite o postojećim,

look for clinical trials,

tražite kliničke probe,

but then between what the doctor can do for you,

ali između onoga što lekari mogu da učine za vas,

we need to start asking what can we do for ourselves.

moramo početi da se pitamo šta možemo da učinimo za sebe.

Ovo je jedna od tema o kojima pričam,

This is one of the themes I'm talking about:

možemo se osnažiti da uradimo one stvari

We can empower ourselves

to do the things that doctors can't do for us,

koje lekari ne mogu da urade za nas,

which is to use knowledge and take action.

a to je da iskoristimo znanje i krenemo u akciju.

And if Mother Nature has given us some clues,

I ako nam je majka priroda dala neke znake,

we think there might be a new future in the value of how we eat,

mislimo da se nova budućnost možda

nalazi u vrednosti onoga što jedemo.

and what we eat is really our chemotherapy three times a day.

A ono što jedemo jeste naša hemoterapija tri puta dnevno.

JC: Right. And along those lines,

DžK: Dobro. Detaljije,

for people who might have risk factors for cancer,

da li biste ljudima koji imaju faktor rizika

would you recommend pursuing any treatments prophylactically,

od raka preporučili neke preventivne tretmane

or simply pursuing the right diet,

ili samo da istraju u zdravoj ishrani

with lots of tomato sauce?

sa mnogo paradajz sosa?

WL: Well, you know, there's abundant epidemiological evidence,

VL: Pa, znate, postoje bogati epidemiološki dokazi.

and I think in the information age,

I mislim da, u informatičkom vremenu,

it doesn't take long to go to a credible source like PubMed,

nije potrebno mnogo da se ode do pouzdanog izvora,

kao što su Pubmed, Nacionalna medicinska biblioteka,

the National Library of Medicine,

to look for epidemiological studies for cancer risk reduction

i da se potraže epidemiološke studije

o smanjenju rizika od raka

based on diet and based on common medications.

na osnovu ishrane i na osnovu uobičajenih lekova.

And that's certainly something that anybody can look into.

A to je svakako nešto što svako može da vidi.

JC: Okay. Well, thank you so much.

DžK: Okej. Pa, hvala Vam mnogo.

(Applause)

(aplauz)