Can we eat to starve cancer? | William Li

譯者: Ching-Yi Wu 審譯者: Lin Su-Wei(林書暐)

Good afternoon.

午安

There's a medical revolution happening all around us,

有項醫學上的變革正在我們身邊發生

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

這將幫助我們克服

some of society's most dreaded conditions,

社會最憂慮的部份狀況

including cancer.

包括癌症

The revolution is called angiogenesis,

這項變革被稱做血管新生

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

也就是在我們體內

血管生長的過程

So why should we care about blood vessels?

為什麼我們得在乎血管呢？

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

因為，我們的身上到處都是血管

60,000 miles worth in a typical adult.

將一位標準體型的成人體內所有的血管

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

頭尾相連，能連成一條長度約十萬公里

可繞地球整整兩圈的直線

The smallest blood vessels are called capillaries.

最小的血管被稱做微血管

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

我們體內約有190億條微血管

And these are the vessels of life,

微血管是生之徑

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

同時，如我將展示給各位看的

它們也可以是死之徑

Now, the remarkable thing about blood vessels

微血管有個驚人之處：

is that they have this ability

它們能因應不同的生長環境

to adapt to whatever environment they're growing in.

出現不同的形式

比如說：在肝臟裡

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

微血管是讓血液解毒的管道

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

在肺臟裡則形成氣囊幫助氣體交換

In muscle, they corkscrew,

在肌肉中以如軟木塞開瓶器的形狀排列

so that muscles can contract without cutting off circulation.

這樣在肌肉收縮時，血液循環也不會中斷

And in nerves, they course along like power lines,

在神經中，微血管蜿蜒如電線

keeping those nerves alive.

維持神經細胞的活力

We get most of these blood vessels

我們身上大部分的血管

when we're actually still in the womb.

是在胎兒時期就長出來的

也就是說，在正常情況下

And what that means is that as adults,

blood vessels don't normally grow.

成人身上的血管不會自發地生長

Except in a few special circumstances.

某些特別的情況則是例外

In women, blood vessels grow every month,

每個月，女人的子宮裡

to build the lining of the uterus.

血管會增生形成內膜

During pregnancy, they form the placenta,

懷孕時，子宮內膜將演變成胎盤

which connects mom and baby.

也就是母親和寶寶間的連結

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

我們受傷時，在傷疤下

血管會不斷生長

in order to heal a wound.

來幫助傷口癒合

And this is actually what it looks like,

這是血管的真實樣貌

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

數以百計的微血管

全都長在傷口的中間

So the body has the ability to regulate

可見，我們的身體在任何時候

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

都有調節全身血管數量的能力

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

身體藉著計畫完善精良的調控系統

來維持那些控制血管新生的

stimulators and inhibitors of angiogenesis,

刺激物或是抑制物間的平衡

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

也就是說，若是在短時間內需要大量血管

the body can do this by releasing stimulators,

體內會釋放血管新生的刺激物

proteins called angiogenic factors,

這是一種被稱為血管新生因子的蛋白質

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

就像我們體內的天然肥料一般

能刺激新血管的萌發

When those excess vessels are no longer needed,

若是體內不再需要這樣過量的血管

the body prunes them back to baseline,

身體就會藉著自然釋放的血管新生抑制因子

using naturally-occurring inhibitors of angiogenesis.

讓血管新生速度降到基準值

There are other situations where we start beneath the baseline,

而在其他需要比基準速度更低的血管新生

的情況，這時我們就得讓血管生長回到正常值

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

像是受傷後

for example, after an injury --

我們體內的血管先大量增生

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

再降到健康時的正常數量

that set point.

也就是身體設定好的正常值

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

但現在我們知道，就有些疾病而言

there are defects in the system,

這個控制血管生長的系統有缺陷

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

身體沒辦法減低過量的血管

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

或是沒辦法讓新生血管

出現在正確的時間或是位置

And in these situations, angiogenesis is out of balance.

這樣的情況就是

血管新生失去平衡

And when angiogenesis is out of balance,

而血管新生失去平衡

a myriad of diseases result.

是非常嚴重的疾病

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

比方說，血管新生不夠

體內就不會有足夠的血管

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

這樣傷口不會癒合、心肌梗塞

legs without circulation, death from stroke,

足部血液循環不良、因為中風死亡

nerve damage.

或是傷害神經

And on the other end, excessive angiogenesis --

相反的，過多的血管新生

會讓體內有過多的血管，也會造成疾病

too many blood vessels -- drives disease,

and we see this in cancer, blindness,

如癌症、失明

arthritis, obesity, Alzheimer's disease.

關節炎、肥胖

阿茲海默症

In total, there are more than 70 major diseases

總的來說，有70多種疾病

affecting more than a billion people worldwide,

正影響著世界上十億人口

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

它們表面上看起來毫無關係

但事實上，這些疾病

but all actually share abnormal angiogenesis

都以異常血管新生

as their common denominator.

為共同特徵

And this realization is allowing us to re-conceptualize

明白這一點

能讓我們重新思考

the way that we actually approach these diseases,

如何藉著控制血管新生

by controlling angiogenesis.

來治療這些疾病的確切方法

Now, I'm going to focus on cancer,

現在，我將重點放在癌症

because angiogenesis is a hallmark of cancer --

因為無論是哪一種癌症

every type of cancer.

都以血管新生為重要特徵

So here we go.

好，我們來談談癌症

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

這是一個腫瘤。一團深灰色、

看來不妙的細胞團在腦中生長

And under the microscope,

在顯微鏡下，你可以看見

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

數以百計如這樣被染成褐色的血管

capillaries that are feeding cancer cells,

或是正在餵養癌細胞的微血管

bringing oxygen and nutrients.

將氧氣或是養份帶給它們

But cancers don't start out like this,

然而，腫瘤一開始不是這樣

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

事實上，腫瘤一開始

沒有血液供給

They start out as small, microscopic nests of cells,

原初的腫瘤是顯微鏡下的小細胞群

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

它們頂多長成

半立方毫米大小

That's the tip of a ballpoint pen.

大概是是筆尖大小

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

這些腫瘤長不大就是因為它們沒有血液供給

也就沒有足夠的氧氣和養分

so they don't have enough oxygen or nutrients.

In fact, we're probably forming these microscopic cancers

事實上，我們的體內可能

隨時都在形成這些微腫瘤

all the time in our body.

Autopsy studies from people who died in car accidents

對因癌症而死的病人進行的病理解剖顯示

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

在40到50歲的女性裡

有百分之40的人

actually have microscopic cancers in their breasts.

的確有這樣的微腫瘤

存在於乳房內

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

年約50到60歲的男性

have microscopic prostate cancers,

其中50%於攝護腺裡有微腫瘤

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

我們到了70歲以後

百分之百的人

will have microscopic cancers growing in our thyroid.

甲狀腺裡有生長中的微腫瘤

Yet, without a blood supply,

然而，在沒有血液供給的情況下

most of these cancers will never become dangerous.

大部分這樣的微腫瘤

是不會變得有害的

Dr. Judah Folkman, who was my mentor

我的導師，佛克曼醫師

and who was the pioneer of the angiogenesis field,

同時也是血管新生研究的先驅者

once called this "cancer without disease."

曾經說這些微腫瘤是「非病腫瘤」

So the body's ability to balance angiogenesis,

因此，我們的身體有平衡血管新生的能力

when it's working properly,

當這樣的能力運作良好

prevents blood vessels from feeding cancers.

就能避免血管餵養癌症生長

And this turns out to be

這樣的機制也就變成

one of our most important defense mechanisms

我們體內最重要抵抗癌症的

against cancer.

防禦機轉之一

In fact, if you actually block angiogenesis

事實上，當你能確實阻斷血管新生

and prevent blood vessels from ever reaching cancer cells,

讓血管永遠無法和癌細胞接觸

腫瘤就不會生長

tumors simply can't grow up.

But once angiogenesis occurs,

然而，一旦腫瘤周圍出現血管新生

cancers can grow exponentially.

它們就能以倍數成長

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

這就是腫瘤

如何從無害變得

to being deadly.

有害的實情

Cancer cells mutate,

癌細胞突變

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

並且釋放許多

跟血管新生有關的物質

natural fertilizer,

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

這些天然肥料會刺激血管生長

進入腫瘤組織

And once those vessels invade the cancer,

一旦血管進入腫瘤

it can expand, it can invade local tissues,

腫瘤就能擴張，侵犯周邊的組織

and the same vessels that are feeding tumors

在血管餵養腫瘤的同時

allow cancer cells to exit into the circulation as metastases.

腫瘤也得以進入循環系統

這就是所謂的轉移

And unfortunately, this late stage of cancer

當血管已經開始生長

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

腫瘤就會瘋狂地增生

而不幸的，在這個癌症發展的

when angiogenesis is already turned on,

最後階段，轉移癌是

and cancer cells are growing like wild.

幾乎不可能被診斷的

So, if angiogenesis is a tipping point

所以，如果血管新生

是從無害的微腫瘤轉變成

between a harmless cancer and a harmful one,

有害的癌症的關鍵點

then one major part of the angiogenesis revolution

那麼，這個血管新生革命的主要部份

is a new approach to treating cancer

就是藉著切斷血液供給

by cutting off the blood supply.

來治療癌症的新方法

We call this antiangiogenic therapy,

我們稱之為抗血管新生治療

and it's completely different from chemotherapy,

這跟化療完全不同

because it selectively aims

因為這個療法選擇性地瞄準

at the blood vessels that are feeding the cancers.

供應腫瘤養份的血管

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

之所以能這麼做，是因為

腫瘤的血管跟一般健康的

在身體其他部分的血管不同

we see in other places of the body --

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

腫瘤的血管異常之處

在於它們的結構脆弱

and because of that, they're highly vulnerable

因此，這類血管對專門來

to treatments that target them.

對付它們的藥物很敏感

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

臨床上，當我們在癌症病人身上

施以對抗血管新生的藥物

here, an experimental drug for a glioma,

像是這個治療神經膠細胞瘤的實驗性藥物

which is a type of brain tumor --

神經膠細胞瘤是一種腦瘤

you can see that there are dramatic changes that occur

我們可以在病人身上看到

when the tumor is being starved.

當腫瘤不再有養分時產生的顯著變化

Here's a woman with a breast cancer,

這是一位有乳癌的女士

being treated with the antiangiogenic drug called Avastin,

她接受美國食品藥物管理局核准的

which is FDA approved.

血管新生藥物Avastin的治療

And you can see that the halo of blood flow

如你所見，這區血流在治療後

disappears after treatment.

即消失不見

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

我剛剛已經告訴妳們

抗血管新生藥物對

that both responded to antiangiogenic therapy.

兩種癌症有效

So a few years ago, I asked myself,

所以，幾年前，我自問

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

我們能夠更進一步

用這種藥來治療其他癌症嗎

even in other species?"

甚至是其他物種的癌症

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

這是一隻九歲大的鬥牛犬，Milo

who had a very aggressive tumor

牠的肩膀有個惡性神經纖維瘤

called a malignant neurofibroma growing on his shoulder.

這是一種極具侵入性的腫瘤

It invaded into his lungs.

已經進入牠的肺臟

His veterinarian only gave him three months to live.

獸醫認為牠只有三個月可活

So we created a cocktail of antiangiogenic drugs

因此，我們做了可以混在牠食物中的

that could be mixed into his dog food,

抗血管新生藥物的雞尾酒配方

as well as an antiangiogenic cream,

跟可以塗抹在腫瘤表面的

that could be applied on the surface of the tumor.

抗血管新生藥物乳霜

And within a few weeks of treatment,

在數個星期的治療後

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

我們得以減緩腫瘤的生長

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

最終得以延長Milo的壽命

to six times what the veterinarian had initially predicted,

達獸醫預測的時間六倍長之久

all with a very good quality of life.

生活品質也很好

And we've subsequently treated more than 600 dogs.

接著我們治療了其他600多隻狗

We have about a 60 percent response rate,

其中大概有60%的治療率

and improved survival for these pets

也能增加那些將被安樂死的

that were about to be euthanized.

寵物的壽命

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

接著，讓我向你們報告

幾個更有趣的病例

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

這是一隻20歲，生活在佛州的海豚

and she had these lesions in her mouth

牠的口裡有些

that, over the course of three years,

出現大概3年多的病灶

developed into invasive squamous cell cancers.

漸漸形成侵入性的鱗狀上皮癌

So we created an antiangiogenic paste.

為此，我們做了抗血管生成的藥糊

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

塗抹在病灶上

每個星期三次

And over the course of seven months,

經過七個禮拜的療程後

the cancers completely disappeared,

上皮癌完全消失了

and the biopsies came back as normal.

切片的結果也正常

Here's a cancer growing on the lip

這是一隻名叫Guiness的奎特馬

of a Quarter Horse named Guinness.

牠嘴唇上的腫瘤

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

是一種非常非常致命的腫瘤，血管肉瘤

It had already spread to his lymph nodes,

已經侵犯到牠的淋巴結

so we used an antiangiogenic skin cream for the lip,

我們用了能抹在嘴唇上的抗血管新生的藥膏

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

跟口服的雞尾酒藥物

讓治療得以內用跟外服雙管齊下

And over the course of six months,

經過6個月的療程

he experienced a complete remission.

腫瘤完全消失了

And here he is six years later,

這是Guiness接受治療後6年

Guinness, with his very happy owner.

跟飼主快樂的合照

(Applause)

（掌聲）

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

現在，顯然的，抗血管新生藥物

能被廣泛的運用在各種癌症的治療上

And in fact, the first pioneering treatments

事實上，第一個於人類

for people as well as dogs,

跟於狗身上的前驅治療

are already becoming available.

已經可以取得

There are 12 different drugs, 11 different cancer types.

總共有12種藥物，用來治療11種癌症

But the real question is:

但真正的問題是

How well do these work in practice?

這些藥物的實際成效如何？

So here's actually the patient survival data

數據為8種不同癌症

from eight different types of cancer.

患者的存活時間

The bars represent survival time

柱狀圖為

taken from the era in which there was only chemotherapy,

僅有化療

手術或是放射線治療時的

or surgery, or radiation available.

患者存活時間

But starting in 2004,

從2004年

when antiangiogenic therapies first became available,

抗血管新生藥物出現在市面上

你可以注意到

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

腎臟癌、多發性硬化症

大腸癌和胃腸道基質腫瘤等

for people with kidney cancer, multiple myeloma,

癌症患者的存活時間

colorectal cancer, and gastrointestinal stromal tumors.

增加了70-100%

That's impressive.

非常令人印象深刻

But for other tumors and cancer types,

但是其它的腫瘤或癌症

the improvements have only been modest.

僅有一般程度的增加

So I started asking myself,

因此，我自問

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

為什麼這些癌症的治療不能更好

And the answer, to me, is obvious:

而答案，對我來說，很顯然的

we're treating cancer too late in the game,

是因為我們太晚開始治療

when it's already established,

當腫瘤已經生成

and oftentimes, it's already spread or metastasized.

往往就已經擴散或是轉移

And as a doctor,

身為一名醫師，我明白

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

一但疾病進程惡化

achieving a cure can be difficult, if not impossible.

即使得治

治療將變得困難

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

讓我們回到

血管生成的生物學

開始這樣想

Could the answer to cancer be preventing angiogenesis,

是否癌症治療

有賴於從癌症發生本身下手

beating cancer at its own game,

藉著預防血管新生

so the cancers could never become dangerous?

讓癌症不至於變得危險？

This could help healthy people,

這能幫助健康人

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

跟已經擊敗過癌症

一兩次的病人

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

還有想找出方法不讓癌症復發的人

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

為了藉由預防癌組織的血管新生，來走出一條新路

I went back to look at cancer's causes.

我回到癌症生成的原因

And what really intrigued me,

真正啟發我的是

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

當我注意到

飲食佔了引起癌症因子中

of environmentally-caused cancers.

30-35%的比重時

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

最明顯不過的想法應是

想想我們可以移除、去掉或是不吃哪些食物

what to strip out, take away.

But I actually took a completely opposite approach,

但是，我用的是完全相反的法子

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

我開始自問，我們能在飲食中

that's naturally antiangiogenic,

加入哪些能抗血管新生的食物

and that could boost the body's defense system,

來刺激體內的防禦系統

and beat back those blood vessels that are feeding cancers?

反擊那些餵養癌細胞的血管？

In other words, can we eat to starve cancer?

也就是說，我們能藉著吃來餓壞癌症嗎？

(Laughter)

這問題的答案為：是的

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

我將告訴你們，這該如何辦到

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

而我們在這方面的研究

帶著我們到了市場、農場跟香料櫃

the farm and to the spice cabinet,

because what we've discovered

因為我們發現

is that Mother Nature has laced a large number

大地之母遺下了大量

of foods and beverages and herbs

能夠天然地抑制

with naturally-occurring inhibitors of angiogenesis.

血管新生的

食物、飲料和藥草

Here's a test system we developed.

這是我們正在研發的測試系統

At the center is a ring

在中央的是血管環，由數百條微血管形成

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

正在向外成星狀爆出生長

我們能利用這個系統

And we can use this system to test dietary factors

來測試我們能藉著飲食

at concentrations that are obtainable by eating.

攝取的抗血管新生因子的濃度的影響

Let me show you what happens

這是當我們加入

when we put in an extract from red grapes.

紅葡萄萃取物的情形

The active ingredient is resveratrol,

其中的有效成份白藜蘆醇

it's also found in red wine.

也能在紅酒中找到

This inhibits abnormal angiogenesis,

白藜蘆醇能抑制

by 60 percent.

60%的異常血管新生

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

這草莓萃取物的測試結果

It potently inhibits angiogenesis.

也有抑制血管生成的效果

And extract from soybeans.

大豆萃取物也是

And here is a growing list

這裡列出我們有興趣、仍在增加中的

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

用來測試抗血管新生效果

的食物跟飲料

For each food type,

我們相信各類食物的

we believe that there are different potencies

不同種類或品種

within different strains and varietals.

都有不同的效果

And we want to measure this because,

我們想測試這樣的效果

well, while you're eating a strawberry

是因為我們吃草莓

or drinking tea,

或喝茶時

why not select the one that's most potent

為何不選擇最有效的那個品種

for preventing cancer?

來預防癌症

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

我們測試了四種

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

市面上常見的茶

香片、日本煎茶

Earl Grey and a special blend that we prepared,

伯爵茶和一種我們配製的茶

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

你可以清楚見到

不同的茶抗血管新生的效果不同

from less potent to more potent.

這裡將效果從低到高列出來

這個研究最棒的地方是

But what's very cool

is when we combine the two less potent teas together,

當你混合兩種

單獨使用時效果不高的茶

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

抗血管新生的效果

比各自單獨使用來得高

This means there's food synergy.

也就是說這些食物有協成效果

Here's some more data from our testing.

還有更多實驗室裡其他測試的結果

Now in the lab, we can simulate tumor angiogenesis,

我們可以刺激腫瘤血管新生

represented here in a black bar.

測試癌症藥物在這個系統裡的效果

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

結果用黑色的柱狀圖表示

So the shorter the bar,

當軸柱越短

the less angiogenesis -- that's good.

血管新生就越少，這是好情況

And here are some common drugs

我們測試了一些常見的

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

跟降低癌症發生率

有關的藥物

Statins, nonsteroidal anti-inflammatory drugs,

Statin、非類固醇消炎劑

跟一些其他藥物

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

能夠抑制血管新生

And here are the dietary factors

而比較某些食物

going head-to-head against these drugs.

跟這些藥物對血管新生的效果

You can see they clearly hold their own,

如你所見，這些食物不比藥物差

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

而某些食物的效果

甚是還比藥物好

Soy, parsley, garlic, grapes, berries.

如大豆、荷蘭芹、大蒜

葡萄跟莓類

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

這讓我們只要回家使用這些食材

烹煮食物就有治療癌症的效果

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

試想我們是否能夠建立

這個世界上第一個根據

in which we could score foods

食物抑制癌症組織的

according to their antiangiogenic, cancer-preventative properties.

血管新生能力

所編列的評分表

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

這也是我們現在正在做的

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

我已經對你們秀出許多實驗室的數據

and so the real question is:

至此，真正的問題是

What is the evidence in people

什麼是人們吃下

that eating certain foods can reduce angiogenesis in cancer?

某些食物就能抑制

癌症組織裡血管新生的證據？

Well, the best example I know

據我所知，最好的證據

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

是一個樣本數為7萬9千人

長達20年的研究

in which it was found that men who consumed cooked tomatoes

科學家發現，每周攝取

烹煮過的番茄兩到三次的男性

two to three times a week,

had up to a 50 percent reduction

最後得到攝護腺癌的機率

in their risk of developing prostate cancer.

降低一半

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

我們現在知道，番茄是很好的茄紅素來源

and lycopene is antiangiogenic.

而茄紅素能減少血管生長

But what's even more interesting from this study,

而這個研究最有趣的部分是

is that in those men who did develop prostate cancer,

在那些得到攝護腺癌的男性中

those who ate more servings of tomato sauce,

攝取較多番茄醬的人

actually had fewer blood vessels feeding their cancer.

組織中確實有較少的

血管能餵養腫瘤

So this human study is a prime example

因此，這個臨床研究是

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

當我們攝取足夠劑量的

存在於食物中抗血管新生物質

can have an impact on cancer.

的確能影響癌症形成的證據

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

我們現在正在跟

Dean Ornish、南加大跟Tufts大學

with Dean Ornish at UCSF and Tufts University --

的工作團隊合作研究

the role of this healthy diet on markers of angiogenesis

我們在血液中找到的健康食物成分

that we can find in the bloodstream.

對血管生成的標記分子的影響

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

而顯然的，我剛才跟各位分享的食物的

even beyond cancer research.

廣泛影響並不侷限於癌症研究

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

因為若我們是正確的，這樣的概念

food services, public health

能衝擊消費者教育、食物供給、公共衛生

and even the insurance industry.

甚至是保險產業

And in fact, some insurance companies

事實上，一些保險公司

are already beginning to think along these lines.

已經開始考慮這樣的概念

Check out this ad from BlueCross BlueShield of Minnesota.

看看這個明尼蘇達的藍十字蘭盾公司的廣告

For many people around the world,

對這個世界的許多人而言

dietary cancer prevention may be the only practical solution,

藉著改善飲食來治療癌症

可能是唯一可靠實際的辦法

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

因為並不是每個人能夠負擔末期癌症治療的費用

but everybody could benefit from a healthy diet

但是每個人都能因為

地區性、永續性的

based on local, sustainable, antiangiogenic crops.

抗血管新生飲食而受惠

Now, finally,

演講的最後

I've talked to you about food,

我們剛剛提到食物

and I've talked to you about cancer,

還有癌症

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

我還想再跟各位說說

and that's obesity.

另外一個疾病，也就是肥胖

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

因為，研究顯示

脂肪組織的形成

is highly angiogenesis-dependent.

跟血管生成也高度相關

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

一如癌症，脂肪隨著血管生長

So the question is:

問題在於：我們是否可以

Can we shrink fat by cutting off its blood supply?

藉著阻斷血液供應使脂肪萎縮？

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

圖表上方的曲線為

先天性肥胖的老鼠的體重

that eats nonstop until it turns fat,

這些老鼠會不斷地吃

直到牠們跟一顆毛茸茸的網球沒兩樣

like this furry tennis ball.

(Laughter)

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

而下方的曲線為正常老鼠的體重

If you take the obese mouse

如果你給一隻肥胖老鼠

and give it an angiogenesis inhibitor, it loses weight.

抗血管形成的藥物，牠們會變瘦

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

一但停藥，體重則回昇

若重新開始治療，體重下降

Stop the treatment, it gains the weight back.

停止治療，體重回昇

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

事實上，利用抑制血管新生的藥物

我們能讓老鼠的體重上上下下變動

simply by inhibiting angiogenesis.

So this approach that we're taking for cancer prevention

因此，這個用來治療癌症的療法

may also have an application for obesity.

也許也能用來治療

肥胖

The truly interesting thing about this

這個實驗最有趣的部分是

is that we can't take these obese mice

我們無法用這個藥讓這些

and make them lose more weight

肥胖老鼠的體重

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

降得比正常老鼠低

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

換句話說，我們沒辦法製造超級名模鼠

（笑）

(Laughter)

And this speaks to the role of angiogenesis

這個實驗說明了血管新生

in regulating healthy set points.

在決定健康狀態時扮演的角色

Albert Szent-Györgi once said,

聖捷爾吉·奧爾貝特曾說

"Discovery consists of seeing what everyone has seen,

創件包括了見眾人所見

and thinking what no one has thought."

思無人所想

I hope I've convinced you

我希望我已經說服各位

that for diseases like cancer, obesity and other conditions,

癌症、肥胖和其他疾病的治療上

there may be a great power

攻擊這些疾病的共有特徵

in attacking their common denominator: angiogenesis.

即血管新生，是更有效的方法

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

我認為這是世人目前需要的，謝謝

Thank you.

(Applause)

（掌聲）

June Cohen: I have a quick question for you.

這些藥物實際上並不是

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

目前癌症治療的主流用藥

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

對目前已有癌症的人

你有什麼建議嗎？

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

你會建議大部分的病人，現在就開始使用這樣的治療嗎？

目前市面上已經有FDA核准的

William Li: There are antiangiogenic treatments

抗血管新生藥物

that are FDA approved,

and if you're a cancer patient,

如果你是位癌症病人

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

或是正在協助或是支持某位癌症病人

你應該向醫生詢問這類藥物

And there are many clinical trials.

目前有許多臨床試驗

The Angiogenesis Foundation is following almost 300 companies,

Andrew J Semesco基金會正追蹤約300家公司

and there are about 100 more drugs in that pipeline.

發現大概有100多種藥

正在上線生產

So, consider the approved ones,

考慮那些已經被核准的藥

look for clinical trials,

找找有無臨床試驗

but then between what the doctor can do for you,

但是除了醫生能提供的協助

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

病人也該自問自己能夠做些什麼

這也是我想跟各位談的

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

我們可以從醫生無法為我們做的

We can empower ourselves

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

方面來自我強化

which is to use knowledge and take action.

擅用知識跟積極行動

And if Mother Nature has given us some clues,

如果自然之母已經給我們提示

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

我們認為未來可能的新方向為

重視我們的飲食

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

而食物本身就是我們一日三次的化療

JC: Right. And along those lines,

基於你的演講

for people who might have risk factors for cancer,

你會建議那些癌症的高風險族群

would you recommend pursuing any treatments prophylactically,

使用預防性的治療

or simply pursuing the right diet,

或是單純正確的飲食

with lots of tomato sauce?

像是吃大量的番茄醬？

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

你知道，現在有許多流行病學調查

and I think in the information age,

我想，在這個知識爆炸的時代

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

取得可信的資料如利用Pubmed資料庫

也就是美國國家醫學圖書館的檢索系統

the National Library of Medicine,

to look for epidemiological studies for cancer risk reduction

來搜尋飲食或是藥物

降低癌症風險的流行病學研究

based on diet and based on common medications.

並不是太花時間的事

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

這確實是任何人都可以試著去做的

JC: Okay. Well, thank you so much.

好，非常謝謝你

(Applause)

（掌聲）