Under The Microscope: The fight to make cancer survivable

THE DIFFERENCE A LONE VOICE CAN MAKE

WHEN I FIRST met Judah Folkman some 20 years ago, I was so excited by his ideas that I wanted to stop strangers in the street to tell them. I also started some new experiments under his influence. What was his novel discovery? How blood vessels develop, and their fundamental role in cancer.

Judah Folkman was a young paediatric surgeon working on cancer at the Harvard Medical School. Like cells, tumours can be grown in a culture medium in a dish. Folkman became puzzled as to why cancer cells in a dish stop growing when they form a small tumour, about the size of a pea. These cultured tumours are always tiny and quite different from the tumours that grow in the body, which can be several centimetres in diameter. He offered his research students a fortnight's holiday for two at the best hotel in Miami if they could get tumours in the culture dishes to grow any larger. Folkman's prize was safe, for what he demonstrated is that tumours need a blood supply in order to grow, and that this is why their growth is so restricted outside the body.

What Folkman then showed was that there is an intimate relationship between tumours and the blood vessels that supply them with nutrients. The tumours actually attract vessels to grow towards them, and if the blood vessels do not reach the tumour, it will remain tiny or die. The way tumours attract vessels is by secreting a substance which causes the fine vessels nearby to migrate towards the source of the substance. The vessel's cells can detect local concentration and will move towards higher and higher concentrations. Once the tumour has received a blood supply, its growth can be explosive - it can become 20,000 times its original volume in a few weeks.

It is this growth that makes tumours lethal. There is evidence that an individual with cancer may have many small tumours in the body that are hard to detect until they receive a blood supply and start to grow. Folkman devoted his next efforts to identifying the substances released by tumours that attract vessels, in order to find ways of preventing them from working and the tumours from acquiring a blood supply. His views were met with considerable scepticism - few believed that it might be possible to treat cancer by blocking blood-vessel development. He had to use considerable powers of persuasion to convince scientists to join him, as other professors actually tried to dissuade them from doing so.

But Folkman received a major boost in 1994, when his laboratory isolated a natural inhibitor of blood-vessel growth called angiostatin (blood-vessel growth is called angiogenesis). Two years later, they isolated another inhibitor, endostatin. When a mouse with a large tumour was treated daily with endostatin, the tum- our almost disappeared within 12 days. It is still not known how the inhibitors work, but tests using related substances to suppress vessel growth in cancer patients are due to start next year. And because of the publicity his work has attracted, his office already receives over 1,000 calls a day from cancer patients or their families, desperate for a life-saving treatment.

In an interview in the journal Science, Folkman was asked whether he thinks that his treatments will eventually cure cancer. His reply: that his inhibitors will not, but that he believes they will make cancer more controllable when used alongside standard treatments like chemotherapy. Folkman is now honoured by numerous prestigious awards. He is a wonderful example of a scientist who did not give up his ideas, despite initial opposition.

Arts and Entertainment
Performers drink tea at the Glastonbury festival in 2010

GlastonburyWI to make debut appearance at Somerset festival

Arts and Entertainment
Lena Headey as Cersei Lannister

TV reviewIt has taken seven episodes for Game of Thrones season five to hit its stride

Have you tried new the Independent Digital Edition apps?
Arts and Entertainment

ebooksNow available in paperback
Arts and Entertainment

ebooks
Arts and Entertainment
Jesuthasan Antonythasan as Dheepan

FilmPalme d'Or goes to radical and astonishing film that turns conventional thinking about immigrants on its head

Arts and Entertainment
Måns Zelmerlöw performing

Eurovision
Arts and Entertainment
Graham Norton was back in the commentating seat for Eurovision 2015

Eurovision
Arts and Entertainment
Richard Hammond, Jeremy Clarkson and James May on stage

TV
Arts and Entertainment
The light stuff: Britt Robertson and George Clooney in ‘Tomorrowland: a World Beyond’
film review
Arts and Entertainment
Reawakening: can Jon Hamm’s Don Draper find enlightenment in the final ‘Mad Men’?
tv reviewNot quite, but it's an enlightening finale for Don Draper spoiler alert
Arts and Entertainment
Breakfast Show’s Nick Grimshaw

Radio
Arts and Entertainment

Eurovision
Arts and Entertainment
'Youth' cast members Paul Dano, Jane Fonda, Harvey Keitel, Rachel Weisz, and Michael Caine pose for photographers at Cannes Film Festival
film
Arts and Entertainment
Adam West as Batman and Burt Ward and Robin in the 1960s Batman TV show

Comics
Arts and Entertainment
I am flute: Azeem Ward and his now-famous instrument
music
Arts and Entertainment
A glass act: Dr Chris van Tulleken (left) and twin Xand get set for their drinking challenge
TV review
Arts and Entertainment
MIA perform at Lovebox 2014 in London Fields, Hackney

music
Arts and Entertainment
Finnish punk band PKN hope to enter Eurovision 2015 and raise awareness for Down's Syndrome

eurovision
Arts and Entertainment
William Shakespeare on the cover of John Gerard's The Herball or Generall Historie of Plantes

books
Arts and Entertainment

Game of Thrones review
Arts and Entertainment
Grayson Perry dedicates his Essex home to Julie

Potter's attempt to create an Essex Taj Mahal was a lovely treat

tv
Arts and Entertainment
A scene from the original Swedish version of the sci-fi TV drama ‘Real Humans’
tv
Arts and Entertainment
Hugh Keays-Byrne plays Immortan Joe, the terrifying gang leader, in the new film
filmActor who played Toecutter returns - but as a different villain in reboot
Arts and Entertainment
Charlize Theron as Imperator Furiosa in Mad Max: Fury Road
film
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    Fifa corruption: The 161-page dossier that exposes the organisation's dark heart

    The 161-page dossier that exposes Fifa's dark heart

    How did a group of corrupt officials turn football’s governing body into what was, in essence, a criminal enterprise? Chris Green and David Connett reveal all
    Mediterranean migrant crisis: 'If Europe thinks bombing boats will stop smuggling, it will not. We will defend ourselves,' says Tripoli PM

    Exclusive interview with Tripoli PM Khalifa al-Ghweil

    'If Europe thinks bombing boats will stop smuggling, it will not. We will defend ourselves'
    Raymond Chandler's Los Angeles: How the author foretold the Californian water crisis

    Raymond Chandler's Los Angeles

    How the author foretold the Californian water crisis
    Chinese artist who posted funny image of President Xi Jinping facing five years in prison as authorities crackdown on dissent in the arts

    Art attack

    Chinese artist who posted funny image of President Xi Jinping facing five years in prison
    Marc Jacobs is putting Cher in the limelight as the face of his latest campaign

    Cher is the new face of Marc Jacobs

    Alexander Fury explains why designers are turning to august stars to front their lines
    Parents of six-year-old who beat leukaemia plan to climb Ben Nevis for cancer charity

    'I'm climbing Ben Nevis for my daughter'

    Karen Attwood's young daughter Yasmin beat cancer. Now her family is about to take on a new challenge - scaling Ben Nevis to help other children
    10 best wedding gift ideas

    It's that time of year again... 10 best wedding gift ideas

    Forget that fancy toaster, we've gone off-list to find memorable gifts that will last a lifetime
    Paul Scholes column: With the Premier League over for another year, here are my end of season awards

    Paul Scholes column

    With the Premier League over for another year, here are my end of season awards
    Heysel disaster 30th anniversary: Liverpool have seen too much tragedy to forget fateful day in Belgium

    Liverpool have seen too much tragedy to forget Heysel

    Thirty years ago, 39 fans waiting to watch a European Cup final died as a result of a fatal cocktail of circumstances. Ian Herbert looks at how a club dealt with this tragedy
    Amir Khan vs Chris Algieri: Khan’s audition for Floyd Mayweather may turn into a no-win situation, says Frank Warren

    Khan’s audition for Mayweather may turn into a no-win situation

    The Bolton fighter could be damned if he dazzles and damned if he doesn’t against Algieri, the man last seen being decked six times by Pacquiao, says Frank Warren
    Blundering Tony Blair quits as Middle East peace envoy – only Israel will miss him

    Blundering Blair quits as Middle East peace envoy – only Israel will miss him

    For Arabs – and for Britons who lost their loved ones in his shambolic war in Iraq – his appointment was an insult, says Robert Fisk
    Fifa corruption arrests: All hail the Feds for riding to football's rescue

    Fifa corruption arrests

    All hail the Feds for riding to football's rescue, says Ian Herbert
    Isis in Syria: The Kurdish enclave still resisting the tyranny of President Assad and militant fighters

    The Kurdish enclave still resisting the tyranny of Assad and Isis

    In Syrian Kurdish cantons along the Turkish border, the progressive aims of the 2011 uprising are being enacted despite the war. Patrick Cockburn returns to Amuda
    How I survived Cambodia's Killing Fields: Acclaimed surgeon SreyRam Kuy celebrates her mother's determination to escape the US

    How I survived Cambodia's Killing Fields

    Acclaimed surgeon SreyRam Kuy celebrates her mother's determination to escape to the US
    Stephen Mangan interview: From posh buffoon to pregnant dad, the actor has quite a range

    How Stephen Mangan got his range

    Posh buffoon, hapless writer, pregnant dad - Mangan is certainly a versatile actor