TED2010
William Li: Can we eat to starve cancer?
William Li: kas me võime vähki toiduga näljutada?
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William Li esitleb uut mõtteviisi vähiravis: angiogeneesi, mis on suunatud kasvajat varustavatele veresoontele. Määrava tähtsusega esimene (ja parim) samm: vähi vastu võitlevate toiduainete söömine võib võita vähki tema enda relvadega.
William Li - Cancer researcher
William Li heads the Angiogenesis Foundation, a nonprofit that is re-conceptualizing global disease fighting. Full bio
William Li heads the Angiogenesis Foundation, a nonprofit that is re-conceptualizing global disease fighting. Full bio
Double-click the English transcript below to play the video.
00:17
Good afternoon.
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Tere päevast.
00:19
There's a medical revolution happening all around us,
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Meie ümber toimub meditsiiniline revolutsioon
00:22
and it's one that's going to help us conquer
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ja see aitab meil saada jagu
00:24
some of society's most dreaded conditions,
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mõnedest ühiskonna kõige kardetumatest haigustest,
00:26
including cancer.
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kaasa arvatud vähk.
00:28
The revolution is called angiogenesis,
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Selle revolutsiooni nimi on angiogenees
00:31
and it's based on the process
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ja see rajaneb protsessil,
00:33
that our bodies use to grow blood vessels.
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mida meie keha kasutab veresoonte kasvatamiseks.
00:36
So why should we care about blood vessels?
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Miks me peaksime veresoontest hoolima?
00:38
Well, the human body is literally packed with them:
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Sest inimkeha on neid sõna otseses mõttes täis,
00:41
60,000 miles worth in a typical adult.
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täiskasvanus on neid 95 000 kilomeetrit.
00:44
End to end, that would form a line
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Üksteise otsa asetatuna moodustaksid nad
00:46
that would circle the earth twice.
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joone, mis ulatuks kaks korda ümber Maa.
00:49
The smallest blood vessels are called capillaries;
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Väikseimaid veresooni kutsutakse kapillaarideks.
00:52
we've got 19 billion of them in our bodies.
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Meie kehas on neid 19 miljardit.
00:55
And these are the vessels of life, and,
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Nad on elu kandjad
00:58
as I'll show you,
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ja ma näitan teile,
01:00
they can also be the vessels of death.
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et nad võivad olla ka surma kandjad.
01:03
Now the remarkable thing about blood vessels
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Veresoonte juures on märkimisväärne,
01:05
is that they have this ability
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et neil on omadus
01:07
to adapt to whatever environment they're growing in.
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kohaneda keskkonnaga, kus nad kasvavad.
01:09
For example, in the liver they form channels
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Näiteks maksas moodustavad nad kanaleid,
01:11
to detoxify the blood;
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mis eemaldavad verest mürgi.
01:13
in the lung they line air sacs for gas exchange;
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Kopsus vooderdavad nad alveoole, et tagada gaasivahetust.
01:16
in muscle they corkscrew so that muscles can contract
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Lihastes moodustavad nad spiraale, et lihased saaksid kokku tõmbuda
01:18
without cutting off circulation;
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ilma vereringet katkestamata.
01:21
and in nerves they course along like power lines,
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Närvides jooksevad nad elektriliinidena,
01:23
keeping those nerves alive.
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hoides neid närve elus.
01:25
We get most of these blood vessels
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Me saame suurema osa neist veresoontest
01:27
when we're actually still in the womb,
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juba üsas olles.
01:29
And what that means is that as adults,
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See tähendab, et täiskasvanuna
01:32
blood vessels don't normally grow.
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veresooned üldiselt ei kasva,
01:34
Except in a few special circumstances:
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välja arvatud teatud konkreetsetel juhtudel.
01:38
In women, blood vessels grow every month
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Naistel kasvavad veresooned igal kuul,
01:40
to build the lining of the uterus;
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vooderdades emakat.
01:42
during pregnancy, they form the placenta,
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Raseduse ajal moodustavad nad platsenta,
01:44
which connects mom and baby.
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mis ühendab ema ja last.
01:47
And after injury, blood vessels
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Pärast vigastust peavad veresooned
01:49
actually have to grow under the scab
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kasvama kärna all,
01:51
in order to heal a wound.
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et haav paraneks.
01:53
And this is actually what it looks like,
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See näeb välja nii.
01:55
hundreds of blood vessels
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Sajad veresooned
01:57
all growing toward the center of the wound.
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kasvavad haava keskpaiga poole.
01:59
So the body has the ability to regulate
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Kehal on võime reguleerida
02:02
the amount of blood vessels that are present at any given time.
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vereoonte arvu, mis mingil hetkel vajalik on.
02:05
It does this through an elaborate
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Ta teeb seda keerulise ja elegantse
02:07
and elegant system of checks and balances,
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võimude lahususe süsteemi abil,
02:09
stimulators and inhibitors of angiogenesis,
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angiogeneesi stimulaatorite ja inhibiitorite abil,
02:12
such that, when we need a brief burst of blood vessels,
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nii et kui me vajame lühiajalist veresoonte hulga kasvu,
02:15
the body can do this by releasing stimulators,
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võib keha seda teha, vallandades stimulaatoreid,
02:18
proteins called angiogenic factors
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valke, mida kutsutakse angiogeenseteks faktoriteks,
02:20
that act as natural fertilizer
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mis toimivad loomuliku väetisena
02:22
and stimulate new blood vessels to sprout.
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ja stimuleerivad uute veresoonte tärkamist.
02:24
And when those excess vessels are no longer needed,
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Kui ülemääraseid veresooni enam vaja ei ole,
02:26
the body prunes them back to baseline
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kärbib keha nad ära, taastades normaalse olukorra,
02:29
using naturally occurring inhibitors of angiogenesis.
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kasutades loomulikke angiogeneesi inhibiitoreid.
02:33
Now there are other situations where we start beneath the baseline
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On teistsuguseid olukordi, kus me alustame normaalsest vähemaga
02:35
and we need to grow more blood vessels just to get back to normal levels --
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ja on vaja veresooni juurde kasvatada, et normaalset taset saavutada.
02:38
for example, after an injury --
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Näiteks pärast vigastust.
02:40
and a body can do that too,
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Keha suudab ka seda,
02:42
but only to that normal level,
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aga ainult selle normaalse tasemeni,
02:44
that set point.
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selle ettenähtud piirini.
02:46
But what we now know is that for a number of diseases,
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Praegu me teame, et mitmete haiguste puhul
02:49
there are defects in the system
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esinevad selles süsteemis vead
02:51
where the body can't prune back extra blood vessels
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ja keha ei suuda ülemääraseid veresooni kärpida
02:54
or can't grow enough new ones
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või kasvatada piisavalt uusi
02:56
in the right place at the right time.
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õiges kohas ja õigel ajal.
02:58
And in these situations, angiogenesis
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Sellistes olukordades on angiogenees
03:00
is out of balance.
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tasakaalust väljas.
03:02
And when angiogenesis is out of balance,
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Kui angiogenees on tasakaalust väljas,
03:04
a myriad of diseases result.
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on tagajärjeks hulk erinevaid haigusi.
03:06
For example, insufficient angiogenesis --
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Näiteks ebapiisav angiogenees,
03:08
not enough blood vessels --
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veresoonte vähesus,
03:10
leads to wounds that don't heal, heart attacks,
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põhjustab haavade paranematust, infarkte,
03:13
legs without circulation, death from stroke,
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verevarustuse häireid jalgades, surma insuldi tagajärjel,
03:15
nerve damage.
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närvikahjustusi.
03:17
And on the other end, excessive angiogenesis --
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Samas, liigne angiogenees,
03:19
too many blood vessels -- drives disease,
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liiga suur hulk veresooni, põhjustab samuti haigusi.
03:22
and we see this in cancer, blindness,
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Seda võib näha vähi, pimeduse,
03:24
arthritis, obesity,
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artriidi, ülekaalulisuse
03:26
Alzheimer's disease.
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ja Alzheimeri tõve puhul.
03:28
In total, there are more than 70 major diseases
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Kokkuvõttes on üle 70 raske haiguse,
03:31
affecting more than a billion people worldwide,
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mis mõjutavad rohkem kui miljardit inimest üle maailma,
03:34
that all look on the surface to be different from one another,
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ja need kõik paistavad pealtnäha erinevad,
03:36
but all actually share
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aga tegelikult on
03:38
abnormal angiogenesis
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ebanormaalne angiogenees
03:40
as their common denominator.
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nende ühiseks nimetajaks.
03:42
And this realization is allowing us
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See avastus lubab meil
03:44
to reconceptualize
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mõelda ümber,
03:46
the way that we actually approach these diseases
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kuidas me nendele haigustele läheneme,
03:48
by controlling angiogenesis.
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kontrollides angiogeneesi.
03:51
Now I'm going to focus on cancer
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Võtan nüüd vaatluse alla vähi,
03:53
because angiogenesis is a hallmark of cancer,
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sest angiogenees on vähi tunnusmärk,
03:56
every type of cancer.
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ükskõik, mis tüüpi vähiga on tegemist.
03:58
So here we go.
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Niisiis.
04:00
This is a tumor: dark, gray, ominous mass
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See on kasvaja, tume, hall, kurjakuulutav mass,
04:02
growing inside a brain.
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mis kasvab ajus.
04:04
And under the microscope, you can see
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Mikroskoobi all näeme
04:06
hundreds of these brown staining blood vessels,
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sadu neid pruuni värvi veresooni,
04:08
capillaries that are feeding cancer cells,
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kapillaare, mis toidavad vähirakke,
04:10
bringing oxygen and nutrients.
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kandes hapnikku ja toitaineid.
04:13
But cancers don't start out like this.
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Aga vähk ei alga niimoodi.
04:15
And, in fact, cancers don't start out
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Tegelikult ei alga vähk
04:17
with a blood supply.
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koos verevarustusega.
04:19
They start out as small, microscopic nests of cells
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See algab väikestest, mikroskoopilistest rakkude pesadest,
04:22
that can only grow to
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mis võivad kasvada ainult
04:24
one half a cubic millimeter in size;
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poole kuupmillimeetri suuruseks.
04:27
that's the tip of a ballpoint pen.
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See on nagu pastapliiatsi ots.
04:29
Then they can't get any larger because they don't have a blood supply,
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Nad ei saa suuremaks kasvada, sest neil ei ole verevarustust,
04:31
so they don't have enough oxygen or nutrients.
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nii et nad ei saa piisavalt hapnikku ega toitaineid.
04:34
In fact, we're probably forming these
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Tõenäoliselt moodustub meie kehas
04:36
microscopic cancers all the time in our body.
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neid mikroskoopilisi vähkkasvajaid kogu aeg.
04:40
Autopsy studies from people who died in car accidents
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Autoõnnetustes surma saanud inimeste lahkamine
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have shown that about 40 percent of women
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on näidanud, et umbes 40 protsendil naistest
04:46
between the ages of 40 and 50
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vanuses 40 kuni 50 aastat
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actually have microscopic
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on mikroskoopilised
04:50
cancers in their breasts,
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vähkkasvajad rindades.
04:52
about 50 percent of men in their 50s and 60s
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Umbes 50 protsendil meestest vanuses üle 50 ja 60
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have microscopic prostate cancers,
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on mikroskoopilised eesnäärmekasvajad.
04:57
and virtually 100 percent of us,
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Ja peaaegu 100 protsendil meist
04:59
by the time we reach our 70s,
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on 70. eluaastaks
05:01
will have microscopic cancers growing in our thyroid.
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mikroskoopilised vähkkasvajad kilpnäärmes.
05:04
Yet, without a blood supply,
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Kuid ilma verevarustuseta
05:06
most of these cancers
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ei muutu enamik neist kasvajatest
05:08
will never become dangerous.
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mitte kunagi ohtlikuks.
05:10
Dr. Judah Folkman, who was my mentor
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Dr. Judah Folkman, kes oli minu mentor
05:12
and who was the pioneer of the angiogenesis field,
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ja angiogeneesi valdkonna teerajaja,
05:15
once called this "cancer without disease."
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kutsus seda kunagi "haiguseta vähiks".
05:19
So the body's ability to balance angiogenesis,
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Keha võime hoida angiogeneesi tasakaalus,
05:22
when it's working properly,
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kui see toimib nii, nagu peab,
05:24
prevents blood vessels from feeding cancers.
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ei lase veresoontel vähkkasvajaid toita.
05:26
And this turns out to be
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Ja selgub, et see on
05:28
one of our most important defense mechanisms
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üks meie kõige olulisemaid kaitsemehhanisme
05:31
against cancer.
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vähi vastu.
05:33
In fact, if you actually block angiogenesis
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Kui blokeerida angiogeneesi
05:35
and prevent blood vessels from ever reaching cancer cells,
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ja takistada veresoonte jõudmist vähirakkudeni,
05:37
tumors simply can't grow up.
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ei saa kasvaja lihtsalt suureks kasvada.
05:39
But once angiogenesis occurs,
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Aga kui angiogenees toimub,
05:41
cancers can grow exponentially.
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võib vähkkasvaja hakata tõusvas tempos vohama.
05:44
And this is actually how
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Täpselt niimoodi
05:46
a cancer goes from being
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vähkkasvaja muutubki
05:48
harmless to deadly.
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ohutust surmavaks.
05:50
Cancer cells mutate
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Vähirakud muteeruvad
05:52
and they gain the ability to release
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ja omandavad võime vallandada
05:54
lots of those angiogenic factors, natural fertilizer,
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ohtralt angiogeenset faktorit, loomulikku väetist,
05:56
that tip the balance in favor of blood vessels
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mis kallutab tasakaalu veresoonte kasuks
05:58
invading the cancer.
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ja need tungivad kasvajasse.
06:00
And once those vessels invade the cancer,
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Kui veresooned on vähkkasvajasse tunginud,
06:02
it can expand, it can invade local tissues.
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võib see paisuda, levida kohalikesse kudedesse.
06:05
And the same vessels that are feeding tumors
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Ja samad veresooned, mis toidavad kasvajaid,
06:07
allow cancer cells to exit into the circulation
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lasevad vähirakkudel väljuda
06:10
as metastases.
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metastaasidena vereringesse.
06:12
And, unfortunately, this late stage of cancer
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Kahjuks diagnoositakse vähki
06:15
is the one at which it's most likely
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kõige tõenäolisemalt
06:17
to be diagnosed,
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selles hilises staadiumis,
06:19
when angiogenesis is already turned on
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kui angiogenees on juba käivitunud
06:21
and cancer cells are growing like wild.
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ja vähirakud kasvavad pöörase kiirusega.
06:25
So, if angiogenesis
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Kui angiognees
06:27
is a tipping point
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on murdepunktiks
06:29
between a harmless cancer and a harmful one,
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ohutu ja ohtliku vähi vahel,
06:32
then one major part of the angiogenesis revolution
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siis angioneneesi revolutsiooni oluliseks tahuks on,
06:35
is a new approach to treating cancer
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et see annab uue viisi, kuidas ravida vähki,
06:37
by cutting off the blood supply.
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lõigates ära selle verevarustuse.
06:40
We call this antiangiogenic therapy,
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Me kutsume seda antiangiogeenseks teraapiaks
06:43
and it's completely different from chemotherapy
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ja see erineb täiesti keemiaravist,
06:45
because it selectively aims
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sest ta on suunatud valikuliselt
06:47
at the blood vessels that are feeding the cancers.
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ainult vähkkasvajat toitvatele veresoontele.
06:50
And we can do this because
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Me saame seda teha, sest
06:52
tumor blood vessels are unlike normal, healthy vessels
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kasvaja veresooned erinevad normaalsetest, tervetest veresoontest,
06:54
we see in other places of the body:
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mida me näeme teistes kehapiirkonades.
06:56
They're abnormal;
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Nad on ebanormaalsed,
06:58
they're very poorly constructed;
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nad on väga halvasti üles ehitatud
07:00
and, because of that, they're highly vulnerable
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ja seetõttu on nad väga haavatavad
07:02
to treatments that target them.
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seoses neile suunatud raviga.
07:05
In effect, when we give cancer patients
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Kui me pakume vähipatsientidele
07:07
antiangiogenic therapy --
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antiangiogeenset teraapiat...
07:09
here, an experimental drug for a glioma,
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siin on eksperimentaalne ravim glioomi vastu,
07:12
which is a type of brain tumor --
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mis on teatud tüüpi ajukasvaja...
07:14
you can see that there are dramatic changes that occur
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te näete, et toimuvad tähelepanuväärsed muutused,
07:17
when the tumor is being starved.
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kui kasvajat näljutatakse.
07:19
Here's a woman with a breast cancer
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Siin saab naine, kellel on rinnavähk,
07:21
being treated with the antiangiogenic drug called Avastin,
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antiangiogeenset ravimit nimega Avastin,
07:24
which is FDA approved.
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mis on USA toidu- ja ravimiameti poolt heaks kiidetud.
07:26
And you can see that the halo of blood flow
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Te näete, et vere voolamist tähistav helendus
07:29
disappears after treatment.
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kaob pärast ravi.
07:32
Well, I've just shown you
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Näitasin teile just
07:34
two very different types of cancer
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kaht väga erinevat vähitüüpi,
07:36
that both responded to antiangiogenic therapy.
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mis mõlemad reageerisid antiangiogeensele ravile.
07:39
So, a few years ago, I asked myself,
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Mõned aastad tagasi küsisin endalt:
07:41
"Can we take this one step further
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"Kas me võime astuda veel sammu edasi
07:43
and treat other cancers,
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ja ravida teisi vähitüüpe,
07:45
even in other species?"
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isegi teistel liikidel?"
07:49
So here is a nine year-old boxer named Milo
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Siin on 9-aastane bokser Milo,
07:51
who had a very aggressive tumor
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kelle õlal kasvas väga agressiivne kasvaja,
07:53
called a malignant neurofibroma growing on his shoulder.
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mille nimi on pahaloomuline neurofibroom.
07:56
It invaded into his lungs.
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See tungis tema kopsudesse.
07:58
His veterinarian only gave him three months to live.
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Veterinaar teatas, et talle on jäänud kolm kuud elada.
08:00
So we created a cocktail of antiangiogenic drugs
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Me valmistasime kokteili antiangiogeensetest ravimitest,
08:03
that could be mixed into his dog food
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mida sai tema koeratoidu sisse segada,
08:05
as well as an antiangiogenic cream
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ja samuti antiangioneense kreemi,
08:07
that could be applied on the surface of the tumor.
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mida võis tema kasvajale määrida.
08:10
And within a few weeks of treatment,
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Pärast mõnenädalast ravi
08:12
we were able to slow down that cancer's growth
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suutsime vähi kasvamist aeglustada,
08:15
such that we were ultimately able to extend milo's survival
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nii et lõpuks pikendasime Milo eluiga
08:18
to six times what the veterinarian had initially predicted,
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veterinaari esialgse ennustusega võrreldes kuuekordseks
08:21
all with a very good quality of life.
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ja väga hea elukvaliteediga.
08:24
And we subsequently treated more than 600 dogs.
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Seejärel ravisime rohkem kui 600 koera.
08:27
We have about a 60 percent response rate
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Oleme saavutanud tulemusi umbes 60 protsendil juhtudest
08:29
and improved survival for these pets
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ja pikendanud lemmikloomade iga,
08:31
that were about to be euthanized.
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keda kavatseti magama panna.
08:34
So let me show you a couple of
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Näitan teile mõnda
08:36
even more interesting examples.
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veelgi huvitavamat näidet.
08:38
This is 20-year-old dolphin living in Florida,
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See on 20-aastane delfiin Floridas.
08:40
and she had these lesions in her mouth
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Tal olid suus kahjustused,
08:42
that, over the course of three years,
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mis kolme aasta jooksul
08:44
developed into invasive squamous cell cancers.
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arenesid invasiivseteks vähirakkudeks.
08:47
So we created an antiangiogenic paste.
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Me valmistasime antiangiogeense pasta.
08:50
We had it painted on top of the cancer
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Lasime määrida seda vähkkasvajatele
08:52
three times a week.
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kolm korda nädalas.
08:54
And over the course of seven months,
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Seitsme kuu jooksul
08:56
the cancers completely disappeared,
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kadusid vähkkasvajad täielikult
08:58
and the biopsies came back as normal.
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ja biopsia andis normaalse tulemuse.
09:02
Here's a cancer growing on the lip
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Siin näeme vähkkasvajat
09:04
of a Wuarter horse named Guinness.
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Guinessi-nimelise ratsahobuse huulel.
09:06
It's a very, very deadly type of cancer called an angiosarcoma.
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See on äärmiselt tappev vähitüüp - angiosarkoom.
09:09
It had already spread to his lymph nodes,
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See oli juba levinud tema lümfisõlmedesse,
09:11
so we used an antiangiogenic skin cream for the lip
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niisiis kasutasime antiangiogeenset ihukreemi huulele
09:14
and an oral cocktail, so we could treat from the inside
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ja suukaudset kokteili, et saaksime ravida nii seest
09:17
as well as the outside.
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kui ka väljast.
09:19
And over the course of six months,
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Kuue kuu jooksul
09:21
he experienced a complete remission.
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kadus kasvaja täiesti.
09:24
And here he is six years later,
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Siin on Guiness kuus aastat hiljem
09:27
Guinness, with his very happy owner.
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koos oma väga õnneliku omanikuga.
09:30
(Applause)
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(Aplaus)
09:33
Now, obviously, antiangiogenic therapy
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Ilmselgelt võiks antiangiogeenset ravi
09:35
could be used for a wide range of cancers.
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kasutada paljude erinevate vähitüüpide vastu.
09:38
And, in fact, the first pioneering treatments
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Esimesed teedrajavad ravivõimalused
09:40
for people, as well as dogs,
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nii inimestele kui ka koertele
09:42
are already becoming available.
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on juba muutumas kättesaadavaks.
09:44
There's 12 different drugs, 11 different cancer types.
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On 12 erinevat ravimit 11 erinevale vähiliigile,
09:47
But the real question is:
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aga tegelik küsimus kõlab:
09:49
How well do these work in practice?
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kui hästi need tegelikult toimivad?
09:51
So here's actually the patient survival data
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Siin on andmed patsientide ellujäämuse kohta
09:54
from eight different types of cancer.
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seoses 8 erinevat tüüpi vähiga.
09:56
The bars represent survival time
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Jooned märgivad ellujäämisperioodi
09:58
taken from the era
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sel ajal,
10:00
in which there was only chemotherapy,
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mil oli olemas ainult keemiaravi,
10:02
or surgery, or radiation available.
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operatsiooni või kiiritusravi võimalus.
10:05
But starting in 2004,
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Aga alates 2004. aastast,
10:07
when antiangiogenic therapies first became available,
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kui antiangiogeenne ravi kättesaadavaks muutus,
10:09
well you can see that there has been
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võite näha, et toimunud on
10:11
a 70 to 100 percent
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70 kuni 100-protsendiline
10:13
improvement in survival
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tõus ellujäämuse osas
10:15
for people with kidney cancer, multiple myeloma,
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inimeste puhul, kellel on neeruvähk, multiipel müeloom,
10:18
colorectal cancer, and gastrointestinal stromal tumors.
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pärasoolevähk või gastrointestinaalne stromaalne tuumor.
10:22
That's impressive.
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Muljetavaldav.
10:24
But for other tumors and cancer types,
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Aga teist tüüpi kasvajate ja vähiliikide osas
10:27
the improvements have only been modest.
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on edusammud olnud vähesed.
10:30
So I started asking myself,
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Niisiis, hakkasin endalt küsima:
10:32
"Why haven't we been able to do better?"
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"Miks me pole olnud suutelised paremaks?"
10:35
And the answer, to me, is obvious;
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Vastus on minu meelest ilmselge:
10:37
we're treating cancer too late in the game,
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me ravime vähki liiga hilja,
10:39
when it's already established
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kui see on juba välja kujunenud
10:41
and, oftentimes, it's already spread or metastasized.
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ja sageli juba levinud või metastaseerunud.
10:44
And as a doctor, I know
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Arstina ma tean,
10:46
that once a disease progresses to an advanced stage,
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et kui haigus jõuab hilisesse staadiumisse,
10:49
achieving a cure
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on selle väljaravimine
10:51
can be difficult, if not impossible.
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keeruline, kui mitte võimatu.
10:54
So I went back to the biology
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Läksin tagasi
10:56
of angiogenesis
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angiogeneesi bioloogia juurde
10:58
and started thinking:
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ja hakkasin mõtlema:
11:00
Could the answer to cancer
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kas lahendus vähi vastu
11:02
be preventing angiogenesis,
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võiks olla angiogeneesi tõkestamine,
11:05
beating cancer at its own game
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vähi võitmine tema enda relvadega,
11:07
so the cancers could never become dangerous?
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nii et vähk ei muutuks kunagi ohtlikuks?
11:11
This could help healthy people
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See võiks aidata terveid inimesi
11:13
as well as people who've already beaten cancer
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ja samuti inimesi, kes on juba korra või kaks
11:15
once or twice
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vähist võitu saanud
11:17
and want to find a way to keep it from coming back.
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ning otsivad viisi, kuidas takistada seda kordumast.
11:20
So to look for a way to prevent angiogenesis in cancer,
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Otsides viisi, kuidas takistada vähkkasvajate angiogeneesi,
11:23
I went back to look at cancer's causes.
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uurisin vähi põhjuseid.
11:25
And what really intrigued me
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Minus äratas huvi see,
11:27
was when I saw that diet
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et ma nägin, kuidas toiduvalik
11:29
accounts for 30 to 35 percent
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põhjustab 30 kuni 35 protsenti
11:31
of environmentally caused cancers.
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keskkonna mõjul tekkinud vähkidest.
11:34
Now, the obvious thing is to think about
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Loomulikult mõeldakse sel puhul kohe,
11:36
what we could remove from our diet, what to strip out, take away.
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mida oma toidusedelist eemaldada, mida mitte süüa.
11:40
But I actually took a completely opposite approach
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Aga mina lähenesin vastupidiselt
11:43
and began asking: What could we be adding to our diet
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ja hakkasin küsima: mida saaksime oma toiduvalikule lisada,
11:46
that's naturally antiangiogenic,
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mis oleks loomulikult antiangiogeenne,
11:49
that could boost the body's defense system
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mis annaks organismi kaitsejõule hoogu
11:51
and beat back those blood vessels that are feeding cancers?
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ja tõrjuks tagasi veresooned, mis vähkkasvajaid toidavad?
11:54
In other words, can we eat to starve cancer? (Laughter)
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Teisisõnu, kas me saame toiduga vähki näljutada?
11:58
Well, the answer's yes,
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Vastus on jah.
12:00
and I'm going to show you how.
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Ma näitan teile, kuidas.
12:02
Our search for this
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Need uuringud viisid meid
12:04
has taken us to the market, the farm and to the spice cabinet,
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turule, tallu ja maitseainete kappi,
12:07
because what we've discovered
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sest me avastasime,
12:09
is that mother nature has laced a large number
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et emake loodus on loonud suure hulga
12:11
of foods and beverages and herbs
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toite, jooke ja ürte,
12:13
with naturally occurring inhibitors
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mis sisaldavad loomulikke
12:15
of angiogenesis.
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angiogeneesi inhibiitoreid.
12:17
So here's a test system we developed.
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Töötasime välja sellise testsüsteemi.
12:19
At the center is a ring from which hundreds of blood vessels
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Keskel on ring, millest kasvavad välja sajad veresooned,
12:21
are growing out in a starburst fashion.
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levides päikesekiirtena laiali.
12:23
And we can use this system
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Me kasutame seda süsteemi,
12:25
to test dietary factors
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et testida toidusedeliga seotud faktoreid
12:27
at concentrations that are obtainable by eating.
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ja kontsentratsioone, mida toiduga on võimalik saavutada.
12:30
So let me show you what happens when we put in
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Ma näitan teile, mis juhtub, kui me lisame
12:32
an extract from red grapes.
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punaste viinamarjade ekstrakti.
12:35
The active ingredient's resveratrol,
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Toimeaine on resveratrool.
12:37
it's also found in red wine.
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Seda leidub ka punases veinis.
12:39
This inhibits abnormal angiogenesis
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See tõkestab ebanormaalset angiogeneesi
12:42
by 60 percent.
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60 protsendi võrra.
12:44
Here's what happens when we added an extract from strawberries;
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Nii juhtub, kui me lisame maasikate ekstrakti.
12:47
it potently inhibits angiogenesis.
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See tõkestab tugevalt angiogeneesi.
12:50
And extract from soybeans.
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Ja sojaubade ekstrakt.
12:54
And here is a growing list of our
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Siin on kasvav nimekiri
12:56
antiangiogenic foods and beverages
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antiangiogeensetest toitudest ja jookidest,
12:58
that we're interested in studying.
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mida me soovime uurida.
13:00
For each food type,
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Iga toiduainetüübi puhul
13:02
we believe that there are different potencies
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eksisteerib meie arvates erinev mõju
13:04
within different strains and varietals.
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alaliikide siseselt.
13:07
And we want to measure this because,
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Me tahame seda mõõta,
13:09
well, while you're eating a strawberry
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sest kui sa näiteks sööd maasikat
13:11
or drinking tea,
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või jood teed,
13:13
why not select the one that's most potent
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siis miks mitte valida see, mis suudab
13:15
for preventing cancer.
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kõige tõhusamalt vähki ära hoida.
13:17
So here are four different teas that we've tested.
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Oleme testinud nelja erinevat tüüpi teed.
13:20
They're all common ones:
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Need on kõik tavalised sordid:
13:22
Chinese jasmine, Japanese sencha,
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hiina jasmiinitee, jaapani sencha,
13:24
Earl Grey and a special blend that we prepared.
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Earl Grey ja üks spetsiaalne segu, mille me valmistasime.
13:26
And you can see clearly
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On ilmselge,
13:28
that the teas vary in their potency
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et teede tõhusus on väga erinev,
13:30
from less potent to more potent.
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vähem tõhusast rohkem tõhusani.
13:33
But what's very cool
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Aga kõige toredam on see,
13:35
is when we actually combined the two
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et kui me panime kokku
13:37
less potent teas together,
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kaks vähem tõhusat teed
13:39
the combination, the blend,
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saime tulemuseks segu,
13:41
is more potent than either one alone.
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mis on tõhusam kui kumbki eraldi võetuna.
13:44
This means there's food synergy.
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See tähendab, et on olemas toidusünergia.
13:49
Here's some more data from our testing.
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Siin on veel andmeid meie katsetest.
13:51
Now, in the lab, we can simulate tumor angiogenesis
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Laboratooriumis simuleerime kasvaja angiogeneesi,
13:54
represented here in a black bar.
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mida tähistab siin must triip.
13:56
And using this system, we can test the potency of cancer drugs.
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Seda süsteemi kasutades võime testida vähiravimite tõhusust.
13:59
So the shorter the bar,
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Mida lühem on triip,
14:01
less angiogenesis, that's good.
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seda vähem on angiogeneesi ja see on hea.
14:04
And here are some common drugs
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Siin on mõned tavalised ravimid,
14:06
that have been associated with reducing the risk
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mida on seostatud inimeste
14:08
of cancer in people.
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vähiriski vähendamisega.
14:10
Statins, nonsteroidal anti-inflammatory drugs
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Statiinid, mittesteroidsed põletikuvastased ravimid
14:12
and a few others,
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ja veel mõned -
14:14
they inhibit angiogenesis too.
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ka nemad pärsivad angiogeneesi.
14:17
And here are the dietary factors
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Aga on olemas toiduvalikuga seotud faktorid,
14:19
going head to head against these drugs.
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mis pakuvad neile ravimitele kõva konkurentsi.
14:22
You can see, they clearly hold their own
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Nagu näete, on nad väärilisteks vastasteks
14:24
and, in some cases, they're more potent
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ja mõnel juhul isegi tõhusamad
14:26
than the actual drugs.
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kui ravimid ise.
14:28
Soy, parsley, garlic,
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Soja, petersell, küüslauk,
14:30
grapes, berries;
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viinamarjad, marjad -
14:32
I could go home and cook a tasty meal
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ma võiksin minna koju ja valmistada maitsva lõunasöögi,
14:34
using these ingredients.
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kasutades neid toiduaineid.
14:36
So imagine if we could create
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Kujutlege, kui me suudaksime luua
14:38
the world's first rating system
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maailma esimese hindamissüsteemi,
14:40
in which we could score foods
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kus me saaksime toiduainetele punkte anda
14:42
according to their antiangiogenic,
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vastavalt nende antiangiogeensetele
14:44
cancer-preventative properties.
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vähivastastele omadustele.
14:46
And that's what we're doing right now.
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Just seda me praegu teemegi.
14:49
Now, I've shown you a bunch of lab data,
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Olen näidanud teile palju laboriandmeid,
14:51
and so the real question is:
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aga tegelik küsimus on:
14:53
What is the evidence in people
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kuidas on tõendatud, et inimeste puhul
14:55
that eating certain foods can reduce
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suudab teatud toitude söömine vähendada
14:57
angiogenesis in cancer?
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vähkkasvajate angiogeneesi?
15:00
Well, the best example I know
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Parim näide, mida ma tean,
15:02
is a study of 79,000 men
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on uuring, mis tehti 79 000 mehega,
15:04
followed over 20 years,
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keda jälgiti 20 aasta jooksul.
15:06
in which it was found that men who consumed
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Uuringuga tuvastati, et meestel, kes sõid
15:08
cooked tomatoes two to three times a week
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kaks või kolm korda nädalas küpsetatud tomateid,
15:10
had up to a 50 percent reduction
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oli 50 protsenti väiksem risk
15:13
in their risk of developing prostate cancer.
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haigestuda eesnäärmevähki.
15:16
Now, we know that tomatoes are a good source of lycopene,
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Me teame, et tomatites on palju lükopeeni
15:19
and lycopene is antiangiogenic.
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ja lükopeen on antiangiogeenne.
15:22
But what's even more interesting from this study
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Aga veelgi põnevam selle uuringu juures on see,
15:24
is that in those men who did develop prostate cancer,
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et neil meestel, kes siiski haigestusid eesnäärmevähki,
15:27
those who ate more servings of tomato sauce
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aga kes sõid rohkelt tomatikastet,
15:30
actually had fewer blood vessels
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oli vähem veresooni,
15:32
feeding their cancer.
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mis vähkkasvajat toitsid.
15:34
So this human study is a prime example
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See inimuuring on suurepärane näide,
15:36
of how antiangiogenic substances
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kuidas antiangiogeensed ained,
15:38
present in food and consumed at practical levels
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mis toidus sisalduvad ja mida vajalikus koguses manustatakse,
15:41
can impact on cancer.
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võivad vähki mõjutada.
15:43
And we're now studying
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Praegu uurime me
15:45
the role of a healthy diet
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tervisliku toiduvaliku rolli
15:47
with Dean Ornish at UCSF and Tufts University
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3000
koostöös Dean Ornishi ning California ja Tuftsi ülikooliga.
15:50
on the role of this healthy diet on markers of angiogenesis
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Uurime tervisliku toiduvaliku mõju seoses angiogneesi markeritega,
15:53
that we can find in the bloodstream.
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mis vereringes leiduvad.
15:56
Now, obviously, what I've shared with you has some far-ranging implications,
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Loomulikult on sellel, mida teiega täna jagasin, oluline tähendus
15:59
even beyond cancer research.
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ka väljaspool vähiuuringuid.
16:01
Because if we're right, it could impact on consumer education,
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Sest kui meil on õigus, võib see mõjutada klientide teadlikkust,
16:04
food services, public health
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toitlustusteenuseid, rahvuslikku tervishoidu
16:06
and even the insurance industry.
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ja isegi kindlustusettevõtteid.
16:08
And, in fact, some insurance companies
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Muuseas, mõned kindlustusettevõtted
16:10
are already beginning to think along these lines.
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on hakanud juba selles suunas mõtlema.
16:12
Check out this ad from Blue Cross Blue Shield of Minnesota.
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Tutvuge selle reklaamiga Minnesotast.
16:16
And for many people around the world,
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Paljude inimeste jaoks kogu maailmas
16:18
dietary cancer prevention
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võib toiduvalikuga seotud vähiennetus
16:20
may be the only practical solution
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olla ainsaks praktiliseks lahenduseks,
16:22
because not everybody can afford expensive end-stage cancer treatments,
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sest igaüks ei suuda endale lubada kallist ravi lõppstaadiumis vähi vastu,
16:25
but everybody could benefit from
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aga igaüks võib saada kasu
16:27
a healthy diet based on local, sustainable,
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tervislikust toiduvalikust, mis põhineb kohalikel, jätkusuutlikel
16:30
antiangiogenic crops.
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antiangiogeensetel saadustel.
16:33
Now, finally,
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Lõpetuseks -
16:35
I've talked to you about food,
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olen rääkinud teile toidust
16:37
and I've talked to you about cancer,
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ja olen rääkinud vähist,
16:39
so there's just one more disease that I have to tell you about
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nii et on jäänud veel ainult üks haigus, millest peaksin rääkima,
16:42
and that's obesity.
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ning see on rasvumine.
16:44
Because it turns out that
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Tuleb välja, et
16:46
adipose tissue, fat,
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rasvkude, rasv,
16:48
is highly angiogenesis dependent.
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sõltub suuresti angiogeneesist.
16:50
And, like a tumor, fat grows when blood vessels grow.
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Nagu vähkkasvaja, kasvab ka rasv koos veresoontega.
16:53
So the question is: Can we shrink fat
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Küsimus on selles: kas me saame kahandada rasvahulka,
16:56
by cutting off its blood supply?
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lõigates ära selle verevarustuse?
16:58
So the top curve shows the body weight
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Ülemine kaar näitab sellise hiire kehakaalu,
17:01
of a genetically obese mouse
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kes on geneetiliselt ülekaaluline
17:03
that eats nonstop
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ja sööb lakkamatult,
17:05
until it turns fat, like this furry tennis ball.
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kuni muutub paksuks nagu see karvane tennisepall.
17:09
And the bottom curve is the weight of a normal mouse.
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Alumine kaar näitab normaalse hiire kehakaalu.
17:12
If you take the obese mouse and give it
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Kui te võtate rasvunud hiire ja annate talle
17:14
an angiogenesis inhibitor, it loses weight.
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angiogeneesi inhibiitorit, võtab ta kaalus alla.
17:16
Stop the treatment, gains the weight back.
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Kui ravi lõpetate, võtab ta kaalus jälle juurde.
17:18
Restart the treatment, loses the weight again.
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Alustage raviga uuesti ja ta võtab taas kaalus alla.
17:20
Stop the treatment, it gains the weight back.
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Lõpetage ravi ja ta võtab kaalus juurde.
17:22
And, in fact, you can cycle the weight up and down
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Te saate kaalu tsüklitena tõsta ja langetada,
17:24
simply by inhibiting angiogenesis.
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lihtsalt pärssides angiogeneesi.
17:27
So this approach that we're taking for cancer prevention
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Meetodit, mida kasutame vähiennetuseks,
17:29
may also have an application
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võib olla võimalik kasutada
17:31
for obesity.
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ka rasvumise vastu.
17:33
The really, truly interesting thing about this
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Väga huvitavaks kogu asja juures on see,
17:35
is that we can't take these obese mice
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et me ei saa võtta rasvunud hiiri
17:37
and make them lose more weight
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ja panna neid kaotama kaalus rohkem,
17:39
than what the normal mouse's weight is supposed to be.
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kui normaalse hiire kehakaal olema peaks.
17:42
In other words, we can't create supermodel mice.
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Teisisõnu, me ei suuda luua hiir-supermodelli.
17:44
(Laughter)
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(Naer)
17:46
And this speaks to the role of angiogenesis
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See tähendab, et angiogeneesi roll
17:48
in regulating healthy set points.
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on määratleda tervislikud lähtekohad.
17:51
Albert Szent-Gyorgi once said that,
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Albert Szent-Gyorgi ütles kord:
17:53
"Discovery consists of seeing what everyone has seen,
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"Avastus tähendab näha seda, mida kõik on näinud,
17:56
and thinking what no one has thought."
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ja mõelda, nagu keegi varem pole mõelnud."
17:58
I hope I've convinced you
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Loodan, et olen teid veennud,
18:00
that, for diseases like cancer, obesity and other conditions,
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et haguste puhul nagu vähk, ülekaalulisus jne
18:03
that there may be a great power
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võib nende ühise nimetaja,
18:05
in attacking their common denominator: angiogenesis.
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angiogeneesi ründamises peituda suur jõud.
18:08
And that's what I think the world needs now. Thank you.
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See on minu arvates see, mida maailm peaks teadma. Tänan teid.
18:11
(Applause)
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(Aplaus)
18:22
June Cohen: I have a quick question for you. So these drugs aren't exactly ...
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Need ravimid ei ole õieti -
18:25
they're not exactly in mainstream cancer treatments right now.
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nad ei kuulu praegu vähiravis levinud ravimite hulka.
18:28
For anyone out here who has cancer,
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Mida te soovitaksite mõnele siinolijale,
18:30
what would you recommend?
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kellel on vähk?
18:32
Do you recommend pursuing these treatments now, for most cancer patients?
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Kas te soovitaksite enamikul vähipatsientidest praegu seda ravi kasutada?
18:35
William Li: So there are antiangiogenic treatments
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On olemas antiangiogeenseid ravimeetodeid,
18:37
that are FDA approved,
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mis on USA toidu- ja ravimiameti poolt heaks kiidetud.
18:39
and if you're a cancer patient
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Kui sa oled vähipatsient
18:41
or working for one or advocating for one,
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või tegutsed tema heaks,
18:43
you should ask about them.
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siis peaksid nende kohta küsima.
18:45
And there are many clinical trials.
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On olemas mitmeid ravimiuuringu programme.
18:48
The Angiogenesis Foundation is following almost 300 companies,
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Angiogeneesi Fond jälgib umbes 300 ettevõtet
18:51
and there are about 100 more
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ja selles süsteemis
18:53
drugs in that pipeline.
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on veel umbes 100 ravimit.
18:55
So consider the approved ones,
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Kaaluge neid ravimeid, mis on heaks kiidetud,
18:57
look for clinical trials,
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püüdke leida ravimiuuringu programme,
18:59
but then between what the doctor can do for you,
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aga lisaks sellele, mida arst teie heaks teha saab,
19:01
we need to start asking what can we do for ourselves.
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peame hakkama küsima, mida me ise saame enda heaks ära teha.
19:03
And this is one of the themes that I'm talking about
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See ongi üks neist teemadest, millest ma räägin -
19:05
is we can empower ourselves to do the things
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me saame anda iseendale väe teha asju,
19:07
that doctors can't do for us,
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mida arstid ei saa meie eest ära teha,
19:09
which is to use knowledge and take action.
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see tähendab kasutada teadmisi ja tegutseda.
19:11
And if Mother Nature has given us some clues,
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Emake loodus on andnud meile mõned näpunäited,
19:14
we think that there might be a new future
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milles meie arvates võiks olla uus arusaam
19:16
in the value of how we eat.
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selle toidu väärtusest, mida me sööme.
19:18
And what we eat is really our chemotherapy three times a day.
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Toiduga saame tegelikult kolm korda päevas keemiaravi.
19:21
JC: Right. And along those lines,
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Selge. Kas inimesed,
19:23
for people who might have risk factors for cancer,
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kellel võib olla kõrge riskifaktor seoses vähiga,
19:26
would you recommend pursuing any treatments sort of prophylactically
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peaksid teie soovitusel järgima mingit profülaktilist ravi
19:29
or simply pursuing the right diet
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või lihtsalt sööma õiget toitu,
19:31
with lots of tomato sauce?
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milles on palju tomatikastet?
19:33
WL: Well, you know, there's abundant epidemiological evidence.
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On olemas palju epidemioloogilist tõendusmaterjali.
19:36
And I think in the information age,
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Ja ma arvan, et tänasel infoajastul
19:38
it doesn't take long to go to a credible source
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ei võta palju aega, et leida usutav allikas
19:40
like PubMed, the National Library of Medicine,
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nagu PubMed või Rahvuslik Meditsiiniraamatukogu,
19:42
to look for epidemiological studies
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kust otsida epidemioloogilisi uurimistöid
19:44
for cancer risk reduction
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seoses vähiriski vähendamisega
19:46
based on diet and based on common medications.
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toiduvaliku ja tavaliste ravimite abil.
19:49
And that's certainly something that anybody can look into.
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Sellega tasub tutvuda igaühel.
19:51
JC: Okay. Well, thank you so much.
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OK. Tänan teid väga.
19:53
(Applause)
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(Aplaus)
ABOUT THE SPEAKER
William Li - Cancer researcherWilliam Li heads the Angiogenesis Foundation, a nonprofit that is re-conceptualizing global disease fighting.
Why you should listen
Many of society’s most devastating diseases -- cancer, cardiovascular disease, diabetes and Alzheimer’s, to name a few -- share a common denominator: faulty angiogenesis, the body’s growth of new capillary blood vessels. Given excessive or insufficient blood vessel growth, serious health issues arise. While researching under Harvard surgeon Judah Folkman, who pioneered the study of angiogenesis, Li learned how angiogenesis-based medicine helps patients overcome numerous diseases by restoring the balance of blood-vessel growth.
Li co-founded the Angiogenesis Foundation in 1994. The foundation’s Project ENABLE -- a global system that integrates patients, medical experts and healthcare professionals -- democratizes the spread and implementation of knowledge about angiogenesis-based medicines, diet and lifestyle. Some 40,000 physicians have been educated on new treatments, ranging from cancer care to wound care, by the foundation’s faculty of medical experts, and they are bringing new, lifesaving and disease-preventing techniques to people around the world.
William Li | Speaker | TED.com