TED2010
William Li: Can we eat to starve cancer?
William Li: Možemo li prehranom izgladnjivati rak?
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William Li predstavlja novi način razmišljanja o tretiranju raka: angiogeneza, ciljana terapija na krvne žile koje prehranjuju tumor. Prvi ključan (i najvažniji) korak je: prehrana koja prekida opskrbu raka hranjivim tvarima i pobjeđuje ga u njegovoj vlastitoj igri.
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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Dobar dan.
00:19
There's a medical revolution happening all around us,
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Upravo se događa medicinska revolucija oko nas
00:22
and it's one that's going to help us conquer
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i ona će nam pomoći da pobijedimo
00:24
some of society's most dreaded conditions,
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neke od najstrašnijih bolesti današnjeg društva,
00:26
including cancer.
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uključujući rak.
00:28
The revolution is called angiogenesis,
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Revolucija se zove angiogeneza,
00:31
and it's based on the process
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a temelji se na procesu
00:33
that our bodies use to grow blood vessels.
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kojim naš organizam stvara krvne žile.
00:36
So why should we care about blood vessels?
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Dakle, zašto bismo brinuli oko krvnih žila?
00:38
Well, the human body is literally packed with them:
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Ta ljudsko tijelo obiluje njima:
00:41
60,000 miles worth in a typical adult.
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96 500 kilometara u prosječnog odraslog čovjeka.
00:44
End to end, that would form a line
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To bi skupno činilo nit
00:46
that would circle the earth twice.
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kojom bismo mogli opasati Zemlju dva puta.
00:49
The smallest blood vessels are called capillaries;
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Najmanje krvne žile u tijelu jesu kapilare;
00:52
we've got 19 billion of them in our bodies.
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ima ih 19 milijardi u našem organizmu.
00:55
And these are the vessels of life, and,
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I to su žile života,
00:58
as I'll show you,
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a kao što ću vam pokazati,
01:00
they can also be the vessels of death.
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mogu biti i žile smrti.
01:03
Now the remarkable thing about blood vessels
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Osobitost krvnih žila jest
01:05
is that they have this ability
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njihova sposobnost
01:07
to adapt to whatever environment they're growing in.
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prilagodbe bilo kojem okruženju u kojemu rastu.
01:09
For example, in the liver they form channels
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Primjerice u jetri formiraju kanale
01:11
to detoxify the blood;
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za detoksikaciju krvi,
01:13
in the lung they line air sacs for gas exchange;
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u plućima oplakuju alveole u svrhu izmjene plinova,
01:16
in muscle they corkscrew so that muscles can contract
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u mišiću one tvore krivulje koje omogućuju kontrakciju mišića
01:18
without cutting off circulation;
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bez prekida cirkulacije.
01:21
and in nerves they course along like power lines,
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U živcima se pružaju uzdužno poput dalekovoda
01:23
keeping those nerves alive.
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i održavaju te živce živima.
01:25
We get most of these blood vessels
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Organizam stvara većinu tih krvnih žila
01:27
when we're actually still in the womb,
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tijekom prenatalnog razvoja.
01:29
And what that means is that as adults,
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To sugerira da u odraslih
01:32
blood vessels don't normally grow.
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krvne žile u normalnom organizmu ne rastu.
01:34
Except in a few special circumstances:
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Izuzev nekoliko osobitih situacija:
01:38
In women, blood vessels grow every month
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U žena krvne žile rastu svakoga mjeseca
01:40
to build the lining of the uterus;
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stvarajući oblogu maternice.
01:42
during pregnancy, they form the placenta,
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Tijekom trudnoće one formiraju posteljicu
01:44
which connects mom and baby.
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koja povezuje majku i dijete.
01:47
And after injury, blood vessels
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A nakon ozljede krvne žile
01:49
actually have to grow under the scab
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moraju rasti ispod kraste
01:51
in order to heal a wound.
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kako bi ozljeda zacijelila.
01:53
And this is actually what it looks like,
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I ovako to zapravo izgleda,
01:55
hundreds of blood vessels
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tisuće krvnih žila
01:57
all growing toward the center of the wound.
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rastu prema centru ozljede.
01:59
So the body has the ability to regulate
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Dakle organizam ima sposobnost regulacije
02:02
the amount of blood vessels that are present at any given time.
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količine prisutnih krvnih žila u određenom vremenu.
02:05
It does this through an elaborate
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Organizam to obavlja kroz usavršen
02:07
and elegant system of checks and balances,
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i fini sustav kontrola i ravnoteža,
02:09
stimulators and inhibitors of angiogenesis,
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stimulatora i inhibitora angiogeneze,
02:12
such that, when we need a brief burst of blood vessels,
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primjerice kada je potrebna brza i značajna količina krvnih žila,
02:15
the body can do this by releasing stimulators,
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organizam to ostvaruje otpuštanjem stimulatora,
02:18
proteins called angiogenic factors
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proteina koji se zovu faktori angiogeneze
02:20
that act as natural fertilizer
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koji djeluju kao prirodno „gnojivo“
02:22
and stimulate new blood vessels to sprout.
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i stimuliraju razvitak novih krvnih žila.
02:24
And when those excess vessels are no longer needed,
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A kada te krvne žile postanu suvišne,
02:26
the body prunes them back to baseline
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organizam ih reducira do normalne vrijednosti
02:29
using naturally occurring inhibitors of angiogenesis.
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koristeći prirodne inhibitore angiogeneze.
02:33
Now there are other situations where we start beneath the baseline
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No postoje i druge situacije kada je količina krvnih žila u organizmu ispod potrebne vrijednosti
02:35
and we need to grow more blood vessels just to get back to normal levels --
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te organizam mora izgraditi nove krvne žile kako bi postigao normalnu vrijednost,
02:38
for example, after an injury --
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na primjer, nakon ozljede,
02:40
and a body can do that too,
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tijelo to može učiniti,
02:42
but only to that normal level,
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ali samo do normalne vrijednosti,
02:44
that set point.
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do normalnog stanja.
02:46
But what we now know is that for a number of diseases,
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No ono što danas znamo, a tiče se većeg broja bolesti,
02:49
there are defects in the system
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jest da u organizmu postoje defekti
02:51
where the body can't prune back extra blood vessels
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kada organizam ne može reducirati suvišne krvne žile
02:54
or can't grow enough new ones
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ili ne može formirati nove
02:56
in the right place at the right time.
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na odgovarajućim mjestima u odgovarajuće vrijeme.
02:58
And in these situations, angiogenesis
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U tim situacijama, angiogeneza
03:00
is out of balance.
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je neuravnotežena.
03:02
And when angiogenesis is out of balance,
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A kada je angiogeneza neuravnotežena,
03:04
a myriad of diseases result.
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kao rezultat pojavljuje se značajan broj bolesti.
03:06
For example, insufficient angiogenesis --
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Na primjer, nedostatna angiogeneza,
03:08
not enough blood vessels --
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nedovoljno krvnih žila,
03:10
leads to wounds that don't heal, heart attacks,
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dovodi do ozljeda koje ne zacjeljuju, srčane kapi,
03:13
legs without circulation, death from stroke,
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loše cirkulacije u nogama, smrti uslijed kapi,
03:15
nerve damage.
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živčanih oštećenja.
03:17
And on the other end, excessive angiogenesis --
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S druge strane, intenzivna angiogeneza,
03:19
too many blood vessels -- drives disease,
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previše krvnih žila potiče bolesti,
03:22
and we see this in cancer, blindness,
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a to uočavamo kod tumora, sljepoće,
03:24
arthritis, obesity,
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artritisa, pretilosti,
03:26
Alzheimer's disease.
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Alzheimerove bolesti.
03:28
In total, there are more than 70 major diseases
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U konačnici, postoji više od 70 značajnih bolesti
03:31
affecting more than a billion people worldwide,
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koje pogađaju više od milijardu ljudi diljem svijeta,
03:34
that all look on the surface to be different from one another,
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a koje se prividno međusobno razlikuju
03:36
but all actually share
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dok ih zapravo povezuje
03:38
abnormal angiogenesis
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nenormalna angiogeneza
03:40
as their common denominator.
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kao zajednička komponenta.
03:42
And this realization is allowing us
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Ovo shvaćanje nam dopušta
03:44
to reconceptualize
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da promijenimo
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the way that we actually approach these diseases
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način pristupa ovim bolestima
03:48
by controlling angiogenesis.
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kontroliranjem angiogeneze.
03:51
Now I'm going to focus on cancer
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Sada ću se usredotočiti na rak
03:53
because angiogenesis is a hallmark of cancer,
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s obzirom da je angiogeneza obilježje raka,
03:56
every type of cancer.
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svakog tipa raka.
03:58
So here we go.
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Dakle, krenimo.
04:00
This is a tumor: dark, gray, ominous mass
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Ovo je tumor: tamna, siva, zloćudna masa
04:02
growing inside a brain.
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koja raste u mozgu.
04:04
And under the microscope, you can see
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I pod mikroskopom, možete vidjeti
04:06
hundreds of these brown staining blood vessels,
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tisuće ovih smeđih krvnih žila,
04:08
capillaries that are feeding cancer cells,
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kapilara koje prehranjuju stanice raka,
04:10
bringing oxygen and nutrients.
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donoseći kisik i hranjive tvari.
04:13
But cancers don't start out like this.
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No tumori ne nastaju na ovaj način.
04:15
And, in fact, cancers don't start out
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I, zapravo, tumori u početku
04:17
with a blood supply.
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nisu prožeti krvnim žilama.
04:19
They start out as small, microscopic nests of cells
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Tumori nastaju iz malog, mikroskopskog gnijezda stanica
04:22
that can only grow to
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koje može narasti do najviše
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one half a cubic millimeter in size;
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pola kubičnog milimetra.
04:27
that's the tip of a ballpoint pen.
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To je veličina vrška kemijske olovke.
04:29
Then they can't get any larger because they don't have a blood supply,
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Oni više od toga ne mogu narasti jer im nedostaje opskrba krvlju,
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so they don't have enough oxygen or nutrients.
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stoga ne primaju dovoljno kisika i hranjivih tvari.
04:34
In fact, we're probably forming these
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Zapravo, u našem organizmu vjerojatno neprestano nastaju
04:36
microscopic cancers all the time in our body.
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ovakvi mikroskopski tumori.
04:40
Autopsy studies from people who died in car accidents
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Nalazi obdukcija žrtava prometnih nezgoda
04:43
have shown that about 40 percent of women
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pokazali su da 40% žena
04:46
between the ages of 40 and 50
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između četrdesete i pedesete godine
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actually have microscopic
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zapravo imaju mikroskopske
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cancers in their breasts,
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tumore u dojkama,
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about 50 percent of men in their 50s and 60s
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oko 50% muškaraca u pedesetim i šezdesetima godinama
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have microscopic prostate cancers,
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imaju mikroskopske tumore prostate,
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and virtually 100 percent of us,
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a gotovo 100% nas
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by the time we reach our 70s,
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do sedamdesetih godina života
05:01
will have microscopic cancers growing in our thyroid.
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imat će mikroskopske tumore u štitnoj žlijezdi.
05:04
Yet, without a blood supply,
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Ipak, bez opskrbe krvlju,
05:06
most of these cancers
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većina ovih tumora
05:08
will never become dangerous.
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nikada neće postati opasna.
05:10
Dr. Judah Folkman, who was my mentor
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Dr. Judah Folkman, koji je bio moj mentor
05:12
and who was the pioneer of the angiogenesis field,
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i pionir u polju angiogeneze,
05:15
once called this "cancer without disease."
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nazvao je ovaj fenomen "tumor koji ne uzrokuje bolesti".
05:19
So the body's ability to balance angiogenesis,
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Dakle, sposobnost tijela da održava ravnotežu angiogeneze,
05:22
when it's working properly,
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kada normalno funkcionira,
05:24
prevents blood vessels from feeding cancers.
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sprječava krvne žile da prehranjuju tumor.
05:26
And this turns out to be
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Ispada da je to
05:28
one of our most important defense mechanisms
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jedan od naših najvažnijih obrambenih mehanizama
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against cancer.
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protiv tumora.
05:33
In fact, if you actually block angiogenesis
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U stvari, ako blokiramo angiogenezu
05:35
and prevent blood vessels from ever reaching cancer cells,
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i spriječimo razvoj krvnih žila u tumoru,
05:37
tumors simply can't grow up.
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tumori tada jednostavno ne mogu rasti.
05:39
But once angiogenesis occurs,
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No kada se angiogeneza ostvari,
05:41
cancers can grow exponentially.
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tumori mogu rasti eksponencijalno.
05:44
And this is actually how
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I to je zapravo način
05:46
a cancer goes from being
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kojim bezopasan tumor
05:48
harmless to deadly.
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postaje smrtonosan.
05:50
Cancer cells mutate
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Tumorske stanice mutiraju
05:52
and they gain the ability to release
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i pridobe sposobnost otpuštanja
05:54
lots of those angiogenic factors, natural fertilizer,
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angiogenetskih faktora, umjetnih gnojiva,
05:56
that tip the balance in favor of blood vessels
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koji pomiču ravnotežu u smjeru invazije krvnih žila
05:58
invading the cancer.
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u tumoru.
06:00
And once those vessels invade the cancer,
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I jednom kada krvne žile urastu u tumor,
06:02
it can expand, it can invade local tissues.
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on se može širiti, zauzeti lokalna tkiva.
06:05
And the same vessels that are feeding tumors
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I iste krvne žile koje prehranjuju tumor
06:07
allow cancer cells to exit into the circulation
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omogućuju tumorskim stanicama ulazak u cirkulaciju
06:10
as metastases.
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kao metastaze.
06:12
And, unfortunately, this late stage of cancer
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I, nažalost, u toj kasnoj fazi tumora,
06:15
is the one at which it's most likely
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tumor će najvjerojatnije
06:17
to be diagnosed,
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biti dijagnosticiran,
06:19
when angiogenesis is already turned on
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kada je angiogeneza uznapredovala
06:21
and cancer cells are growing like wild.
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i kada tumorske stanice nekontrolirano rastu.
06:25
So, if angiogenesis
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Stoga, ako je angiogeneza
06:27
is a tipping point
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ključna točka
06:29
between a harmless cancer and a harmful one,
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pretvorbe tumora iz bezopasnog u opasni,
06:32
then one major part of the angiogenesis revolution
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tada najveći dio angiogenetske revolucije
06:35
is a new approach to treating cancer
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čini novi pristup liječenju tumora
06:37
by cutting off the blood supply.
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prekidom krvne opskrbe tumora.
06:40
We call this antiangiogenic therapy,
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Zovemo to antiangiogenetska terapija,
06:43
and it's completely different from chemotherapy
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i ona je potpuno drugačija od kemoterapije
06:45
because it selectively aims
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jer je usmjerena selektivno
06:47
at the blood vessels that are feeding the cancers.
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na krvne žile koje prehranjuju tumor.
06:50
And we can do this because
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To možemo učiniti zato
06:52
tumor blood vessels are unlike normal, healthy vessels
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što se tumorske krvne žile razlikuju od normalnih, zdravih krvnih žila
06:54
we see in other places of the body:
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koje susrećemo u ostalim dijelovima tijela:
06:56
They're abnormal;
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one su abnormalne,
06:58
they're very poorly constructed;
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loše građene
07:00
and, because of that, they're highly vulnerable
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i zahvaljujući tome, iznimno ranjive
07:02
to treatments that target them.
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na terapiju usmjerenu protiv njih.
07:05
In effect, when we give cancer patients
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U stvari, kada pacijenta tretiramo
07:07
antiangiogenic therapy --
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antiangiogenetskom terapijom
07:09
here, an experimental drug for a glioma,
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ovdje, eksperimentalni lijek protiv glioma,
07:12
which is a type of brain tumor --
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jedan tip tumora mozga,
07:14
you can see that there are dramatic changes that occur
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možete vidjeti da se odvijaju
07:17
when the tumor is being starved.
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dramatične promjene tijekom gladovanja tumora.
07:19
Here's a woman with a breast cancer
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Ovo je žena oboljela od tumora dojke
07:21
being treated with the antiangiogenic drug called Avastin,
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i bila je tretirana antiangiogenetskim lijekom koji se zove Avastin
07:24
which is FDA approved.
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i kojeg je odobrila Američka agencija za hranu i lijekove.
07:26
And you can see that the halo of blood flow
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I možete vidjeti da je polovina krvnog toka
07:29
disappears after treatment.
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nestala nakon terapije.
07:32
Well, I've just shown you
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Dakle, upravo sam vam pokazao
07:34
two very different types of cancer
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dva izrazito različita tipa raka
07:36
that both responded to antiangiogenic therapy.
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koja reagiraju na antiangiogenetsku terapiju.
07:39
So, a few years ago, I asked myself,
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I unatrag nekoliko godina, zapitao sam se:
07:41
"Can we take this one step further
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„Možemo li učiniti korak više
07:43
and treat other cancers,
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i liječiti ostale tipove raka,
07:45
even in other species?"
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čak i u drugih vrsta?“
07:49
So here is a nine year-old boxer named Milo
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Ovo je devetogodišnji bokser Milo
07:51
who had a very aggressive tumor
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koji je patio od agresivnog tumora
07:53
called a malignant neurofibroma growing on his shoulder.
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koji se naziva maligni neurofibrom a koji je rastao na njegovu ramenu.
07:56
It invaded into his lungs.
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Metastazirao je u njegova pluća.
07:58
His veterinarian only gave him three months to live.
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Veterinar je prognozirao još tri mjeseca života.
08:00
So we created a cocktail of antiangiogenic drugs
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No mi smo pripremili koktel antiangiogenetskih lijekova
08:03
that could be mixed into his dog food
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koje je moguće pomiješati sa psećom hranom
08:05
as well as an antiangiogenic cream
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te antiangiogenetsku kremu
08:07
that could be applied on the surface of the tumor.
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koja se može nanijeti na površinu tumora.
08:10
And within a few weeks of treatment,
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I tijekom nekoliko tjedana terapije,
08:12
we were able to slow down that cancer's growth
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uspjeli smo usporiti tumorski rast
08:15
such that we were ultimately able to extend milo's survival
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tako da smo uspjeli produžiti Milov životni vijek
08:18
to six times what the veterinarian had initially predicted,
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šest puta više negoli je to veterinar u početku predvidio,
08:21
all with a very good quality of life.
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a sve uz vrlo dobru kvalitetu života.
08:24
And we subsequently treated more than 600 dogs.
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Naknadno smo tretirali više od 600 pasa.
08:27
We have about a 60 percent response rate
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Ostvarili smo stopu reakcije od oko 60%
08:29
and improved survival for these pets
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i unaprijedili preživljavanje ovih kućnih ljubimaca
08:31
that were about to be euthanized.
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za koje je bila planirana eutanazija.
08:34
So let me show you a couple of
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Dopustite mi da vam pokažem nekoliko
08:36
even more interesting examples.
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još zanimljivijih primjera.
08:38
This is 20-year-old dolphin living in Florida,
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Ovo je dvadesetogodišnji delfin koji živi na Floridi,
08:40
and she had these lesions in her mouth
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i ona je imala lezije u ustima
08:42
that, over the course of three years,
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koje su se razdoblju od tri godine
08:44
developed into invasive squamous cell cancers.
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razvile u zloćudne, skvamozne tumorske stanice.
08:47
So we created an antiangiogenic paste.
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Mi smo pripremili antiangiogenetsku pastu.
08:50
We had it painted on top of the cancer
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Nanosili smo je na vrh tumora
08:52
three times a week.
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tri puta tjedno.
08:54
And over the course of seven months,
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I u roku od 7 mjeseci,
08:56
the cancers completely disappeared,
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tumor je u potpunosti nestao,
08:58
and the biopsies came back as normal.
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a nalaz biopsije dao je normalne rezultate.
09:02
Here's a cancer growing on the lip
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Ovo je tumor koji raste na usni
09:04
of a Wuarter horse named Guinness.
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jahaćeg konja Guinnessa.
09:06
It's a very, very deadly type of cancer called an angiosarcoma.
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To je jako, jako smrtonosan tip tumora koje se zove angiosarkom.
09:09
It had already spread to his lymph nodes,
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Već je metastazirao u limfne čvorove.
09:11
so we used an antiangiogenic skin cream for the lip
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Stoga smo koristili antiangiogenetsku kremu za usne
09:14
and an oral cocktail, so we could treat from the inside
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te oralni koktel, te smo tumor mogli tretirati kako izvana
09:17
as well as the outside.
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tako i iznutra.
09:19
And over the course of six months,
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I tijekom sljedećih 6 mjeseci,
09:21
he experienced a complete remission.
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Guinness je doživio potpunu remisiju.
09:24
And here he is six years later,
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I evo ga nakon šest godina,
09:27
Guinness, with his very happy owner.
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Guinness i njegov zadovoljni vlasnik.
09:30
(Applause)
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(pljesak)
09:33
Now, obviously, antiangiogenic therapy
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Dakle, očito je da je antiangiogenetsku terapiju
09:35
could be used for a wide range of cancers.
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moguće koristiti u borbi protiv širokog spektra karcinoma.
09:38
And, in fact, the first pioneering treatments
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Zapravo su prve terapije
09:40
for people, as well as dogs,
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za ljude kao i za pse
09:42
are already becoming available.
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već dostupne.
09:44
There's 12 different drugs, 11 different cancer types.
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Dostupno je 12 lijekova za 11 različitih tipova raka.
09:47
But the real question is:
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No pravo je pitanje:
09:49
How well do these work in practice?
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koliko su učinkoviti ti lijekovi u praksi?
09:51
So here's actually the patient survival data
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Ovo je dijagram preživljavanja pacijenata
09:54
from eight different types of cancer.
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oboljelih od osam različitih tipova raka.
09:56
The bars represent survival time
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Stupci predstavljaju preostali životni vijek
09:58
taken from the era
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u vremenu kada se
10:00
in which there was only chemotherapy,
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primjenjivala isključivo kemoterapija,
10:02
or surgery, or radiation available.
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operacija ili terapija zračenjem.
10:05
But starting in 2004,
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Počevši s 2004.
10:07
when antiangiogenic therapies first became available,
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kada je započela primjena antioangiogenetske terapije,
10:09
well you can see that there has been
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možete vidjeti
10:11
a 70 to 100 percent
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od 70 do 100 posto
10:13
improvement in survival
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poboljšanja u vidu preživljavanja
10:15
for people with kidney cancer, multiple myeloma,
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pacijenata oboljelih od karcinoma bubrega, multiplog mijeloma,
10:18
colorectal cancer, and gastrointestinal stromal tumors.
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kolorektalnog karcinoma i gastrointestinalnog stromalnog tumora.
10:22
That's impressive.
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To je impresivno.
10:24
But for other tumors and cancer types,
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No za ostale tipove karcinoma
10:27
the improvements have only been modest.
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poboljšanje je bilo skromno.
10:30
So I started asking myself,
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Stoga sam se zapitao:
10:32
"Why haven't we been able to do better?"
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„Zašto nismo mogli polučiti bolje rezultate?"
10:35
And the answer, to me, is obvious;
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Odgovor je očit;
10:37
we're treating cancer too late in the game,
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počinjemo prekasno tretirati karcinom,
10:39
when it's already established
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kada se već razvio
10:41
and, oftentimes, it's already spread or metastasized.
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i često kada se već proširio i metastazirao.
10:44
And as a doctor, I know
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A kao liječnik znam
10:46
that once a disease progresses to an advanced stage,
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da kada bolest uđe u uznapredovalu fazu,
10:49
achieving a cure
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izlječenje je teško postići,
10:51
can be difficult, if not impossible.
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ako ne i nemoguće.
10:54
So I went back to the biology
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Stoga sam se usmjerio na biologiju
10:56
of angiogenesis
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angiogeneze
10:58
and started thinking:
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i promišljao:
11:00
Could the answer to cancer
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"Može li odgovor na problem liječenja karcinoma
11:02
be preventing angiogenesis,
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biti prevencija angiogeneze,
11:05
beating cancer at its own game
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pobjeda karcinoma u njegovoj vlastitoj igri
11:07
so the cancers could never become dangerous?
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tako da ni ne postane opasan?"
11:11
This could help healthy people
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To bi moglo pomoći zdravim ljudima,
11:13
as well as people who've already beaten cancer
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ali i ljudima koji su već
11:15
once or twice
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jedanput ili dvaput pobijedili karcinom
11:17
and want to find a way to keep it from coming back.
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i žele pronaći način sprječavanja njegova povratka.
11:20
So to look for a way to prevent angiogenesis in cancer,
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Kako bih pronašao način prevencije angiogeneze u tumoru,
11:23
I went back to look at cancer's causes.
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vratio sam se proučavanju uzroka tumora.
11:25
And what really intrigued me
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I ono što je zaista pobudilo moje zanimanje,
11:27
was when I saw that diet
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bilo je to kad sam vidio da ishrana
11:29
accounts for 30 to 35 percent
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čini 30 do 35 posto
11:31
of environmentally caused cancers.
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vanjskih uzročnika karcinoma.
11:34
Now, the obvious thing is to think about
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Očito je da trebamo razmišljati o tome
11:36
what we could remove from our diet, what to strip out, take away.
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što možemo ukloniti iz naše prehrane, što trebamo izbaciti.
11:40
But I actually took a completely opposite approach
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No ja sam zapravo zauzeo u potpunosti oprečno stajalište
11:43
and began asking: What could we be adding to our diet
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i zapitao se: što možemo uvesti u našu prehranu,
11:46
that's naturally antiangiogenic,
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a da se ponaša kao prirodni antiangiogenetski faktor
11:49
that could boost the body's defense system
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koji može ojačati obrambeni mehanizam
11:51
and beat back those blood vessels that are feeding cancers?
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i pobijediti krvne žile koje prehranjuju karcinom?
11:54
In other words, can we eat to starve cancer? (Laughter)
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Drugim riječima, možemo li prehranom izgladnjivati tumor? (smijeh)
11:58
Well, the answer's yes,
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Odgovor je da
12:00
and I'm going to show you how.
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i pokazat ću vam kako.
12:02
Our search for this
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Naše istraživanje
12:04
has taken us to the market, the farm and to the spice cabinet,
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odvelo nas je na tržnicu, farmu i među začine
12:07
because what we've discovered
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jer smo otkrili
12:09
is that mother nature has laced a large number
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da nam je majka priroda darovala veliki broj
12:11
of foods and beverages and herbs
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namirnica, pića i biljaka
12:13
with naturally occurring inhibitors
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koji sadrže prirodne inhibitore
12:15
of angiogenesis.
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angiogeneze.
12:17
So here's a test system we developed.
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Ovo je sustav koji smo razvili.
12:19
At the center is a ring from which hundreds of blood vessels
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U centru je smješten prsten od kojega rastu tisuće krvnih žila
12:21
are growing out in a starburst fashion.
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tvoreći zvjezdastu formu.
12:23
And we can use this system
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I mi možemo iskoristiti ovaj sistem
12:25
to test dietary factors
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radi testiranja prehrambenih faktora
12:27
at concentrations that are obtainable by eating.
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u koncentracijama koje dobivamo tijekom jela.
12:30
So let me show you what happens when we put in
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Dopustite mi da vam pokažem što se događa kada dodamo
12:32
an extract from red grapes.
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ekstrakt crnog grožđa
12:35
The active ingredient's resveratrol,
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Aktivni sastojak jest resveratrol,
12:37
it's also found in red wine.
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koji se može naći i u crnom vinu.
12:39
This inhibits abnormal angiogenesis
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On inhibira abnormalnu angiogenezu
12:42
by 60 percent.
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za 60%.
12:44
Here's what happens when we added an extract from strawberries;
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Ovo se događa kada dodamo ekstrakt jagode;
12:47
it potently inhibits angiogenesis.
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on je snažan inhibitor angiogeneze.
12:50
And extract from soybeans.
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I ekstrakt soje.
12:54
And here is a growing list of our
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Ovo je lista koja još uvijek raste,
12:56
antiangiogenic foods and beverages
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antiangiogenetskih namirnica i pića
12:58
that we're interested in studying.
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koje želimo proučiti.
13:00
For each food type,
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Vjerujemo da za svaki tip hrane
13:02
we believe that there are different potencies
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postoje različiti potencijali
13:04
within different strains and varietals.
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unutar različitih vrsta i sojeva.
13:07
And we want to measure this because,
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I mi to želimo izmjeriti jer,
13:09
well, while you're eating a strawberry
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pa, kada već jedete jagode
13:11
or drinking tea,
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ili pijete čaj,
13:13
why not select the one that's most potent
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zašto ne biste izabrali onaj koji je najsnažniji
13:15
for preventing cancer.
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u prevenciji raka.
13:17
So here are four different teas that we've tested.
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Ovo su četiri različite vrste čaja koje smo testirali.
13:20
They're all common ones:
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Svi su uobičajeni:
13:22
Chinese jasmine, Japanese sencha,
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kineski jasmin, japanski sencha zeleni čaj,
13:24
Earl Grey and a special blend that we prepared.
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Earl Grey te posebna mješavina koju smo pripremili.
13:26
And you can see clearly
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I možete jasno vidjeti
13:28
that the teas vary in their potency
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da čajevi variraju u svojoj potenciji
13:30
from less potent to more potent.
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inhibicije angiogeneze od slabih do snažnih inhibitora.
13:33
But what's very cool
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No ono što je super
13:35
is when we actually combined the two
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je kada smo kombinirali dva
13:37
less potent teas together,
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slabija čaja,
13:39
the combination, the blend,
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kombinacija, mješavina,
13:41
is more potent than either one alone.
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snažnija je od svakog čaja zasebno.
13:44
This means there's food synergy.
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To sugerira da postoji sinergija hrane.
13:49
Here's some more data from our testing.
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Evo nekih podataka iz naših testiranja.
13:51
Now, in the lab, we can simulate tumor angiogenesis
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Sada, u laboratoriju, možemo simulirati angiogenezu tumora,
13:54
represented here in a black bar.
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što prikazuje crni stupac.
13:56
And using this system, we can test the potency of cancer drugs.
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Koristeći ovaj sustav, možemo testirati snagu antikancerogenih lijekova.
13:59
So the shorter the bar,
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Dakle kraći stupac
14:01
less angiogenesis, that's good.
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znači slabiju angiogenezu, to je dobro.
14:04
And here are some common drugs
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I evo nekih uobičajenih lijekova
14:06
that have been associated with reducing the risk
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koji se povezuju sa smanjenjem rizika
14:08
of cancer in people.
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oboljenja od raka.
14:10
Statins, nonsteroidal anti-inflammatory drugs
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Statini, nesteroidni protuupalni lijekovi
14:12
and a few others,
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i još neki,
14:14
they inhibit angiogenesis too.
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koji također inhibiraju angiogenezu.
14:17
And here are the dietary factors
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A evo i hranidbenih faktora
14:19
going head to head against these drugs.
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koji idu rame uz rame sa spomenutim lijekovima.
14:22
You can see, they clearly hold their own
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Možete vidjeti, oni očito imaju vlastitu snagu,
14:24
and, in some cases, they're more potent
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u nekim slučajevima, čak su i snažniji
14:26
than the actual drugs.
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od spomenutih lijekova.
14:28
Soy, parsley, garlic,
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Soja, peršin, češnjak,
14:30
grapes, berries;
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grožđe, bobičasto voće,
14:32
I could go home and cook a tasty meal
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mogao bih otići kući i skuhati ukusan obrok
14:34
using these ingredients.
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koristeći ove sastojke.
14:36
So imagine if we could create
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Zamislite da možemo napraviti
14:38
the world's first rating system
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prvi vrijednosni sustav
14:40
in which we could score foods
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u kojemu bismo mogli vrednovati hranu
14:42
according to their antiangiogenic,
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ovisno o njenim antiangiogenetskim svojstvima,
14:44
cancer-preventative properties.
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svojstvima koja preveniraju rak.
14:46
And that's what we're doing right now.
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I to je ono što upravo sada radimo.
14:49
Now, I've shown you a bunch of lab data,
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Sada, pokazao sam vam mnoštvo laboratorijskih podataka,
14:51
and so the real question is:
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i pravo pitanje jest:
14:53
What is the evidence in people
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kakvi su dokazi na ljudima
14:55
that eating certain foods can reduce
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da konzumiranje određene hrane može reducirati
14:57
angiogenesis in cancer?
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tumorsku angiogenezu?
15:00
Well, the best example I know
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Pa, najbolji primjer koji poznajem
15:02
is a study of 79,000 men
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jest istraživanje provedeno na 79 000 muškaraca
15:04
followed over 20 years,
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u proteklih 20 godina,
15:06
in which it was found that men who consumed
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koje pokazuje da muškarci koji su konzumirali
15:08
cooked tomatoes two to three times a week
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kuhane rajčice dva do tri puta tjedno
15:10
had up to a 50 percent reduction
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imaju 50% manji rizik
15:13
in their risk of developing prostate cancer.
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od razvijanja raka prostate.
15:16
Now, we know that tomatoes are a good source of lycopene,
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Sada, znamo da su rajčice dobar izvor likopena,
15:19
and lycopene is antiangiogenic.
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a likopen djeluje antiangiogenetski.
15:22
But what's even more interesting from this study
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No što je još zanimljivije u ovom istraživanju
15:24
is that in those men who did develop prostate cancer,
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jest da oni muškarci koji su ipak oboljeli od raka prostate,
15:27
those who ate more servings of tomato sauce
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oni koji su jeli više umaka od rajčica,
15:30
actually had fewer blood vessels
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zapravo su imali manje krvnih žila
15:32
feeding their cancer.
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koje su prehranjivale njihov tumor.
15:34
So this human study is a prime example
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Dakle ovo istraživanje na ljudima glavni je odgovor
15:36
of how antiangiogenic substances
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na pitanje kakav utjecaj antiangiogenetske tvari,
15:38
present in food and consumed at practical levels
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prisutne u hrani i konzumirane u praktičnim količinama,
15:41
can impact on cancer.
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imaju na tumor.
15:43
And we're now studying
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I sada proučavamo
15:45
the role of a healthy diet
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ulogu zdrave prehrane
15:47
with Dean Ornish at UCSF and Tufts University
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u suradnji s Deanom Ornishem, Kalifornijskim univerzitetom i Univerzitetom Tufts
15:50
on the role of this healthy diet on markers of angiogenesis
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ulogu zdrave ishrane na markere angiogeneze
15:53
that we can find in the bloodstream.
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koje možemo pronaći u krvotoku.
15:56
Now, obviously, what I've shared with you has some far-ranging implications,
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Sada, očigledno, podijelio sam s vama neke šire implikacije,
15:59
even beyond cancer research.
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čak izvan okvira istraživanja raka.
16:01
Because if we're right, it could impact on consumer education,
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Jer ako smo u pravu, to bi moglo utjecati na obrazovanje potrošača,
16:04
food services, public health
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restorane, javno zdravstvo
16:06
and even the insurance industry.
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i čak na osiguravajuće kuće.
16:08
And, in fact, some insurance companies
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I, zapravo, neke osiguravajuće kuće
16:10
are already beginning to think along these lines.
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već počinju razmišljati sukladno ovim spoznajama.
16:12
Check out this ad from Blue Cross Blue Shield of Minnesota.
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Pogledajte ovaj oglas iz Blue Cross Blue Shield iz Minnesote.
16:16
And for many people around the world,
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I za mnogo ljudi diljem svijeta,
16:18
dietary cancer prevention
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prevencija raka prehranom
16:20
may be the only practical solution
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možda je jedino praktično rješenje
16:22
because not everybody can afford expensive end-stage cancer treatments,
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jer ne mogu si svi priuštiti skupe terapije liječenja raka,
16:25
but everybody could benefit from
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ali svatko može imati koristi
16:27
a healthy diet based on local, sustainable,
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od zdrave prehrane temeljene na lokalnim, održivim,
16:30
antiangiogenic crops.
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antiangiogenetskim usjevima.
16:33
Now, finally,
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Sada, konačno,
16:35
I've talked to you about food,
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govorio sam vam o hrani,
16:37
and I've talked to you about cancer,
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i govorio sam vam o raku,
16:39
so there's just one more disease that I have to tell you about
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preostala je još samo jedna bolest o kojoj vam nisam govorio,
16:42
and that's obesity.
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a to je pretilost.
16:44
Because it turns out that
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Ispostavlja se da je
16:46
adipose tissue, fat,
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masno tkivo, salo,
16:48
is highly angiogenesis dependent.
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ovisno o angiogenezi.
16:50
And, like a tumor, fat grows when blood vessels grow.
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Kao i tumor, salo se razvija kada se razvijaju i krvne žile.
16:53
So the question is: Can we shrink fat
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Stoga je pitanje: možemo li smanjiti salo
16:56
by cutting off its blood supply?
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prekidom krvne opskrbe istog?
16:58
So the top curve shows the body weight
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Gornja krivulja prikazuje tjelesnu masu
17:01
of a genetically obese mouse
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genetički pretilog miša
17:03
that eats nonstop
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koji neprestano jede
17:05
until it turns fat, like this furry tennis ball.
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dok ne postane pretio, poput ove krznene teniske loptice.
17:09
And the bottom curve is the weight of a normal mouse.
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Donja krivulja prikazuje tjelesnu masu normalnog miša.
17:12
If you take the obese mouse and give it
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Ukoliko pretilog miša tretirate
17:14
an angiogenesis inhibitor, it loses weight.
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angiogenetskim inhibitorom, on izgubi na tjelesnoj masi.
17:16
Stop the treatment, gains the weight back.
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Ukoliko prekinete tretman, opet postane pretio.
17:18
Restart the treatment, loses the weight again.
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Opet započnete tretman, miš opet izgubi na tjelesnoj masi.
17:20
Stop the treatment, it gains the weight back.
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Obustavite tretman, miš opet postaje pretio.
17:22
And, in fact, you can cycle the weight up and down
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I zapravo možete mijenjati težinu miša
17:24
simply by inhibiting angiogenesis.
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inhibiranjem angiogeneze.
17:27
So this approach that we're taking for cancer prevention
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Dakle ovaj pristup koji koristimo u prevenciji raka
17:29
may also have an application
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također se može primijeniti
17:31
for obesity.
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i na pretilost.
17:33
The really, truly interesting thing about this
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Doista zanimljiva stvar u tome
17:35
is that we can't take these obese mice
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jest da tretiranjem pretiloga miša ne možemo
17:37
and make them lose more weight
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smanjiti njegovu težinu
17:39
than what the normal mouse's weight is supposed to be.
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na vrijednost manju od težine normalnog miša.
17:42
In other words, we can't create supermodel mice.
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Drugim riječima, ne možemo dobiti miševe supermodele.
17:44
(Laughter)
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(smijeh)
17:46
And this speaks to the role of angiogenesis
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To govori o ulozi angiogeneze
17:48
in regulating healthy set points.
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u regulaciji zdravstvenih vrijednosti.
17:51
Albert Szent-Gyorgi once said that,
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Albert Szent-Gyorgi jednom je rekao:
17:53
"Discovery consists of seeing what everyone has seen,
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„Otkriće je u tome da vidimo ono što su svi već vidjeli
17:56
and thinking what no one has thought."
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a razmišljamo o čemu još nitko nije razmišljao.“
17:58
I hope I've convinced you
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Nadam se da sam vas uvjerio
18:00
that, for diseases like cancer, obesity and other conditions,
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da kod bolesti poput raka, pretilosti i ostalih stanja,
18:03
that there may be a great power
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možda postoji velika snaga
18:05
in attacking their common denominator: angiogenesis.
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u napadanju njihove zajedničke značajke: angiogeneze.
18:08
And that's what I think the world needs now. Thank you.
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I mislim da je to ono što je svijetu trenutačno potrebno. Hvala.
18:11
(Applause)
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(pljesak)
18:22
June Cohen: I have a quick question for you. So these drugs aren't exactly ...
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June Cohen: Imam kratko pitanje za vas. Dakle ovi lijekovi zapravo nisu,
18:25
they're not exactly in mainstream cancer treatments right now.
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zapravo nisu uključeni u normalnu terapiju raka trenutačno.
18:28
For anyone out here who has cancer,
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Za bilo koga ovdje oboljelog od raka,
18:30
what would you recommend?
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što biste preporučili?
18:32
Do you recommend pursuing these treatments now, for most cancer patients?
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Preporučujete li provođenje ovih tretmana sada za većinu oboljelih od raka?
18:35
William Li: So there are antiangiogenic treatments
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William Li: Dakle, postoje antiangiogenetski tretmani
18:37
that are FDA approved,
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koje je odobrila Američka agencija za hranu i lijekove,
18:39
and if you're a cancer patient
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i ako ste oboljeli od raka
18:41
or working for one or advocating for one,
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ili radite za, odnosno zastupate nekog oboljelog od raka,
18:43
you should ask about them.
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trebate se raspitati za njih.
18:45
And there are many clinical trials.
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I postoje mnoga klinička ispitivanja.
18:48
The Angiogenesis Foundation is following almost 300 companies,
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Angiogenetska zaklada obuhvaća gotovo 300 tvrtki
18:51
and there are about 100 more
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i postoji još oko 100
18:53
drugs in that pipeline.
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potencijalnih lijekova.
18:55
So consider the approved ones,
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Stoga uzmite u obzir odobrene lijekove,
18:57
look for clinical trials,
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potražite klinička istraživanja,
18:59
but then between what the doctor can do for you,
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no osim onoga što liječnik može učiniti za vas,
19:01
we need to start asking what can we do for ourselves.
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moramo se upitati što možemo učiniti sami za sebe.
19:03
And this is one of the themes that I'm talking about
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I to je jedna od tema o kojoj govorim;
19:05
is we can empower ourselves to do the things
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mi možemo osnažiti sebe tako da činimo stvari
19:07
that doctors can't do for us,
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koje liječnici ne mogu činiti za nas,
19:09
which is to use knowledge and take action.
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tj. sami iskoristiti znanje i biti poduzetni.
19:11
And if Mother Nature has given us some clues,
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I ako nam je majka priroda dala neke tragove,
19:14
we think that there might be a new future
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mi smatramo da nas čeka nova budućnost
19:16
in the value of how we eat.
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u vidu vrijednosti onoga što jedemo.
19:18
And what we eat is really our chemotherapy three times a day.
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I ono što jedemo zapravo je naša kemoterapija tri puta dnevno.
19:21
JC: Right. And along those lines,
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JC: Točno. I zajedno s ovim preporukama,
19:23
for people who might have risk factors for cancer,
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za ljude koji možda imaju rizične faktore za razvoj raka,
19:26
would you recommend pursuing any treatments sort of prophylactically
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biste li im preporučili da slijede bilo koji preventivni tretman,
19:29
or simply pursuing the right diet
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ili da se jednostavno pridržavaju odgovarajuće dijete
19:31
with lots of tomato sauce?
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s mnogo umaka od rajčica?
19:33
WL: Well, you know, there's abundant epidemiological evidence.
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WL: Pa, znate, postoje bogati epidemiološki dokazi.
19:36
And I think in the information age,
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I mislim da u današnje vrijeme
19:38
it doesn't take long to go to a credible source
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nije potrebno mnogo vremena da bi se našao vjerodostojni izvor
19:40
like PubMed, the National Library of Medicine,
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kao što je Nacionalna medicinska knjižnica Pubmed,
19:42
to look for epidemiological studies
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i pogledalo epidemiološko istraživanje
19:44
for cancer risk reduction
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o smanjenu faktora rizika raka,
19:46
based on diet and based on common medications.
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baziranih na prehrani ili uobičajenim lijekovima.
19:49
And that's certainly something that anybody can look into.
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To svakako bilo tko može pogledati.
19:51
JC: Okay. Well, thank you so much.
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JC: O.K. Mnogo hvala.
19:53
(Applause)
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(pljesak)
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