TED2010
William Li: Can we eat to starve cancer?
Vilijam Li: Možemo li da jedemo da bismo izgladneli rak?
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Vilijam Li (William Li) predstavlja novi način razmišljanja o lečenju raka: angiogeneza, ciljanje na krvne sudove koji hrane tumor. Značajan prvi (i najbolji) korak: konzumiranje hrane koja pobeđuje rak u njegovoj sopstvenoj 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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Svuda oko nas se dešava jedna medicinska revolucija,
00:22
and it's one that's going to help us conquer
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a to je ona koja će nam pomoći da pobedimo
00:24
some of society's most dreaded conditions,
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neka od stanja kojih se najviše bojimo,
00:26
including cancer.
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uključujući rak.
00:28
The revolution is called angiogenesis,
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Ta revolucija se naziva angiogeneza
00:31
and it's based on the process
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i zasnovana je na procesu
00:33
that our bodies use to grow blood vessels.
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koji naša tela koriste da proizvode krvne sudove.
00:36
So why should we care about blood vessels?
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Dakle, zašto bismo brinuli o krvnim sudovima?
00:38
Well, the human body is literally packed with them:
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Pa, ljudsko telo je bukvalno njima pretrpano,
00:41
60,000 miles worth in a typical adult.
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u tipičnom odraslom telu ih ima oko 96000km.
00:44
End to end, that would form a line
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Od jednog do drugog kraja, to bi formiralo liniju
00:46
that would circle the earth twice.
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koja bi obišla oko Zemlje dva puta.
00:49
The smallest blood vessels are called capillaries;
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Najmanji krvni sudovi nazivaju se kapilari.
00:52
we've got 19 billion of them in our bodies.
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U telu ih imamo 19 milijardi.
00:55
And these are the vessels of life, and,
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Ovo su krvni sudovi života i
00:58
as I'll show you,
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kao što ću vam pokazati,
01:00
they can also be the vessels of death.
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mogu takođe biti i krvni sudovi smrti.
01:03
Now the remarkable thing about blood vessels
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Izvanredna stvar u vezi s krvnim sudovima
01:05
is that they have this ability
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jeste njihova sposobnost
01:07
to adapt to whatever environment they're growing in.
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da se prilagode bilo kakvom okruženju u kom se razvijaju.
01:09
For example, in the liver they form channels
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Na primer, u jetri formiraju kanale
01:11
to detoxify the blood;
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da prečiste krv.
01:13
in the lung they line air sacs for gas exchange;
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U plućima, okružuju kesice sa vazduhom za razmehu kiseonika.
01:16
in muscle they corkscrew so that muscles can contract
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U mišićima krivudaju, tako da mišići mogu da se stežu,
01:18
without cutting off circulation;
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a da ne prekinu cirkulaciju.
01:21
and in nerves they course along like power lines,
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A u nervima, oni se protežu kao strujni kablovi,
01:23
keeping those nerves alive.
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održavajući te nerve živim.
01:25
We get most of these blood vessels
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I većinu ovih krvnih sudova dobijemo
01:27
when we're actually still in the womb,
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dok smo još u materici.
01:29
And what that means is that as adults,
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A to znači da, kod odraslih,
01:32
blood vessels don't normally grow.
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ne nastaju novi krvni sudovi,
01:34
Except in a few special circumstances:
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osim u nekoliko posebnih slučajeva.
01:38
In women, blood vessels grow every month
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Kod žena, krvni sudovi nastaju svakog meseca
01:40
to build the lining of the uterus;
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da ograde matericu.
01:42
during pregnancy, they form the placenta,
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Tokom trudnoće, oni formiraju palcentu,
01:44
which connects mom and baby.
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koja povezuje majku i bebu.
01:47
And after injury, blood vessels
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A posle povrede, krvni sudovi
01:49
actually have to grow under the scab
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zapravo moraju da nastaju ispod kraste
01:51
in order to heal a wound.
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kako bi zalečili ranu.
01:53
And this is actually what it looks like,
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To ovako izgleda.
01:55
hundreds of blood vessels
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Stotine krvnih sudova
01:57
all growing toward the center of the wound.
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koji se formiraju ka centru rane.
01:59
So the body has the ability to regulate
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Znači telo je sposobno da kontroliše
02:02
the amount of blood vessels that are present at any given time.
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količinu krvnih sudova koji postoje u bilo kom trenutku.
02:05
It does this through an elaborate
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A to čini jednim složenim
02:07
and elegant system of checks and balances,
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i elegantnim sistemom podele moći,
02:09
stimulators and inhibitors of angiogenesis,
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stimulatorima i inhibitorima angiogeneze,
02:12
such that, when we need a brief burst of blood vessels,
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tako da, kada su nam brzo potrebni krvni sudovi,
02:15
the body can do this by releasing stimulators,
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telo to može da učini otpuštajući stimulatore,
02:18
proteins called angiogenic factors
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proteine koji se zovu angiogenski faktori
02:20
that act as natural fertilizer
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koji se ponašaju kao prirodno đubrivo
02:22
and stimulate new blood vessels to sprout.
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i stimulišu cvetanje novih krvnih sudova.
02:24
And when those excess vessels are no longer needed,
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I kada ti dodatni sudovi nisu više potrebni,
02:26
the body prunes them back to baseline
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telo ih smanji na osnovni nivo,
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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Postoje druge situacije kada polazimo ispod osnovnog nivoa,
02:35
and we need to grow more blood vessels just to get back to normal levels --
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kada nam je potrebno da proizvedemo više krvnih sudova da bismo se vratili na normalni nivo.
02:38
for example, after an injury --
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Na primer, posle povrede.
02:40
and a body can do that too,
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Telo može i to da uradi,
02:42
but only to that normal level,
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ali samo do normalnog nivoa,
02:44
that set point.
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te određene tačke.
02:46
But what we now know is that for a number of diseases,
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Ali sada znamo da, kod nekih bolesti,
02:49
there are defects in the system
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postoje greške u sistemu,
02:51
where the body can't prune back extra blood vessels
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kada telo ne može da smanji višak krvnih sudova
02:54
or can't grow enough new ones
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ili ne može da proizvede nove
02:56
in the right place at the right time.
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u pravo vreme na pravom mestu.
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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nije u ravnoteži.
03:02
And when angiogenesis is out of balance,
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A kada je angiogeneza u neravnoteži,
03:04
a myriad of diseases result.
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može se javiti bezbroj bolesti.
03:06
For example, insufficient angiogenesis --
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Na primer, nedovoljna angiogeneza,
03:08
not enough blood vessels --
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nedovoljno krvnih sudova,
03:10
leads to wounds that don't heal, heart attacks,
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vodi do rana koje ne zarastaju, do srčanih udara,
03:13
legs without circulation, death from stroke,
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nogu bez cirkulacije, smrti od moždanog udara,
03:15
nerve damage.
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oštećenja nerava.
03:17
And on the other end, excessive angiogenesis --
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S druge strane, preterana angiogeneza,
03:19
too many blood vessels -- drives disease,
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previše krvnih sudova, podstiče bolesti.
03:22
and we see this in cancer, blindness,
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To vidimo kod raka, slepila,
03:24
arthritis, obesity,
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artritisa, gojaznosti,
03:26
Alzheimer's disease.
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Alchajmerove bolesti.
03:28
In total, there are more than 70 major diseases
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Sve ukupno, postoji preko 70 ozbiljnih oboljenja
03:31
affecting more than a billion people worldwide,
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koja muče više od milijardu ljudi širom sveta,
03:34
that all look on the surface to be different from one another,
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koja na površini izgledaju kao da se razlikuju
03:36
but all actually share
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ali zapravo im je
03:38
abnormal angiogenesis
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abnormalna angiogeneza
03:40
as their common denominator.
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zajednički imenitelj.
03:42
And this realization is allowing us
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I ovo otkriće nam omogućava
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to reconceptualize
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da preispitamo
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the way that we actually approach these diseases
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način na koji prilazimo ovim bolestima,
03:48
by controlling angiogenesis.
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tako što kontrolišemo angiogenezu.
03:51
Now I'm going to focus on cancer
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Sad ću se koncentrisati na rak,
03:53
because angiogenesis is a hallmark of cancer,
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jer angiogeneza je obeležje 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, evo.
04:00
This is a tumor: dark, gray, ominous mass
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Ovo je tumor, tamna, siva, zlokobna masa
04:02
growing inside a brain.
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koja raste u jednom mozgu.
04:04
And under the microscope, you can see
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I pod mikroskopom možete videti
04:06
hundreds of these brown staining blood vessels,
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stotine ovih braon krvnih sudova,
04:08
capillaries that are feeding cancer cells,
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kapilara koji hrane ćelije raka,
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bringing oxygen and nutrients.
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donoseći kiseonik i hranljive materije.
04:13
But cancers don't start out like this.
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Ali rak ne počinje na ovaj način.
04:15
And, in fact, cancers don't start out
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Ustvari, rak ne počinje
04:17
with a blood supply.
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dotokom krvi.
04:19
They start out as small, microscopic nests of cells
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Počinje kao mala, mikroskopska mreža ćelija
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that can only grow to
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koja može da naraste do
04:24
one half a cubic millimeter in size;
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veličine od samo pola kubnog milimetra.
04:27
that's the tip of a ballpoint pen.
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To je vrh hemijske olovke.
04:29
Then they can't get any larger because they don't have a blood supply,
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Onda ne može da naraste jer se ne snabdeva krvlju,
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so they don't have enough oxygen or nutrients.
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pa nema dovoljno kiseonika i hranljivih materija.
04:34
In fact, we're probably forming these
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Ustvari, verovatno svo vreme proizvodimo
04:36
microscopic cancers all the time in our body.
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ove mikroskopske rakove u našim telima.
04:40
Autopsy studies from people who died in car accidents
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Izveštaji sa autopsija ljudi koji su poginuli u saobraćajnim nesrećama
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have shown that about 40 percent of women
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pokazuju da oko 40 procenata žena
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between the ages of 40 and 50
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između 40 i 50 godina starosti
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actually have microscopic
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zapravo ima mikroskopske
04:50
cancers in their breasts,
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rakove u svojim grudima.
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about 50 percent of men in their 50s and 60s
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Oko 50% muškaraca u pedesetim i šezdesetim
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have microscopic prostate cancers,
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godinama ima mikroskopske rakove prostate.
04:57
and virtually 100 percent of us,
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I praktično 100% nas,
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by the time we reach our 70s,
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do vremena kada dođe u sedamdesete,
05:01
will have microscopic cancers growing in our thyroid.
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imaće mikroskopske rakove u tiroidnoj žlezdi.
05:04
Yet, without a blood supply,
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Ipak, bez snabdevanja 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 Juda Folkman, koji je bio moj mentor
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and who was the pioneer of the angiogenesis field,
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i koji je pionir na polju angiogeneze,
05:15
once called this "cancer without disease."
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jednom je ovo nazvao "rak bez bolesti".
05:19
So the body's ability to balance angiogenesis,
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Znači sposobnost tela da balansira angiogenezu,
05:22
when it's working properly,
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kada funkcioniše ispravno,
05:24
prevents blood vessels from feeding cancers.
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sprečava krvne sudove da hrane rak.
05:26
And this turns out to be
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Ispostavlja se da je ovo
05:28
one of our most important defense mechanisms
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jedan od najvažnijih odbrambenih mehanizama
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against cancer.
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protiv raka.
05:33
In fact, if you actually block angiogenesis
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Ustvari, ako blokirate angiogenezu
05:35
and prevent blood vessels from ever reaching cancer cells,
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i sprečite krvne sudove da stignu do ćelija raka,
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tumors simply can't grow up.
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tumori jednostavno ne mogu da rastu.
05:39
But once angiogenesis occurs,
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Ali kada nastane angiogeneza,
05:41
cancers can grow exponentially.
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tumori mogu eksponencijalno da rastu.
05:44
And this is actually how
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Ovo je način na koji
05:46
a cancer goes from being
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jedan rak od bezopasnog
05:48
harmless to deadly.
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postaje smrtonosan.
05:50
Cancer cells mutate
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Ćelije raka mutiraju
05:52
and they gain the ability to release
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i stiču sposobnost da otpuštaju
05:54
lots of those angiogenic factors, natural fertilizer,
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mnoge od ovih angiogenskih faktora, prirodnog đubriva,
05:56
that tip the balance in favor of blood vessels
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koji remete ravnotežu u korist krvnih sudova
05:58
invading the cancer.
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prodirući u rak.
06:00
And once those vessels invade the cancer,
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I kada ti sudovi prodru u rak,
06:02
it can expand, it can invade local tissues.
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on se širi i može da prodre u okolna tkiva.
06:05
And the same vessels that are feeding tumors
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I isti krvni sudovi koji hrane tumore
06:07
allow cancer cells to exit into the circulation
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omogućavaju ćelijama raka da uđu 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 ovoj kasnoj fazi raka
06:15
is the one at which it's most likely
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se on najčešće
06:17
to be diagnosed,
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dijagnostikuje,
06:19
when angiogenesis is already turned on
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kada je angiogeneza uključena
06:21
and cancer cells are growing like wild.
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i ćelije raka rastu kao lude.
06:25
So, if angiogenesis
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Dakle, ako je angiogeneza
06:27
is a tipping point
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granica između
06:29
between a harmless cancer and a harmful one,
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bezopasnog i opasnog raka,
06:32
then one major part of the angiogenesis revolution
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onda je jedan veliki deo u revoluciji angiogeneze
06:35
is a new approach to treating cancer
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novi pristup tretmanu raka,
06:37
by cutting off the blood supply.
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prekidanjem snabdevanja krvlju.
06:40
We call this antiangiogenic therapy,
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Ovo nazivamo terapijom antiangiogenezom
06:43
and it's completely different from chemotherapy
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i to je potpuno drugačije od hemoterapije
06:45
because it selectively aims
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jer selektivno cilja
06:47
at the blood vessels that are feeding the cancers.
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krvne sudove koji hrane rak.
06:50
And we can do this because
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Ovo možemo da uradimo jer se
06:52
tumor blood vessels are unlike normal, healthy vessels
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krvni sudovi tumora razlikuju od normalnih, zdravih
06:54
we see in other places of the body:
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sudova koje vidimo na drugim mestima u telu.
06:56
They're abnormal;
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Oni su abnormalni;
06:58
they're very poorly constructed;
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vrlo su slabo napravljeni
07:00
and, because of that, they're highly vulnerable
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i zbog toga su veoma osetljivi
07:02
to treatments that target them.
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na tretmane koji ih ciljaju.
07:05
In effect, when we give cancer patients
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Kao rezultat toga, kada obolelima od raka
07:07
antiangiogenic therapy --
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damo ovakvu terapiju -
07:09
here, an experimental drug for a glioma,
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ovde, eksperimentalni lek za gliom,
07:12
which is a type of brain tumor --
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koji je vrsta tumora na mozgu -
07:14
you can see that there are dramatic changes that occur
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možete videti da se javljaju ozbiljne promene
07:17
when the tumor is being starved.
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kada se tumor izgladnjuje.
07:19
Here's a woman with a breast cancer
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Ova žena ima rak dojke
07:21
being treated with the antiangiogenic drug called Avastin,
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koji se tretira antiangiogenetskim lekom Avastinom,
07:24
which is FDA approved.
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koji je odobrila administracija za hranu i lekove.
07:26
And you can see that the halo of blood flow
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I možete videti da je oreol toka krvi
07:29
disappears after treatment.
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nestao posle tretmana.
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 veoma različita tipa raka
07:36
that both responded to antiangiogenic therapy.
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koji su reagovali na antiangiogenetsku terapiju.
07:39
So, a few years ago, I asked myself,
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Pre nekoliko godina sam se zapitao,
07:41
"Can we take this one step further
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"Možemo li ovo da odvedemo korak dalje,
07:43
and treat other cancers,
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i lečimo druge tumore,
07:45
even in other species?"
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čak i kod drugih vrsta?"
07:49
So here is a nine year-old boxer named Milo
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Ovde je devetogodišnji bokser po imenu Majlo
07:51
who had a very aggressive tumor
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koji je imao veoma agresivni tumor
07:53
called a malignant neurofibroma growing on his shoulder.
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po imenu maligni neurofibrom, koji je rastao na njegovom ramenu.
07:56
It invaded into his lungs.
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Prešao mu je na pluća.
07:58
His veterinarian only gave him three months to live.
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Njegov veterinar mu je dao tri meseca života.
08:00
So we created a cocktail of antiangiogenic drugs
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Mi smo napravili koktel antiangiogenetskih lekova
08:03
that could be mixed into his dog food
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koji mogu da se pomešaju s njegovom hranom,
08:05
as well as an antiangiogenic cream
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kao i antiangiogenetsku kremu
08:07
that could be applied on the surface of the tumor.
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koja se može namazati na površinu tumora.
08:10
And within a few weeks of treatment,
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I u okviru nekoliko nedelja tretmana
08:12
we were able to slow down that cancer's growth
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uspeli smo da usporimo rast tog raka
08:15
such that we were ultimately able to extend milo's survival
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tako da smo na kraju mogli da produžimo Majlov život
08:18
to six times what the veterinarian had initially predicted,
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za šest puta u odnosu na veterinarevu prognozu,
08:21
all with a very good quality of life.
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i to uz veoma dobar kvalitet života.
08:24
And we subsequently treated more than 600 dogs.
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Nakon toga smo lečili više od 600 pasa.
08:27
We have about a 60 percent response rate
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Imamo oko 60% učinka
08:29
and improved survival for these pets
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i poboljšanog opstanka ovih ljubimaca
08:31
that were about to be euthanized.
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koji bi bili uspavani.
08:34
So let me show you a couple of
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Pokazaću vam dva
08:36
even more interesting examples.
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još interesantnija primera.
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 ove lezije u ustima
08:42
that, over the course of three years,
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koje su se, tokom tri godine
08:44
developed into invasive squamous cell cancers.
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razvile u invazivne, slojevite ćelije raka.
08:47
So we created an antiangiogenic paste.
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Napravili smo antiangiogenetsku pastu.
08:50
We had it painted on top of the cancer
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Tri puta nedeljno smo je
08:52
three times a week.
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nanosili na rak.
08:54
And over the course of seven months,
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Tokom sedam meseci
08:56
the cancers completely disappeared,
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rak je u potpunosti nestao,
08:58
and the biopsies came back as normal.
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a rezultati biopsije bili su normalni.
09:02
Here's a cancer growing on the lip
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Ovde je rak koji raste na usni
09:04
of a Wuarter horse named Guinness.
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jednog trkačkog konja koji se zove Ginis.
09:06
It's a very, very deadly type of cancer called an angiosarcoma.
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To je veoma, veoma smrtonosna vrsta raka po imenu angiosarkom.
09:09
It had already spread to his lymph nodes,
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Već se proširio na njegove limfne čvorove,
09:11
so we used an antiangiogenic skin cream for the lip
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tako da smo koristili kremu za usnu,
09:14
and an oral cocktail, so we could treat from the inside
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kao i koktel, kako bismo ga lečili iznutra
09:17
as well as the outside.
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i spolja.
09:19
And over the course of six months,
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I u roku od šest meseci
09:21
he experienced a complete remission.
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potpuno se oporavio.
09:24
And here he is six years later,
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A evo ga šest godina posle,
09:27
Guinness, with his very happy owner.
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Ginis, sa svojim srećnim vlasnikom.
09:30
(Applause)
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(aplauz)
09:33
Now, obviously, antiangiogenic therapy
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Očigledno da se antiangiogenetska terapija
09:35
could be used for a wide range of cancers.
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može koristiti za razne vrste tumora.
09:38
And, in fact, the first pioneering treatments
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Ustvari, prva pionirska lečenja,
09:40
for people, as well as dogs,
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namenjena ljudima kao i životinjama,
09:42
are already becoming available.
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već postaju dostupna.
09:44
There's 12 different drugs, 11 different cancer types.
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Postoji 12 različitih lekova, 11 različitih vrsta raka,
09:47
But the real question is:
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ali pravo pitanje je:
09:49
How well do these work in practice?
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koliko su oni dobri u praksi?
09:51
So here's actually the patient survival data
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Evo podataka o izlečenim pacijentima
09:54
from eight different types of cancer.
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od osam različitih vrsta raka.
09:56
The bars represent survival time
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Ovi podaci predstavljaju vreme preživljavanja
09:58
taken from the era
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koje je uzeto iz ere
10:00
in which there was only chemotherapy,
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kada su bile dostupne samo
10:02
or surgery, or radiation available.
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hemoterapija ili operacija ili radijacija.
10:05
But starting in 2004,
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Ali počevši od 2004.
10:07
when antiangiogenic therapies first became available,
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kada su prve antioangiogenetske terapije postale dostupne,
10:09
well you can see that there has been
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možete videti da je
10:11
a 70 to 100 percent
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za 70 do 100 procenata
10:13
improvement in survival
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povećano preživljavanje
10:15
for people with kidney cancer, multiple myeloma,
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za ljude sa rakom bubrega, višestrukim mijelomima,
10:18
colorectal cancer, and gastrointestinal stromal tumors.
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kolorektalnim rakom i gastrointestinalnim stromalnim tumorom.
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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Ali za druge tumore i vrste raka
10:27
the improvements have only been modest.
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poboljšanja su skromna.
10:30
So I started asking myself,
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Tako sam se zapitao,
10:32
"Why haven't we been able to do better?"
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"Zašto nismo uspeli da postignemo više?"
10:35
And the answer, to me, is obvious;
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A odgovor je, po meni, očigledan;
10:37
we're treating cancer too late in the game,
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lečimo rak prekasno,
10:39
when it's already established
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kada se već smesti
10:41
and, oftentimes, it's already spread or metastasized.
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i često, već se i raširio i metastazirao.
10:44
And as a doctor, I know
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I kao doktor, ja znam da,
10:46
that once a disease progresses to an advanced stage,
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kada bolest uznapreduje,
10:49
achieving a cure
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postizanje izlečenja
10:51
can be difficult, if not impossible.
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može biti teško, ako ne i nemoguće.
10:54
So I went back to the biology
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Onda sam se vratio na biologiju
10:56
of angiogenesis
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angiogeneze
10:58
and started thinking:
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i počeo da razmišljam:
11:00
Could the answer to cancer
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da li bi lek za rak
11:02
be preventing angiogenesis,
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mogla da bude prevencija angiogeneze,
11:05
beating cancer at its own game
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pobeda raka u njegovoj igri
11:07
so the cancers could never become dangerous?
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tako da rak nikada ne postane opasan?
11:11
This could help healthy people
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Ovo bi moglo da pomogne zdravim ljudima
11:13
as well as people who've already beaten cancer
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kao i onima koji su već pobedili rak
11:15
once or twice
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jednom ili dva puta
11:17
and want to find a way to keep it from coming back.
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i žele da nađu način da se on ne vrati.
11:20
So to look for a way to prevent angiogenesis in cancer,
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Dakle, da bih pronašao način da sprečim angiogenezu kod raka,
11:23
I went back to look at cancer's causes.
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vratio sam se na uzroke raka.
11:25
And what really intrigued me
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I ono što me je stvarno kopkalo,
11:27
was when I saw that diet
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je kad sam video da ishrana
11:29
accounts for 30 to 35 percent
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učestvuje sa 30 do 35%
11:31
of environmentally caused cancers.
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u rakovima koji uzrok imaju u okruženju.
11:34
Now, the obvious thing is to think about
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Sad, očigledno bi bilo da razmišljamo
11:36
what we could remove from our diet, what to strip out, take away.
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o tome šta bismo mogli da izbacimo iz ishrane, da smanjimo.
11:40
But I actually took a completely opposite approach
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Ali ja sam imao potpuno suprotan pristup
11:43
and began asking: What could we be adding to our diet
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i počeo da pitam: šta bismo mogli da dodamo našoj ishrani
11:46
that's naturally antiangiogenic,
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što je prirodno antiangiogenetsko,
11:49
that could boost the body's defense system
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što bi moglo da ojača odbrambeni sistem tela
11:51
and beat back those blood vessels that are feeding cancers?
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i pobedi te krvne sudove koji hrane rak?
11:54
In other words, can we eat to starve cancer? (Laughter)
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Drugim rečima, možemo li da jedemo da bismo izgladneli rak?
11:58
Well, the answer's yes,
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Pa, odgovor je da.
12:00
and I'm going to show you how.
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I pokazaću vam kako.
12:02
Our search for this
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Naše istraživanje ovoga
12:04
has taken us to the market, the farm and to the spice cabinet,
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odvelo nas je na pijacu, na farmu i među začine,
12:07
because what we've discovered
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jer otkrili smo
12:09
is that mother nature has laced a large number
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da nam je majka priroda podarila veliki broj
12:11
of foods and beverages and herbs
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hrane i pića i bilja
12:13
with naturally occurring inhibitors
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koja 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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Evo sistema za test koji smo razvili.
12:19
At the center is a ring from which hundreds of blood vessels
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U centru je krug iz kog stotine krvnih sudova
12:21
are growing out in a starburst fashion.
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polaze u obliku zvezde.
12:23
And we can use this system
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Možemo koristiti ovaj sistem
12:25
to test dietary factors
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za testiranje hranljivih faktora
12:27
at concentrations that are obtainable by eating.
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u koncentracijama koje se dobijaju putem jela.
12:30
So let me show you what happens when we put in
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Pokazaću vam šta se dešava kada stavimo
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 je resveratrol.
12:37
it's also found in red wine.
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Može se naći i u crnom vinu.
12:39
This inhibits abnormal angiogenesis
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Ovo inhibira abnormalnu angiogenezu
12:42
by 60 percent.
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za 60 procenata.
12:44
Here's what happens when we added an extract from strawberries;
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Evo šta se dešava kada dodamo ekstrakt jagoda.
12:47
it potently inhibits angiogenesis.
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To veoma moćno inhibira angiogenezu.
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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A evo i naše rastuće liste
12:56
antiangiogenic foods and beverages
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antiangiogenetskih pića i hrane
12:58
that we're interested in studying.
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koje želimo da proučimo.
13:00
For each food type,
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I mislimo da za svaku vrstu
13:02
we believe that there are different potencies
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hrane postoje različite snage
13:04
within different strains and varietals.
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u okviru različitih vrsta i varijacija.
13:07
And we want to measure this because,
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I ovo želimo da merimo jer,
13:09
well, while you're eating a strawberry
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pa, kad 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 najjači
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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Evo četiri različita čaja koja smo testirali.
13:20
They're all common ones:
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Oni su svi uobičajeni,
13:22
Chinese jasmine, Japanese sencha,
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kineski jasmin, vrsta japanskog zelenog čaja,
13:24
Earl Grey and a special blend that we prepared.
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Earl Grey i posebna mešavina koju smo mi pripremili.
13:26
And you can see clearly
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I jasno možete videti
13:28
that the teas vary in their potency
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da čajevi varijaju u snazi
13:30
from less potent to more potent.
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od manje snažnog do snažnijeg.
13:33
But what's very cool
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Ali ono što je super
13:35
is when we actually combined the two
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je kad smo pomešali dva
13:37
less potent teas together,
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manje snažna čaja,
13:39
the combination, the blend,
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ta kombinacija, mešavina,
13:41
is more potent than either one alone.
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snažnija je od oba čaja posebno.
13:44
This means there's food synergy.
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To znači da postoji sinergija hrane.
13:49
Here's some more data from our testing.
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Evo još nekih podataka iz naših testiranja.
13:51
Now, in the lab, we can simulate tumor angiogenesis
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E sad, u laboratoriji simuliramo angiogenezu tumora,
13:54
represented here in a black bar.
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što je prikazano crnim stupcem.
13:56
And using this system, we can test the potency of cancer drugs.
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Koristeći ovaj sistem možemo da testiramo snagu lekova protiv raka.
13:59
So the shorter the bar,
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Dakle, kraći stubac,
14:01
less angiogenesis, that's good.
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manje angiogeneze, to je dobro.
14:04
And here are some common drugs
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A evo i nekih uobičajenih lekova
14:06
that have been associated with reducing the risk
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za koje se smatra da smanjuju rizik
14:08
of cancer in people.
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od raka kod ljudi.
14:10
Statins, nonsteroidal anti-inflammatory drugs
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Statini, antizapaljenski lekovi bez steroida,
14:12
and a few others,
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i još neki,
14:14
they inhibit angiogenesis too.
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oni takođe inhibiraju angiogenezu.
14:17
And here are the dietary factors
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A evo i faktora ishrane
14:19
going head to head against these drugs.
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koji idu rame uz rame sa ovim lekovima.
14:22
You can see, they clearly hold their own
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Možete videti da oni očigledno imaju svoje,
14:24
and, in some cases, they're more potent
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a u nekim slučajevima su i jači
14:26
than the actual drugs.
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od običnih lekova.
14:28
Soy, parsley, garlic,
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Soja, peršun, beli luk,
14:30
grapes, berries;
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grožđe, bobice,
14:32
I could go home and cook a tasty meal
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mogao bih da odem kući i skuvam ukusan
14:34
using these ingredients.
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obrok sa ovim sastojcima.
14:36
So imagine if we could create
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Zamislite da možemo da napravimo
14:38
the world's first rating system
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prvi sistem da ocenjivanje hrane
14:40
in which we could score foods
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gde bismo mogli da bodujemo hranu
14:42
according to their antiangiogenic,
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prema tome kolika su im antiangiogenetska
14:44
cancer-preventative properties.
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i svojstva koja preveniraju rak.
14:46
And that's what we're doing right now.
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I to ćemo upravo sada da uradimo.
14:49
Now, I've shown you a bunch of lab data,
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Sad, pokazao sam vam gomilu podataka iz laboratorije,
14:51
and so the real question is:
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a pravo pitanje je:
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 smanjiti
14:57
angiogenesis in cancer?
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angiogenezu kod raka?
15:00
Well, the best example I know
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Pa, najbolji primer koji znam
15:02
is a study of 79,000 men
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je studija o 79.000 muškaraca
15:04
followed over 20 years,
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koji su praćeni preko 20 godina,
15:06
in which it was found that men who consumed
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u kojoj je utvrđeno da je muškarcima koji
15:08
cooked tomatoes two to three times a week
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su konzumirali kuvani paradajz dva do tri
15:10
had up to a 50 percent reduction
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puta nedeljno, rizik od razvijanja raka
15:13
in their risk of developing prostate cancer.
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prostate bio smanjen za 50%.
15:16
Now, we know that tomatoes are a good source of lycopene,
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Sad, znamo da je paradajz dobar izvor likopena,
15:19
and lycopene is antiangiogenic.
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a likopen je antiangiogenetski.
15:22
But what's even more interesting from this study
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Ali ono što je iz ove studije još interesantnije
15:24
is that in those men who did develop prostate cancer,
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je da oni muškarci kod kojih se ipak razvio rak prostate,
15:27
those who ate more servings of tomato sauce
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oni koji su jeli više porcija paradajz sosa,
15:30
actually had fewer blood vessels
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oni su imali manje krvnih sudova
15:32
feeding their cancer.
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koji su hranili rak.
15:34
So this human study is a prime example
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Dakle ova ljudska studija je glavni primer
15:36
of how antiangiogenic substances
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toga kakav uticaj antiangiogenetske supstance,
15:38
present in food and consumed at practical levels
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koje su prisutne u hrani i konzumiraju se u praktičnim količinama,
15:41
can impact on cancer.
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mogu imati na rak.
15:43
And we're now studying
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A sada proučavamo
15:45
the role of a healthy diet
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ulogu zdrave ishrane
15:47
with Dean Ornish at UCSF and Tufts University
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sa Dinom Ornišem i kalifornijskim i Tufts univerzitetom,
15:50
on the role of this healthy diet on markers of angiogenesis
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ulogu ove zdrave ishrane na markere angiogeneze
15:53
that we can find in the bloodstream.
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koje možemo da pronađemo u krvotoku.
15:56
Now, obviously, what I've shared with you has some far-ranging implications,
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Sad, očigledno da ovo što sam podelio s vama ima neke široke implikacije,
15:59
even beyond cancer research.
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čak i dalje od proučavanja 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 uticati na obrazovanje potrošača,
16:04
food services, public health
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restorane, javno zdravlje,
16:06
and even the insurance industry.
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čak i na industriju osiguranja.
16:08
And, in fact, some insurance companies
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Zapravo, neke osiguravajuće kompanije
16:10
are already beginning to think along these lines.
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već počinju da razmišljaju u skladu sa ovim.
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 Minesote.
16:16
And for many people around the world,
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I za mnoge ljude širom sveta
16:18
dietary cancer prevention
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prevencija raka ishranom
16:20
may be the only practical solution
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može biti jedino praktično rešenje
16:22
because not everybody can afford expensive end-stage cancer treatments,
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jer ne mogu svi da priušte skupa lečenja
16:25
but everybody could benefit from
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ali svi mogu imati koristi od
16:27
a healthy diet based on local, sustainable,
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zdrave ishrane koja se zasniva na lokalnim, održivim
16:30
antiangiogenic crops.
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antiangiogenetskim usevima.
16:33
Now, finally,
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Sada, konačno,
16:35
I've talked to you about food,
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pričam o hrani,
16:37
and I've talked to you about cancer,
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pričam vam i o raku,
16:39
so there's just one more disease that I have to tell you about
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ali ima još samo jedna bolest o kojoj moram da vam ispričam,
16:42
and that's obesity.
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a to je gojaznost.
16:44
Because it turns out that
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Ispostavlja se da
16:46
adipose tissue, fat,
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masno tkivo, salo,
16:48
is highly angiogenesis dependent.
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veoma zavisi od angiogeneze.
16:50
And, like a tumor, fat grows when blood vessels grow.
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I kao i tumor, salo se širi kad se krvni sudovi množe.
16:53
So the question is: Can we shrink fat
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Znači pitanje je: možemo li da smanjimo salo
16:56
by cutting off its blood supply?
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tako što ćemo mu prekinuti dotok krvi?
16:58
So the top curve shows the body weight
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Gornja krivulja pokazuje telesnu masu
17:01
of a genetically obese mouse
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genetski gojaznog miša
17:03
that eats nonstop
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koji neprekidno jede,
17:05
until it turns fat, like this furry tennis ball.
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dok se ne pretvori u ovakvu krznenu tenisku lopticu.
17:09
And the bottom curve is the weight of a normal mouse.
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A donja krivulja je težina normalnog miša.
17:12
If you take the obese mouse and give it
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Ako uzmete gojaznog miša i date mu
17:14
an angiogenesis inhibitor, it loses weight.
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inhibitor antiangiogeneze, on izgubi na težini.
17:16
Stop the treatment, gains the weight back.
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Prekinete tretman, opet se ugoji.
17:18
Restart the treatment, loses the weight again.
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Ponovo počnete tretman, opet izgubi na težini.
17:20
Stop the treatment, it gains the weight back.
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Prekinete tretman, opet se ugoji.
17:22
And, in fact, you can cycle the weight up and down
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I ustvari, možete da menjate težinu gore dole
17:24
simply by inhibiting angiogenesis.
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samo inhibiranjem angiogeneze.
17:27
So this approach that we're taking for cancer prevention
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Znači ovaj pristup koji imamo za prevenciju raka
17:29
may also have an application
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možda može da se primeni
17:31
for obesity.
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i na gojaznost.
17:33
The really, truly interesting thing about this
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Stvarno veoma interesantna stvar u vezi s ovim
17:35
is that we can't take these obese mice
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je da ne možemo gojaznom mišu
17:37
and make them lose more weight
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smanjiti težinu više
17:39
than what the normal mouse's weight is supposed to be.
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nego što bi trebala da bude težina normalnog miša.
17:42
In other words, we can't create supermodel mice.
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Drugim rečima, ne možemo napraviti miševe super modele.
17:44
(Laughter)
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(smeh)
17:46
And this speaks to the role of angiogenesis
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I to govori o ulozi angiogeneze
17:48
in regulating healthy set points.
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u regulaciji zdravih vrednosti.
17:51
Albert Szent-Gyorgi once said that,
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Albert Snet-Đerđ je jednom rekao da se
17:53
"Discovery consists of seeing what everyone has seen,
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"Otkriće sastoji u tome da vidimo ono što svi vide,
17:56
and thinking what no one has thought."
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i da mislimo da ono što niko nije mislio."
17:58
I hope I've convinced you
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Nadam se da sam vas ubedio
18:00
that, for diseases like cancer, obesity and other conditions,
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da, kod bolesti kao što su rak, gojaznost i neke druge,
18:03
that there may be a great power
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može biti veoma moćno
18:05
in attacking their common denominator: angiogenesis.
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da se napadne njihov zajednički imenitelj, angiogeneza.
18:08
And that's what I think the world needs now. Thank you.
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I to je ono što ja mislim da je svetu potrebno sada. Hvala.
18:11
(Applause)
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(aplauz)
18:22
June Cohen: I have a quick question for you. So these drugs aren't exactly ...
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Džun Koen: Dakle ovi lekovi nisu -
18:25
they're not exactly in mainstream cancer treatments right now.
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oni nisu deo rasprostranjenog lečenja raka u ovom trenutku.
18:28
For anyone out here who has cancer,
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Za nekoga ko ima rak,
18:30
what would you recommend?
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šta biste preporučili?
18:32
Do you recommend pursuing these treatments now, for most cancer patients?
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Da li preporučujete, većini obolelih od raka, da traže ove tretmane?
18:35
William Li: So there are antiangiogenic treatments
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Vilijam Li: Postoje antiangiogenetski lekovi
18:37
that are FDA approved,
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koje je odobrila administracija za lekove.
18:39
and if you're a cancer patient
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I ako ste oboleli od raka,
18:41
or working for one or advocating for one,
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ili radite za nekog ili zastupate nekog ko jetse,
18:43
you should ask about them.
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trebalo bi da ih tražite.
18:45
And there are many clinical trials.
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Postoji i mnogo kliničkih proba.
18:48
The Angiogenesis Foundation is following almost 300 companies,
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Fondacija Angiogeneze prati skoro 3000 kompanija,
18:51
and there are about 100 more
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a postoji još oko 100
18:53
drugs in that pipeline.
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lekova u najavi.
18:55
So consider the approved ones,
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Dakle razmislite o postojećim,
18:57
look for clinical trials,
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tražite kliničke probe,
18:59
but then between what the doctor can do for you,
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ali između onoga što lekari mogu da učine za vas,
19:01
we need to start asking what can we do for ourselves.
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moramo početi da se pitamo šta možemo da učinimo za sebe.
19:03
And this is one of the themes that I'm talking about
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Ovo je jedna od tema o kojima pričam,
19:05
is we can empower ourselves to do the things
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možemo se osnažiti da uradimo one stvari
19:07
that doctors can't do for us,
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koje lekari ne mogu da urade za nas,
19:09
which is to use knowledge and take action.
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a to je da iskoristimo znanje i krenemo u akciju.
19:11
And if Mother Nature has given us some clues,
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I ako nam je majka priroda dala neke znake,
19:14
we think that there might be a new future
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mislimo da se nova budućnost možda
19:16
in the value of how we eat.
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nalazi u vrednosti onoga što jedemo.
19:18
And what we eat is really our chemotherapy three times a day.
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A ono što jedemo jeste naša hemoterapija tri puta dnevno.
19:21
JC: Right. And along those lines,
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DžK: Dobro. Detaljije,
19:23
for people who might have risk factors for cancer,
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da li biste ljudima koji imaju faktor rizika
19:26
would you recommend pursuing any treatments sort of prophylactically
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od raka preporučili neke preventivne tretmane
19:29
or simply pursuing the right diet
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ili samo da istraju u zdravoj ishrani
19:31
with lots of tomato sauce?
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sa mnogo paradajz sosa?
19:33
WL: Well, you know, there's abundant epidemiological evidence.
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VL: Pa, znate, postoje bogati epidemiološki dokazi.
19:36
And I think in the information age,
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I mislim da, u informatičkom vremenu,
19:38
it doesn't take long to go to a credible source
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nije potrebno mnogo da se ode do pouzdanog izvora,
19:40
like PubMed, the National Library of Medicine,
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kao što su Pubmed, Nacionalna medicinska biblioteka,
19:42
to look for epidemiological studies
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i da se potraže epidemiološke studije
19:44
for cancer risk reduction
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o smanjenju rizika od raka
19:46
based on diet and based on common medications.
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na osnovu ishrane i na osnovu uobičajenih lekova.
19:49
And that's certainly something that anybody can look into.
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A to je svakako nešto što svako može da vidi.
19:51
JC: Okay. Well, thank you so much.
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DžK: Okej. Pa, hvala Vam mnogo.
19:53
(Applause)
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(aplauz)
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