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  • Good afternoon.

    午安

  • There's a medical revolution happening all around us,

    有項醫學上的變革正在我們身邊發生

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

    這將幫助我們克服

  • some of society's most dreaded conditions,

    社會最憂慮的部份狀況

  • including cancer.

    包括癌症

  • The revolution is called angiogenesis,

    這項變革被稱做血管新生

  • and it's based on the process

    也就是在我們體內

  • that our bodies use to grow blood vessels.

    血管生長的過程

  • So why should we care about blood vessels?

    為什麼我們得在乎血管呢?

  • Well, the human body is literally packed with them:

    因為,我們的身上到處都是血管

  • 60,000 miles worth in a typical adult.

    將一位標準體型的成人體內所有的血管

  • End to end, that would form a line

    頭尾相連,能連成一條長度約十萬公里

  • that would circle the earth twice.

    可繞地球整整兩圈的直線

  • The smallest blood vessels are called capillaries;

    最小的血管被稱做微血管

  • we've got 19 billion of them in our bodies.

    我們體內約有190億條微血管

  • And these are the vessels of life, and,

    微血管是生之徑

  • as I'll show you,

    同時,如我將展示給各位看的

  • they can also be the vessels of death.

    它們也可以是死之徑

  • Now the remarkable thing about blood vessels

    微血管有個驚人之處:

  • is that they have this ability

    它們能因應不同的生長環境

  • to adapt to whatever environment they're growing in.

    出現不同的形式

  • For example, in the liver they form channels

    比如說:在肝臟裡

  • to detoxify the blood;

    微血管是讓血液解毒的管道

  • in the lung they line air sacs for gas exchange;

    在肺臟裡則形成氣囊幫助氣體交換

  • in muscle they corkscrew so that muscles can contract

    在肌肉中以如軟木塞開瓶器的形狀排列

  • without cutting off circulation;

    這樣在肌肉收縮時,血液循環也不會中斷

  • and in nerves they course along like power lines,

    在神經中,微血管蜿蜒如電線

  • keeping those nerves alive.

    維持神經細胞的活力

  • We get most of these blood vessels

    我們身上大部分的血管

  • when we're actually still in the womb,

    是在胎兒時期就長出來的

  • And what that means is that as adults,

    也就是說,在正常情況下

  • blood vessels don't normally grow.

    成人身上的血管不會自發地生長

  • Except in a few special circumstances:

    某些特別的情況則是例外

  • In women, blood vessels grow every month

    每個月,女人的子宮裡

  • to build the lining of the uterus;

    血管會增生形成內膜

  • during pregnancy, they form the placenta,

    懷孕時,子宮內膜將演變成胎盤

  • which connects mom and baby.

    也就是母親和寶寶間的連結

  • And after injury, blood vessels

    我們受傷時,在傷疤下

  • actually have to grow under the scab

    血管會不斷生長

  • in order to heal a wound.

    來幫助傷口癒合

  • And this is actually what it looks like,

    這是血管的真實樣貌

  • hundreds of blood vessels

    數以百計的微血管

  • all growing toward the center of the wound.

    全都長在傷口的中間

  • So the body has the ability to regulate

    可見,我們的身體在任何時候

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

    都有調節全身血管數量的能力

  • It does this through an elaborate

    身體藉著計畫完善精良的調控系統

  • and elegant system of checks and balances,

    來維持那些控制血管新生的

  • stimulators and inhibitors of angiogenesis,

    刺激物或是抑制物間的平衡

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

    也就是說,若是在短時間內需要大量血管

  • the body can do this by releasing stimulators,

    體內會釋放血管新生的刺激物

  • proteins called angiogenic factors

    這是一種被稱為血管新生因子的蛋白質

  • that act as natural fertilizer

    就像我們體內的天然肥料一般

  • and stimulate new blood vessels to sprout.

    能刺激新血管的萌發

  • And when those excess vessels are no longer needed,

    若是體內不再需要這樣過量的血管

  • the body prunes them back to baseline

    身體就會藉著自然釋放的血管新生抑制因子

  • using naturally occurring inhibitors of angiogenesis.

    讓血管新生速度降到基準值

  • Now there are other situations where we start beneath the baseline

    而在其他需要比基準速度更低的血管新生

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

    的情況,這時我們就得讓血管生長回到正常值

  • for example, after an injury --

    像是受傷後

  • and a body can do that too,

    我們體內的血管先大量增生

  • but only to that normal level,

    再降到健康時的正常數量

  • that set point.

    也就是身體設定好的正常值

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

    但現在我們知道,就有些疾病而言

  • there are defects in the system

    這個控制血管生長的系統有缺陷

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

    身體沒辦法減低過量的血管

  • or can't grow enough new ones

    或是沒辦法讓新生血管

  • in the right place at the right time.

    出現在正確的時間或是位置

  • And in these situations, angiogenesis

    這樣的情況就是

  • is out of balance.

    血管新生失去平衡

  • And when angiogenesis is out of balance,

    而血管新生失去平衡

  • a myriad of diseases result.

    是非常嚴重的疾病

  • For example, insufficient angiogenesis --

    比方說,血管新生不夠

  • not enough blood vessels --

    體內就不會有足夠的血管

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

    這樣傷口不會癒合、心肌梗塞

  • legs without circulation, death from stroke,

    足部血液循環不良、因為中風死亡

  • nerve damage.

    或是傷害神經

  • And on the other end, excessive angiogenesis --

    相反的,過多的血管新生

  • too many blood vessels -- drives disease,

    會讓體內有過多的血管,也會造成疾病

  • and we see this in cancer, blindness,

    如癌症、失明

  • arthritis, obesity,

    關節炎、肥胖

  • Alzheimer's disease.

    阿茲海默症

  • In total, there are more than 70 major diseases

    總的來說,有70多種疾病

  • affecting more than a billion people worldwide,

    正影響著世界上十億人口

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

    它們表面上看起來毫無關係

  • but all actually share

    但事實上,這些疾病

  • abnormal angiogenesis

    都以異常血管新生

  • as their common denominator.

    為共同特徵

  • And this realization is allowing us

    明白這一點

  • to reconceptualize

    能讓我們重新思考

  • the way that we actually approach these diseases

    如何藉著控制血管新生

  • by controlling angiogenesis.

    來治療這些疾病的確切方法

  • Now I'm going to focus on cancer

    現在,我將重點放在癌症

  • because angiogenesis is a hallmark of cancer,

    因為無論是哪一種癌症

  • every type of cancer.

    都以血管新生為重要特徵

  • So here we go.

    好,我們來談談癌症

  • This is a tumor: dark, gray, ominous mass

    這是一個腫瘤。一團深灰色、

  • growing inside a brain.

    看來不妙的細胞團在腦中生長

  • And under the microscope, you can see

    在顯微鏡下,你可以看見

  • hundreds of these brown staining blood vessels,

    數以百計如這樣被染成褐色的血管

  • capillaries that are feeding cancer cells,

    或是正在餵養癌細胞的微血管

  • bringing oxygen and nutrients.

    將氧氣或是養份帶給它們

  • But cancers don't start out like this.

    然而,腫瘤一開始不是這樣

  • And, in fact, cancers don't start out

    事實上,腫瘤一開始

  • with a blood supply.

    沒有血液供給

  • They start out as small, microscopic nests of cells

    原初的腫瘤是顯微鏡下的小細胞群

  • that can only grow to

    它們頂多長成

  • one half a cubic millimeter in size;

    半立方毫米大小

  • that's the tip of a ballpoint pen.

    大概是是筆尖大小

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

    這些腫瘤長不大就是因為它們沒有血液供給

  • so they don't have enough oxygen or nutrients.

    也就沒有足夠的氧氣和養分

  • In fact, we're probably forming these

    事實上,我們的體內可能

  • microscopic cancers all the time in our body.

    隨時都在形成這些微腫瘤

  • Autopsy studies from people who died in car accidents

    對因癌症而死的病人進行的病理解剖顯示

  • have shown that about 40 percent of women

    在40到50歲的女性裡

  • between the ages of 40 and 50

    有百分之40的人

  • actually have microscopic

    的確有這樣的微腫瘤

  • cancers in their breasts,

    存在於乳房內

  • about 50 percent of men in their 50s and 60s

    年約50到60歲的男性

  • have microscopic prostate cancers,

    其中50%於攝護腺裡有微腫瘤

  • and virtually 100 percent of us,

    我們到了70歲以後

  • by the time we reach our 70s,

    百分之百的人

  • will have microscopic cancers growing in our thyroid.

    甲狀腺裡有生長中的微腫瘤

  • Yet, without a blood supply,

    然而,在沒有血液供給的情況下

  • most of these cancers

    大部分這樣的微腫瘤

  • will never become dangerous.

    是不會變得有害的

  • Dr. Judah Folkman, who was my mentor

    我的導師,佛克曼醫師

  • and who was the pioneer of the angiogenesis field,

    同時也是血管新生研究的先驅者

  • once called this "cancer without disease."

    曾經說這些微腫瘤是「非病腫瘤」

  • So the body's ability to balance angiogenesis,

    因此,我們的身體有平衡血管新生的能力

  • when it's working properly,

    當這樣的能力運作良好

  • prevents blood vessels from feeding cancers.

    就能避免血管餵養癌症生長

  • And this turns out to be

    這樣的機制也就變成

  • one of our most important defense mechanisms

    我們體內最重要抵抗癌症的

  • against cancer.

    防禦機轉之一

  • In fact, if you actually block angiogenesis

    事實上,當你能確實阻斷血管新生

  • and prevent blood vessels from ever reaching cancer cells,

    讓血管永遠無法和癌細胞接觸

  • tumors simply can't grow up.

    腫瘤就不會生長

  • But once angiogenesis occurs,

    然而,一旦腫瘤周圍出現血管新生

  • cancers can grow exponentially.

    它們就能以倍數成長

  • And this is actually how

    這就是腫瘤

  • a cancer goes from being

    如何從無害變得

  • harmless to deadly.

    有害的實情

  • Cancer cells mutate

    癌細胞突變

  • and they gain the ability to release

    並且釋放許多

  • lots of those angiogenic factors, natural fertilizer,

    跟血管新生有關的物質

  • that tip the balance in favor of blood vessels

    這些天然肥料會刺激血管生長

  • invading the cancer.

    進入腫瘤組織

  • And once those vessels invade the cancer,

    一旦血管進入腫瘤

  • it can expand, it can invade local tissues.

    腫瘤就能擴張,侵犯周邊的組織

  • And the same vessels that are feeding tumors

    在血管餵養腫瘤的同時

  • allow cancer cells to exit into the circulation

    腫瘤也得以進入循環系統

  • as metastases.

    這就是所謂的轉移

  • And, unfortunately, this late stage of cancer

    當血管已經開始生長

  • is the one at which it's most likely

    腫瘤就會瘋狂地增生

  • to be diagnosed,

    而不幸的,在這個癌症發展的

  • when angiogenesis is already turned on

    最後階段,轉移癌是

  • and cancer cells are growing like wild.

    幾乎不可能被診斷的

  • So, if angiogenesis

    所以,如果血管新生

  • is a tipping point

    是從無害的微腫瘤轉變成

  • between a harmless cancer and a harmful one,

    有害的癌症的關鍵點

  • then one major part of the angiogenesis revolution

    那麼,這個血管新生革命的主要部份

  • is a new approach to treating cancer

    就是藉著切斷血液供給

  • by cutting off the blood supply.

    來治療癌症的新方法

  • We call this antiangiogenic therapy,

    我們稱之為抗血管新生治療

  • and it's completely different from chemotherapy

    這跟化療完全不同

  • because it selectively aims

    因為這個療法選擇性地瞄準

  • at the blood vessels that are feeding the cancers.

    供應腫瘤養份的血管

  • And we can do this because

    之所以能這麼做,是因為

  • tumor blood vessels are unlike normal, healthy vessels

    腫瘤的血管跟一般健康的

  • we see in other places of the body:

    在身體其他部分的血管不同

  • They're abnormal;

    腫瘤的血管異常之處

  • they're very poorly constructed;

    在於它們的結構脆弱

  • and, because of that, they're highly vulnerable

    因此,這類血管對專門來

  • to treatments that target them.

    對付它們的藥物很敏感

  • In effect, when we give cancer patients

    臨床上,當我們在癌症病人身上

  • antiangiogenic therapy --

    施以對抗血管新生的藥物

  • here, an experimental drug for a glioma,

    像是這個治療神經膠細胞瘤的實驗性藥物

  • which is a type of brain tumor --

    神經膠細胞瘤是一種腦瘤

  • you can see that there are dramatic changes that occur

    我們可以在病人身上看到

  • when the tumor is being starved.

    當腫瘤不再有養分時產生的顯著變化

  • Here's a woman with a breast cancer

    這是一位有乳癌的女士

  • being treated with the antiangiogenic drug called Avastin,

    她接受美國食品藥物管理局核准的

  • which is FDA approved.

    血管新生藥物Avastin的治療

  • And you can see that the halo of blood flow

    如你所見,這區血流在治療後

  • disappears after treatment.

    即消失不見

  • Well, I've just shown you

    我剛剛已經告訴妳們

  • two very different types of cancer

    抗血管新生藥物對

  • that both responded to antiangiogenic therapy.

    兩種癌症有效

  • So, a few years ago, I asked myself,

    所以,幾年前,我自問

  • "Can we take this one step further

    我們能夠更進一步

  • and treat other cancers,

    用這種藥來治療其他癌症嗎

  • even in other species?"

    甚至是其他物種的癌症

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

    這是一隻九歲大的鬥牛犬,Milo

  • who had a very aggressive tumor

    牠的肩膀有個惡性神經纖維瘤

  • called a malignant neurofibroma growing on his shoulder.

    這是一種極具侵入性的腫瘤

  • It invaded into his lungs.

    已經進入牠的肺臟

  • His veterinarian only gave him three months to live.

    獸醫認為牠只有三個月可活

  • So we created a cocktail of antiangiogenic drugs

    因此,我們做了可以混在牠食物中的

  • that could be mixed into his dog food

    抗血管新生藥物的雞尾酒配方

  • as well as an antiangiogenic cream

    跟可以塗抹在腫瘤表面的

  • that could be applied on the surface of the tumor.

    抗血管新生藥物乳霜

  • And within a few weeks of treatment,

    在數個星期的治療後

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

    我們得以減緩腫瘤的生長

  • such that we were ultimately able to extend milo's survival

    最終得以延長Milo的壽命

  • to six times what the veterinarian had initially predicted,

    達獸醫預測的時間六倍長之久

  • all with a very good quality of life.

    生活品質也很好

  • And we subsequently treated more than 600 dogs.

    接著我們治療了其他600多隻狗

  • We have about a 60 percent response rate

    其中大概有60%的治療率

  • and improved survival for these pets

    也能增加那些將被安樂死的

  • that were about to be euthanized.

    寵物的壽命

  • So let me show you a couple of

    接著,讓我向你們報告

  • even more interesting examples.

    幾個更有趣的病例

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

    這是一隻20歲,生活在佛州的海豚

  • and she had these lesions in her mouth

    牠的口裡有些

  • that, over the course of three years,

    出現大概3年多的病灶

  • developed into invasive squamous cell cancers.

    漸漸形成侵入性的鱗狀上皮癌

  • So we created an antiangiogenic paste.

    為此,我們做了抗血管生成的藥糊

  • We had it painted on top of the cancer

    塗抹在病灶上

  • three times a week.

    每個星期三次

  • And over the course of seven months,

    經過七個月的療程後

  • the cancers completely disappeared,

    上皮癌完全消失了

  • and the biopsies came back as normal.

    切片的結果也正常

  • Here's a cancer growing on the lip

    這是一隻名叫Guiness的奎特馬

  • of a Wuarter horse named Guinness.

    牠嘴唇上的腫瘤

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

    是一種非常非常致命的腫瘤,血管肉瘤

  • It had already spread to his lymph nodes,

    已經侵犯到牠的淋巴結

  • so we used an antiangiogenic skin cream for the lip

    我們用了能抹在嘴唇上的抗血管新生的藥膏

  • and an oral cocktail, so we could treat from the inside

    跟口服的雞尾酒藥物

  • as well as the outside.

    讓治療得以內用跟外服雙管齊下

  • And over the course of six months,

    經過6個月的療程

  • he experienced a complete remission.

    腫瘤完全消失了

  • And here he is six years later,

    這是Guiness接受治療後6年

  • Guinness, with his very happy owner.

    跟飼主快樂的合照

  • (Applause)

    (掌聲)

  • Now, obviously, antiangiogenic therapy

    現在,顯然的,抗血管新生藥物

  • could be used for a wide range of cancers.

    能被廣泛的運用在各種癌症的治療上

  • And, in fact, the first pioneering treatments

    事實上,第一個於人類

  • for people, as well as dogs,

    跟於狗身上的前驅治療

  • are already becoming available.

    已經可以取得

  • There's 12 different drugs, 11 different cancer types.

    總共有12種藥物,用來治療11種癌症

  • But the real question is:

    但真正的問題是

  • How well do these work in practice?

    這些藥物的實際成效如何?

  • So here's actually the patient survival data

    數據為8種不同癌症

  • from eight different types of cancer.

    患者的存活時間

  • The bars represent survival time

    柱狀圖為

  • taken from the era

    僅有化療

  • in which there was only chemotherapy,

    手術或是放射線治療時的

  • or surgery, or radiation available.

    患者存活時間

  • But starting in 2004,

    從2004年

  • when antiangiogenic therapies first became available,

    抗血管新生藥物出現在市面上

  • well you can see that there has been

    你可以注意到

  • a 70 to 100 percent

    腎臟癌、多發性硬化症

  • improvement in survival

    大腸癌和胃腸道基質腫瘤等

  • for people with kidney cancer, multiple myeloma,

    癌症患者的存活時間

  • colorectal cancer, and gastrointestinal stromal tumors.

    增加了70-100%

  • That's impressive.

    非常令人印象深刻

  • But for other tumors and cancer types,

    但是其它的腫瘤或癌症

  • the improvements have only been modest.

    僅有一般程度的增加

  • So I started asking myself,

    因此,我自問

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

    為什麼這些癌症的治療不能更好

  • And the answer, to me, is obvious;

    而答案,對我來說,很顯然的

  • we're treating cancer too late in the game,

    是因為我們太晚開始治療

  • when it's already established

    當腫瘤已經生成

  • and, oftentimes, it's already spread or metastasized.

    往往就已經擴散或是轉移

  • And as a doctor, I know

    身為一名醫師,我明白

  • that once a disease progresses to an advanced stage,

    一但疾病進程惡化

  • achieving a cure

    即使得治

  • can be difficult, if not impossible.

    治療將變得困難

  • So I went back to the biology

    讓我們回到

  • of angiogenesis

    血管生成的生物學

  • and started thinking:

    開始這樣想

  • Could the answer to cancer

    是否癌症治療

  • be preventing angiogenesis,

    有賴於從癌症發生本身下手

  • beating cancer at its own game

    藉著預防血管新生

  • so the cancers could never become dangerous?

    讓癌症不至於變得危險?

  • This could help healthy people

    這能幫助健康人

  • as well as people who've already beaten cancer

    跟已經擊敗過癌症

  • once or twice

    一兩次的病人

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

    還有想找出方法不讓癌症復發的人

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

    為了藉由預防癌組織的血管新生,來走出一條新路

  • I went back to look at cancer's causes.

    我回到癌症生成的原因

  • And what really intrigued me

    真正啟發我的是

  • was when I saw that diet

    當我注意到

  • accounts for 30 to 35 percent

    飲食佔了引起癌症因子中

  • of environmentally caused cancers.

    30-35%的比重時

  • Now, the obvious thing is to think about

    最明顯不過的想法應是

  • what we could remove from our diet, what to strip out, take away.

    想想我們可以移除、去掉或是不吃哪些食物

  • But I actually took a completely opposite approach

    但是,我用的是完全相反的法子

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

    我開始自問,我們能在飲食中

  • that's naturally antiangiogenic,

    加入哪些能抗血管新生的食物

  • that could boost the body's defense system

    來刺激體內的防禦系統

  • and beat back those blood vessels that are feeding cancers?

    反擊那些餵養癌細胞的血管?

  • In other words, can we eat to starve cancer? (Laughter)

    也就是說,我們能藉著吃來餓壞癌症嗎?

  • Well, the answer's yes,

    這問題的答案為:是的

  • and I'm going to show you how.

    我將告訴你們,這該如何辦到

  • Our search for this

    而我們在這方面的研究

  • has taken us to the market, the farm and to the spice cabinet,

    帶著我們到了市場、農場跟香料櫃

  • because what we've discovered

    因為我們發現

  • is that mother nature has laced a large number

    大地之母遺下了大量

  • of foods and beverages and herbs

    能夠天然地抑制

  • with naturally occurring inhibitors

    血管新生的

  • of angiogenesis.

    食物、飲料和藥草

  • So here's a test system we developed.

    這是我們正在研發的測試系統

  • At the center is a ring from which hundreds of blood vessels

    在中央的是血管環,由數百條微血管形成

  • are growing out in a starburst fashion.

    正在向外成星狀爆出生長

  • And we can use this system

    我們能利用這個系統

  • to test dietary factors

    來測試我們能藉著飲食

  • at concentrations that are obtainable by eating.

    攝取的抗血管新生因子的濃度的影響

  • So let me show you what happens when we put in

    這是當我們加入

  • an extract from red grapes.

    紅葡萄萃取物的情形

  • The active ingredient's resveratrol,

    其中的有效成份白藜蘆醇

  • it's also found in red wine.

    也能在紅酒中找到

  • This inhibits abnormal angiogenesis

    白藜蘆醇能抑制

  • by 60 percent.

    60%的異常血管新生

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

    這草莓萃取物的測試結果

  • it potently inhibits angiogenesis.

    也有抑制血管生成的效果

  • And extract from soybeans.

    大豆萃取物也是

  • And here is a growing list of our

    這裡列出我們有興趣、仍在增加中的

  • antiangiogenic foods and beverages

    用來測試抗血管新生效果

  • that we're interested in studying.

    的食物跟飲料

  • For each food type,

    我們相信各類食物的

  • we believe that there are different potencies

    不同種類或品種

  • within different strains and varietals.

    都有不同的效果

  • And we want to measure this because,

    我們想測試這樣的效果

  • well, while you're eating a strawberry

    是因為我們吃草莓

  • or drinking tea,

    或喝茶時

  • why not select the one that's most potent

    為何不選擇最有效的那個品種

  • for preventing cancer.

    來預防癌症

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

    我們測試了四種

  • They're all common ones:

    市面上常見的茶

  • Chinese jasmine, Japanese sencha,

    香片、日本煎茶

  • Earl Grey and a special blend that we prepared.

    伯爵茶和一種我們配製的茶

  • And you can see clearly

    你可以清楚見到

  • that the teas vary in their potency

    不同的茶抗血管新生的效果不同

  • from less potent to more potent.

    這裡將效果從低到高列出來

  • But what's very cool

    這個研究最棒的地方是

  • is when we actually combined the two

    當你混合兩種

  • less potent teas together,

    單獨使用時效果不高的茶

  • the combination, the blend,

    抗血管新生的效果

  • is more potent than either one alone.

    比各自單獨使用來得高

  • This means there's food synergy.

    也就是說這些食物有協成效果

  • Here's some more data from our testing.

    還有更多實驗室裡其他測試的結果

  • Now, in the lab, we can simulate tumor angiogenesis

    我們可以刺激腫瘤血管新生

  • represented here in a black bar.

    測試癌症藥物在這個系統裡的效果

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

    結果用黑色的柱狀圖表示

  • So the shorter the bar,

    當軸柱越短

  • less angiogenesis, that's good.

    血管新生就越少,這是好情況

  • And here are some common drugs

    我們測試了一些常見的

  • that have been associated with reducing the risk

    跟降低癌症發生率

  • of cancer in people.

    有關的藥物

  • Statins, nonsteroidal anti-inflammatory drugs

    Statin、非類固醇消炎劑

  • and a few others,

    跟一些其他藥物

  • they inhibit angiogenesis too.

    能夠抑制血管新生

  • And here are the dietary factors

    而比較某些食物

  • going head to head against these drugs.

    跟這些藥物對血管新生的效果

  • You can see, they clearly hold their own

    如你所見,這些食物不比藥物差

  • and, in some cases, they're more potent

    而某些食物的效果

  • than the actual drugs.

    甚是還比藥物好

  • Soy, parsley, garlic,

    如大豆、荷蘭芹、大蒜

  • grapes, berries;

    葡萄跟莓類

  • I could go home and cook a tasty meal

    這讓我們只要回家使用這些食材

  • using these ingredients.

    烹煮食物就有治療癌症的效果

  • So imagine if we could create

    試想我們是否能夠建立

  • the world's first rating system

    這個世界上第一個根據

  • in which we could score foods

    食物抑制癌症組織的

  • according to their antiangiogenic,

    血管新生能力

  • cancer-preventative properties.

    所編列的評分表

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

    這也是我們現在正在做的

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

    我已經對你們秀出許多實驗室的數據

  • and so the real question is:

    至此,真正的問題是

  • What is the evidence in people

    什麼是人們吃下

  • that eating certain foods can reduce

    某些食物就能抑制

  • angiogenesis in cancer?

    癌症組織裡血管新生的證據?

  • Well, the best example I know

    據我所知,最好的證據

  • is a study of 79,000 men

    是一個樣本數為7萬9千人

  • followed over 20 years,

    長達20年的研究

  • in which it was found that men who consumed

    科學家發現,每周攝取

  • cooked tomatoes two to three times a week

    烹煮過的番茄兩到三次的男性

  • had up to a 50 percent reduction

    最後得到攝護腺癌的機率

  • in their risk of developing prostate cancer.

    降低一半

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

    我們現在知道,番茄是很好的茄紅素來源

  • and lycopene is antiangiogenic.

    而茄紅素能減少血管生長

  • But what's even more interesting from this study

    而這個研究最有趣的部分是

  • is that in those men who did develop prostate cancer,

    在那些得到攝護腺癌的男性中

  • those who ate more servings of tomato sauce

    攝取較多番茄醬的人

  • actually had fewer blood vessels

    組織中確實有較少的

  • feeding their cancer.

    血管能餵養腫瘤

  • So this human study is a prime example

    因此,這個臨床研究是

  • of how antiangiogenic substances

    當我們攝取足夠劑量的

  • present in food and consumed at practical levels

    存在於食物中抗血管新生物質

  • can impact on cancer.

    的確能影響癌症形成的證據

  • And we're now studying

    我們現在正在跟

  • the role of a healthy diet

    Dean Ornish、南加大跟Tufts大學

  • with Dean Ornish at UCSF and Tufts University

    的工作團隊合作研究

  • on the role of this healthy diet on markers of angiogenesis

    我們在血液中找到的健康食物成分

  • that we can find in the bloodstream.

    對血管生成的標記分子的影響

  • Now, obviously, what I've shared with you has some far-ranging implications,

    而顯然的,我剛才跟各位分享的食物的

  • even beyond cancer research.

    廣泛影響並不侷限於癌症研究

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

    因為若我們是正確的,這樣的概念

  • food services, public health

    能衝擊消費者教育、食物供給、公共衛生

  • and even the insurance industry.

    甚至是保險產業

  • And, in fact, some insurance companies

    事實上,一些保險公司

  • are already beginning to think along these lines.

    已經開始考慮這樣的概念

  • Check out this ad from Blue Cross Blue Shield of Minnesota.

    看看這個明尼蘇達的藍十字蘭盾公司的廣告

  • And for many people around the world,

    對這個世界的許多人而言

  • dietary cancer prevention

    藉著改善飲食來治療癌症

  • may be the only practical solution

    可能是唯一可靠實際的辦法

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

    因為並不是每個人能夠負擔末期癌症治療的費用

  • but everybody could benefit from

    但是每個人都能因為

  • a healthy diet based on local, sustainable,

    地區性、永續性的

  • antiangiogenic crops.

    抗血管新生飲食而受惠

  • Now, finally,

    演講的最後

  • I've talked to you about food,

    我們剛剛提到食物

  • and I've talked to you about cancer,

    還有癌症

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

    我還想再跟各位說說

  • and that's obesity.

    另外一個疾病,也就是肥胖

  • Because it turns out that

    因為,研究顯示

  • adipose tissue, fat,

    脂肪組織的形成

  • is highly angiogenesis dependent.

    跟血管生成也高度相關

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

    一如癌症,脂肪隨著血管生長

  • So the question is: Can we shrink fat

    問題在於:我們是否可以

  • by cutting off its blood supply?

    藉著阻斷血液供應使脂肪萎縮?

  • So the top curve shows the body weight

    圖表上方的曲線為

  • of a genetically obese mouse

    先天性肥胖的老鼠的體重

  • that eats nonstop

    這些老鼠會不斷地吃

  • until it turns fat, like this furry tennis ball.

    直到牠們跟一顆毛茸茸的網球沒兩樣

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

    而下方的曲線為正常老鼠的體重

  • If you take the obese mouse and give it

    如果你給一隻肥胖老鼠

  • an angiogenesis inhibitor, it loses weight.

    抗血管形成的藥物,牠們會變瘦

  • Stop the treatment, gains the weight back.

    一但停藥,體重則回昇

  • Restart the treatment, loses the weight again.

    若重新開始治療,體重下降

  • Stop the treatment, it gains the weight back.

    停止治療,體重回昇

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

    事實上,利用抑制血管新生的藥物

  • simply by inhibiting angiogenesis.

    我們能讓老鼠的體重上上下下變動

  • So this approach that we're taking for cancer prevention

    因此,這個用來治療癌症的療法

  • may also have an application

    也許也能用來治療

  • for obesity.

    肥胖

  • The really, truly interesting thing about this

    這個實驗最有趣的部分是

  • is that we can't take these obese mice

    我們無法用這個藥讓這些

  • and make them lose more weight

    肥胖老鼠的體重

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

    降得比正常老鼠低

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

    換句話說,我們沒辦法製造超級名模鼠

  • (Laughter)

    (笑)

  • And this speaks to the role of angiogenesis

    這個實驗說明了血管新生

  • in regulating healthy set points.

    在決定健康狀態時扮演的角色

  • Albert Szent-Gyorgi once said that,

    聖捷爾吉·奧爾貝特曾說

  • "Discovery consists of seeing what everyone has seen,

    創件包括了見眾人所見

  • and thinking what no one has thought."

    思無人所想

  • I hope I've convinced you

    我希望我已經說服各位

  • that, for diseases like cancer, obesity and other conditions,

    癌症、肥胖和其他疾病的治療上

  • that there may be a great power

    攻擊這些疾病的共有特徵

  • in attacking their common denominator: angiogenesis.

    即血管新生,是更有效的方法

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

    我認為這是世人目前需要的,謝謝

  • (Applause)

    (掌聲)

  • June Cohen: I have a quick question for you. So these drugs aren't exactly ...

    這些藥物實際上並不是

  • they're not exactly in mainstream cancer treatments right now.

    目前癌症治療的主流用藥

  • For anyone out here who has cancer,

    對目前已有癌症的人

  • what would you recommend?

    你有什麼建議嗎?

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

    你會建議大部分的病人,現在就開始使用這樣的治療嗎?

  • William Li: So there are antiangiogenic treatments

    目前市面上已經有FDA核准的

  • that are FDA approved,

    抗血管新生藥物

  • and if you're a cancer patient

    如果你是位癌症病人

  • or working for one or advocating for one,

    或是正在協助或是支持某位癌症病人

  • you should ask about them.

    你應該向醫生詢問這類藥物

  • And there are many clinical trials.

    目前有許多臨床試驗

  • The Angiogenesis Foundation is following almost 300 companies,

    Andrew J Semesco基金會正追蹤約300家公司

  • and there are about 100 more

    發現大概有100多種藥

  • drugs in that pipeline.

    正在上線生產

  • So consider the approved ones,

    考慮那些已經被核准的藥

  • look for clinical trials,

    找找有無臨床試驗

  • but then between what the doctor can do for you,

    但是除了醫生能提供的協助

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

    病人也該自問自己能夠做些什麼

  • And this is one of the themes that I'm talking about

    這也是我想跟各位談的

  • is we can empower ourselves to do the things

    我們可以從醫生無法為我們做的

  • that doctors can't do for us,

    方面來自我強化

  • which is to use knowledge and take action.

    擅用知識跟積極行動

  • And if Mother Nature has given us some clues,

    如果自然之母已經給我們提示

  • we think that there might be a new future

    我們認為未來可能的新方向為

  • in the value of how we eat.

    重視我們的飲食

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

    而食物本身就是我們一日三次的化療

  • JC: Right. And along those lines,

    基於你的演講

  • for people who might have risk factors for cancer,

    你會建議那些癌症的高風險族群

  • would you recommend pursuing any treatments sort of prophylactically

    使用預防性的治療

  • or simply pursuing the right diet

    或是單純正確的飲食

  • with lots of tomato sauce?

    像是吃大量的番茄醬?

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

    你知道,現在有許多流行病學調查

  • And I think in the information age,

    我想,在這個知識爆炸的時代

  • it doesn't take long to go to a credible source

    取得可信的資料如利用Pubmed資料庫

  • like PubMed, the National Library of Medicine,

    也就是美國國家醫學圖書館的檢索系統

  • to look for epidemiological studies

    來搜尋飲食或是藥物

  • for cancer risk reduction

    降低癌症風險的流行病學研究

  • based on diet and based on common medications.

    並不是太花時間的事

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

    這確實是任何人都可以試著去做的

  • JC: Okay. Well, thank you so much.

    好,非常謝謝你

  • (Applause)

    (掌聲)

Good afternoon.

午安

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