Dr. Folkman's War: Angiogenesis and the Struggle to Defeat Cancer - Softcover

Cooke, Robert

Softcover

ISBN 10: 0812974840 ISBN 13: 9780812974843

Publisher: Random House, 2001

Synopsis

In 1961, twenty-eight-year-old Dr. Judah Folkman saw something while doing medical research in a United

States navy lab that gave him the first glimmering of a wild, inspired hunch. What if cancerous tumors, in order to expand, needed to trigger the growth of new blood vessels to feed themselves? And if that was true, what if a way could be found to stop that growth? Could cancers be starved to death? Dr. Folkman had ample reason to be self confident — second in his class at Harvard Medical School, he was already considered one of the most promising doctors of his generation. But even he never guessed that his idea would eventually grow into a multibillion-dollar industry that is now racing through human trials with drugs that show unparalleled promise of being able to control cancer, as well as other deadly diseases.

For the creation of this book, Dr. Judah Folkman cooperated fully and exclusively with acclaimed science writer Robert Cooke. He granted Cooke unlimited interviews, showed him diaries and personal papers, and threw open the doors of his lab. The result is an astonishingly rich and candid chronicle of one of the most significant medical discoveries of our time and of the man whose vision and persistence almost single-handedly has made it possible.

Dr. Folkman's radical new way of thinking about cancer was once considered preposterous. So little was known about how cancer spreads and how blood vessels grow that he wasn't even taken seriously enough to be considered a heretic. Other doctors shook their heads at the waste of a great mind, and ambitious young medical researchers were told that accepting a position in Folkman's lab would be the death of their careers. Now, though, the overwhelming majority of experts believes that the day will soon come when antiangiogenesis therapy supplants the current more toxic and less-effective treatments — chemotherapy, radiation, and surgery-as the preferred method of treatment for cancer in patients around the world, and Dr. Folkman's breakthrough will come to be taken for granted the way we now take for granted the polio vaccine and antibiotics.

Dr. Folkman's War brilliantly describes how high the odds are against success in medical research, how vicious the competition for grants, how entrenched the skepticism about any genuinely original thinking, how polluted by politics and commerce the process of getting medicine into patients' hands. But it also depicts with rare power how exalted a calling medicine can be and how for the rare few—the brilliant, the tireless, and the lucky — the results of success can be world-changing.


From the Hardcover edition.

About this title

About the Author

ROBERT COOKE, a native of Southern California, served four years in the coast guard before graduating from California State Polytechnic College and receiving a master's degree from UCLA a year later. Since then he has spent thirty-five years covering science and medicine for major newspapers, including The Boston Globe, The Atlantic journal and Constitution, and Newsday. His fascination with science news began with the advent of the space age and matured with continuing exposure to the biological sciences. His interests are wide-ranging and include molecular biology, genetics, geology, astronomy, and archaeology and anthropology.

Cooke has been with Newsday for fifteen years. He is married to the former Sue Bailey Cato, whom he met just before he entered high school, and they have three grown children-Gregory, Karen, and Emily. He lives in Huntington, Long Island, New York.



From the Hardcover edition.

Excerpt. © Reprinted by permission. All rights reserved.

IT WAS A TANTALIZING idea that Judah Folkman had nurtured for nearly four decades—he had hatched it, worked it, published it, defended it, romanced it. He had withstood the ridicule of his peers. He had fought battles of medical and scientific politics. And he had endured, seemingly obsessed, never straying from the ideas in his head, the conviction in his heart, and the truth he saw in his laboratory. That was where the real battles were waged, where Folkman had been trying for nearly forty years to read and understand Nature's book, page by page. Now the time had come to see what it all amounted to. The answers were starting to trickle in from medical wards around the country, and there was little more for Folkman to do than wait, and hope.

At the core was a simple notion that had gradually matured in Folkman's mind ever since that day in 1961 when he was noodling in a navy lab in Bethesda, Maryland, a twenty-eight-year-old draftee trying to make cells grow under artificial conditions. That was when he'd first noticed a strange thing about tumors: They wouldn't grow unless they first recruited their own blood vessels. Over time he convinced himself that there had to be some way to block the growth of those blood vessels. To starve the tumor to death-and save the patient.

So Folkman had been trying to conquer cancer for nearly four decades when, in the waning days of the twentieth century, the first patients began to be infused with the natural drugs that had come from his long campaign. The new compounds had worked marvelously in mice-"We've never lost a Mouse yet," Folkman liked to say-and now they were being given the first crucial tests in men and women. Three clinical trials were under way to test one of the potent substances, endostatin, that had been discovered in Folkman's laboratory. And as many as two hundred biotechnology companies, some large and others tiny, were exploring the once-ridiculed field that Folkman had years before named "angiogenesis," meaning the growth of the blood vessels de novo needed to support tumor growth.

In Boston, where Folkman had lived, studied, and worked since leaving Ohio behind in 1953, the volunteers trooped to the Dana-Farber Cancer Institute for their daily infusions of the possible wonder drug. The infusion center was on the ground floor, equipped with a collection of beds, some of which were fashioned after chairs, designed for patients who could take their medicine sitting up. Each would take his or her place, and the dose would then be thawed. Endostatin was a precious commodity that couldn't be wasted-the first one-kilogram batch was said to be worth seven million dollars-so it was never thawed before the patient actually arrived, in case the patient didn't show up. But they always did. These were people facing terminal cancer, desperate for the cure and very relieved to find that this drug, unlike the standard chemotherapy they had received, did not make them awfully sick. Of course, they hoped the treatments would also be different in a much more important way: Chemotherapy had not worked. That's why they were here. The infusion process, during which the drug was given through an IV line, lasted twenty minutes. Then the patients would leave, returning the same time the next day, Saturdays and Sundays included.

Would the new treatment live up to its billing, actually erase tumors without dangerous side effects? Would patients who had been given little or no chance of survival emerge unscathed, as if touched by magic? No one could tell-but everyone was watching. Although the first phase of the trials was only meant to test for signs of toxicity, those involved could not resist the natural impulse to peek beyond the government-enforced protocols, hoping for signs, even the barest hint, of efficacy. The doctors running the trials, gagged by their institutions, refused to utter a public word. But the rumors were flying. The doctors talked sub rosa, and so did the nurses and interns who were close to the trials. Word got around the biomedical grapevine that at DanaFarber and both of the other experiment centers conducting the trials in Texas and Wisconsin some patients' tumors had stopped growing. One man, it was said, had experienced remarkable progress. As one insider put it, the mystery man's cancer, both the primary tumor and its dangerous metastases, had been "galloping." But since he began getting endostatin-in only small doses during the toxicity phase of the trial-his tumors had shrunk by half One patient was just one patient, but it was an encouraging


From the Hardcover edition.

Edition details

• Publisher: Random House
• Publication date: 2001
• Language: English
• ISBN 10: 0812974840
• ISBN 13: 9780812974843
• Binding: Paperback
• Edition number: 1
• Number of pages: 392