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Judah Folkman
Judah Folkman
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Judah Folkman Interview (page: 6 / 6)

Cancer Research

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  Judah Folkman

What makes your work so exciting for you?

Judah Folkman: What is exciting about studying just this process, it's a process called angiogenesis, how blood vessels grow, is that it continues to lead to fruitful discoveries. These come every -- they come over long periods of time, sort of an "Aha!" moment. When you find out, for example, that the same molecules that you were studying that the tumor has made in excess, one of them is the one that completely is the cause of diabetic retinopathy, of the millions of people who have blood vessels in their eye. And that this one is also the cause, in a different regulation, of macular degeneration. 15 million Americans who have that -- blood vessels again in the back of the eye -- elderly, and 200,000 blind from it. No drug at all exists, nothing, and even laser doesn't work. And that's primitive because they burn away the retina and then it doesn't work, so people go blind. And now you realize that you have -- in fact -- you understand it enough to turn that off.

[ Key to Success ] Passion

That's going into clinical trials. It takes years. But as you pursue understanding this process, you suddenly understand how psoriasis works: blood vessels. How arthritis works: blood vessels grow in the joint and just destroy the cartilage. Now for example, every week brings an article on endometriosis in women. The lining of the uterus sometimes backs up and grows in their abdominal cavity, especially in professional women, women who have delayed childbirth. It's a poorly understood disease. Now we really understand it. Hemangiomas in children in the brain, which we never understood, we can now treat.

So all of these rules are coming out. You have a map suddenly, and as you understand the rules of this process, you suddenly understand a whole lot of diseases. This isn't just in our laboratory; they're making these discoveries all over the world. Every week you pick up a journal, Science or Nature, and there's a new discovery. There's one out today, Science, reporting an incredible new discovery coming out of Regenerize , a company, about angiogenesis and tumors, that never occurred to us. It's very fruitful if you keep doing it.

What do you see as the next great challenge, the next great frontier for you?

Judah Folkman: There are two big areas. We want to see validation in the clinics.

We want to see proof of principle in humans, that you can take an angiogenesis inhibitor, these normal proteins, and you could add it to chemotherapy, or add it to radiotherapy, or add it to any current immunotherapy, and improve it, or add them to each other, and improve the care of cancer. Proving means, "Can you lower the terrifying toxicity?" That's what scares patients. Can you make it more of a -- nuisance? Like if you look at bleeding ulcers in the 1950s, if you had that, there were no drugs except Maalox. You went right to the operating room. That's all we could do to stop it. I was there in the '60s, that's what we did. And then when the drugs came in, Tagamet, and now the antibiotics, it's a nuisance, and we don't ever operate, or almost rarely. Can you do that? That's the question.

We'd really love to see that validated over the next five, ten years. And secondly, can you begin to use these principles to turn off other diseases? Can you have a drug for diabetic retinopathy? Can you use that for the other diseases that cause blindness? That's one area. The other area is very basic. Can we really understand why the body makes these proteins in the first place, and why it's using them under normal conditions? For example...

In both ovaries there about 400 potential follicles, but every month a woman turns out only one, and it gets a huge amount of blood vessels for four or five days, and then the ovum comes out. But the other -- when those vessels go on, the others are turned off, prevented from having vessels, so you never have two ova at the same time. Now suddenly -- nobody's ever understood that. It's called the dominant follicle, but it's turning out to be the same process by which a big primary tumor will suppress blood vessel growth and its metastasis. You take out this tumor and these grow up. It's the same process. It's just in a different setting. So it's exciting to understand that suddenly, because when you understand something, you can predict and you can control it.

What do you understand about achievement now that you did not understand when you were younger?

Judah Folkman: If you were told all the obstacles you face when you started, you'd probably never start. But once you're under way, you don't want to give up.

How would you define the American dream? What does it mean to you?

Judah Folkman: I've talked to people who can tell you better, because they've come to this country. They see it in a much different light.

There's a freedom to pursue ideas and jobs and kinds of work that fit you, that you like to do, freedom to express yourself, to write. It's not freedom from responsibility, but most places in the world you're told what you can't do, by the government, by the police, I mean, very few places like this country. And even in places like in Europe, great countries in Europe, after five o'clock, it's not so good to be working past five. It's frowned on. You are told, "That's not the way we do it here." There's a style. So there's enormous freedom here to do -- that just doesn't exist in other parts of the world. And I think that's what's so great about this country.

[ Key to Success ] The American Dream

A few minutes ago I was taking a cab to the airport, and there was a Russian cabdriver who had been here only two and a half years, so he's just barely speaking English, but he had four cell phones going, all pasted on his dashboard, and they were ringing, and he was answering them. He was dispatching, and he was driving, and I said, "What are you doing here?" He said, "Well, I own a cab company. I have four other Russians working for me, and we do not make enough money. We make money, but we don't make enough money to rent a place to have a dispatcher." So he's the dispatcher. So he was saying -- I can't remember his words -- saying, "What a country!" Because he could never have done this where he was. And he was about 30, and he was working 18 hours a day. It's amazing.

[ Key to Success ] The American Dream

Thank you so much, Dr. Folkman. We really appreciate it.

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This page last revised on Sep 21, 2010 20:19 EST
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