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Thursday, January 17, 2008

Cancer Therapy Pioneer Folkman Dies at Age 74

Judah Folkman, who pioneered a groundbreaking cancer treatment known as angiogenesis inhibition, where tumors are starved of their blood supply, died aged 74, on Monday night in Denver, Colorado, USA. His wife, Paula Folkman said on Tuesday that her husband probably died of a heart attack while changing planes en route to a conference in Vancouver, British Columbia, according to a New York Times report this morning, Wednesday.

President and Medical Director of the Angiogenesis Foundation, Dr. William W. Li, said in a statement on the Foundation's website that the news of Dr. Folkman's death "comes as a great shock to all who trained with and were students of this remarkable surgeon, scientist, teacher, and visionary".

Dr. Folkman was "one of the greatest scientific minds of our time", said Li, and he inspired the creation of the Foundation, which was founded 14 years ago and now works to advance the application of angiogenesis to over 70 different diseases.

Folkman started thinking about angiogenesis in relation to cancer tumors while serving as a Navy surgeon in the 1960s. Later, between 1967 and 1981, while he was the hospital surgeon in chief at Children's Hospital Boston, he published a paper in the New England Journal of Medicine putting forward the idea that in order to thrive, tumors relied on angiogenesis, or the growth of new blood cells to feed the swelling mass of tissue.

However, for about two decades he was shunned by his peers who found his ideas too revolutionary. Sources of funds gradually withered, and he was eventually forced to accept a large sum from chemical giant Monsanto to continue his research, according to an article in Scientific American.

The breakthrough came in the mid 1990s when researchers at Folkman's lab showed that endostatin had dramatically shrunk aggressive malignant tumors in mice by sapping their blood supply. The discovery was further enhanced by the fact not only did the method slow down tumor growth, it also stopped the more stable endothelial cells that make blood vessels and not just tumor generated blood vessel making cells.

Folkman became front page news in 1988 when the New York Times reported that two of his experimental drugs had destroyed tumors in laboratory mice. The report quoted Nobel laureate James Watson, co-discoverer of DNA, as saying that "Judah is going to cure cancer in two years".

But as with many breakthroughs at first, the excitement exceeds the reality, and other researchers had problems trying to get the same results reported by Folkman. The experimental drugs did not seem to work as well in humans as in mice, and funding for them again, dried up.

One of Folkman's experimental drugs was successfully taken to market in China, and the ones that eventually made it in the US were not developed by Folkman. But according to the New York Times, experts say none of the drugs would exist if it had not been for Folkman's work.

A long standing colleague of Folkman, and President emeritus of the Dana-Farber Cancer Institute in Boston, Dr. David G. Nathan, told the paper that the controversies are not important, "the point is, he made the field", he said.

Author of a book on Folkman's struggle titled "Dr. Folkman's War: Angiogenesis and the Struggle to Defeat Cancer", Robert Cooke, told the Associated Press that Dr. Folkman did not develop a cure for cancer, but his ideas helped to turn it into a disease that can be managed, like diabetes, which was a huge breakthrough at the time.

There are ten cancer drugs currently helping 1.2 million people worldwide to manage their cancer, including Avastin and Thalomid, and dozens more in development, all inspired by Folkman's work.

However, there is still some controversy about how angiogenesis inhibitors actually work. Some experts suggest they may not be cutting off the blood supply to tumors, but could actually be fixing blood vessels which makes it easier for the chemotherapy drugs to reach the cancer cells in the tumors.

Li said that Folkman:

"Had the good fortune to witness the field he pioneered evolve, on a global scale, into a major force in modern science and medicine."

"He lived to see his ideas from the laboratory become translated into real, practical treatments that are today helping patients afflicted by cancer, age-related macular degeneration, diabetic wounds, and other serious diseases," he added.

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