It’s tough to feel hopeful about anything having to do with cancer — until you hear a story like Pamela Lipton’s.
On March 31, 2005, after having already endured a lumpectomy to remove a cancerous tumor from her breast, and a follow-up surgery to remove lymph nodes under her arm, Lipton, then just 44 years old, got a call from her doctor with the results of a CAT Scan. “She said, ‘I hate making calls like this,’” Lipton recalls. “You have multiple lesions, too many to count, all over your liver.” The cancer had metastasized.
The prognosis? “She said, ‘I can’t cure you.’”
The young doctor, of whom Lipton now understandably says she is “not a fan,” went on to tell her that metastatic breast cancers such as hers would lead to her death in as little as three years. Some women had been known to live for 15, she added: “But you’ll definitely die of breast cancer.’ I was blown away by that,” Lipton tells Tonic, “as you can imagine.”
She hung up the phone, hopeless.
It is now August of 2010, and Pamela Lipton is alive, well and full of all the hope in the world. The countless lesions on her liver are gone, replaced by harmless scars. She’s running off to the Berkshires on vacation — living life to the fullest. How is that possible? It all started with yet another phone call, this time a call that Lipton placed to The Angiogenesis Foundation.
If you’re familiar with TED, the forward-thinking lecture series aimed at sharing the work of some of the world’s great scientists and researchers, you may already know a bit about The Angiogenesis Foundation. Dr. William Li, one of the Boston organization’s founders, gave an inspiring talk at the TED 2010 conference last February that has been viewed countless times on the web.
Lipton herself had been fortunate enough to meet Li, along with his brother, Vincent, in social circles in the mid-1990s. When faced with her own mortality, she recalled their stories of miraculous cancer cases in which people diagnosed with previously-thought incurable cancers had lived. Even though she hadn’t spoken to them in years, she reached out to Vincent. “He immediately kicked in,” she says, and in a matter of days the foundation turned her hopelessness to hope — by putting her in touch with new doctors, starting her on new cutting-edge drug therapies and directing her to adjust her diet in ways that they hoped would literally starve the cancer out of her body.
Within three months, tumor markers in her blood dropped dramatically. And after enduring more aggressive chemotherapy that fall, coupled with the Angiogensis Foundation’s recommended therapies, “at the end of January, all there was on my liver were scars — something I never, ever had thought would happen,” Lipton says. Her cancer was gone. It would take constant monitoring, and follow up visits, and tests to make sure that cancer wouldn’t resurface. Still, Lipton tells Tonic, “That was a really amazing day.”
Eliminating Cancer’s Food Supply
Angiogenesis refers to the body’s ability to create new capillary blood vessels — a process that’s vitally important for, say, healing cuts, but can turn deadly when pulled out of balance. When tumors develop in the body, they can actually release triggers to spur angiogenesis, to create a blood supply on which they can feed.
The relatively new field of antiagiogenic therapies, of which the foundation has played a key research role, stops that process in its tracks. Without the growth of new capillaries, and without a blood supply to feed their growth, tumors die.
So why hasn’t everyone heard of this? Dr. William Li laughs a bit when asked that question. After all, he’s been fighting for more funding for angiogenesis research for over two decades.
According to Li, who began as a student of Dr. Judah Folkman at Harvard, and who has been working in the field of angiogenesis since 1985, we are finally now in the throes of what he calls the Angiogenesis Revolution.
“This field of angiogenesis has arrived,” he tells Tonic. “Its time has come. People are just beginning to learn about the Angiogenesis Revolution.”
The “revolution” is, in many ways, just a realization of something that has been present all along. Like other defense systems in the body, including the immune system, the blood-clotting system and the inflammatory system, Li notes, that the angiogenesis system also needs to be kept in balance. When any of those systems are out of balance, the imbalance itself can lead to disease — and it’s remarkable how many diseases rely on angiogenesis to take root.
Thanks to this realization, “we can begin to look at diseases in an entirely new way — not only as individual entities that are attacking our health, but as a disturbance in a system in the body that needs to be balanced,” Li tells Tonic. “When angiogenesis is unbalanced, many diseases can result: cancer, heart disease, stroke, blindness, obesity, Alzheimer’s … and so a new perspective that this revolution is giving us is that we can now begin to look for new ways to maintain a healthy balance, to keep angiogenesis in optimal condition.”
To put it simply: Maintaining optimal angiogenesis in the body could actually prevent diseases like cancer from taking hold in the first place.
Hope & Empowerment
When Pamela Lipton came to the foundation looking for help, “We were able to not only empower her, but to give her some concrete tools to allow her to go back to her doctor as a health consumer,” Li notes. “When you think about demand and supply, health care really is no different than any other part of the economy. When health consumers have an appetite based on their knowledge, it can actually open doors and give them access to treatments that might not appear to be readily available. That can be transformative. In Pamela’s case it was life-changing, and life-saving.”
In addition to going back for more targeted chemotherapy, Lipton was put on the antiangiogenic drug Avastin.
“That was the life-saving drug for her,” Li notes.
Avastin was first provisionally approved for treating breast cancer in 2008, and was very recently back in the news: In July, an FDA panel called for halting the drug’s prescribed use for breast cancer, citing side-effects and a statistical lack of clear beneficial results in a large sampling of Avastin users.
“I was on it right at the beginning of my treatment for the summer of 2005,” Lipton tells Tonic. “I had absolutely no side effects. I’ve had so many treatments that it’s hard to know exactly what kicked me into remission, but I feel badly about how Avastin has been dissed in the breast cancer community. They like to yell about how horrible the side effects are and I always wonder if any of them have been on it, because I had virtually no side effects.” Chemotherapy, of course, has many side effects, none of which would deter her from going on it “if I thought they had a chance of giving me more time or even possibly saving me,” she adds. “I know of one woman who was recently diagnosed with [metastatic breast cancer] and has been on Avastin (again with no side effects) and has had to change her course of treatment because of the ruling. She’s now on infusion chemo, losing her hair, vomiting, dealing with peripheral neuropathy, the whole bit. I think time will show that Avastin is very effective for some people, but because it hasn’t proved to be a home run for the whole [metastatic breast cancer] population, some people are wary of it.”
Dr. Li agrees with her assessment, which gets to a larger point: While the FDA panel recognized that Avastin didn’t work for everyone, “The fact remains that there are many individual patients with breast cancer that actually have dramatically benefited from the drug. And this speaks to the new directions in cancer treatments, where we need to personalize the treatment to the individual patient.”
“If we could find out what makes a patient like Pamela respond to drugs like Avastin,” he adds, “we would be able to create a framework for making sure the right patients get the right medicines. The era of personalized medicine is still in its infancy, and there’s a lot more work to do.”
Looking to Prevent Cancer
While the drug companies will continue to pursue drugs, like Avastin, to stop cancer in its tracks after the body’s angiogenesis system has taken hold, The Angiogenesis Foundation is looking ahead — to try to find a way to prevent cancers from taking hold of that system to begin with.
“At the Angiogenesis Foundation we have been and always will be a champion of innovation in medical therapy development, but we recognize that medicines are only half of the equation,” he says. “Prescription medicines are ordered by the doctor and given to the patient. It’s not a choice that the patient necessarily makes themselves.”
“The question we are asking is, ‘What is the answer to cancer?’” he says. “The answer is obvious: The answer to cancer is prevention. If we could prevent cancer, we would completely alter the economics of the disease, the suffering of the disease, the burden of the disease. It would be transformative, in the same way we could prevent polio, tuberculosis, AIDS — these are hugely important and societally important diseases where prevention became the focus.”
Prevention, according to Li, may be found all around us, in the foods we eat. Already, the foundation’s work has uncovered powerful and potent antiangiogenic substances in foods ranging from kale to tea, from tomato sauce to red wine. And they’ve found that by combining certain varieties of foods and beverages — Chinese and Japanese teas, for instance — they can increase the anti-angiogenic potency of those foods.
“Because there is evidence, we feel that the answer to cancer may wind up not being in the medicine cabinet, but on the grocery shelf and in the garden,” Li says. “It’s an area of research that has never been done, and is extremely hard to get funding for.”
That’s one area where everyday people can help, by making donations directly to The Angiogenesis Foundation.
“We need to be able to fuel the research to empower people to improve their health. Drug companies aren’t supporting this. Food companies haven’t yet gotten into the game. So this is really for the people, by the people,” Li says. It’s not some pie-in-the-sky (or tea-in-the-cup) dream, either. “It’s coming out of a very vigorous and validated area of medicine — angiogenesis.”
Need more validation? Just look to Pamela Lipton. “I never ever thought that it would happen to me. I never thought of myself as a particularly lucky person,” she says. “Five years ago, I couldn’t think of feeling as good as I feel right now, or even being alive.”
“I’m a big believer,” she says of The Angiogenesis Foundation’s work. “I am very grateful.”
To help The Angiogenesis Foundation continue their inspired research, Donate Now.
Read more about breast cancer prevention here on Tonic, in a column by the president of the NRDC.
Photos courtesy of Pamela Lipton.