Judah Folkman, MD 1933-2008
He was a folk hero. He was my hero. In 1971, he published a unique theory of cancer growth for which he was ridiculed for years. I remember attending one of his lectures in the late 1980s. He spoke at the national meeting of medical cancer specialists about angiogenesis-the process by which new blood vessels are generated. The process, he felt, was fundamental to understanding how cancers grew. The talk was the last presentation before the lunch break. I remember people drifting toward the doors at the back of the large lecture hall, more worried about the food lines during the lunch hour than Folkman’s conclusions.
It was the biotechnology company Genentech that brought Folkman’s ideas to the clinic. Company scientists identified vascular endothelial growth factor-a protein that spurred the development of new blood vessels. In 2004, Avastin-a drug that blocks that factor-was approved for use in cancer patients.
In 2006, Folkman spoke at UCSB in a program cosponsored by the university, the Cancer Center of Santa Barbara, and the Doreen J. Putrah Cancer Research Foundation. The talk was recorded and played on the university cable channel. The program has been exceedingly popular. It has been played over and over again, like a favorite I Love Lucy rerun. Of all our programs at the Cancer Center, none has been greeted with as much enthusiasm. During his talk, Folkman explained his concept of tumor angiogenesis in terms as clear as a favorite bedtime story. He told stories of miraculous recoveries and of disbelieving doctors. He wore his years of criticism not with bitterness but with pride. Avastin had been approved, and patients were being helped. That seemed to be all that mattered.
I had the opportunity that evening to introduce Dr. Folkman. When the introduction was played on cable TV, my children would roll their eyes and walk out of the room. “How could you go on and on?” they asked. I couldn’t help it. He epitomized so much of what I thought was special about cancer medicine. He was a scientist, and his work changed our view of tumor biology. He was a clinician, and his research has changed the way we treat patients. He was caring-he loved telling stories about patients, including anecdotes about the close relationships he had with their families. He was also overwhelmingly human-he loved telling stories about his granddaughter’s reaction to his research.
Genentech’s Avastin has some serious drawbacks, and we are a long way from solving the mysteries of tumor cellular growth, but Dr. Folkman left us some very special gifts: He left us important science and a model for healing to which all of us in cancer medicine can aspire.