There's a medical revolution happening all around us,

and it's one that's going to help us conquer

some of society's most dreaded conditions,

including cancer.

The revolution is called angiogenesis,

and it's based on the process

that our bodies use to grow blood vessels.

So why should we care about blood vessels?

Well, the human body is literally packed with them:

60,000 miles worth in a typical adult.

End to end, that would form a line

that would circle the earth twice.

The smallest blood vessels are called capillaries;

we've got 19 billion of them in our bodies.

And these are the vessels of life, and,

as I'll show you,

they can also be the vessels of death.

Now the remarkable thing about blood vessels

is that they have this ability

to adapt to whatever environment they're growing in.

For example, in the liver they form channels

to detoxify the blood;

in the lung they line air sacs for gas exchange;

in muscle they corkscrew so that muscles can contract

without cutting off circulation;

and in nerves they course along like power lines,

keeping those nerves alive.

We get most of these blood vessels

when we're actually still in the womb,

And what that means is that as adults,

blood vessels don't normally grow.

Except in a few special circumstances:

In women, blood vessels grow every month

to build the lining of the uterus;

during pregnancy, they form the placenta,

which connects mom and baby.

And after injury, blood vessels

actually have to grow under the scab

in order to heal a wound.

And this is actually what it looks like,

hundreds of blood vessels

all growing toward the center of the wound.

So the body has the ability to regulate

the amount of blood vessels that are present at any given time.

It does this through an elaborate

and elegant system of checks and balances,

stimulators and inhibitors of angiogenesis,

such that, when we need a brief burst of blood vessels,

the body can do this by releasing stimulators,

proteins called angiogenic factors

that act as natural fertilizer

and stimulate new blood vessels to sprout.

And when those excess vessels are no longer needed,

the body prunes them back to baseline

using naturally occurring inhibitors of angiogenesis.

Now there are other situations where we start beneath the baseline

and we need to grow more blood vessels just to get back to normal levels --

for example, after an injury --

and a body can do that too,

but only to that normal level,

that set point.

But what we now know is that for a number of diseases,

there are defects in the system

where the body can't prune back extra blood vessels

or can't grow enough new ones

in the right place at the right time.

And in these situations, angiogenesis

is out of balance.

And when angiogenesis is out of balance,

a myriad of diseases result.

For example, insufficient angiogenesis --

not enough blood vessels --

leads to wounds that don't heal, heart attacks,

legs without circulation, death from stroke,

nerve damage.

And on the other end, excessive angiogenesis --

too many blood vessels -- drives disease,

and we see this in cancer, blindness,

arthritis, obesity,

Alzheimer's disease.

In total, there are more than 70 major diseases

affecting more than a billion people worldwide,

that all look on the surface to be different from one another,

but all actually share

abnormal angiogenesis

as their common denominator.

And this realization is allowing us

to reconceptualize

the way that we actually approach these diseases

by controlling angiogenesis.

Now I'm going to focus on cancer

because angiogenesis is a hallmark of cancer,

every type of cancer.

So here we go.

This is a tumor: dark, gray, ominous mass

growing inside a brain.

And under the microscope, you can see

hundreds of these brown staining blood vessels,

capillaries that are feeding cancer cells,

bringing oxygen and nutrients.

But cancers don't start out like this.

And, in fact, cancers don't start out

with a blood supply.

They start out as small, microscopic nests of cells

that can only grow to

one half a cubic millimeter in size;

that's the tip of a ballpoint pen.

Then they can't get any larger because they don't have a blood supply,

so they don't have enough oxygen or nutrients.

In fact, we're probably forming these

microscopic cancers all the time in our body.

Autopsy studies from people who died in car accidents

have shown that about 40 percent of women

between the ages of 40 and 50

actually have microscopic

cancers in their breasts,

about 50 percent of men in their 50s and 60s

have microscopic prostate cancers,

and virtually 100 percent of us,

by the time we reach our 70s,

will have microscopic cancers growing in our thyroid.

Yet, without a blood supply,

most of these cancers

will never become dangerous.

Dr. Judah Folkman, who was my mentor

and who was the pioneer of the angiogenesis field,

once called this "cancer without disease."

So the body's ability to balance angiogenesis,

when it's working properly,

prevents blood vessels from feeding cancers.

And this turns out to be

one of our most important defense mechanisms

against cancer.

In fact, if you actually block angiogenesis

and prevent blood vessels from ever reaching cancer cells,

tumors simply can't grow up.

But once angiogenesis occurs,

cancers can grow exponentially.

And this is actually how

a cancer goes from being

harmless to deadly.

Cancer cells mutate

and they gain the ability to release

lots of those angiogenic factors, natural fertilizer,

that tip the balance in favor of blood vessels

invading the cancer.

And once those vessels invade the cancer,

it can expand, it can invade local tissues.

And the same vessels that are feeding tumors

allow cancer cells to exit into the circulation

as metastases.

And, unfortunately, this late stage of cancer

is the one at which it's most likely

to be diagnosed,

when angiogenesis is already turned on

and cancer cells are growing like wild.

So, if angiogenesis

is a tipping point

between a harmless cancer and a harmful one,

then one major part of the angiogenesis revolution

is a new approach to treating cancer

by cutting off the blood supply.

We call this antiangiogenic therapy,

and it's completely different from chemotherapy

because it selectively aims

at the blood vessels that are feeding the cancers.

And we can do this because

tumor blood vessels are unlike normal, healthy vessels

we see in other places of the body:

They're abnormal;

they're very poorly constructed;

and, because of that, they're highly vulnerable

to treatments that target them.

In effect, when we give cancer patients

antiangiogenic therapy --

here, an experimental drug for a glioma,

which is a type of brain tumor --

you can see that there are dramatic changes that occur

when the tumor is being starved.

Here's a woman with a breast cancer

being treated with the antiangiogenic drug called Avastin,

which is FDA approved.

And you can see that the halo of blood flow

disappears after treatment.

Well, I've just shown you

two very different types of cancer

that both responded to antiangiogenic therapy.

So, a few years ago, I asked myself,

"Can we take this one step further

and treat other cancers,

even in other species?"

So here is a nine year-old boxer named Milo

who had a very aggressive tumor

called a malignant neurofibroma growing on his shoulder.

It invaded into his lungs.

His veterinarian only gave him three months to live.

So we created a cocktail of antiangiogenic drugs

that could be mixed into his dog food

as well as an antiangiogenic cream

that could be applied on the surface of the tumor.

And within a few weeks of treatment,

we were able to slow down that cancer's growth

such that we were ultimately able to extend milo's survival

to six times what the veterinarian had initially predicted,

all with a very good quality of life.

And we subsequently treated more than 600 dogs.

We have about a 60 percent response rate

and improved survival for these pets

that were about to be euthanized.

So let me show you a couple of

even more interesting examples.

This is 20-year-old dolphin living in Florida,

and she had these lesions in her mouth

that, over the course of three years,

developed into invasive squamous cell cancers.

So we created an antiangiogenic paste.

We had it painted on top of the cancer

three times a week.

And over the course of seven months,

the cancers completely disappeared,

and the biopsies came back as normal.

Here's a cancer growing on the lip

of a Wuarter horse named Guinness.

It's a very, very deadly type of cancer called an angiosarcoma.

It had already spread to his lymph nodes,

so we used an antiangiogenic skin cream for the lip

and an oral cocktail, so we could treat from the inside

as well as the outside.

And over the course of six months,

he experienced a complete remission.

And here he is six years later,

Guinness, with his very happy owner.

(Applause)

Now, obviously, antiangiogenic therapy

could be used for a wide range of cancers.

And, in fact, the first pioneering treatments

for people, as well as dogs,

are already becoming available.

There's 12 different drugs, 11 different cancer types.

But the real question is:

How well do these work in practice?

So here's actually the patient survival data

from eight different types of cancer.

The bars represent survival time

taken from the era

in which there was only chemotherapy,

or surgery, or radiation available.

But starting in 2004,

when antiangiogenic therapies first became available,

well you can see that there has been

a 70 to 100 percent

improvement in survival

for people with kidney cancer, multiple myeloma,

colorectal cancer, and gastrointestinal stromal tumors.

That's impressive.

But for other tumors and cancer types,

the improvements have only been modest.

So I started asking myself,

"Why haven't we been able to do better?"

And the answer, to me, is obvious;

we're treating cancer too late in the game,

when it's already established

and, oftentimes, it's already spread or metastasized.

And as a doctor, I know