The switch in tumors from the quiescent state to malignancy is signaled by the commencement of the angiogenesis process. Tumors need an extensive network of capillaries to provide nutrients and oxygen. Solid tumors will not grow beyond 2 millimeters (about 1/4 inch -- the size of a BB) without new blood vessels. Malignancy and invasion are angiogenesis dependent.

Since the early 1970s when Dr. Folkman first identified the angiogenesis process and its therapeutic implications, research in this area continued mainly in the laboratory. Only in the last ten years has research moved out of the lab and into the clinic. In 1989, the first clinical trial of an angiogenesis inhibitor began for a life-threatening, non-cancerous blood tumor.

In the last 10 years, researchers have been able to refine their work with the discovery and identification of proteins found in the blood that act an angiogenesis inhibitors.

Top left: Implanted cancer cells glow with green fluorescence protein.
Top right: Three of the original cancer cells have survived to begin replicating. Signals between the existing blood vessel and the growing cancer cells cause the cells to grow toward the vessel.
Bottom left: The cancer cells have reached the existing blood vessel.
Bottom right: When they number only 100-300, the cancer cells have created new, fully-functioning blood vessels.
Graphic illustration by Stanley Coffman, Duke University Medical Center

Click on links below to learn more.

Quick Study-

"Cancer research focuses on starving tumors of their blood supply"
From the Ovarian Cancer Research Notebook of the National Ovarian Cancer Association of Toronto, Canada. Of special interest in this article is the last section titled "Combined Approach".

"Understanding Angiogenesis: A Key to New Cancer Treatments"
From the Fall 1997 issue of the Progress Newsletter of the American Cancer Society.

For more in-depth information see below-

"Cancer Warrior" This is a Nova program offered in Quicktime and RealVideo formats. The eight-chapter program covers Dr. Judah Folkman's revolutionary cancer research, the concept of starving cancer, angiogenesis, looking for inhibitors, experimental drugs and clinical trials.

"Fighting Cancer by Attacking Its Blood Supply"
This is an article dated September 1996 by Dr. Judah Folkman, from Scientific American.

"Angiogenesis and Cancer Control: From Concept to Therapeutic Trial"
This is a research paper published in 1999, by Steven Brem, M.D., of the H. Lee Moffitt Cancer Center & Research Institute. Comprehensive and detailed.

http://www.med.unibs.it/~airc
This is Special Project Angiogenesis, by the University of Brescia, Italy. Comprehensive and detailed.

"Tumor angiogenesis: past, present and the near future"
This is an article published March 2000 by Robert S. Kerbel in Carcinogenesis, Oxford University Press.