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"It is said that genius disdains the beaten path, and that's certainly true of Dr. Judah Folkman. He has suffered for it, but his imagination, his persistence-and yes, his glorious obsession-will benefit us all. We owe him our boundless gratitude."
-JONATHAN HARR, author of A Civil Action
"Rarely in the history of modem biomedical research has a major advance been attributable directly to the energies and vision of a single individual. This is such a story, about one man's vision, drive, indeed obsession with an idea that will one day dramatically change cancer therapy."
-ROBERT A. WEINBERG, Whitehead Institute for Biomedical Research and MIT, author of One Renegade Cell: How Cancer Begins and Racing to the Beginning of the Road: The Search for the Origin of Cancer
"I first encountered Judah Folkman when I was a surgical intern at Boston City Hospital. His already legendary crisp intellect provided a logical scaffold for my understanding of complex diseases. Judah, full of warmth and humanity, inspired me and generations of young doctors and scientists to pursue careers in his image. Dr Folkman's War does a masterly job of describing his gentle and determined magic. We are fortunate that Mr. Cooke has so meticulously, engagingly, and honestly captured Judah's story. It will serve as a powerful beacon for all who tenaciously pursue the understanding and treatment of human disease."
-WARREN M. ZAPOL, Reginald Jenney Professor of Anaesthesia, Harvard Medical School, and anesthetist-in-chief, Massachusetts General Hospital
"Sadly, my first meeting with Dr. Judah Folkman may have and most likely did come too late. We met as I searched desperately for a medical solution to the critical illness of my wife, Winnie, but by then her cancer had advanced beyond salvation. Nonetheless, I was deeply impressed by what I learned of Dr. Folkman's pioneering work in the cancer research field and his personal commitment and that of his close associates to success in this vital effort."
"Robert Cooke is without a doubt the most scrupulous and judicious science writer I have ever known. His strong passion for accuracy and fair play sings from every page of Dr Folkman's War, taking the battle against cancer beyond sensationalism to a place that is at once informative and exciting. Because the book is grounded, as such journalism should be, on solid science, hope sounds from it all the more loudly."
-LAURIE GARRETT, author of Betrayal of Trust: The Collapse of Global Public Health
From the Hardcover edition.
It was a tantalizing idea that Judah Folkman had nurtured for nearly four decades -- he had hatched it, worked it, published it, defended it, romanced it. He had withstood the ridicule of his peers. He had fought battles of medical and scientific politics. And he had endured, seemingly obsessed, never straying from the ideas in his head, the conviction in his heart, and the truth he saw in his laboratory. That was where the real battles were waged, where Folkman had been trying for nearly forty years to read and understand Nature's book, page by page. Now the time had come to see what it all amounted to. The answers were starting to trickle in from medical wards around the country, and there was little more for Folkman to do than wait, and hope.
At the core was a simple notion that had gradually matured in Folkman's mind ever since that day in 1961 when he was noodling in a navy lab in Bethesda, Maryland, a twenty-eight-year-old draftee trying to make cells grow under artificial conditions. That was when he'd first noticed a strange thing about tumors: They wouldn't grow unless they first recruited their own blood vessels. Over time he convinced himself that there had to be some way to block the growth of those blood vessels. To starve the tumor to death -- and save the patient.
So Folkman had been trying to conquer cancer for nearly four decades when, in the waning days of the twentieth century, the first patients began to be infused with the natural drugs that had come from his long campaign. The new compounds had worked marvelously in mice -- "We've never lost a mouse yet," Folkman liked to say -- and now they were being given the first crucial tests in men and women. Three clinical trials were under way to test one of the potent substances, endostatin, that had been discovered in Folkman's laboratory. And as many as two hundred biotechnology companies, some large and others tiny, were exploring the once-ridiculed field that Folkman had years before named "angiogenesis," meaning the growth of the blood vessels de novo needed to support tumor growth.
In Boston, where Folkman had lived, studied, and worked since leaving Ohio behind in 1953, the volunteers trooped to the Dana-Farber Cancer Institute for their daily infusions of the possible wonder drug. The infusion center was on the ground floor, equipped with a collection of beds, some of which were fashioned after chairs, designed for patients who could take their medicine sitting up. Each would take his or her place, and the dose would then be thawed. Endostatin was a precious commodity that couldn't be wasted -- the first one kilogram batch was said to be worth seven million dollars -- so it was never thawed before the patient actually arrived, in case the patient didn't show up. But they always did. These were people facing terminal cancer, desperate for the cure and very relieved to find that this drug, unlike the standard chemotherapy they had received, did not make them awfully sick. Of course, they hoped the treatments would also be different in a much more important way: Chemotherapy had not worked. That's why they were here. The infusion process, during which the drug was given through an IV line, lasted twenty minutes. Then the patients would leave, returning the same time the next day, Saturdays and Sundays included.
Would the new treatment live up to its billing, actually erase tumors without dangerous side effects? Would patients who had been given little or no chance of survival emerge unscathed, as if touched by magic? No one could tell -- but everyone was watching. Although the first phase of the trials was only meant to test for signs of toxicity, those involved could not resist the natural impulse to peek beyond the government-enforced protocols, hoping for signs, even the barest hint, of efficacy. The doctors running the trials, gagged by their institutions, refused to utter a public word. But the rumors were flying. The doctors talked sub rosa, and so did the nurses and interns who were close to the trials. Word got around the biomedical grapevine that at Dana-Farber and both of the other experiment centers conducting the trials in Texas and Wisconsin some patients' tumors had stopped growing. One man, it was said, had experienced remarkable progress. As one insider put it, the mystery man's cancer, both the primary tumor and its dangerous metastases, had been "galloping." But since he began getting endostatin -- in only small doses during the toxicity phase of the trial -- his tumors had shrunk by half. One patient was just one patient, but it was an encouraging start....
Excerpted by permission of Random House, a division of Random House, Inc. Copyright © 2000 by Robert Cooke.
Posted July 14, 2002
The best part of Folkman's war is in its description of the ethical challenges of contemporary academic medicine, e.g. the pitfalls of dealing with the press, the games scientists play to keep their lab out of the red, the relationship between science and industry, the slow transition of basic research to the clinic, and the unfortunate politics associated with drug trials. The discussion of these issues, if nothing else, make this a very worthwhile read. One minor downside is Cooke portrays Folkman as a demi-god and offers limited insight into the occasional mis-steps Judah has made. Judah's interactions with the press repeatedly reveal questionable judgements. If Folkman is so shy of the media then why did he agree to work with Cooke on a book that is directed to a lay audience? Cooke may have indeed repeatedly interviewed Folkman and his lab but this work would be substantially improved if Cooke could have spent much more time with others in the oncology/cell bio fields (both supporters and detractors of Folkman) and then provided a more balanced presentation of Judah's excellent work.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted March 18, 2002
This story is exciting. The future treatments for cancer and many other diseases may be controllable or cured from the results of his research. Dr. Folkman's life and work will be long remembered and he will be hailed as a hero for his efforts. Considering I am a person with no medical background the author delivered a masterpiece - a book with detailed medical intricacies that anyone can read and understand.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted October 13, 2001
Often we think scientific research is black or white, but this book about the life of Judah Folkman gives us a backstage pass to how scientific discoveries are painfully made. Reminds me of William Harvey's observation in the 17th century that blood circulates in the body...no one believed him either.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted June 12, 2001
Dr Folkmans War is an inside look at 1)the tight compartmentalization of medical knowledge and practice; 2)the thrill and pain of conducting unconventional research; 3) why Nobel prizes are awarded so belatedly; 4) why the past fifty years of cancer treatment encountered so many dead-ends; and 5) how cancers are really being cured now. Somewhat redundant in presentation, but that's my only criticism.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted April 9, 2001
The story highlights the closed mindedness of the medical profession. One must wonder how many people have died because Dr. Folkman lacked support in the early years of his study causing years of delay in his research. What a shame and disgrace. Dr. Folkman should now be recognized by his profession and given the highest rewards for his work. The book illustrates that hard work does indeed pay off in the long run and that one should never give up on their dreams. An excellent story about true courage and conviction.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted February 20, 2001
Robert Cooke does an amazing job of rendering what could have been a dense scientific discussion of anti-angiogenesis and its role in treating cancer, into an engaging and meaningful discussion that someone without a medical background can easily understand. Cooke aptly chronicles Folkman's career ups and downs, and ably captures the doctor's frustration of being a scientist two decades ahead of his time. <br> <br> The real message in this book, however, is one of triumph in the face of scorn and ridicule. That Folkman's peers - be they colleagues at Boston's Children's Hospital who sought to have him ousted from his position as Chief of Surgery or to have his laboratory closed, or anonymous reviewers at the medical journals who refused to publish his work finding it too implausible, or conference attendees who would simply walk out of one of his scientific lectures thinking he was a crackpot - could subject him to so much difficulty in pursuing his scientific vision speaks volumes about how we have trouble dealing with a visionary. Most of us, in Folkman's shoes, would have moved on to something else.<br> <br> Now that Folkman's ideas have come of age - science finally possesses the tools to validate his work and we are seeing the fruits in clinical trials around the country - I truly hope that his early critics will have the courage to acknowledge their error. As Cooke reminds us, genius can be very hard to recognize. Now that it is upon us, however, shame on those who continue to diminish it. <br> <br> This book is ideal for anyone possessing a fascination with science or medicine, anyone who appreciates stories of personal triumph, or anyone who is interested in how insight can be mistaken for heresy. Furthermore, as someone whose family has been touched by cancer, I found the book to be incredibly insightful in understanding the disease. Cooke's writing is clear and concise, and the Folkman story is incredibly engaging.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted February 18, 2001
Robert Cooke's biography of man dedicated to improve life on earth is exceptional in its grasp of the science, the milieu in which scientific revolution takes place in the U.S., and the response from those who hold the conventional wisdom as immune to change. This is like reading of Madam Curie's struggle with radium, but in a modern setting. Very exciting, wonderful insights by Robert Cooke. A fine gift for young readers who may decide to take Judah Folkman as a role model. Easy for the non-scientist to follow, and to learn from.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted March 31, 2001
This book clearly deserves many more than five stars. Dr. Folkman's War contains many valuable insights including how to: Raise children to be outstanding people; be an astute observer about nature to unlock new lessons; pioneer in a new field of science; and be persistent about something important. When the history of medicine in the twentieth century is written, Dr. Judah Folkman will be considered one of the most important figures. This book is the most accessible and complete source of information about his remarkable life and accomplishments. Dr. Folkman's research to date 'has found applications in twenty-six diseases as varied as cancer, diabetic retinopathy, macular degeneration, psoriasis, arthritis, and endometriosis.' 'Ordinarily, researchers working in any of these fields do not communicate with each other.' Angiogenesis looks at the way that capillaries are formed in response to the body's biochemistry to help and harm health. Tumors depend on this action to get the blood supply they need to grow. Wounds also rely on a similar mechanism to grow scar tissue. I have been following Dr. Folkman's career for over twenty-five years, and heard him speak about angiogenesis just a little over two years ago. Because I felt I was well-informed, I almost skipped this book. That would have been a major mistake on my part. Dr. Folkman's War contained much new and interesting information that helped me to better understand the lessons of Dr. Folkman's life, as well as the future implications of angiogenesis. Unknown to me, Dr. Folkman had also played a role as an innovator in implantable pacemakers, time-released drug implants, and specialized types of heart surgery before he began his serious assault on angiogenesis. The discoveries had their beginning in 1961 when he was a draftee in a Navy lab in Bethesda, Maryland. He noticed that tumors could not grow unless they first recruited their own capillaries to bring an increased blood supply. 'Over time, he convinced himself that there had to be some way to block the growth of those blood vessels.' He was right, but it took a long time before he knew any of the answers. In brief opening comments about the book, former surgeon general C. Everett Koop, M.D. and Sc.D. observed how this new science evolved. 'In the 1970s, laboratory scientists didn't believe any of it.' ' . . . [T]he critics' objections were hushed for good in 1989.' 'In the 1990s, the criticisms came chiefly from the clinical side, and the pharmaceutical companies didn't want anything to do with angiogenesis.' The story is a very heart-warming one. Dr. Folkman's father was a rabbi who asked each member of the family each night what she or he had learned that day. He also constantly implored his son to 'Be a credit to your people.' His father clearly thought that Dr. Folkman would also become a rabbi. Having announced his attention to become a physician, his father told him, 'You can be a rabbi-like doctor.' This injunction was one he took to heart, often seeking out his father's counsel on how to console the families of his patients. His first taste of how close mortality is to all of us was when his first two children inherited cystic fibrosis. The younger of the two died, and the older one needed lots of special care to deal with infections. This probably made him a better doctor, by helping him see things more from the patients' points of view. Space constraints keep me from discussing the book's description of how angiogenesis developed, but if you like stories about trail-blazing research, you will be amply rewarded. The key hurdles are described, along with the blind alleys that were followed. Anyone reading this will see how important it is to add new skills to the study of any new subject. I was particularly interested in the way that press reports tended to harm the progress of angiogenesis, either by annoying other scientists, attracting hucksters, or delaying key dWas this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted February 19, 2001
Robert Cook does a marvelous job presenting the life of Judah Folkman. I felt as though I have known him all along. If you have not read this book, you must. The world needs more people like Judah Folkman to look up to.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.