What new idea or innovation is having the most significant impact on medicine or public health?
One consequence of health reform is the recognition by the medical community that what really matters, at the end of the day, is how a medical treatment affects people in the real world. This means that pharmaceutical clinical trials studying only a narrowly defined group of people with a specific illness don't tell us enough. We need to study how treatments work in real-world populations (populations made up of people with different genetics, lifestyles, and health conditions) in order to truly understand what works, what doesn't, who benefits, and who doesn't.
What's something that most people just don't understand about your field?
Most people learn about angiogenesis in the context of cancer and are led to believe that growing blood vessels is harmful and needs to be stopped at all costs. That's wrong. Angiogenesis is actually one of our defense systems against disease. The body has to be able to grow blood vessels when required (as in wound healing or pregnancy) but ordinarily keeps them at bay. As with so many other things in the body, what we want to do is keep angiogenesis in balance, not destroy the system.
What's an emerging trend you think will shake up the health world?
Understanding that food is the chemotherapy we take three times per day is a game changer. We are learning that Mother Nature has imbued many foods--fruits, vegetables, herbs, seafoods, tea, coffee, even chocolate--with natural substances that can cut off the blood vessels that feed cancer and other diseases. Eating to starve cancer will pull the rug from under the cancer epidemic, and in a way that puts control in the hands of consumers, not doctors. Using foods that prevent angiogenesis is a strategy that can cut across socioeconomic, cultural, and geographic barriers.
What's a health trend that you wish would go away?
Waiting to treat a disease, instead of preventing it. We spend our limited resources--time, money, and human capital--too heavily on seeking ways to treat advanced stages of diseases like cancer instead of developing and implementing preventative measures. As a result, our entire health care system, and the incentives for innovation, are skewed towards "sick care" when prevention yields greater dividends, in terms of cost savings and quality of life.
What's an idea you became fascinated with but that ended up taking you off track?
After 20 years of working on ways to develop designer anti-angiogenesis drugs for cancer treatment, I arrived at the conclusion that drugs are not the optimal way to prevent cancer. They are too expensive, too toxic, and unsuitable for lifetime use to keep microscopic cancers from gaining a blood supply. So about five years ago, I took my work "off-road" into the worlds of food science and epidemiology.