Ginn 1 Lauren Ginn Instructor: Professor Campbell English 1102 27 March 2014 The Tumornator: Is Antiangiogenic Therapy the

new Cure for Cancer? A 35 year old woman goes in for her annual checkup just like she does every year; shes feeling healthy and living her busy life as a wife, teacher, and mother of two beautiful children. A week after her checkup, she receives a call from the doctors office telling her she needs to come in right away theres urgent news. Thinking little of it, she goes in to get the results; she cant stay too long because her son needs to be picked up from soccer practice in an hour and food needs to be on the table by six for the family. Little did she know, her life would be changed forever in that doctors office with the utterance of five simple, yet shattering words. The doctor walks in with a look on his face that screams devastation; the woman, now worried for her health and future, begs the doctor to tell her what he has to say. He can barely look at her when he life-shattering phrase Im sorry, you have cancer comes from his mouth. This horrific scenario is played out daily all over the world, affecting every life in some way, shape, or form. The silent killer has taken hold of more than 13,000,000 people in the United States the number increasing more and more each day. On average, as many as 500,000 people die each year from some type of cancer in the United States, and 1,000,000 or more people are diagnosed with cancer each year in the United States (SEER). Cancer research has become more prevalent in todays society. In recent years, the National Cancer Institute has received a budget of over 4 billion dollars in cancer research, with the budget increasing by millions of dollars each year (NCI). As time has passed, People have become more desperate
Commented [JM2]: when he presents Commented [JM1]: I love how you started off with a story, this draws the readers attention in!

Ginn 2 than ever for a cure to this daunting disease and will not stop the fight until the battle is won and cancer is no longer a threat to the lives of millions of people. Within the last two decades, a new type of cancer treatment, antiangiogenic therapy, has been researched and developed as a possible cure or combat to cancer. According to William Li, M.D., the founder and president of Angiogenesis Foundation, Angiogenesis is the growth of new capillary blood vessels in the body. This process is essential for life it helps to heal wounds, build tissue, and transport needed nutrients throughout the body. When angiogenesis is out of balance, it causes multiple health problems. According to Li, Abnormal blood vessel growth, either excessive or insufficient, is now recognized as a common denominator underlying many deadly and debilitating conditions, including cancer. In order for cancer to grow and spread, it must have some type of blood and nutrient provider and a transport mechanism this is the part angiogenesis plays in cancer growth. According to the National Cancer Institute, a research facility dedicated solely to the development of cures for cancer, angiogenesis [] is necessary for cancerous tumors to keep growing and spreading (NCI). In order for angiogenesis to occur, the VGEF growth factor, a pathway that is used in order to initiate a certain function in the body to take place, must be signaled. Once angiogenesis has been established and blood vessels have been developed to feed the cancer, the cancer is able to not only able to receive the nutrients it needs to grow, but it also has the ability to travel through the blood vessels to other parts of the body. This stage of cancer, known as metastasis, is very lethal and increases the chances of death by as much as 50% (American). In order to combat metastasis and the growth of cancer, William Li and his team of oncologists and cancer researchers have hypothesized that if cancer is attacked from the main source of growth and the VGEF factor is blocked there will be no possible potential for the
Commented [JM6]: Take this out because you repeated Commented [JM5]: Well done how you credited this doctor. Commented [JM3]: This paragraph had maybe two grammatical issues but they were simple I fixed them. Commented [JM4]: Its great how you talked about cancer and why it is such a big deal in the United States.

Ginn 3 cancer to become advanced; this will lead to the shrinking and disappearance of the cancerous tumor (Li). In simpler terms, the main purpose of antiangiogenic therapy is to starve out cancer by cutting off its blood and nutrient supply. Some research has proven antiangiogenic therapy to be an asset for future battles against cancer. William Li, one of the major advocates for antiangiogenic therapy and the importance of controlling angiogenesis, has conducted several experiments and found that antiangiogenic drugs can, in fact, stop the growth of cancerous tumors. In his presentation with TEDTalks, Li presents his data to give the general public an overview of the recent findings in antiangiogenic research. While presenting his data, he shows the difference between the use of antiangiogenic drugs as opposed to using radiation or chemotherapy. According to Li, When [] breast cancer was treated with Avastin (an FDA approved antiangiogenic drug), the cancerous tumor decreased by as much as 80%. Li also concluded from his tests and research that severe cancer in humans, dogs, dolphins, and horses can be treated with a mixture of antiangiogenic drugs and prolong the person or animals lifespan by as much at 7 years (Li). This research from the Angiogenesis Foundation is used in support of the antiangiogenic chapter of cancer research and sheds light on the great advances being made in cancer research in general. Along with this research, Li has also found that the diet a person uses can be helpful in fighting cancer. According to his research, 35% of all cancers are related to a persons diet. If a person is to surround themselves with antiangiogenic foods and drinks, such as pomegranate, pineapple, wine, and green tea, they will lower their chances of cancer and keep angiogenesis in check before it becomes a problem in a persons life. Aside from Lis research, other oncologists have found positive results while working with antiangiogenic drugs and using them as part of their cancer treatments. In a recent study
Commented [JM10]: So far I can tell that you went into depth with your research and you used resources that really support your topic! Commented [JM9]: Its good that you tell you readers what these terms are/what they mean in case they may not know. Commented [JM8]: Great way of telling readers who he is Commented [JM7]: In this paragraph you do a great job of helping those who may not understand the concept of angiogeneic therapy get a grasp of what it is.

Ginn 4 performed by the Tongji Medical College in China, the antiangiogenic drug Bevacizumab was used on a total of 103 patients with cancer, with the results showing that the antiangiogenic drug had the potential in most cases to prolong a patients life by as much as one year or more (Su). With this information, people are more likely to gravitate towards this kind of treatment in order to prolong their life and, in some cases, save themselves from death. In another study performed by the University of Copenhagen, Anderson and his team found that breast cancer can be healed through the use of many different antiangiogenic drugs. With all of this information, it is easy to assume that antiangiogenic treatments will become part of the cancer regimen for future patients and their fight with the silent killer. When antiangiogenic therapy was first introduced to the public in the late 1990s, it created a sense of hope that cancer might be able to be cured. According to the CNN News report in 1999 about this subject, [] researchers generated excitement by announcing a novel way of treating cancer -- by cutting off the flow of blood to tumors in mice. However, they were not able to follow up with this excitement because of extreme holdbacks from the FDA and the studies of the medicines. One of the first antiangiogenic drugs to be tested, thalidomide, took up to 6 year to be fully tested and brought to people with cancer as a possible treatment. This is because of the after affects that could possibly be seen with the use of these medicines. This drug (is) best known for causing tragic birth defects, according to CNN News, when doctors in some countries prescribed if for nausea in early pregnancy (CNN). The fact that antiangiogenic drugs stop angiogenesis in multiple places besides just the designated area of treatment is a risk factor in many people because it could potentially cut off the blood supply. In addition, some studies have also proven antiangiogenic therapy to not be enough to fight cancers on its own. In a recent study performed by Department of Oncology at the
Commented [JM12]: by the Commented [JM11]: years

Ginn 5 University of Copenhagen, it was found that antiangiogenic drugs could not stop cancer from going on its own. The only way it was slightly successful was when paired with an already used treatment such as radiation or chemotherapy (Anderson). Such a finding sets back the thoughts about antiangiogenic therapy and brings more skepticism to the table about its benefits if it truly has any at all. In other experiments, such as ones from performed by S.M. Sagar, an MD and research specialist in holistic health, antiangiogenic therapy did not help to cure cancer in any patient with holistic healing process (processing with only natural remedies and no harmful or dangerous chemicals) (Sagar). This provides the awareness that antiangiogenic therapy is not enough to combat cancer on its own, in some cases, and must be paired with one of the other known treatments for cancer, such as radiation. This information that has been added to the knowledge of antiangiogenic therapy and will help to further research on this topic. Along with this information, some oncologists have found some severe side effects that occur because of the use of antiangiogenic drugs. According to a study by David Cunningham, an oncologist from London who has spent his life researching cancer, side effects such as hypertension (high blood pressure), proteinuria (excessive serum proteins in urine),thrombosis (blood clots inside blood vessels), internal bleeding, impaired wound healing, and gastrointestinal perforation (a hole that develops through the entire esophagus, stomach, small intestine, large bowel, rectum, or gallbladder) occurred while a patient was using antiangiogenic drugs. However, it was found that the most common side effect was hypertension, which occurred in approximately 20% of the 105 patients that were tested. The most dangerous side effect, gastrointestinal perforation, only occurred in about 1.5% of the 105 patients (Cunningham). This gives antiangiogenic therapy some validation because it proves to not be as detrimental as some other forms of treatment that effect the entire body in harmful ways.
Commented [JM13]: Great use of statistics within this paragraph. Commented [JM14R13]:

Ginn 6 This data collected by Cunningham is challenged, however, by the research performed by other oncologists and researchers in recent years. the Department of Cell Therapy and Hematology from San Bortolo Hospital in Vicenza, Italy, it was found that the use of antiangiogenic drugs actually caused severe bleeding and clogging of the vascular endothelial growth factor (VEGF) (Elice). While the growth factor needs to be blocked in order to prohibit angiogenesis from occurring, clogging or bleeding at the location of the VEGF growth factor can be detrimental to the overall health of the body; it can also cause internal bleeding and blood clots. This finding sets back the use of antiangiogenic drugs because adding health problems on top of cancer will only put a patients life further at risk of death a risk most oncologist are unwilling to take. In addition to this finding, many scientists have also found that some people and some cancers are actually resistant to the antiangiogenic drugs. In a recent study conducted by Shojaei F. of the Oncology Research Unit in the United States, results showed that found that many of his patients that were treated with a mix of antiangiogenic drugs eventually showed a resistance to this cancer and the tumor eventually started growing again (F.). These results, where completely contradicted what had been found in earlier tests over the years, created skepticism and allowed for further research into the topic. Gabriele Bergers and Douglas Hanahan, both cancer researchers from the University of California, studied the possible resistance to antiangiogenic drugs that Shojaei F. found in his research with the drugs. From their research, they also found that over a prolonged period of time a cancerous tumor being treated with antiangiogenic drugs would start growing and spreading again. From this, they studied what could cause this growth of the tumor; they concluded from their research that two main reasons are the source for this growth: evasive
Commented [JM16]: Just take one out Commented [JM15]: You do well when presenting your opposing side

Ginn 7 resistance, an adaptation to circumvent the specific angiogenic blockade; and intrinsic or preexisting indifference (Bergers). In simpler terms, the cancer either adapts in order to overcome the barrier created by antiangiogenic drugs, or they are naturally resistant to the drugs and they have no effect on them. From this research, scientists are still trying to piece together the puzzle and discover what causes a certain cancer to be resistant to antiangiogenic drugs and possible mechanisms to overcome this resistant to make the drugs more affective. Overall, antiangiogenic therapy is still in the middle of being tested and the future for the treatment is very unclear. While it has been proven to have some benefits, the complications, risks, and inconsistency of its results makes antiangiogenic therapy a treatment that needs to be researched more and developed in order to decrease the amount of potential problems and setbacks. With more research, there is no limit to what can be uncovered about this type of cancer treatment and cancer in general. Only time will tell the overall effect antiangiogenic therapy will have on cancer and the changes it will bring to treating the silent killer. (I probably need to work on the conclusion some, but I just dont have any ideas! Any input on your part would be phenomenal. THANKS! )
Commented [JM17]: I feel that you have a strong, wellwritten conclusion. Wow! Your paper is great Lauren and readers will be able to tell that you went deep with your research which shows that you were interested in your topic. Only a few grammatical issues (not a really big deal). By reading your paper, I see that I have a lot more in depth research to do for my topic. Well done!