February 24, 1933, is the birthdate of Judah Folkman, the surgeon-researcher who persisted over decades, in the face of detractors, in his search for a protein that he was convinced helped cancerous tumors grow.
Operating in part on intuition, he felt strongly that such a mechanism could lead to cancer therapies that would not necessarily include surgery, or chemo- or radiotherapy, with their often-deleterious side effects.
His colleagues, and the medical establishment in general, disregarded the proteins Folkman found and his resultant theories of angiogenesis - the process by which tumors spur the growth of blood vessels that "feed" them - for as long as they could, until eventually he proved his case, and in so doing, opened up a whole new field of cancer treatment.
Moses Judah Folkman was born in Cleveland, Ohio, to Jerome Folkman and the former Bessie Schomer. Jerome was a Reform rabbi, also Cleveland-born, who would go on to be longtime leader of Reform Temple Israel, in Columbus.
Most biographical accounts tell how, as a seven-year-old who enjoyed accompanying his father on pastoral visits to hospitalized congregants, Judah informed his rabbi-father of his intention to become a physician. “In that case,” said Jerome, whose own father had been an Orthodox rabbi, “you can be a rabbi-like doctor.”
By all accounts, Folkman indeed became a gentle clinician and a generous teacher, in addition to being an ambitious and creative researcher.
Living hearts and implantable contraceptives
While still in high school, in the Columbus suburb of Bexley, Judah experimented at home with keeping an isolated rat’s heart beating, and he spent his four years at Ohio State University, which he entered as an undergraduate at age 15, working part-time in a surgical lab.
Folkman was 19 when he began Harvard Medical School. There, he continued working in a surgery lab, which is where he and a fellow student built their own primitive heart pacemaker. He graduated in 1957.
A surgical residency at Massachusetts General Hospital was interrupted by two years in the U.S. Navy. Folkman spent his service at the navy’s medical research center, in Bethesda, Maryland, where he designed a synthetic blood replacement that would remain fresh during long voyages. He also developed an implant for slow-release of drugs, which later served as the basis for an implantable contraceptive.
It was during his service that Folkman also first observed what later became the focus of his research: the fact that malignant tumors seem to spontaneously generate blood vessels in a way that healthy tissue does not. That vessel growth in turn allowed the tumor to grow rapidly. He postulated that tumors must secrete a growth factor affecting the vascular system, and that if it could be blocked, it might induce the tumor’s death.
Upon his return to Boston, in 1967, Folkman was named chief surgeon at Boston Children’s Hospital, the youngest person to hold that position, which he received even though he lacked experience in pediatric surgery (something he made up for with a six-month interval working with C. Everett Koop, later the U.S. surgeon-general, at Children’s Hospital of Philadelphia.)
Big business on board
Along with his clinical work, however, Folkman continued doing research on his own. This was unusual for a surgeon, especially as colleagues – who were inclined to channel their energies to killing cancer cells directly -- were skeptical of his hypothesis, grants were hard to come by, and journals were reluctant to publish his findings.
Folkman found a way around the financial hurdle by accepting funding from industry, with the expectation that his sponsors – initially, Monsanto -- would be able to develop any discoveries that had commercial potential. Today, this is common, but in 1974, this was unusual in academic research.
By the early 1990s, Folkman and his team had identified several natural proteins that could inhibit angiogenesis, which they thought could be isolated and serve as the basis for cancer-fighting pharmaceuticals. It would be another decade before the first such drug, Avastin, hit the market.
Judah Folkman died of a heart attack in the Denver airport on January 14, 2008, while he was in transit to a medical conference in Vancouver. The field he helped will into existence, however, has continued to develop and yield new therapies.
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