September 1998

Miracles of Saint Judah

When it comes to reporting on cancer "breakthroughs," journalists fall back on the same old myths.

By Stephen S. Hall

One of the more amusing aspects of the recent flurry of stories about two promising new cancer treatments is the way researcher Judah Folkman, the son of a rabbi, has been hailed as a secular saint-even though all his miracles, as he's the first to admit, have taken place in mice.

Hardly a week had passed after the now-notorious May 3 front-page story in The New York Times, which described the work of Folkman's lab at Children's Hospital in Boston on endostatin and angiostatin, before Folkman was canonized. As the noted molecular biologist Yogi Berra once observed, "It's dj vu all over again."

Anti-angiogenic factors work by blocking the formation of new blood vessels to tumors, essentially starving the cancer. Last November, Folkman's group reported in Nature that repeated courses of one such agent, endostatin, cured three different kinds of implanted tumors in mice.

Since we live in an age when the fate of a few genetically challenged rodents can send shivers through the stock market, revisiting the scene of this crime for a moment affords an opportunity to reiterate a few obvious points about biotechnology, the press and the public. With apologies to Wallace Stevens, here are Five Ways of Looking at a Breakthrough.

The Magic Bullet Syndrome: We've all been spoiled by penicillin, a magic bullet the likes of which we'll probably not see again in our lifetime. Every few years, however, a new cancer treatment heads into the clinic with the kind of buildup more suitable to Hollywood than to Harvard. Connoisseurs of this form of hopeful hype will recall the examples of interferon (heralded by a cover story in Life in 1979), interleukin-2 (cover stories in Fortune and Newsweek in 1985), monoclonal antibodies (another Fortune story in 1987), tumor necrosis factor, shark cartilage...you name it. Between IPOs and voracious news cycles, every dog of a molecule has its day in the biotech business.The Salk Complex: This is a special concoction of the press and the lay public. We like our breakthroughs to be singular, the product of soloists or divas or maestros. If they've struggled mightily upstream against the tide of Conventional Wisdom, all the better for the story line. Jonas Salk's polio vaccine, the model of 20th century scientific heroism, arrived at a unique moment of American innocence, optimism and gratitude, but you saw some of the Salk treatment in the Folkman coverage, especially in the suggestion that scientists used to snicker at angiogenesis as an approach. I heard plenty of laughter when I sat in on a Folkman talk not long ago-but only because he has such a great sense of humor. In fact, any narrative that depicts the scientist as a lone wolf hero ignores the reality that science is a collaborative, synergistic, community-driven enterprise.