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重新審視抗癌之戰(zhàn)

重新審視抗癌之戰(zhàn)

Brian Dumaine 2012-02-21
南加州大學(xué)著名腫瘤學(xué)專(zhuān)家、史蒂夫·喬布斯的主治醫(yī)生之一戴維·阿古斯的新作,徹底顛覆了我們已有的大部分醫(yī)學(xué)知識(shí)

????此外還有一些預(yù)防炎癥的簡(jiǎn)單方法。阿古斯解釋道,與其一次性進(jìn)行大量高強(qiáng)度的激烈運(yùn)動(dòng)然后在桌子后面坐一整天,遠(yuǎn)遠(yuǎn)不如多走點(diǎn)路更好。(走路的節(jié)奏對(duì)人體的淋巴系統(tǒng)有益,而淋巴系統(tǒng)在一定程度上控制著免疫系統(tǒng)。)盡量穿舒服的鞋子,它可以減輕關(guān)節(jié)的壓力。(光腳或穿高跟鞋走路可能導(dǎo)致關(guān)節(jié)受損,從而引發(fā)足部炎癥。)

????不過(guò)也有人反對(duì)阿古斯的理論。比如加州大學(xué)舊金山分校(UCSF)的醫(yī)學(xué)教授麗塔?萊德伯格認(rèn)為,現(xiàn)有證據(jù)并不支持他汀類(lèi)藥物的廣泛使用。她說(shuō):“我給病人開(kāi)藥的目的是要讓病人感覺(jué)更好或活得更久,而他汀類(lèi)藥物并不能起到以上任何一種效果?!辈粌H如此,他汀類(lèi)藥物還可能導(dǎo)致包括肌肉疼痛和糖尿病在內(nèi)的副作用。

????當(dāng)然,阿古斯還是認(rèn)為他汀類(lèi)藥物在許多情況下利大于弊。除此之外,他還有許多別的養(yǎng)生辦法,這些辦法好在并不需要我們做出什么超人的努力。阿古斯的許多養(yǎng)生之道都是常識(shí)性的,也就是培養(yǎng)健康的生活方式。

????阿古斯也相信,我們還需要一些新的工具才能真正了解我們的身體。他建議我們每個(gè)人都應(yīng)進(jìn)行基因成像?;驁D像并不會(huì)告訴我們是否會(huì)染上某種疾病,但會(huì)告訴我們?nèi)旧线@種病的幾率有多大,從而幫助我們做出正確的判斷。幾年前,他與別人合作創(chuàng)辦了一家名叫Navigenics(意為“基因?qū)Ш健薄g注)的公司,專(zhuān)門(mén)提供基因檢測(cè)服務(wù),每次收費(fèi)400美元。這家公司得到了凱鵬華盈投資公司(Kleiner Perkins)風(fēng)投家約翰?杜爾的資助,他是谷歌的早期投資人之一。阿古斯也給自己的DNA畫(huà)了像,還把結(jié)果展示在書(shū)里公之于眾——他發(fā)現(xiàn)自己存在罹患心臟病的風(fēng)險(xiǎn)。這有點(diǎn)奇怪,因?yàn)樗哪懝檀妓揭恢焙艿?。盡管如此,他還是開(kāi)始攝入更健康的飲食,并開(kāi)始服用他汀類(lèi)藥物。

????我們?cè)谝恍┬鹿ぞ叩膸椭禄蛟S能在更早的階段檢測(cè)到隱藏的疾病。問(wèn)題的關(guān)鍵在于我們需要理解構(gòu)建生命的基石——蛋白質(zhì)的活動(dòng)機(jī)理。缺損的蛋白質(zhì)可能是某種疾病的早期標(biāo)志,然而追蹤蛋白質(zhì)是一項(xiàng)極其因難的工作——蛋白質(zhì)的大小只有一個(gè)中子那么大。大約8年前,阿古斯創(chuàng)辦了另一家公司,名叫Applied Proteomics。他與超級(jí)計(jì)算機(jī)專(zhuān)家丹尼?希利斯合作開(kāi)發(fā)了一個(gè)系統(tǒng),有能力對(duì)幾十萬(wàn)個(gè)蛋白質(zhì)水平進(jìn)行編目。目前這家公司仍處于科研階段,一旦它取得成功,就能為醫(yī)學(xué)界提供一個(gè)重要的診斷工具。

????阿古斯說(shuō),上個(gè)月英國(guó)的《每日鏡報(bào)》(Daily Mirror)刊發(fā)了一篇書(shū)評(píng),介紹了他的新書(shū),結(jié)果一下子有7,000多人憤怒地發(fā)博文或?qū)戨娮余]件對(duì)他進(jìn)行譴責(zé)。有些人指責(zé)他想乘機(jī)宣傳自己的基因成像公司以此謀利。阿古斯對(duì)這個(gè)問(wèn)題的回答是,他在那家DNA公司只有很少的股份。

????實(shí)際上,阿古斯未來(lái)面臨著更大的挑戰(zhàn)——他需要讓自己的理念被醫(yī)學(xué)界廣泛接受。也許到那時(shí),他才能把聽(tīng)眾席上的噓聲變成歡呼聲。

????譯者:樸成奎

????There are other simple ways to fight inflammation. Agus explains that it's better to walk a lot than to do an intense burst of exercise and then sit behind a desk all day. (The rhythmic part of walking helps your lymphatics function, part of the system that controls your immune system.) Wear comfortable shoes, which lowers stress on joints. (Walking barefoot or in high heels can cause damage to the joints and thus inflame your feet.)

????His approach has its detractors. Dr. Rita Redberg, a professor of medicine at UCSF, argues that the evidence doesn't support the widespread use of statins. "I prescribe medicine to make people feel better or live longer, and statins do neither," she says. Not only that, statins can have side effects ranging from muscle aches to diabetes.

????Of course, Agus thinks statins in many cases do more good than harm and, anyway, are just one tool in his arsenal. The nice thing about his approach is that nothing requires a superhuman effort -- a lot of it is just commonsense, healthy living.

????Agus also believes we need new tools to really understand our bodies. He suggests that each of us get genetically profiled. This won't tell us whether we'll contract a certain disease but will tell us the probability of getting it, allowing us to make the proper adjustments. A few years ago he co-founded Navigenics, a company that does genetic screening at $400 a pop and is backed by venture capitalist John Doerr of Kleiner Perkins, an early investor in Google (GOOG). When Agus had his own DNA profiled -- the results are in the book for all to see -- he found he was at risk of having a heart attack. This was strange because his cholesterol had always been low. Nonetheless, it was enough to persuade him to go on a healthier diet and start taking statins.

????New tools may also make it possible to detect diseases at a much earlier stage. The key is understanding how proteins -- which are the building blocks of life -- operate. Faulty proteins can be early indicators of a disease. The trouble is, tracing proteins is incredibly hard to do -- they are the size of a single neutron. About eight years ago Agus started another company called Applied Proteomics. He joined up with supercomputer guru Danny Hillis to create a system with the horsepower to catalogue hundreds of thousands of protein levels. The company is still a work in progress, but if it succeeds, it will provide an important diagnostic tool.

????When Agus's book was reviewed by the Daily Mirror in England last month, he says he got 7,000 angry blog and e-mail responses. Some accused him of trying to cash in on his DNA-profiling firm. Agus's response? That he has only a small stake in the DNA firm.

????Agus, however, has a bigger challenge ahead. He needs to get his ideas widely accepted by the medical community. Maybe then he can turn those hisses into cheers.

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