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August 1, 2012

Curing cancer: Nobel laureate Hershko on whether it’s possible

http://www.jewishjournal.com/health/article/curing_cancer_nobel_laureate_hershko_on_whether_its_possible_20120801

Dr. Avram Hershko

Dr. Avram Hershko

Pick up any newspaper and there are certain types of stories that repeat day after day.

Armed men are killing each other in this or that war, car and train crashes claim varying numbers of victims, tearful politicians acknowledge sexual misconduct, and somewhere a scientist is working on a promising research project that might lead, according to the headline, to a cure for cancer.

So, with all these heralded “breakthroughs” in cancer research by brilliant scientists, supported by millions of dollars in public and private funds, are we actually winning the drawn-out war against cancer?

Fortuitously, Technion — Israel Institute of Technology’s Dr. Avram Hershko, co-winner of the 2004 Nobel Prize in Chemistry, was recently in Los Angeles, and the Israel Cancer Research Fund (ICRF), which supports his work, arranged an interview to provide an expert’s view.

Hershko, 74, and a child Holocaust survivor,  shared the Nobel Prize with a fellow Israeli and an American scientist for their discovery on how individual cells kill or get rid of malfunctioning proteins.

The way that proteins, which carry out the directives of genes, are formed in cells has long been a major research focus. But just as important is how to detect and eliminate “bad” proteins before they destroy or over-stimulate the “good” cells, leading to cancer, Parkinson’s, Alzheimer’s and other dreaded diseases.

Among the benefits of Hershko’s past and continuing research has been the development of an effective drug against a specific cancer, multiple myeloma.

However, instead of focusing on Hershko’s own research, which has been widely reported, The Journal asked Hershko to make some sense of the layman’s confusion about the endless, and sometimes contradictory, claims of new advances to end the scourge of cancer.

The key to understanding the fight against cancer is that it is not a single disease, like polio, which can be prevented with a single vaccine or other magic bullet.

“There are thousands of different kinds of cancer, and just one kind, breast cancer, can be triggered by 15 different causes,” Hershko said.

Other experts narrow the list of cancer types, but the numbers are still impressive. The American Cancer Society, for instance, lists 71 types; other compilers cite 200 types.

The Imperial Cancer Research Fund in England enumerates six different theories, each by a distinguished scientist, to try and explain why apparently normally functioning cells at some point “begin to grow and multiply in an abnormal way in some part of the body … [and then] invade and destroy the surrounding tissues.”

Hershko is quite skeptical of claims and expectations of a “cure” for cancer. To achieve that, he says, “We must remove every cancer cell in a patient’s body. If only one remains, it can grow and proliferate again.”

Hershko’s prognosis is not as pessimistic as it sounds. Even absent a cure, the goal of cancer research, he believes, should be to point the way to treatments that will “not merely prolong life, but allow for a reasonably good quality of life” for years to come.

There has been considerable progress in developing such treatments against, for instance, breast cancer and leukemia, especially if these diseases are detected in their early stages.

Ask Hershko what he prizes most in his life, and it’s not the Nobel or other honors, but his six grandchildren. Unlike the stereotype of the ivory tower scientist, completely consumed by his work, Hershko spends two or three days a week taking the kids to school, sports games or dance lessons.

One key to such devotion may be his own childhood experiences, which he is reluctant to discuss, particularly with his family, “because I don’t want to traumatize my grandchildren,” he said.

He was raised in the Hungarian town of Karcag, where both his parents were teachers. In 1944, when Hershko was 6, Nazi troops arrived and deported Karcag’s roughly 1,000 Jews, two-thirds of whom perished in concentration camps.

Hershko’s family was relatively lucky. The boy, with his mother, brother and paternal grandparents, were put on a train to a labor camp in Austria, were they worked in the fields near Vienna.

The family was liberated shortly before the end of the war, in April 1945. Eventually, Hershko’s father, having survived forced labor camps in Hungary and the Soviet Union, rejoined the family. However, the boy’s maternal grandparents and other relatives perished in Auschwitz. In 1950, the Hershkos made aliyah to Israel.

In 1969, Hershko started his research on how the body cleanses itself of unneeded and malfunctioning proteins, but his work was largely ignored or dismissed for the next 10 years.

“People just weren’t interested in my research; they didn’t realize how important it was,” he said. “Some scientists started avoiding me.”

With his theories now validated by tests and the Nobel Prize, Hershko has become something of a celebrity and is often enlisted as an all-purpose maven by the media.

At the Technion in Haifa, Hershko carries the title of distinguished professor, which exempts him from the university’s mandatory retirement-age rule, and in conversation he comes across as a modest and humorous man.

His work is also supported through a research professorship, funded by the ICRF, an organization founded in 1975 by American and Canadian oncologists to help underwrite the work of promising young researchers in Israel and prevent their migration to more lucrative offers at foreign institutions. (See related story on Page 22.)

The ICRF draws its support from American and Canadian contributors, and its grants “are very significant and make a big difference,” Hershko noted. All grant recipients must conduct their research at Israeli institutions.

Last year, ICRF gave out 69 grants, totaling $2.5 million, to scientists at 22 Israeli universities, hospitals and medical centers, according to Lynn Addotta, director of operations for ICRF’s Los Angeles office.

Toward the end of a lengthy interview, Hershko expressed his apprehension about the perceived diminished interest of American Jews, especially the younger ones, in the future of Israel.

“We need your support in every way, not only money,” he insisted. “Israel is the only country we have.”

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