Curing cancer is a lofty goal — and has proven a very difficult one to attain. But when it comes to breast cancer, at least, some Negev physicians and researchers don’t think developing a cure is an impossible task.
“Certainly an honest goal is to cure every case of breast cancer,” said David Geffen, M.D., chief of Breast Oncology Services at the Soroka Medical Center. “Right now, it’s not a fantasy in the sky.”
Researchers from the medical center, along with those from the Memorial Sloan Kettering Cancer Center and its Evelyn H. Lauder Breast Center in New York City, met at Soroka in Beersheba on Wednesday to review some of the world’s latest cancer research findings. The conference explored ideas that are changing researchers’ definitions and understanding of the disease, and analyzed ties between cancer and bone health, obesity and other factors.
Soroka’s location and status were key in hosting this conference — and in conducting this research, said Dr. Ehud Davidson, the medical center’s director general, at a Tuesday briefing in Jerusalem prior to the conference.
“The residents of 60% of Israel’s land mass all depend on one hospital — ours, which is of course a big one and a good one, but still just one,” he said. “We call ourselves the ‘medical Iron Dome’ in the Negev — in times of war and times of peace.”
The Soroka Medical Center serves 1 million people — 400,000 of whom are children — in the Negev region. As the largest employer in the Negev, it has a staff of 4,200, including 800 physicians and 2,000 nurses.
But Davidson noted that, on average, people living in the Negev area live seven or eight years less than those who reside in Tel Aviv — in part because of the relative shortage of doctors and nurses. And with the transfer of Israel Defense Forces bases to the Negev, the need for more personnel and facilities will only increase. The hospital’s trauma center is already the busiest in the country: More than 3,000 patients — both civilian and military — are admitted each year.
To better serve not only the Negev region but all of Israel, Soroka can’t simply rely on what Larry Norton, M.D., medical director of the Evelyn H. Lauder Breast Center at Memorial Sloan-Kettering Cancer Center, called “immaculate records and superb clinicians.”
And although infrastructure development and access to the newest technology are important, they aren’t enough either, Davidson said.
“One of the main attractions for doctors and researchers — good doctors, young doctors and also experienced doctors — is an institution that presents them with opportunities,” he continued. “One of the main ones is to be able to practice advanced, groundbreaking research.”
That’s where the recent cancer studies come in. By looking at the entire human body as it relates to cancer — blood cells, bone marrow, and not just the concentrated cancer cells — researchers can learn more about cancer’s habits, continued the director. And by studying the genetic makeup, bone health, obesity, hormone use and other factors in people who have cancer, researchers can draw conclusions about the ties between those influences and the disease.
“What most people don’t understand is that the cancer cells themselves are harmless,” Norton explained. “Nobody ever died of cancer cells. You die of tumors. And tumors are intimately tied to many parts of the body — making a holistic approach necessary.”
As researchers study the relationship between cancer and other factors, breast cancer has become a key aspect of their studies. And because it is one of the more common types of cancer in women, many subjects are available in Israel.
Soroka’s role in the Negev and the people it serves — including Bedouin populations, which are more likely than many others to have uniform genetic makeups — combined with Israel’s knack for innovation make Soroka a perfect place to conduct cancer research, explained Norton.
“This is literally made in heaven for an extraordinary clinical research project,” he continued. “The whole environment is a setup that can make it a world center for this type of research.” He noted that every time he visits Israel, he sees a willingness to chart new territory.
“The term is a pioneering spirit,” Norton said. “It takes confidence in yourself, confidence in your peers, and the courage to move into the unknown. I feel that spirit in Israel: ‘We can do it; let’s get it done.’ ”
And although studies are bringing new facts to light, basic prevention is important as well, agreed the researchers at the conference. People all over the world are not exercising enough; smokers tend to have more difficulty with any type of cancer; and, for breast-cancer prevention and detection, yearly testing is vital, although researchers’ recommendations vary as to when women should start. Typically, they argue, women should begin to have mammograms between the ages of 40–50.
“If your goal, as a woman, is to minimize the risk of dying of breast cancer, you should get annual mammograms,” Norton advised.
And early detection isn’t just for women. Genetic tests indicate that, although far fewer men have breast cancer, they are just as likely as women to have a recurrence of the disease. “The big problem with men is that most of them don’t know they have breasts, and they don’t know what that lump is,” Norton said. “They think it’s benign, and it’s caught late.”
Researchers don’t have all the answers about where their current work will take them. But they do have a goal, said M.D. Geffen from Soroka: They want cancer to become a chronic disease — something that can be managed throughout a long life. Right now, more than half of breast-cancer patients reach old age, and scientists want those numbers to increase.
“People live with diabetes and hypertension,” he said. “We want the same for cancer patients — to have long, productive lives. And with breast cancer, we’re closer than with other cancers.”