Houston forges cancer research links with Israel

Israel is the location of world-class cancer research. Historically, Professors Isaac Birnbaum and Leo Sachs in Israel made one of the first groundbreaking cancer research discoveries. They laid the foundation for differentiating between cancer cells and normal cells and under-standing the transformation of a normal cell into a cancerous cell.

Israel continues to make a huge impact on cancer research, said Dr. Raphael Pollock, head of the division of surgery and professor and chairman of surgical oncology at The University of Texas M.D. Anderson Cancer Center. His specialty is oncogenes and tumor suppressor genes in soft-tissue sarcoma.

"Israel is an incubator in the fields of high tech, medical tech, computer science and bio-pharmaceuticals," said Dr. Pollock. "It's an environment where young people sit together in close proximity so they can cross- pollinate each other. That's part of it. There's also the tremendous respect the Jewish people put on education and learning, including medicine. We can go all the way back to Rambam [Maimonides] for examples.

"Another reason is that as Jews, we have traditionally been interested in taking on new fields. Look at the role of Jews at the beginning of emerging fields such as psychology and neurology, fields that were subsequently borne out to have great importance. Perhaps there is a proclivity to recognize that uncharted fields may hold great opportunity."

Dr. Pollock will be one of the featured speakers at "Israel: Shaping the Future." The May 17 program will present Israeli technology and its impact in medicine, energy and high-tech in America. Participants will also include Michael Granoff of Better Place and Ilia Rosenberg of Boeing. The program is part of the American Jewish Committee Houston's 2010 annual meeting.

Thanks to much of the research done in Israel, we now know that many cancers have a genetic basis. When you look at cancer cells through a microscope, you often find that they have abnormal chromosomes located along the chromosomal chain. These are called translocations, chromosomes that detach and come back together in the wrong place. These translocations can cause normal genes to become oncogenes (cancer cells), often by short-circuiting the normal signals that tell cells when to divide and when to stop dividing. The hallmark of cancer is uncontrolled growth.

Dr. Pollock explained that there are two entities that are normally in a balance in our cells: oncogenes and tumor-suppressor genes. We know today that an absence of tumor suppressor genes and/or the presence of oncogenes can lead to various types of cancer.

The oncogene codes for the production of an oncoprotein. The presence of an oncoprotein is probably an abnormal protein that shouldn't be there in the first place or has been produced. So that's one way cancers happen.

The other way is when something goes wrong between the balance of oncogenes and tumor suppressor genes. Normally, we all have tumor- suppressor genes. They act like traffic cops, directing cellular traffic. If there is a mutation in a suppressor gene, it produces an abnormality. The tumor-suppressor genes are extremely powerful and normally they suppress cancer by maintaining a normal balance.

Dr. Pollock works with soft-tissue sar-coma, a rare form of cancer that causes tumors of connective tissue like muscles and blood vessels. There are two broad categories of cancer: sarcoma (from which connective tissue is derived) and carcinoma (formed by epithelial cells).

"About 75 percent of our body is connective tissue, so it's good that sarcomas are rare," said Dr. Pollock. He does his research at the Sarcoma Research Laboratory at M.D. Anderson. The Sarcoma Research Lab is headed by Dr. Dina Lev, originally from Israel, who also happens to be married to Dr. Pollock.

Both Dr. Pollock and Dr. Lev spend much of the year in Israel. Over the past several years, M.D. Anderson has developed a sister relationship with Tel HaShomer's Chaim Sheba Medical Center in Tel Aviv. The relationship focuses on shared lab research programs, professional exchanges between visiting scientists and trainees from both institutions, and new cancer treatments.

Chaim Sheba also has one of the most advanced medical simulation units in the world, said Dr. Pollock.

"This is a facility that can model difficult medical problems and situations. There is a group of 150 professional actors on contract who can simulate medical situations - for example, battlefield trauma. The facility contains a room with vents that push simulations like gunfire smoke. So, they train front-line personnel in these simulators. To qualify for medical school in Israel, you have to take a psychometric exam. They will film prospective doctors interviewing an actor- patient and students will be graded on empathy and compassion.

"We're working to develop models at Sheba. We will bring the models to Anderson for surgical trainees. Israelis also have some of the best training in the world in how to break bad news to patients. They are also top class in programs that mentor young faculty. These are all programs we're doing in collaboration. You get to see how Israelis actually manage these situations. And, their programs are used throughout the world in Europe and Latin America.

"I've been very involved in helping to develop this relationship. We have similar programs that we're developing with hospitals in Korea, China, Brazil and the United Kingdom and Mexico. We call this program ‘Global Oncology."