Battling The Scourge Of Cancer, One Drug Cocktail At A Time: The Work Of Medical Pioneer Dr. Howard BrucknerThursday, November 17th, 2016
On a balmy evening in a neighborhood restaurant on New York City’s Upper East Side, I sit across the table from renowned oncologist Dr. Howard Bruckner. “Today,” he tells me, “I gave the news to a longtime patient that the cancer was in remission, baruch Hashem.”
A small black yarmulke perched on his head of graying hair, Dr. Bruckner acknowledges the words of the rebbes who call on his help: “Everything but everything in life is orchestrated by Hashem; the doctor is a shaliach.”
He has earned a reputation of being the doctor of last resort for those battling complex gastrointestinal and gynecological cancers with high mortality rates. He notes that Jewish philosophy categorically rejects hopelessness. “A sensible scientific plan and a ‘can do and must try’ attitude benefit everyone and are absolutely necessary.”
Dr. Bruckner explains that he has identified special criteria for integrating lessons learned from testing tumors in leading laboratories. He has further refined these findings in his laboratory in order to integrate them with the most promising clinical treatments from the leading cancer centers. This approach has made formidable inroads in enhancing their application to integrative and personalized medicine, thereby already extending many (and potentially countless) lives.
His earliest discoveries for exceptionally ill patients have now become fundamental parts of standard treatments used both before and after surgery. They substantially improve long-term survival. He hopes that because his current innovations are more potent they will have a greater impact on both heavily treated and new patients than his earlier successes that are now used worldwide.
He explains that from the onset of a patient’s diagnosis tumors are too often already recognizably resistant to standard treatment, and he expresses the hope that the new technology, which can identify resistance, will allow his safer treatments to provide earlier help for many previously resistant patients.
“We’ve discovered,” he says, “that as a result of these treatments, patients with our most challenging cancers often survive two to three times longer and more often. ”
A pioneer in the field of designing new moderate low-dose chemotherapy regimens to treat a variety of tumors that are often resistant to standard treatments, Dr. Bruckner has been a member of more than 20 national professional societies and committees, a consultant and reviewer for numerous professional journals and pharmaceutical and biotechnology companies, and has authored and co-authored more than 150 peer-reviewed reports and articles.
In his 40 years as an academic and full professor, he was a frequently invited speaker for various symposia and lectures. In addition to training at both Albert Einstein College of Medicine and Yale University School of Medicine, Dr. Bruckner has held appointments at Mount Sinai School of Medicine and State University of New York (SUNY) Downstate Medical Center.
He began his own practice in the Bronx in his sixties, when many doctors start thinking of retirement, Under his leadership, the staff of physicians and nurses work as partners with their patients to find the best treatment plan for each.
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“My approach,” he says, “is to substantially add to the options offered at major cancer centers; to work toward complementing and refining existing treatment programs. In essence, we are not here to compete with the standard oncology practices but rather to build on them by providing complementary interactive treatments in time to help patients.”
It was while Dr. Bruckner was immersed in immunological research at Albert Einstein Medical College that he was offered a coveted position at the National Institutes of Health (NIH) where he would work with a Nobel prize-winning physician. He did not take that position or an already offered postdoctoral infectious disease position at Harvard. He recalls that during an interview for the NIH position, the associate director of the NIH’s National Cancer Institute (NIC) “told me of a number of best research projects they had started and offered me my choice to join any one of them. I explained to him why each one would not succeed because the technology was not up to par in order to measure the critical pathological factors under study. After giving what I had said some thought, he said I was ‘a very good critic.’ ”
Asked whether he could propose practical research objectives, Dr. Bruckner suggested investigating why therapy causes infections and offered testable stratagems to make cancer therapy safe, which became his key career-long priority.
Startling revelations quickly emerged from Dr. Bruckner’s first experiments as a special assistant to the NCI associate director. Offering an explanation in layman’s terms, Dr, Bruckner said he used a very important but dangerous leukemia drug and injected it into laboratory mice. He then gave the mice antibiotics to protect them from infection, as this mimicked everyday clinical practice. The wholly unexpected finding was that the antibiotic was not helping. The opposite, in fact, was true.
Dr. Bruckner came to understand that the action of antibiotics also improved the use of cancer drugs against the tumors. Most important, recognition of the problem led to solutions, still applied, that make many cancer drugs safe and increase their therapeutic benefit.
He then began to create “models” that mimicked critical problematic strategies in cancer therapy in a lab setting in order to test drugs in depths impossible to achieve in the clinical research. This remains his preferred research method.
“In six months, I showed how the normal human bacteria would affect radiation and drugs, making them safe and unsafe. Bacteria determined the metabolism of the oral and intestine mucosa and bone marrow, and the metabolic rate determined safety.”
After NCI, while at Yale Medical College, Dr. Bruckner found that most international cancer research and treatment had not been applied to ovarian cancer. The ovarian cancer survival rate was a dismal 5 percent. This became a pivotal factor in his decision to move on to Mount Sinai Hospital in New York City where he found a strong working interest in gynecologic cancers. It was also an ideal setting in which to explore the numerous science-based treatment opportunities.
“In essence, we knew about a promising platinum drug that was too toxic to use. I figured out how to use it safely and that led us to discover step-wise how the drugs could work even more effectively without killing people. We made it usable. We have made and can make many drugs safer and more effective.”
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It was working on patient safety and ovarian cancer that led to Dr. Bruckner’s novel laboratory and clinical methods designed to optimize drug matching: finding a better and safer dosage and comprehensive team comprised of a cocktail of partners for drugs. This even led to successes with patients suffering from pancreatic cancer, which he describes as perhaps the “worst and most dangerous form of cancer.”
“You can’t just pair any two drugs,” he says. “Drugs that barely work individually will work with the right drug partner, especially multiple partners.” Through his lab work he found multiple simultaneous moderate and low-dose safe partners for combination drug therapy that has since had unprecedented success against resistant cancers.
Recently, leaders in cancer drug development have afforded multi-drug methodology new praise. They recognize a possible HIV analogy, where multi-drug methodology provided both critical safety and efficacy breakthroughs. Dr. Bruckner says that when this approach is applied to cancer it results in not only safer additional drug treatments but also safer drug interactions. It also empowers anti-vascular tumor starving drugs and promotes immune stimulation.Fern Sidman