Meet Dr. Howard Bruckner, a pioneer in the field is designing safe chemotherapy regimens to treat a variety of once untreatable cancers.
The times in which we live are fraught with a multitude of dangerous challenges but one of the most devastating is a diagnosis of terminal cancer. After making the rounds to an army of exceptionally qualified oncologists and receiving many conflicting and discouraging treatment recommendations, patients brace themselves for the worst. The words come crashing down like deafening thunder when they are told by a medical professional that “there is nothing more that can be done.”
On a balmy spring evening on New York City’s Upper East Side, I sit across the table of a neighborhood restaurant with a humble man. With palpable emotion, renowned oncologist, Dr. Howard Bruckner said, “Today I gave the news to a longtime patient that the cancer was in remission. Baruch Hashem.” With a small black yarmulka perched on his head of graying hair, Dr. Bruckner acknowledged 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 adds that Jewish philosophy categorically rejects hopelessness. “A sensible scientific plan, and a “can do and must try” attitude benefits everyone and is absolutely necessary. Dr. Bruckner has earned the stellar reputation of being the doctor of last resort for those battling complex gastrointestinal and gynecological cancers with high mortality rates. Because of his unrelenting commitment to understanding, and devising new modalities for effectively confronting this dreaded illness, Dr Bruckner explains that he has identified special criteria for integrating lessons learned from testing tumors in leading laboratories. He has further refined these best findings in his laboratory in order to integrate them with the leading cancer centers’ clinical most promising treatments. This 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 these exceptionally ill patients have now become fundamental parts of standard treatments used both before and after surgery. They substantially improve long term survival. He has great hopes that because his current innovations are more potent they will have a greater impact for both heavily treated and new patients than his earlier successes now used worldwide. He explains that tumors are too often already recognizably resistant to standard treatment from the onset of a patient’s diagnosis, and before starting any treatment he expresses great hope that the available new technology which can identify resistance will allow his safer treatments to provide earlier help for these many resistant patients.
“We have discovered that as a result of these treatments, patients with our most challenging cancers often survive two to three times longer and more often ” said Dr. Bruckner.
Dr. Bruckner has pioneered the field of designing new moderate low dose chemotherapy regimens to treat a variety of tumors that are very often resistant to standard treatments. He is among the first successful practitioners to demonstrate the ability to often shrink these cancers thereby allowing for better chance of success for both radiation therapy and surgery to eliminate tumors that had previously been thought to be untreatable or inoperable.
He has been a member of over 20 national professional societies and committees, a consultant and reviewer for numerous professional journals and pharmaceutical and biotechnology companies, co-authored over 150 peer reviewed reports and articles, numerous book chapter and abstracts. In his 40 years as an academic and full professor, he was an often 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 also held appointments at the Mount Sinai School of Medicine and State University of New York (SUNY) Downstate Brooklyn NY School of Medicine.
So, in his sixties, when many doctors could start thinking of retirement, he began his own practice in the Bronx. Under his leadership, the entire staff of physicians and nurses extends their clinical reach to work as partners with their patients to find the best treatment plan for each individual patient, personalized medicine both as science and individualized care.
“My approach is to substantially add to the options offered at major cancer centers; to work towards complementing and refining existing treatment programs. In essence, we are not here to compete with the standard oncology practices but rather, we are committed to building on them by providing complimentary interactive treatments in time to help current patients.” Recalling the era of his then nascent career, Dr. Bruckner said, “I was always a person with modest ambition. I really never wanted to have anything to do with cancer. I had no personal experience and my prestigious professors had a poor, un-optimistic opinion regarding the state of practice. I wanted to be a pediatrician but after my first day on the pediatric ward, I knew it was not for me. The medical field lacked the science needed in order to advance the treatment of neurological diseases in children.”
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 Institute for Health (NIH) where he would work with a Nobel prize winning physician. He did not take this position nor an already offered following post doctoral infectious disease position at Harvard. He explains that during an interview for the NIH position “with the number two guy in cancer in America”, the associate director of the Cancer Institute “told me of a number of best research projects that they had started and offered me my choice to join any one of them. I explained to him why each one would not succeed and it was 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 surprised thought, he said I was “a very good critic.”
When queried as to whether he could propose practical research objectives, Dr. Bruckner right off the cuff suggested investigating what he considered to be the Achilles heel of cancer therapy. He proposed to seek answers for why therapy causes infections in order to improve safety and thereby treatment. He also offered testable stratagems to make cancer therapy safe and this became his key career long priority.
Startling revelations quickly emerged from Dr. Bruckner’s first experiments as a special assistant to the associate director of the NCI. 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. This resulted in the wholly unexpected finding that the antibiotic was not helping. It made the cancer very toxic. However, he was to learn that understanding the action of antibiotics also improved the use of cancer drugs against the tumors. Most importantly, recognition of the problem led to solutions still applied to make many cancer drugs safe and increase their therapeutic benefit. “We were testing axioms; those things that doctors accepted as basic assumptions, that never should have been considered axioms,” declared Dr. Bruckner.
He then began to create “models” which 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”, said Dr. Bruckner. “In a way, this was one of the first attempts to evaluate and apply the human micro-biome to clinical care.”
After the NCI, and 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 only at a dismal 5%. 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 these numerous science based promising 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,” Dr. Bruckner said.
Working with patients’ safety and ovarian cancer led to Dr. Bruckner’s novel laboratory and clinical methods which were designed to optimize drug matching; thus finding a better and safer dosage and comprehensive team that consisted of a cocktail of partners for drugs. This even led to cures for pancreatic cancer which he described as perhaps the “worst and most dangerous form of cancer.” He added that he has been making inoperable tumors operable for thirty years and that every drug that was used for patients with pancreatic cancer had failed. “You can’t just pair any two drugs. Drugs that barely work individually will work with the right drug partner; especially multiple partners,” he said.
(To Be Continued Next Week)
By: Fern Sidman