Israeli researchers offer new hope for cancer survivors suffering from side effects of treatment

By Shelley A. Sackett


When Emil and Lili Berkovits moved to Boynton Beach, Florida, from Salem, Massachusetts, in 2014, they were excited to start their retirement after Emil’s long career as a cantor.

A fifth-generation hazzan who had emigrated from Czechoslovakia as a young child following World War II and grown up in Montreal, Berkovits spent most of his professional career in the United States.

He was a well-built, physically active man who played baseball professionally, but after an injury he gave it up for a career in musical and communal leadership. Berkovits helped bring generations of boys and girls to their bar and bat mitzvahs and made music that stirred the souls of many a congregant.

Decades later, after retiring to Florida, Berkovits, then 78, developed a persistent sore throat and noticed a lump on his neck. He soon was diagnosed with cancer of the oropharynx, near the back of his throat. Oropharyngeal cancer can be slow growing and, like many cancers, often spreads before any symptoms appear. By the time the cancer is detected it can be quite advanced.

The treatment was grueling. Over seven weeks, Berkovits received 35 radiation and seven chemotherapy treatments. He developed a heart infection and his throat became so inflamed that he couldn’t eat — both results of the radiation, doctors told him.

But the treatment was effective: For five years, well into his 80s, Berkovits lived cancer-free.

Yet he suffered dearly from the consequences of the treatment. He no longer could produce saliva, leaving his mouth permanently dry. He lost most of his ability to taste. He went on an exclusively liquid diet because regular food could cause him to choke. He lost 25 pounds, leaving him physically weak.

“Because he can’t eat normal food, he has no energy,” his wife, Lili, said earlier this year, shortly before Berkovits’ death over the summer. “Nothing can help these eating and swallowing issues.”

Berkovits’ experience was not unusual. Many cancer survivors find themselves struggling with health issues related to their treatment for years after they are declared cancer-free. Problems may include pain, fertility issues, infections, memory problems, sexual health issues, cognitive impairments and more, including increased risk of secondary cancers. For many, the health problems last a lifetime.

In Israel, a growing cadre of cancer researchers is focusing not just on cancer treatments but on improving life for cancer survivors by trying to mitigate treatment side effects.

“Quality of life is a subject of utmost importance as cancer patients go through therapy, and even once they complete their treatment,” said Dr. Mark Israel, national executive director of the Israel Cancer Research Fund, or ICRF. “It is not enough to cure cancer. We must also address the patients themselves and their experience.”

ICRF is now investing in research that aims to offset the debilitating side effects of cancer treatments that linger even after the disease is eradicated.

At the Rambam Health Care Campus in Haifa, its director of oncology, Dr. Irit Ben-Aharon, is studying how chemotherapy damages blood vessels, which can lead to vascular disease and fertility problems. By helping cancer patients avoid these toxic effects of their treatment, doctors can reduce their risk of developing cardiovascular disease or infertility in the future.

Ben-Aharon is hopeful her work will be of special benefit to younger cancer survivors.

“As the incidence of cancer in younger individuals is increasing, survivors with very long life expectancy are emerging as a group with significant challenges related to treatment,” she said.

Ben-Aharon’s work is one of four research projects currently funded by ICRF focused on improving the lives of cancer survivors. Two of the projects are being supported by grants provided through the Brause Family Initiative for Quality of Life at ICRF.

Since its founding in 1975, ICRF has raised more than $72 million for Israeli cancer research, including groundbreaking work that has led to both treatment breakthroughs and improved treatment outcomes.

While cancer treatments such as chemotherapy, radiation therapy to the brain and immunotherapy are crucial for curing cancer, they may leave the patient with cognitive deficits. Up to 75 percent of cancer survivors suffer cognitive impairments, including problems with attention, memory and learning.

Dr. Yafit Gilboa, an occupational therapist at The Hebrew University of Jerusalem’s Department of Medicine, is using her ICRF grant funded by the Brause Family Initiative to explore a novel approach to ameliorating that cognitive decline. This new approach, tele-rehabilitation, provides for the remote delivery of courses designed to diminish the cognitive effects of cancer therapy.

Gilboa’s strategy for treating patients with cancer-related cognitive impairment is comprised of 30-minute cognitive trainings several times a week using their home computer, supplemented by a weekly videoconference session with an occupational therapist.

Gilboa credits the Israel Cancer Research Fund for supporting not just research for cancer treatments, but also for treatment of side effects.

“This research makes a valuable difference in the quality of life for cancer survivors,” Gilboa said.

She and her team at The Hebrew University already have recruited patients from Hadassah Medical Center and completed a pilot study that showed encouraging results in cognitive and occupational performance. Patients also reported decreased depression and anxiety and an increased sense of well-being.

“One patient reported that since starting this therapy, he was striving to live the way he did before he got sick. Another said she felt more self-confident,” Gilboa reported.

Dr. Jacob Hanna of the Department of Molecular Genetics at the Weizmann Institute of Science in Rehovot is focused on pluripotent stem cells, which are like the cells from which babies are formed in that they have the ability to become any type of organ or tissue. Hanna and his team are studying how cells with the properties of embryonic stem cells can be generated from a patient’s skin or hair follicles and then used to create an array of cell types for transplantation into cancer patients. This could be instrumental in helping cancer survivors whose treatment regimen destroyed tissue or damaged organs.

Dr. Avi Priel of The Hebrew University’s School of Pharmacy is working on the problem of chronic pain among cancer survivors. While opioids are the most powerful tools for managing pain, they can have debilitating side effects and may be addictive for those requiring chronic relief.

“In the last two decades, the misuse of opioids — powerful but problematic drugs — has shed light on the need for new, less addictive painkillers with fewer side effects,” Priel said. “This is precisely my lab’s research goal.”

Priel’s research team, another recipient of a grant provided through the Brause Family Initiative, is working to develop novel analgesics — painkillers — that will have a potency similar to opioids but with minimal side effects. The team is also investigating drugs that can be combined with opioids to reduce the frequency and amount of opioid required to achieve good pain control.

“We believe these will enable patients who suffer from cancer pain to enjoy a better quality of life,” Priel said.

Funding Cancer Research: ACS Fights the Good Fight

Above: Aaron Goldman, Ph.D., American Cancer Society pay-if grantee.

By Shelley A. Sackett

This year, 1.6 million Americans will receive a new cancer diagnosis. Yet, federal funding for cancer research is at its lowest ebb in decades, according to American Society of Clinical Oncology (ASCO).

“It’s scary what we’re doing nationally with funding,” said Tom Flanagan, Interim Senior Director of the New England Division of the American Cancer Society (ACS).

Tom Flanagan

Tom Flanagan

In 2014, cancer caused 585,720 deaths in the United States, or one fourth of all reported deaths. According to the ACS, the number of new cancer cases is expected to rise by almost forty percent by 2030. Yet, federal funding of medical research has remained flat for more than a decade when adjusted for inflation.

The U.S.’s National Institute of Health (NIH) is the largest source of funding for medical research in the world. Since 2003, however, its inflation-adjusted appropriation is down 23 percent, according to the ASCO. The NIH budget peaked in fiscal year 2010 at $30.9 billion, falling to $30.3 billion for fiscal year 2015.

Diminished resources have had immediate effects. For example, patient enrollment in NIH’s clinical trials network decreased from 29,000 patients in 2009 to 20,000 in 2013. Clinical trials are a critical step in bringing potential new therapies to the marketplace.

Next to the federal government, the ACS is the largest private funder of cancer research, subsidizing 809 research grants in the U.S. worth $438 million in 2015. Of that national total, $47.5 million, or over ten percent, is earmarked to fund 96 Massachusetts grants.

In addition, the ACS’s multi-disciplinary review panel sometimes approves applications that are beyond that year’s funding resources. Called “pay-if” grants, individual donors who wish to support research that would not otherwise be funded subsidize the work. In 2014, these individual donors stepped up to contribute more than $8.8 million in funding, financing 46 additional “pay-if” grants.

One pay-if grantee is Aaron Goldman, Ph.D., an instructor of medicine at Harvard Medical School who was a fellow with ACS for three years, until this past July. He received a $150,000 research grant to study the biological mechanism that makes some breast cancer cells resistant to cancer therapy. His goal was to develop a drug that would attack this mechanism.

“The focus of our work is not just to keep testing and playing with pathways and molecules, but to really make something come to fruition. There is a huge unmet need, particularly when it comes to cancer cells’ resistance to chemotherapy,” he said. In fact, he and his team have developed drugs that they know are working. “We got a lot of great research accomplished in just three years,” he said proudly.

Goldman and his team are currently seeking private funding to expand these drugs into a full-fledged company so they can study and license them. With the right funding, these new therapies could be market-ready within a year-and-a-half, Goldman estimates, improving a cancer patient’s overall therapeutic outcome and preventing relapse.

Over the course of his 15-year involvement in cancer research, which started as an undergraduate and then graduate student at the University of Arizona, he has had a lot of experience with foundation and government grants. ACS is unique among funders.

“ACS brings you in as family. You’re interacting with the actual funders and the patient population. All the work I’m doing gets communicated throughout the community of administrators and the grant committee,” he said. By contrast, NIH is more anonymous and diffuse. “You feel a little more detached from the population that you’re trying to help – the people suffering from cancer.”

Goldman’s main takeaway from his experience with medical research and securing funding is that foundation grants are crucial in the current fiscal environment that has created even fiercer competition for federal grants, making it very difficult for a young investigator to even qualify for one.

“It’s the old paradigm of applying for a job without the experience but you need the job to get the experience. These foundation grants, like ACS, have been fantastic in filling those gaps,” he said.

ACS is trying to get Congress to refill NIH cancer research funding gaps by increasing appropriations. In 2001, it created ACS Cancer Action Network (ACS CAN) to amplify the organization’s work in the public policy arena. As the nation’s leading nonprofit, nonpartisan cancer advocacy organization, ACS CAN promotes its agenda of fighting cancer at the state and federal levels. ACS provides 92 percent of ACS CAN’s 2015’s budget of $35.9 million. The other 8 percent is donated by individuals, health systems and companies.

“We hold candidates as well as lawmakers accountable for their stance on public policies that we know will make a positive impact on fighting cancer,” said Shalini Vallabhan, ACS CAN Vice President of Government Relation in New England. With one million volunteers nationwide, trained volunteers in every congressional district and a lobbyist and grass roots manager in every state, the group is a political force to be reckoned with.

“We all know the level of partisanship that is taking place in Washington, D.C. Increasing funding for medical research is an area we see strong bipartisan support for,” Vallabhan said, pointing out that on July 15, the U.S. House of Representatives passed House Bill 6, “The 21st Century Cures Act” ( which provides for dedicated funding for NIH for the next five years at $1.75 million per year, or $8.75 million total.

The bill must next pass in the Senate before President Obama can sign it into law. Later this month, over 700 volunteers and ACS CAN staff will travel to Washington, D.C. to lobby lawmakers from all 435 congressional districts.

ACS would not receive any of this increased funding. “This is for the public good. We have to get the story out because it’s such an exciting time in life sciences and cancer treatment and if we continue to decrease funding from the federal government, it will have a ripple effect for decades in terms of research and science in these areas,” Vallabhan said.

Since its first cancer prevention study in the 1950’s linked smoking and lung cancer, ACS has funded long-term prospective studies on large groups of people to help researchers identify cancer risk factors. Currently, 300,000 people across the country are involved in a study that looks at lifestyle, medical history and changes in medical history, trying to uncover the next big link that can help in the fight to prevent cancer.

“We know that cancer will cost our economy over $200 billion in medical costs and lost productivity this year. We also know that 50 percent of cancer is preventable either through preventing tobacco use or ensuring good nutrition and proper physical activity, “Vallabhan said, pausing. “It’s common sense that it’s better both from a cost perspective and certainly in terms of impact on families and communities if we’re preventing the disease,” she added.

ACS CAN Outreach

June 2015 ACS CAN Research Breakfast, standing from left to right are: Shalini Vallabhan (Vice President of Government Relations, ACS CAN), Mike Ruggiero (Vice President of Government Relations, EMD Serono), Governor Baker, Paris Panayiotopoulos (President and Managing Director, EMD Serono), and Paul Guzzi (then - President, The Greater Boston Chamber of Commerce).

June 2015 ACS CAN Research Breakfast, standing from left to right are: Shalini Vallabhan (Vice President of Government Relations, ACS CAN), Mike Ruggiero (Vice President of Government Relations, EMD Serono), Governor Baker, Paris Panayiotopoulos (President and Managing Director, EMD Serono), and Paul Guzzi (then – President, The Greater Boston Chamber of Commerce).

Each year, the American Cancer Society Cancer Action Network brings together leaders from the life sciences ecosystem, health care systems, non-profit sector and businesses. The annual Research Breakfast highlights new breakthroughs in federal funding for cancer research and calls on policymakers to commit to increases in federal funding for the National Institute of Health and National Cancer Institute.

In June 2015, the 8th annual event featured Governor Charlie Baker, Mayor Marty Walsh and Paul Guzzi from the Boston Chamber of Commerce as guest speakers. More than 80 percent of federal funding for the NIH and NCI (National Cancer Institute) is spent on biomedical research projects at research facilities across the country. In FY 2015, researchers in Massachusetts received $2 billion in NIH funding, which supported more than 32,800 jobs across the state.

ACS CAN also launched the OneDegree project this year in partnership with Stand Up to Cancer to push for increased funding at the federal level. ASC CAN asks everyone to sign the petition at A two-minute video about the OneDegree campaign is at:

For more information or to donate to the American Cancer Society, visit; for the American Cancer Society Cancer Action Network, visit, and for the One Degree project, visit