Health 114V1 Connection Training in Ann Arbor is changing cancer treatment in Israel. SUZANNE CHESSLER Special to the Jewish News T wo University of Michigan administrators, in the midst of dinner with col- leagues at a restaurant in Israel, had a very dramatic interrup- tion of their meal. Dr. Theodore Lawrence and Marc Halman, both of the Department of Radiation Oncology at the U-M Medical School, were introduced to a cancer .patient whose life was extend- ed by treatments developed and learned in Michigan. Hearing the patient's thanks- pro- vided only one among many reasons that the two visitors want to continue the program, the Israeli Fellowship in Radiation Oncology, that resulted in the man being helped. His comments capped a series of positive impres- sions gained from hospital observa- tions throughout the' day. The two-year fellowship, which brings Israeli doctors to Ann Arbor, offers training in state-of-the-art radi- ation oncology and benefits U-M by assigning fellows to assist with research projects. The success of the program, started in 1993, has motivated the university to seek ways of making it permanent. The goal is to establish a named endowment of $2 million to fund one fellow per year in perpetuity. Triple Hit "When Israeli cancer patients learn they need radiation treatments, the bad news can be a triple blow," says Halman, director of administration at the U-M Department of Radiation Oncology. "Besides having to face the disease and possible side effects from therapy, they also might be forced to seek care in another country. Although Israel can provide some radiation therapy, there are not enough fully-trained specialists in this field." The fellowship program was started by Dr. Allen Lichter, former professor and chair of the Department of Radiation Oncology. After a six- . month sabbatical at Hadassah University Hospital, Lichter noted the different ways in which the United States and Israel trained doc- tors and carried out treatments. U.S. oncologists must complete a four-year residency in their specialty. Israeli cancer specialists undergo radi- ation instruction as only a small part of an oncology study program. While American radiation oncologists typi- cally treat between 150 and 300 patients per year, their Israeli coun- applied to the program because he considers the Michigan facility one of the best in the country. He complet- ed an internal medicine residency prior to studying oncology and was on staff at Hadassah Hospital in Jerusalem. While here, Dr. Meirovitz is involved in several research projects and is a primary investigator in pre- venting radiation damage in the treatment of brain cancer. He will continue his research when he returns 4thsc tt&v Drs. Meirovitz and Lawrence discuss the U-M radiation oncology program. terparts treat about 650 patients per year. "There are six or seven radiation oncologists in Israel, and we've trained half of them," says Dr. Lawrence, who succeeded Dr. Lichter. "If we could train 10 people, we could deeply change the way can- cer is treated throughout Israel. "The training is done in a two-year sequence that places participants in the lab for one year and the clinic for another year. We offer instruction in the latest methods, and the outstand- ing research work of the fellows has helped improve treatments for can- cers of the liver and pancreas." Dr. Amichay Meirovitz, the fourth Israeli oncology fellow at U-M, to Israel, and the U-M team expects to accelerate the results of their stud- ies by having information from both countries. "I wanted to be part of this pro- gram so I could do more to help can- cer patients in Israel," Dr. Meirovitz says. "Almost any subject in medicine interests me, but radiation oncology is my main interest. This program combines high technology with patient contact, and that's what mod- ern medicine is all about." Ripple Effect The Oncology Institute at the Chaim Sheba Medical Center in Israel also has benefited from the training pro- gram in Ann Arbor. Dr. Zvi Symon, of Chaim Sheba's radiotherapy unit, was a U-M fellow from 1999-2001 and is utilizing new techniques in radiation therapy planning, treatment and delivery as well as design and implementation of clinical trials. "Under the guidance of Dr. Lawrence, I performed and published some very clinically-oriented labora- tory studies and learned how to move things quickly from the laboratory to the clinic," Dr. Symon says. "In the clinic, I worked on new treatments for prostate cancer and therapy for head and neck cancer. "The whole experience has con- tributed deeply to the way I practice medicine — from the way I commu- nicate with and educate my patients to the scrutiny of all clinical data, quality assurance and search for bet- ter treatments." The cancer specialists who have been to Ann Arbor communicate with each other as they apply their knowledge at different hospitals in Israel. Dr. Marc Wygoda, chief of radia- tion oncology at Hadassah University Hospital, was a fellow from 1995-97. "It is estimated that for each caricer patient cured by drugs, four patients are cured by radiation," Dr. Wygoda says. "In recent years, the techniques used in radiation oncology have made immense progress, mainly as a con- sequence of advances in computer technology. The future of radiation oncology appears to be in a combi- nation of technology and biological understanding of cancer. "During my fellowship, I partici- pated in projects in gene therapy and radiation sensitizers and did clinical work and research. This allowed me to learn evidence-based medicine and bring basic research to the bedside. "The partnership between U-M and Israel has played a pivotal role in the development of radiation oncolo- gy in our country, and I cannot overemphasize the need to continue and develop this relationship for the greatest interest of Israeli cancer patients." ❑