As a young medical student, Dr. Fadlo R. Khuri planned on becoming a psychiatrist. Then, on the first day of his surgery rotation, he treated a much-loved rabbi with cancer who died within weeks after being admitted to the hospital. “I just saw the devastation that cancer caused and the immediacy of the disease,” Khuri said. He has treated some 10,000 patients since then, most with tobacco-related cancers. Earlier this month, the American Association for Cancer Research also honored the 49-year-old oncologist as the 2013 most outstanding young clinical cancer researcher. In addition to seeing patients, Khuri serves as deputy director of the Winship Cancer Institute of Emory University and holds the Roberto C. Goizueta chair in translational cancer research at the university’s medical school. Like that rabbi, Khuri is known for his compassion and generosity of spirit.
Q: Can you talk about your work in the prevention of lung, head and neck cancers?
A: The prevention work involves large trials that have used natural compounds such as Vitamin A, selenium and others. We learned that patients who quit smoking and took certain natural compounds did meaningfully better than patients who took the supplements but didn’t quit smoking.
Q: What about in the treatment area?
A: We helped develop viruses that we injected into tumors that, when combined with chemotherapy, did a pretty good job controlling the growth of metastatic disease. Unfortunately, we couldn’t get the viruses to all of the places where the cancer was. Now, we are developing newer viruses that can be given to patients intravenously. We are helping lead some of these trials.
Q: You also were recognized for advancing the understanding of lung cancer. What do we know about it?
A: With cancer cells, genes and proteins behave differently than they do in normal tissue. That was our first really important discovery. Also, we have learned that while patients may seem similar, they can have dramatically different outcomes. Over the years, we have increasingly taken a personalized or precision-medicine approach to treatment.
Q: What drew you to lung cancer?
A: There was a real need. I liked that molecular biology was enabling us to understand the cancer better. We understood it was often but not always tobacco related. Lung cancer also is an incredibly intimate and all encapsulating disease at the same time. It affects everything — patients’ lives, their families, their jobs, their stature in society.
Q: What about patients with lung cancer who have never smoked?
A: That seems to be an increasing group and we are seeing a lot more young women. We don’t know the cause.
Q: What is the biggest misconception about lung cancer?
A: That it is somehow the patient’s fault. Patients who don’t smoke get lumped in with patients who do. Even with smokers, it’s not their fault. Most are picking up their first cigarette in their early teens. The other big misconception is that lung cancer is untreatable. The average person with metastatic disease will live about a year or longer with treatment. They will live less than three or four months with no treatment.
Q: How close are we to a cure for lung cancer?
A: We cure some cancers now. I would love to see more cures but I would settle for making lung cancer a chronic disease that we catch early, that people can live a normal life with.
Q: Are you for banning cigarettes?
A: I am all for banning cigarettes. I’d be really worried if we banned them here and yet, exported them by the billions to other countries.
Q: Do you think cigarettes will ever be banned?
A: I treat lung, head and neck cancer so you could say I am a born optimist.
The Sunday Conversation is edited for length and clarity. Writer Ann Hardie can be reached by email at firstname.lastname@example.org.
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