Dr. H. was trained in traditional, regimented, oncology. He joined the practice of Howard Bruckner where the emphasis was on finding new solutions.
Example: Metastatic Pancreatic Cancer. The standard of care did not deliver very good results so new regimens were desperately needed.
Had to determine when and how to implement low-dose combination therapy. He had to make decisions on what to implement and when not to implement a novel therapy.
Many older patients simply cannot tolerate chemo. One patient had ovarian cancer. She visited NY with her daughter to get Dr. H’s opinion. The patient was quite debilitated, with lots of fluid in the abdomen. She had been warned that chemo was going to be too toxic. Dr. H. thought this was a great opportunity for a low-dose treatment. When he lowers the dosage the toxicity is lowered. Vs. taking her to the MTD (maximum tolerated dose), Dr. H was of the opinion in this case that 60% of the MTD would kill the cancer, yet would be more tolerable.
So they used the dose range around 60 – 65%. Because of this he could use multiple drugs and maximize the synergy between the drugs. After a few weeks, her markers improved. In less than two months her ascites (fluid) dissipated. This was a big moment for the patient and Dr. H.
Ovarian Cancer MRI