Wednesday, September 16, 2009

(PART 3)Stem Cells: Lab nerd tweaks tiny particles to renew life

(Third of a series)

Philippine Daily Inquirer/Special Report/by Ma. Ceres P. Doyo
MANILA, Philippines—Physician, lawyer, chemist, molecular biologist, Ph.D. and MBA holder, professor of medicine, cancer director in US hospitals, leading figure in stem cell research, cancer therapy and bioregenerative medicine. Cancer survivor.
“Before I became a medical doctor,” says Dr. Samuel D. Bernal, “I was a hard-core chemist.” As a lab nerd, he poked, coaxed and tweaked the smallest particles of life. He then segued into medicine. His specialization: Stem cells in regenerative medicine and oncology, or the treatment of cancer. But he never really left behind the amazing world of molecules.
This Filipino-American doctor is a moving force in the regenerative medicine department of The Medical City (TMC) where he holds clinic when he’s not abroad.

Whether health practitioners and medical schools realize it or not, molecular is the way to go in the brave new world of medicine. In the smallest and basic particles of the human body—the cells—are contained a wealth of information and potent forces that could open doors to new ways of treating ailments.

Bernal, 59, brings to his medical practice an approach that is personalized and customized down to the molecular level. This means debunking the one-size-fits all standard-of-care approach that puts patients in neat categories or assembly lines.

Impersonal care
“When I ask how a patient is and an intern just gives figures, I become red. I want to know how is the patient faring emotionally, spiritually? Is he comfortable, happy, sad, in pain?” Bernal says.

He rues the way patient care has become impersonal.

This is what moved him to file on behalf of a Filipino-American family, a landmark malpractice suit against a group of doctors, a hospital and a health insurance group in the United States that he accused of hiding behind so-called standard of care procedures. The respondents settled out of court for an unprecedented sum.
Born in Iloilo, Bernal went abroad after his father became a US consultant.

The third of four siblings, Bernal finished chemistry at the University of Illinois in 1969. He already had a doctorate in biochemical pathology when he took up medicine at the University of Chicago.

In 1979 he was a fellow in internal medicine at Harvard Medical School and, later, in medicine at the Peter Brent Brigham Hospital in Boston. He trained in oncology at the Dana-Farber Cancer Institute at Harvard.

Multidimensional person
Bernal is a board-certified oncologist and is a diplomate of the American Board of Cancer Specialists. He has authored papers and books on cancer.

Bernal earned his Doctorate in Jurisprudence from Loyola University and is a licensed attorney. He also has an MBA degree from the Pepperdine University on biotechnology business strategies.

Since 1992, Bernal has been with the University of California in Los Angeles where he is professor of medicine. He is connected with several hospitals and biotechnology institutions and still finds time to teach at the Ateneo School of Medicine.

A multidimensional person, he is also into theater and literature.

Cancer strikes
In 2000, Bernal was stricken with cancer.

“I had no clue, I was completely healthy, writing a book,” he remembers. “I was doing the chapter on kidney cancer.” He noticed a change in the color in his urine and looked at a sample in the microscope. He could not believe what he saw.

Examinations later showed the cancer had invaded his abdomen, left kidney, liver and lung.

“You could be dying and you don’t know it. My head was floating, my mind went numb. It was a totally surreal experience. I was given a pronouncement of death, three to four months,” he says.

“I was on top of my profession and in control. Suddenly I was vulnerable. It was a setback. I had several papers and two more books in progress. I kept telling myself that my work was not finished.”

Customized treatment
Bernal consulted colleagues all over the world. He was advised to enter into a protocol. “I had to customize my own treatment,” Bernal says.

He went for abdominal and thoracic surgery even if it meant working around a major blood vessel to scrape and carve out the damaged parts.

“I was in the ICU for three weeks because my lungs would not re-expand,” he said.

“During the operation they got live cancer cells that were then cultured so we could observe their behavior and response to treatment. This is not ordinarily done,” he says.

Bernal’s cancer was the type that will not respond to radiotherapy or chemotherapy. The treatment he drew up for himself was admittedly expensive and difficult.

“A lot of it was based on molecular biology work of scientists and this knowledge was not available to clinicians,” he says.

Bernal devised his own dendritic immune therapy, using his own stem cells.

“The experts around the world encouraged me to do it myself. But at that time, they wouldn’t recommend it to their own hospitals. They said it was difficult, impractical and expensive. It was being done but on an experimental basis,” he says.

Intimations of mortality
“I prepared myself to face my mortality. I fixed my finances and properties. I was already divorced then,” Bernal says.

He lost 40 pounds. But after six months things began to clear up. After more than a year, Bernal was back on his feet.

No wonder Bernal is passionate about customized medicine and is on a personal mission to promote it. “The one-size-fits all protocol for serious diseases does not work. But 99 percent of cancer specialists cannot do it if their hospitals cannot do it,” he says.

Stem cell therapy, Bernal points out, is only one of the components of regenerative medicine. And because cells are not drugs that are mass-produced, they are not for food-and-drug approval.

He shares a 2006 study that shows the significant impact stem cell technology could have on poor, developing countries in addressing their health concerns.

“Even if 99.99 percent of doctors here would say it is inappropriate, here are these world experts saying otherwise,” he says. “The most powerful force for healing our body is in our own body.” (To be continued)