This Father’s Day, I’ll be thinking of my dad, Cleveland’s Dr. Saul Hertz (1905-1950), originator of targeted precision oncology to diagnose and cure cancer. His parents were immigrants who made Cleveland’s Eastside home during the early 1900s. Saul received his medical degree from Harvard Medical School in 1929 when strict quotas limited minority students. Dr. Hertz completed his internship and residency at Cleveland’s Mt. Sinai Medical Center.
Dr. Hertz conceived of the medical uses of radioactive iodine (radioiodine, or RAI) and brought radiopharmaceuticals from bench to bedside. As a result, he is the father of successful treatments with radioactive drugs. Hertz’s enduring treatment and the process of targeted therapy has extended the lives of countless generations of patients worldwide.
Radioiodine is used to diagnose and treat thyroid cancer. Radioiodine in the form of Iodine-125 seeds is used to treat prostate cancer. The same type of Iodine-125 seeds is used in breast cancer surgery to detect cancerous cells. In addition, radioactive drugs diagnose heart and neurological conditions. Positron emission tomography (PET) scans check for diseases. The scan uses a special dye containing radioactive tracers.
Currently, radioactive drugs are the technological backbone for much of biomedical research. They are used to identify how genes work. For example, the research on AIDS depended upon their use. Monoclonal antibodies made in the laboratory to bind to a specific protein on a patient’s tumor cells can be labeled with radionuclides. When the antibodies are injected into a patient, they stick to the tumor’s cancerous cells, which are then killed by the radioactivity, but the nearby normal cells remain healthy.
Saul Hertz, the son of Jewish immigrants to Cleveland, overcame many challenges to bring his lifesaving research to fruition. Discrimination played out in educational and medical institutions. In 1931, he was not paid or allowed on the staff as was customary at that time for outsiders (mainly Jews and Catholics – there were no women). Economic pressures created challenges to the acceptance of radioiodine that was a less expensive treatment than surgery. Questionable ethics regarding medical publication as well as false information created fear. A world war shut down everyday daily life, just as the pandemic has done today. Dr. Hertz’s first clinical trials were interrupted when he became an officer in the Navy during World War II. Nevertheless, Dr. Hertz never gave up!
Dr. Saul Hertz’s prediction that radioactive drugs “would hold the key to the larger problem of cancer in general” offers the promise of diagnosing and treating cancer successfully. Yes, radioiodine has been used for decades to diagnose and treat thyroid cancer, the first of today’s “theranostics,” a term that is a combination of “therapy” and “diagnosis.” Theranostics is now used to treat neuroendocrine tumors; the late Steve Jobs suffered from such a tumor. Liver cancer, brain tumors, and leukemia are responsive to this targeted approach, with the hope of more to come.
Here’s a shoutout of gratitude this Father’s Day to my dad, Cleveland’s Dr. Saul Hertz, for his precious gift to the world.
Barbara Hertz is curator of the Dr. Saul Hertz Archives and of saulhertzmd.com.