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Oncologist, researcher first sought career in music by Mary Helen Yarborough Public Relations Harry Drabkin had a career choice to make—each leading in distinctly different directions. One way lead to music and the other to medicine.   As the young jazz and classical saxophonist stared down an opportunity to attend the Paris Conservatory of Music in the 1970s, the music major-turned-scientist decided instead to attend medical school. As a result, the oncologist has made many important contributions to science: He identified the gene responsible for one of the most prevalent forms of leukemia. He identified a gene that causes a rare form of hereditary kidney cancer, and he discovered another gene that suppresses the growth of lung cancer. Drabkin also has helped study drugs used to treat kidney cancer.   Since May, he has been a member of the Hollings Cancer Center team of world-renowned experts.   Dr. Harry Drabkin conducts a physical exam on a patient. Drabkin now plans to develop a national model for multidisciplinary kidney cancer treatment. He wants the kidney cancer clinic to include urologists, fellows and other medical oncologists to replicate a successful program he established in Denver.   “This will be the main site for referrals for all of South Carolina and the Southeast, and it will be of national note,” he said. “I want this to be a site filled with people who are engaged in trying to cure this disease.”   Drabkin attended pre-med courses at night at Boston University in the city where he also had earned his bachelor’s from Berklee College of Music.   “I was a member of the Berklee saxophone quartet, which was one of the best anywhere, performing a lot of contemporary music, working as a musician, and teaching at Berklee. But I decided to take some science courses and consider medicine,” Drabkin said. “I liked it. So then I went back to school full-time at Kansas U (being a native of Junction City, Kansas), finished pre-med, and was accepted to the University of Kansas School of Medicine.”   After his internship and residency in internal medicine at the University of Cincinnati, he accepted a fellowship in oncology and hematology at the University of Colorado where he rose to become a full professor and earned an endowed chair in cancer research. Drabkin started his research while he was a second-year fellow at University of Colorado Health Sciences Center.   Of the three drugs that have been approved by the Food and Drug Administration to treat kidney cancer, Drabkin participated in the clinical trials that led to the development of two of them, Sorafenib and Sunitinib. A third, which was approved in May, is Temsirolimus.   “Kidney tumors are extremely vascular,” said Drabkin, adding that the drugs work in part to inhibit the formation of new blood vessels, thereby squeezing off the blood supply to the tumor.   Kidney cancer also is notoriously resistant to chemotherapy, Drabkin said, explaining that it does not respond to therapies commonly used for other cancers. Only one previous drug has the potential for a cure, Interleukin-2 (IL-2), but it only happens in a small minority of patients and it’s toxic. IL-2 stimulates the growth of T-lymphocytes, a type of white blood cell that plays a key role in immune response.   “You have to be otherwise healthy, have minimal disease and be able to tolerate the toxicity of IL-2,” he said. Even then the number of complete responses is low.   Roughly 39,000 people will be diagnosed with kidney cancer this year. While the rate of kidney cancer appears to be increasing, Drabkin said greater detection tools, such as CT scans, have made the discovery of the disease more frequent.   Like all cancers, kidney cancer tends to run in families. About 5 percent of most cancer has a hereditary link. And like many cancers, behavior and environment play a role. Tobacco use has become a trigger for many urologic cancers, particularly bladder and kidney cancer, Drabkin said.   “The kidney is the body’s main blood purifier,” he said. “Tobacco smoke is believed to contain as many as 2,000 carcinogens and the kidney is heavily exposed to these toxins.”   With the kidney inundated by toxins, mutations develop and the progression of normal cells to cancer is under way. Likewise, toxins passing through the kidney move below and settle in the bladder where they also cause mutations and invite the development of cancer, he said.   Most people who have early stages of kidney cancer wouldn’t know it.   “It’s an asymptomatic disease,” Drabkin said, “until it progresses into advanced stages.”   Generally, early forms of the cancer are detected through CT scans obtained for other reasons. This is when small tumors are discovered, he said.   When the cancer remains undetected in the kidney and grows often to a large size, victims of the disease may experience back pain or blood in their urine. While still potentially curable by surgery, the risk of spread (metastasis) increases substantially. Once the cancer spreads, surgery can still help with local symptoms and quality of life, but systemic treatment with the new drugs becomes the basis of treatment. Music and mountains After years of denying his musical talents, Drabkin recently picked up his saxophone, dusted it off and played with his musician son, Rob, at a concert in his former Denver base. “I was getting pressured at Christmas by my wife and daughter to play with my son especially before it was too late,” Drabkin recalled.   He kept his word and performed surprising well after only a couple weeks of regaining his embouchure. Then he headed to Charleston, a place much hotter and flatter then he had been used to.   Drabkin and his wife, a pianist with a music therapy background, look forward to returning to the Rocky Mountains of Colorado to retreat from the hot flatlands of the Lowcountry. He said he will, however, enjoy discovering the bike paths of the Carolinas. Meanwhile, he is practicing his saxophone for those promised sessions with Rob, a Denver-based singer-songwriter with a biochemistry degree. His daughter, Anne, is in medical school in Germany and has treated people in the villages of India and Africa. She plans to go to Montreal for a rotation in emergency medicine. Drabkin hopes to lure his daughter, who wants to become an OB/GYN, to Charleston one day. Friday, July 6, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.