The Israeli Scientist Who Is Sniffing Out Cancer

Nazareth native Dr. Hossam Haick is one of the world's leading scientists; he explains how he came up with his idea of detecting cancer via breath tests.

Every time Dr. Hossam Haick - only 35 and one of the most brilliant scientists to come out of Israel - is invited to attend a scientific conference abroad, he is taken aside at Ben-Gurion International Airport and subjected to a rigmarole of questions and interrogations. "I told the security people that I am a scientist who represents the State of Israel, and that they ought to show me more respect, but it did not help. Only after I went to the media and to Knesset members, and I made noise, they gave me a VIP card and the harassment stopped."

Despite the fact that Haick, a Christian Arab, is an icon in the scientific and academic world, and oversees dozens of scientists around the globe from his office at the Technion - Israel Institute of Technology, he is practically unknown on the Israeli street. Among other honors, in 2008 he was included in the TR35, a list of the world's top 35 young scientists created by the Massachusetts Institute of Technology's journal Technology Review.

In March 2010, the French government made Haick a Knight of the Order of Academic Palms (Chevalier dans l'Ordres des Palmes Academiques ), which Napoleon Bonaparte established in 1808 to honor social and scientific pioneers, and which is among the world's oldest civilian accolades.

Haick spends most of his time working on an "electronic nose" to detect several types of cancer in their early stages. His goal is to detect cancer at an early enough stage to give the human body a better chance of beating the disease. This could be one of the biggest scientific breakthroughs for Israel and the world.

When Haick was studying for his doctorate, a friend of his was diagnosed with leukemia. "It was very painful for me. He did recover, but he went through a very difficult recovery process. I spoke with him daily. I saw his suffering. That was the first time I began to think about diagnosing cancer by means of oxygenating substances that are excreted in a photocatalytic procedure (accelerated by light ) and come into contact with cancer cells.

Tomer Neuberg

"In my doctoral research I discovered what takes place on the surface of those photocatalytic materials. I discovered that there are oxygenating substances, which can influence a biological or organic substance upon contact. In the case of a cancer cell, they can break it down.

"During my postdoc I came to realize that while treating cancer is important, early detection is more important. In the case of lung cancer, if you detect the disease early on, your chances of recovery go from 15 percent to 70 percent, even if you use the treatment currently available. When I was at the California Institute of Technology, I started thinking it was possible to find a scientific solution to sniff out cancer. There was no evidence at the time that anyone had found that a particular smell is associated with cancer. I thought the organic substances in a person's breath would let me develop sensors that could diagnose diseases.

"It is very difficult to diagnose cancer by means of a breath sensor. The problem is that the concentration of substances that enable disease detection is very small, 0.1-10 particles per billion. Thus you need nanotechnology to create sensors to detect even these minuscule amounts. This led me to study molecular electronics, in order to incorporate nanotechnology and sensors into cancer detection.

"It turns out that the ancient Greeks tried to identify diseases through breath. There were also anecdotal stories about dogs that could identify cancerous diseases based on the smell of a person's urine, but scientific studies found that their sensitivity to patients' smells is not especially high. A dog's odds of succeeding are 48 percent, nearly like flipping a coin. In science you need a system that can diagnose correctly more than 80 percent of the time. Yes, it is true that dogs are 10,000 times more sensitive than humans to smells, and that they can identify millions of scents, but the dog is not sufficiently sensitive to smell, and it does not know how to communicate with humans, and we do not know how to teach it. So what I tried to do is simulate the canine olfactory system, only my olfactory system has an electronic nose."

An article in the journal Scientific American explains how Haick's electronic nose works. The nose contains a system of tiny sensors. When a patient breathes into the device, the molecules in his breath bind to the sensors, which then transmit the data to a computer chip. The chip analyzes the substances by means of neuron network algorithms, and identifies them based on templates. If they match a particular type of cancer that the chip has been programmed to recognize, it presents the diagnosis.

In October 2006 Haick signed on as a researcher at the Technion, and began setting up a research lab there. Now he is in charge of two labs in the chemical engineering department, another lab in the building's basement, and another two in the Alfred Mann Institute at the Technion building.

Haick has approval for two additional labs, which would give him a total of seven. The Technion has great faith in Haick and his research. Haick's labs employ 27 researchers and 14 technology developers. His team has registered 17 patents so far.

"I brought together researchers from all over the world based on their talents. An Indian researcher, a Romanian researcher, a Singaporean researcher, a German researcher, Arab researchers, Jewish researchers, both Orthodox and secular. The sole criterion for any researcher who works here is talent, and the researchers work in complete harmony. It goes to show how beautiful scientific work is. Science can include different people under the same umbrella. There are no barriers between people."

Offers from around the globe

Haick was born in Nazareth in 1975. His father, a Technion graduate, is a lecturer in machine engineering, and his mother is a housewife. After graduating from high school, Haick spent two years working in relatively low-skilled labor, including as a waiter and factory worker. In 1995, with his parents' encouragement, he began studying for a bachelor's degree in chemical engineering at Ben-Gurion University of the Negev. In 1998 he went on to a special direct Ph.D. track at the Technion.

Haick completed his doctorate in chemical engineering in 2002, and then did a two-year postdoc at the Weizmann Institute of Science. His research was on molecular electronics, a futuristic field that studies how molecules can serve as transistors in electronic appliances and computers. "This is a field that will come of age only in another 15-20 years at least," Haick says.

He went on from there to the California Institute of Technology, where he completed another postdoc in nanotechnology and materials science. It was at Caltech that he began gaining experience in developing chemical sensors and nanodevices. That was when offers started coming in from universities around the globe, all hoping to recruit him as a researcher.

"The Technion approached me, like other universities abroad. I had to get back to them with an idea for potentially relevant research. That was when I got the idea of researching disease diagnosis through breath tests with sophisticated sensors. In the end I chose the Technion, which offered me excellent conditions, although I also had good offers from other universities including the University of California, Berkeley.

"I wanted to return to Israel. My wife, who works as an engineer at the Health Ministry, and I were both raised in families that believe in contributing to your society. I understand the brain drain phenomenon, but I personally opted not to remain abroad. I want to stay in Israel and contribute to society. It pains me to see Israeli scientists who go abroad and don't return. It's a pity. There are many scientists who do not get a chance in Israel, because there are no openings. A scientist cannot switch to another profession. If they were to ask me, I would add new jobs at the universities to keep attracting Israeli scientists, and to bring them back to Israel."

How can an Israeli university compete with the leading universities in the United States?

"I received offers from leading universities in the U.S., and all of them accepted my demands regarding the lab and research. The Technion too. There was a rumor at the time that even though the Technion has a great reputation, it does not offer much - but that is absolutely not true. In fact, when you add up all of my requests from the Technion, they come out to $1 million, whereas at other, equally prestigious universities, I was offered up to half a million. I was not chosen easily. I competed against 27 other researchers who wanted the slot at the Technion."

When he was about to make his final decision to go to the Technion, the dean of the chemical engineering department there, Prof. Yachin Cohen, asked Haick to consider applying for a grant from the European Union. The final deadline for applications was only 10 days away, but Haick decided to give it a try.

"It was a shot in the dark to do it on such short notice. I told the team at Caltech that I was taking a 10-day break to work exclusively on that. I sat from morning till evening and worked on the grant application, which dealt with breath tests for detecting lung cancer with an electronic nose. A quarter of an hour before the deadline, I submitted the grant request to the EU. I had barely slept for 10 nights. And in the end I won. I got it. I later found out that it was the biggest grant the EU had ever approved for an Israeli researcher. We are talking about 1.73 million euros, and that is a lot for a researcher like me. When I got the grant approval, I was already at the Technion.

"I rejoiced, but five minutes later something tempered my joy: I realized what a responsibility was on my shoulders. ISF, the Israel Science Foundation, gives out a maximum of $180,000 for four years to Israeli researchers. Here we are dealing with 1.73 million euros, a fortune for research, even for an American university."

After that first grant, Haick received another EU grant, of $5.3 million. The grant was to develop a new generation of nanometric sensors for screening, diagnosing and monitoring lung cancer. This grant was not awarded only to Haick, but rather to a group of scientists from eight universities and from European companies. Haick's team competed for the research grant against 460 teams of researchers from all over Europe. Only 11 teams were successful.

You talk about unpleasant experiences you've had as an Arab-Israeli researcher. Why live in Israel? Wouldn't you prefer to live in San Francisco or some other more pluralistic place?

"The interrogations I went through at Ben-Gurion International Airport were not the only trouble I have encountered as a Christian Arab. When I tried to rent an apartment in Be'er Sheva with a roommate, I had practically signed the lease, but at the meeting where we were supposed to sign, they discovered my roommate lives in Baka al-Garbiyeh. Right then and there they apologized and said they had not been aware of that, but they could not rent the apartment to us. Now that roommate is doing a postdoc in Spain.

"I was born here. I am tied to Israel. I also want to prove to others from the Arab community that nothing is impossible. You hear quite a few prejudices from Arab-Israelis, that Arabs cannot get ahead in Israeli academia. I wanted to prove that this is not true; to prove that if you are talented enough, you get to wherever you want. I wish politics emulated academia. The Technion did not take me because of my ethnic background. I hope that my personal story will show a lot of Arab youngsters that if they make an effort and dismiss the prejudices, which can be quite paralyzing, they can get ahead in life.

"To young Arabs I say categorically: Study. Maximize your potential. And most importantly, try and do. I just tell them: Get the prejudices out of your mind and try for yourselves. Don't listen to what your grandfather said.

"Luckily, this insight is seeping down to as many people as possible, and more Arab-Israelis are studying for advanced degrees. At Jewish schools I get asked how I feel as an Arab. There have been polls published showing that the Jewish public does not want any contact with Arabs. There is a belief that Arabs still ride camels. I explain to them that there are also educated Arabs.

"True, there is a gap between the Jewish and Arab communities. But at least in academia and high tech, if you are talented, then they take you. I hope the gaps will shrink in other fields as well. I know that it is not easy to motivate yourself as an Arab. I also have quite a bit of criticism for people in the Arab community who do not do enough to push themselves forward; who operate on the basis of prejudice."

Do you believe there will be peace in your time between Jews and Arabs?

"I do not think so. The people are divided today. The Arab right wing and the Jewish right wing are at two extremes. The left wing in both communities tries somehow to bridge the gaps, but it is very limited. Based on the flotilla events, I don't expect peace in the next 15 years. And that is too bad. If you were to say to me: 'Replicate the Technion as a microcosm for the 7 million citizens in Israel,' I would tell you that peace would be here within two years. But unfortunately the whole country is not the Technion."

Cancer, the holy grail

Where does the development stand technology-wise?

"We are working on four fronts simultaneously. We are dealing with the characterization and production of the nanotechnology sensors, and at the same time running clinical trials. We have made progress on all fronts. Back in August 2007, our electronic nose took part in clinical trials at Rambam hospital in Haifa. We are still conducting experimental trials. Each time we finish one clinical trial, we begin a new one. Out of 27 researchers, 24 are working on early detection of lung cancer. The rest are researching detection of other diseases, but that is still in the feasibility stage.

"There is no doubt that the holy grail is cancer. In the first stage we are trying to diagnose lung cancer. We are now focused on five types of cancer: lung, breast, colon, prostate, and head-neck. Why these types specifically? Because they are responsible for 60 percent of all cancer deaths worldwide. There are 150 other types of cancer, but the mortality rates from these are lower.

"I want to focus on the most common types of cancer. For men that means lung cancer, prostate cancer and colon cancer. For women it is lung cancer, breast cancer and colon cancer. I am not saying that our electronic nose cannot diagnose other types of cancer or other diseases, but we prefer to stay focused. Our diagnosis rates are very good. We have reached 89 percent in early detection of breast cancer. With lung cancer we have achieved an early detection capability of 100 percent, but the samples in the clinical trials are still too small. We tested lung cancer detection on 70 patients and on 80 healthy people."

What is the crux of the problem when it comes to diagnosing cancer?

"Cancer diagnosis currently is done mainly through imaging scans - CT or MRI. The second method is molecular - DNA tests. But MRIs cannot show the cancer at an early stage. The machine is also big and expensive, and it is hard to analyze its results categorically. It therefore requires experts who know how to analyze its results. A CT scan can cost $600. An MRI scan can cost $1,500. That's expensive. Additionally, the CT machine itself emits carcinogenic x-ray radiation. So it is difficult to diagnose early.

"This disease is devilish. Why? It develops over four stages. The fifth stage is death. In the first stage, the cells transform from healthy to sick. Their shape and concentration within the tissue change. In the second stage, small tumors form that penetrate the tissues. In the third stage, the cancerous tumor measures several centimeters. Up until the third stage, a person does not feel anything. Only when he is between the third and fourth stages, when he starts showing symptoms such as vomiting and fatigue, does he go to see a doctor. The general tests that hospitals run are not conducive to diagnosis, unless you perform a special blood test for cancer. So a good number of patients are not aware they are sick until they see some physical sign, or they feel ill. At that point the disease is already advanced, and the survival rates are low.

"Because the machines in hospitals have limited diagnostic ability, an accurate and inexpensive tool is needed for use not only in hospitals. You have to be able to go see your doctor at the health clinic for a check-up, do a breath test and get an early diagnosis if there is a chance you may have cancer. When a person is diagnosed with cancer during the first or second stage, his chances of survival are high. And it is of course important that the tool be easy to operate, so that doctors and public health clinics can use it. It is also important that it provide immediate results, from within a few minutes up to an hour."

How close are you to realizing this vision?

"We are heading in the right direction. The clinical results are promising, but we have to expand the clinical trials to a larger population sample, to people of different races and nationalities. In terms of research, we have succeeded in diagnosing five types of cancer by means of breath tests."

How significant is your achievement for the global scientific community?

"The entire scientific community considers us the leading researchers in the field of cancer detection. Physicians never dreamed we could do what we are researching. Consider the grants we've received. The European Union would not have given us $5.3 million without knowing we have unique research with a track record of achievement. My research group publishes scientific articles in leading journals. We are cited in numerous places. We have received recognition. Hardly a day goes by without a telephone call from some major company or entity that would like to collaborate with us. Johnson & Johnson, other major companies - they all want to share our vision."

What about the desire to make money from this product? To see the technology you're developing succeed?

"That is certainly a goal, but bear in mind that the more in-depth and established the clinical trial is, the more valuable it will be. Therefore it is important that we continue to research. In terms of speed, we are one of the fastest research groups in the world. We have achieved a great deal in our three years. We published 47 articles in the most respected journals. That is a lot more than other researchers."

How does a team of researchers from a single university manage to achieve much better research results than big pharmaceutical companies, which invest millions of dollars each year in research and development?

"Even a major company will not devote more than 40 scientists to a project like this. You want to know how I came up with the idea for my technology? Sometimes you simply have a brainstorm. It happens not only to me, but in many scientific discoveries. I do not have a precise explanation for how I was the one to come up with this idea."

Do you believe your innovation will be able to stop cancer?

"I believe we will be able to reduce the mortality rate by enabling more early diagnosis, but naturally we will not prevent the disease completely. The main problem with cancer is that we still don't understand why it happens in the first place. There are explanations as to what might cause cancer, but it is not clear what the trigger is. Until we discover that, we will not be able to turn a sick cell into a healthy cell. However, there are quite a few innovations in the world that are trying to address cancerous cells. We also have a team of researchers at the Technion working on this."

Was it hard to convince the medical community of the credibility and validity of your research?

"If I had told doctors four years ago that cancer could be diagnosed on the basis of breath tests, they would have called it a crazy idea. Some of the doctors would have laughed outright at the notion. The hardest thing is presenting proof that will convince the medical community. You therefore have to conduct serious and careful research, and then when you show the results, a lightbulb goes on for the doctors and they suddenly grasp the breakthrough. But a breakthrough is only the beginning. It takes millions of dollars and years of research to develop intellectual property and to transform it into a commercial product. My vision is that the technology I am developing and researching will enable research groups and other scientists to work on other diseases from A to Z, and provide the means for early detection of various diseases."

Why don't you set up a start-up company and try to make millions? Why remain in academia?

"I am where I feel that I contribute the most, and I can contribute a lot more as a researcher than as a company director. It would be a pity to squander my talent on business. There are enough talented people who can run businesses and build companies. I will give them the technology, and they will make a business out of it. You ask where I see myself in the distant future? Still in academia. For years to come. I will be involved in the companies that get built on the technologies I have developed, but not as their CEO."