Ever since he was a science whiz at an Ohio high school, he's been fixated on the brain. Now, at age 40, Doctor Black is one of the preeminent brain surgeons on the planet. He's chief of neurosurgery at Cedars Sinai Medical Center in Los Angeles.
He's made it his life goal, his mission, to conquer brain cancer. "It's clearly my enemy," he says. "I cannot think of something that is more devastating to patients and their family and loved ones. If it's untreated, the survival can be as short as 12 weeks."
Dr. Black is a star in this world. He gets out cancers that are so deep in the brain, so close to vital areas that most neurosurgeons calls them "inoperable brain tumors."
Just ask Michael Elkin. Dr. Black cut out a malignant tumor from his brain last February. Elkin will tell you, "The attitude of the other doctor was, 'well, I feel I can get most of it.' Dr. Black says, 'I can get it all.' Who would you want doing your work?"
As Black sees it, "If we leave as little as ten percent of the tumor behind, we don't affect the outcome of the patient. We have to get 99.9 percent of the tumor out."
All without damaging the brain. Using state-of-the-art imaging technology, he meticulously maps a path to the tumor that bypasses what are called "eloquent" parts of the brain - the areas responsible for language, vision, and motion.
"We consider that we're traversing sacred ground," Black says. He adds, "We find a safe passageway to get in...sneak into the brain and sneak out, so that the brain never knows that you've been there."
He performs up to 300 brain tumor surgeries a year on adults and children. Only a handful of other surgeons do as many. He says he's not so special; it's the technology that enables him to be so exquisitely precise. And, Black knows surgery is never enough. Some cancer cells always remain.
So, Black has opened another front in his personal war against brain cancer: science. "Surgery is an art that someone has taught you," he says. "Science is the ability to create new knowledge that can affect tens of thousands of people."
His labs at Cedars are at the leading edge of research into what causes - and what can kill - brain cancer cells. His teams of researchers are working on new strategies to outsmart a tenacious killer that has multiple lines of defense.
Case in point: A nurse races out of surgery with a black container, inside of which is a piece of brain tumor Dr. Black has just surgically removed. It's rushed to the lab, where a scientist strips protins from the malignant growth to use in one of Black's most radical and promising new experimental therapies. It's a kind of brain cancer vaccine custom-made for each patient from his own tumor, and it's designed to kill the cells that remain after surgery.
Says Black, "The immune system can now recognize the bad proteins on the tumor cells, understand that they need to be eradicated, and then seek them out everywhere in the body and destroy them."
The vaccine has worked in lab rats. Michael Elkin is one of the first humans to try it in the first clinical trials in the nation. After surgery, Elkin jumped at the chance to take the vaccine - the "magic elixir of life," he calls it.
There were no tumors showing in the scans taken on Elkin's brain. Something did show up on a follow-up MRI, but it turned out to be just a clump of his own white blood cells, indicating Elkin's immune system now is on the attack.
Does Elkin fear the return of the cancer? He admits: "I think about it. But I really feel they got it all and it's gone and the MRIs are clear and it's not coming back."
Keith Black puts it in perspective: "With the vaccine, we think that, yes, maybe we'll get through the front lines. But we're not naive enough to think that we're going to be able to make it all the way through and capture the king."
So the lab is working on gene therapy, new drugs, and new ways to get them into the brain for a direct hit on the tumor. It's no cure yet, but it does offer new hope for patients.
Dr. Black says: "It lets them know we're fighting. Maybe we can get two or three or four years. Maybe we can keep this tumor in remission longer."
But waging total war costs money. At a time of research cutbacks, all the prestigious federal and corporate grants he gets don't cover the tab.
According to Black, "The National Cancer Institute spends $2.7 billion a year on research on cancer. That's the price of one B-1 bomber, and that to me is appalling when you consider that one out of three people in this country will be diagnosed with cancer during their lifetime."
So these days, running a top research effort means being a fundraiser, too. Star power shouldn't matter when we're talking about curing cancer, but it surely doesn't hurt.
Philanthropist Maxine Dunitz just donated $5 million. She says: "It's up to the private sector to come forward and to be generous in giving, for everyone's future."
A potent group of Los Angeles women calling themselves The Brain Trust is determined to raise another $5-million within a year.
Pauletta Washington is actor Denzel Washington's wife. She is determined to raise the money. "We're going to do it!" she says. "We're just going to do it.":
All of these women are mothers, like Cookie Parker. Parker explains. "That's kind of like a little bit of our legacy that we'd like to leave; that we made a smalstep to help cure something."
Dr. Black's legacy is simple. He wants a cure soon so another generation doesn't even have to deal with the fear of cancer. Because, for reasons no one understands, brain cancer is on the rise in children. Because, for Keith Black, it isn't brain surgery. It's a mission.
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