Professor Jonas Bergh arrives half an hour late for our interview – he tripped in a hole on the street, fell and hurt himself as he was walking and thinking about his research. Initially, the secretary is a bit dismayed, but once inside his office at Radiumhemmet, Professor Bergh quickly regains his energy and smiles a little at the band-aid on his face, apologizing because it hurts when he tries to shake hands. The very image of a researcher lost in his own world, completely caught up in his mission?
“It may seem that way, but I often think about what I'm doing in my work and then I'm not always so observant about everything happening around me,” he says and explains that he heads up one of the two newly established research projects made possible by a donation of SEK 50 million from Märit and Hans Rausing in January 2010 for breast cancer research at Karolinska Institutet. Professor Bergh is far from lost in his own world; in addition to discussions about research and medicine, we also engage in an interesting and dynamic exchange about politics and the Cuban author Valladares.
The second part, the Karma Project, is headed by colleague Professor Per Hall and includes 100,000 healthy women in Stockholm and Helsingborg. A few days earlier, this major study was featured in the center spread of one of Sweden’s largest newspapers. The reporter puts considerable effort into the presentation of breast cancer research as a problematic discipline suffering from “a new setback”, and writes that it has been shown that the genetic relationship differs from case to case in such a complicated way that it is difficult for researchers to find new treatments when no two tumors are alike.
Professor Bergh definitely is not fond of this pessimistic and, in his view, incorrect slant, and emphasizes instead the great progress that has been made over time. He emphatically underscores that Sweden is one of the best countries in the world for breast cancer patients and that we should be proud of how we’ve succeeded in reducing mortality. But at the same time, we shouldn’t fritter away this position by failing to invest sufficiently in clinical research and modern evidence-based treatment today, because what we see now is based on findings from a decade ago.
“If you treat women suffering from early breast cancer with chemotherapy and hormonal therapy, when we follow them for 15 years, we can see that their mortality rates drop by 50 percent. This accomplishment was made possible through national and international collaborative projects in which Karolinska and Sweden have played an extremely important role in deciphering certain pieces of the puzzle. So it doesn’t get me down when researchers find many mutations in breast cancer cells, since this should provide unique opportunities to develop specific drugs to target these mutations,” he says optimistically.
Research that Professor Bergh’s team – researchers at CCK, Cancercentrum Karolinska, Radiumhemmet and researchers and clinicians at the Department of Oncology at Karolinska – pursues is aimed at customizing individual treatment based on the specific properties of the tumor. The goal is to initiate the right treatment as early as possible for the right patient, based on the specific prognosis. For many years Professor Bergh has been one of the leading breast cancer researchers who study cancer cell properties, implications for prognosis and how to find the most appropriate treatment.
“It largely involves the molecular characteristics of tumor tissue in patients, the details of how genes are assembled and how they appear in cancer cells compared with cells that are normal and healthy. For each newly diagnosed breast cancer patient, routine blood samples are taken and stored to give us access to their normal DNA,” he says. These procedures are carried out in collaboration with Professor Jan Frisell and his colleagues at the Department of Surgery at Karolinska and Södersjukhuset hospitals.
In addition, the parts of the tumors that are not needed for normal diagnostic purposes are frozen in liquid nitrogen. This tradition has been in place since the 1970s, for many years under the leadership of Professor Lambert Skoog, and for the past five years Professor Bergh’s research team, with patient consent, saves tumors with normal genetic material. |
Mammogram |
“I’d like to emphasize that I am just one of many people working on all this. I collaborate locally with many people at Karolinska: researchers at CCK, doctors, nurses, laboratory personnel, etc., along with other research groups in Sweden and abroad. There’s a whole constellation of people, some of whom only do research, while others are clinicians. As the leader of our research group, I try to get a handle on both disciplines,” says Professor Bergh.
Along with Södersjukhuset, Professor Bergh’s research includes half of the patients in Stockholm County. He would prefer to have everyone participate in the project and notes critically that this would have been possible if clinical research hadn’t been caught in the middle of several different actors, since more bureaucratic bodies are now involved. He believes that some feel more responsible than others and that financial issues play a major role.
“Quality, not economics, should come first. For this reason, it is extremely important for clinical research in Stockholm that upon entering into contracts, the County Council should be required to consult with KI so that nothing is detrimental to patients receiving private care. KI should always have veto rights in these circumstances,” he says.
Part of Professor Bergh’s work is associated with the
Breast Cancer Theme Center (BRECT).
“The aim is for important preclinical studies to facilitate interaction with the clinical environment at KI. We exchange ideas about observations as to the environment where different studies should be carried out. Clinical research is often done in collaborative projects in which we sometimes conduct studies at KI, but also in other research environments in Sweden, sometimes even internationally,” says Professor Bergh.
When asked how much time he spends abroad, the answer is that during the fall of 2010, he was on the road every week except two. Usually he is in Europe, but sometimes also the US.
“Since I run clinical trials, contact with patients is very important, so I always try to have clinic hours on Tuesdays. I try to plan trips to avoid scheduling conflicts, and usually it works out because conferences are often planned one year in advance.”
Professor Bergh continues his research so that we can offer even more targeted therapy in order to provide the best care possible for patients who require intervention. Today, more people are treated than necessary just to be on the safe side, but through new discoveries it will be possible to optimize the individual treatment profile. Professor Bergh describes the goal as ensuring the right medicine reaches the right patient at an optimal dose, while minimizing “unnecessary” treatment |
Professor Jonas Bergh |
“That’s why we are so interested in molecules and DNA. We are convinced that this is the rational way forward.”
Text: Gunnar Sandelin
Photo: Stefan Holm