Her family doctor missed it the first time. The dry cough, the tiredness -probably an allergy or a virus, he thought. She guessed it might be menopause or the sadness over losing her mother with whom she was close. Nonetheless, Ofra Tempkin was looking forward to her 50th birthday. Her many friends and family were making a special party. But before the party, she and her husband Zeev, a city planner, took a short vacation to Tuscany. "I couldn't finish a sentence without coughing," she said. “Zeev insisted that as soon as we got back I was going to have a chest x-ray. Maybe I had pneumonia." It was worse.
The doctor set up an immediate appointment with Dr. Uzi Yizhar at Hadassah Hospital. "He said it was serious. A 99 percent chance that I had lung cancer. All I could think of was, 'the poor doctor who has to tell people this bad news.' My own defense mechanism wouldn't let me absorb that I had just heard very bad news." Lung cancer is the number one cause of death from cancer for both men and women. Like Ofra, most patients are diagnosed late. She was already stage 4, with no better than a two percent chance of surviving five years, according to statistics.
Tempkin was already worried about how her son and daughter, then in high school, were going to serve in the IDF and get though their adolescence without a mom. But Prof. Tamar Peretz, whom Dr. Yitzhar called in immediately on this case, took Ofra aside. "Forget about statistics," she said. "You are a hundred percent a young woman with low cholesterol, no diabetes-except for the cancer you are healthy."
"I didn't realize it at the time, "says Tempkin, "But I was experiencing what personalized medicine is all about."
Ofra Tempkin was born in Tel Aviv, the daughter of a father from White Russia and a mother from Bulgaria. Both parents smoked. Her father died at 58, less than a year after being diagnosed with lung cancer. Her mother died of Alzheimer's' disease. After studying sociology and anthropology at Tel Aviv University, Tempkin worked for Israel's nature society, where she met and fell in love with city planner Zeev Tempkin, a former kibbutznik, divorced with two daughters. Zeev smoked for much of the marriage but gave it up. Ofra Tempkin had never smoked. "My circle of friends and family heard immediately of my diagnosis because we cancelled the party. We never sat the kids down for a family meeting to tell them, the way they do in books. My daughter asked me if I had "a cancerous tumor I don't know where she got that term, but we all began to use it. It wasn't that I had cancer, the tumor did."
Treatment began with chemotherapy, which shrunk the tumor. "I hated losing my hair," said Tempkin, today with red hair and big green eyes. "It was winter, and I wore hats and wigs, and wondered how I could go on. " That was the winter of 2002-3, but Tempkin was indifferent to the terror attacks around her. "I felt as if I had an intifada inside of me." After a year, she was offered Iressa, (Gefitinib). "Today, there are genetic tests to see if this is a good match for a patient. Back then, it was thought at Hadassah to be good for non-smoking women and it worked well for me." She took it for two years.
The pain in her pelvis turned out to be a secondary cancer site in her hip. Tempkin underwent radiation, and another course of chemotherapy. "My team expanded, and now Prof. Nehushtan was working together with Prof. Peretz. I'm not one of those persons who says 'I hate hospitals.' I like the doctors and nurses at Hadassah. I feel as if it is my second home, sort of like a place of work. I developed deep personal connections with the staff the way one does with co-workers."
In 2008, Tempkin was a year beyond the five-year survival measure, but she still had lung cancer. As it happens, clinical trials were going on at Hadassah using the Listeria bacteria as a cancer vaccine, taking advantage of the bacteria's ability to induce immunity. Although there was no clinical proof that it could impede metastasizing lung cancer, Tempkin was able to get the vaccine on a compassionate basis, through the connections of the Hadassah researchers. It worked for her. "We can't prove why it worked for her and not other patients," said Dr. Nechushtan. "The vaccine may have improved her body's response to more traditional cancer treatment." In Israel, the listeria vaccine was only available at Hadassah Hospital.
She's still in treatment. "At every juncture, a solution was found for my problem." Says Tempkin. "My life is full of joy. We’ve travelled to Japan and Argentina. I've seen my children grow up and marry. I have beautiful grandchildren.” Zeev's business is largely Tel Aviv based these days, but Ofra won't hear of moving. "I have to be near home, my second home-Hadassah."