On seeing [my friend’s] recovery I realized it was the beginning of a scientific revolution—I wanted to be aboard that train, so I decided to become an oncologist.
— David Khayat, MD, PhD
David Khayat, MD, PhD, Chair of the Department of Medical Oncology at the Pitié-Salpêtrière Hospital in Paris, was inspired to become an oncologist by an episode that could have been ripped from the pages of one of his best-selling novels. At the age of 18, Dr. Khayat was the witness at his best friend’s marriage in Nice, France. When the couple returned from their honeymoon, the 19-year-old bride suffered a genital hemorrhage and was diagnosed with advanced cancer. She went to Paris to see the famous hematologist Dr. Jean Bernard. “After each treatment, she would return to Nice to be with her husband. Only weeks before she was so young and radiant in her white wedding dress; now she looked like the living dead,” said Dr. Khayat.
It was the early 1970s, and her diagnosis was presumed to be a death sentence. However, it turned out that the original pathology report was inaccurate; she actually had lymphoma, not a solid tumor. After two years of treatment, she was cured; her hair grew back and she returned to school. “I was a medical student at the time and on seeing her recovery I realized it was the beginning of a scientific revolution—I wanted to be aboard that train, so I decided to become an oncologist,” said Dr. Khayat.
About 10 years ago, the same woman, a smoker, had another bout with cancer and this time her oncologist was her life-long friend, Dr. Khayat. “I cured her lung cancer and she is still alive, having survived two malignant diseases. Despite success stories like my friend and others, it has been painful to watch so many of my other patients die slow deaths over the years. But that is the emotional price oncologists pay,” said Dr. Khayat.
Dr. Khayat was born in Tunisia into humble circumstances; his family immigrated to France when he was 4-years-old. “No one in my family was ever in the medical field, nor did they think about it. We were quite poor, so it was a great source of pride when I decided to become a doctor,” said Dr. Khayat.
In France, the road to becoming a doctor involved starker decisions than in the United States. “We had to decide whether to be a general practitioner or a specialist, in which case you entered an extremely difficult specialist competition. I won an internship contest, and went to study oncology at a Parisian cancer institute,” said Dr. Khayat.
Shortly thereafter, faced with mandatory national military service, Dr. Khayat opted to defer his enlistment in favor of representing France as medical emissary. He asked his boss, Professor Claude Jasmin, if he could serve in the French Caribbean, confiding a passion for windsurfing. “Professor Jasmin laughed, but he wasn’t amused. He said, ‘To hell with that. You’re too bright to waste time windsurfing! There’s a research lab in Israel where I think I can get you a position.’ So off I went, to Tel Aviv,” said Dr. Khayat.
From Israel to Mount Sinai and a PhD
The 18-month research stint in Israel proved fruitful. While testing immunoglobulin Fc receptors, Dr. Khayat used mouse serum instead of cell lines; the test came back positive for soluble Fc receptors. After the lab’s chief of microbiology said that the results were just an artifact, Dr. Khayat redid the test 15 times, getting Fc-positive results each time. “When I presented this finding to the chief, he simply said, ‘Now it’s a repetitive artifact.’ I couldn’t accept that so I worked on identifying and isolating the proteins, and published the results in major U.S. journals,” said Dr. Khayat.
The papers caught the eye of microbiology researchers at Mount Sinai School of Medicine in New York who were investigating the same topic. Since Dr. Khayat had found the mouse cell serum connection first, they invited him to their lab in New York to continue the line of inquiry in human cells. “After about a year in the Mount Sinai lab, we identified the same protein marker in human serum. At the end of the day, it gave me my PhD and helped launch my research career,” said Dr. Khayat
The Charter of Paris against Cancer
Dr. Khayat commented that his success is due in large part to the valuable relationships that he has cultivated since his earlier days in oncology. His friendship with ASCO Past President Gabriel Hortobagyi, MD, with whom he wrote the Charter of Paris against Cancer, is of particular note. “In 1999, Gabriel and I, along with some friends, were having dinner in a marvelous Parisian restaurant and discussing ways to commemorate the millennium by raising awareness about global cancer issues—one that doesn’t leave the patients on the sidelines,” said Dr. Khayat. Over fine wine and food, Dr. Khayat and nine other luminaries in the cancer community, including current ASCO President Sandra Swain, MD, hammered out a blueprint for a collection of articles that together would form the international Charter. “The first article stated that all those signing the Charter had to recognize that cancer patients’ rights are human rights,” said Dr. Khayat.
The Charter was finished in June of that year. But Dr. Khayat saw more downstream potential by involving friends in high places, notably French President Jacques Chirac. “I asked Chirac if he would endorse the Charter. He did, with enthusiasm. I then went to see the General Director of UNESCO. He also endorsed the Charter, giving it the organization’s imprimatur. The Charter was signed on February 4, 2000, at the Palais de l’Élysée, which is the French White House,” said Dr. Khayat.
Role in the War on Cancer
Dr. Khayat explained that each French President is given the opportunity to leave a “legacy,” such as Charles de Gaulle Airport. During President Chirac’s first term in 1995, his legacy was the elegant Museum of Primitive Art. After he was reelected in 2002, a reporter asked him what his next term’s legacy would be. He answered, “No more stones. This time, my legacy will be a War on Cancer.”
Dr. Khayat was on holiday with friends in Turkey when President Chirac called and said bluntly, “Three years ago you convinced me to sign the Charter; now you are going to develop my War on Cancer plan.” Dr. Khayat politely demurred, explaining that he knew how to treat cancer patients, not lay plans on such a grand scale. “But Chirac was persuasive, and, well, it’s hard to say no to the President. When I returned from holiday, I met with all the stakeholders and began Chirac’s War on Cancer, which has been a great success in France,” said Dr. Khayat.
French National Cancer Institute
A centerpiece of President Chirac’s grand plan was the creation in 2005 of the French National Cancer Institute (Institut National du Cancer), which sought, among other goals, to coordinate national cancer research and care. Dr. Khayat, who spearheaded the project as the Institute’s founding President, noted that this undertaking was not without its difficulties. “People in high places don’t like change and there were huge political issues with various health ministries, but I met regularly with Chirac and he handled most of the blockades I encountered,” he said.
As per his agreement with President Chirac, Dr. Khayat stepped down as President of the French National Cancer Institute after 3 groundbreaking years. For his invaluable leadership, he was made Honorary President of the Institute. Not resting on his laurels, Dr. Khayat’s busy days now center on his patients, his research interests, teaching his interns, and running his department.
As previously mentioned, Dr. Khayat is also a published author, with a string of best-selling novels and a recent book, also a list-topper, that he says is “the sum of our knowledge about diet and cancer.” Asked how he manages to balance his medical and artistic pursuits, Dr. Khayat paused, then said firmly, “I only write during my holidays or when on a plane or train. Not one second of my time as a doctor is devoted to anything but patients, science, and medicine.” ■
Disclosure: Dr. Khayat reported no potential conflicts of interest.