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This is a guest essay by Mitch Schneider, a writer in Israel.
You can also listen to the podcast version of this essay on Apple Podcasts, YouTube Music, YouTube, and Spotify.
Up in the hills outside Jerusalem, there is a hospital called Hadassah, and this summer a team of doctors there put radiation directly inside a man’s brain tumor.
The man was 77 years old. He already had the surgery, and then the radiation, and then the drugs, and the tumor came back anyway. By the time he walked into that hospital, the medicine that exists for a man in his position had all been used up.
And the thing is, that team had been rehearsing for him for years, back before anybody in the building knew his name.
There is a sentence families wait years to hear after cancer surgery: We got all of it. For one tumor, nobody has ever gotten to say it. Most tumors are a stone in a garden bed. You dig around it, you lift it out, you’re done. That’s the kind the phrase was invented for.
Glioblastoma is a weed.
It grows out of the cells that hold your brain together, the packing material around all the wiring rather than the wiring itself. Instead of sitting in a lump, it sends runners. By the time it is big enough to show up on a scan, it has already pushed threads out into brain tissue that looks healthy on the screen, the way a dandelion’s roots are already three feet sideways before you notice the flower.
Which is why there is no clean edge to cut around. The edge runs through whatever that piece of brain was doing.
So the doctors do everything right, and everything right is not enough. They cut out what they can safely reach, then radiate, then run chemo. Israel gets somewhere between 150 and 250 new cases a year. Hadassah puts median survival at 15 to 16 months, which means half the people who get it are gone before then, and about one patient in 10 makes five years.
And then it comes back, in almost everybody. Alpha Tau, the Israeli company in this story, puts it in lawyer-careful language: Recurrence happens in virtually all patients, usually within six to nine months of finishing treatment, and there is no established standard of care for what to do about it. Once it comes back, median survival is another six to nine months — not from diagnosis, but from the day the scan shows it again.
That is where the trap closes. He cannot have another surgery, he is too fragile and the tumor is in the wrong place. More radiation to the head is on the table for some people, and it can damage healthy brain, so it is never automatic. The scan is right there on the monitor and the medicine is out of moves.
A good doctor anywhere in the world reads that chart and starts a gentler conversation. Comfort, time, what he would want these months to look like. Nothing cowardly or cruel about it. Sometimes it is the most loving medicine there is.
But somebody has to decide whether it is the only conversation on the table. And in Jerusalem, in a hospital up in the hills of Ein Kerem, a team had spent years making sure it was not.
There is an operating room with nobody on the table. There is a model instead, and a team from neurosurgery standing around it, running the procedure, taking it apart, running it again. They did that over and over, for years.
Professor Yigal Shoshan runs the unit at Hadassah that does brain surgery and the kind of pinpoint radiation aimed at tumors inside the skull. He described what the buildup took, and one detail in it tells you how far out ahead they were working. The applicators did not exist. The ones on the market were built for other parts of the body, so his team had new ones made for the brain.
Then the lab studies. Then the same thing in animals big enough for it to mean something. Then the wiring into the navigation system. Then the drills, and the drills, and the drills, until the day this finally got tried on a human being was a day nobody in that room was going to be surprised by anything.
His reasoning is the least dramatic sentence in the whole story and the one I keep coming back to. Every step, he says, was built so that when they moved to a patient it happened with the highest level of accuracy and safety.
And every one of those mornings, the patient did not exist. Nobody had signed a consent form. There was no name on the board. They were practicing on a dummy for a man who had not yet been told his tumor was back.
That is the part I would want said out loud at a Shabbat table, and it has nothing to do with physics. They decided ahead of time that whoever walked through that door would find people who already knew what to do.
Then he walked through the door. He was 77, with everything standard medicine had already tried behind him and the glioblastoma back anyway.
Doctors have been putting treatment straight into brain tumors for 40 years. The best known try is a chemo wafer called Gliadel, approved in the 90s, dropped into the hole once the tumor is out. It bought about two extra months. It also brought infections, seizures, swelling, and wounds that would not close, and its use has dropped sharply since. Radioactive seeds and tiles have been tried too. All of it needs the skull open and the tumor gone first.
And they all keep running into the same wall, which has a name that doctors say calmly and you should not: radiation necrosis. It means dead brain. The radiation will not stay in the tumor. It carries on out into living tissue and kills that too, and with the older seeds that happened to about one patient in seven on average, and in some series to a good deal more than that. Fixing it often meant opening the skull a second time. So the whole problem was how to make radiation quit while it was still inside the tumor.
There is an alpha emitter in your house right now. It is in the smoke detector screwed to your ceiling, a tiny speck of americium quietly throwing off alpha particles, which is how the thing senses smoke. You have never worried about it, and you are right not to. An alpha particle does more damage per hit to living tissue than anything else we know how to produce, and it is also the easiest thing in the world to hide from.
It is a helium nucleus thrown out of a decaying atom, heavy and fast. Most radiation nicks one strand of a cell’s DNA and the cell repairs it. An alpha particle snaps both strands together, in clusters, faster than the repair crew can show up. Cancer cells are very good at surviving damage. This is the damage they are worst at surviving.
The catch is that a single sheet of paper stops it cold, and so does the dead outer layer of your skin. In air, it travels a couple of inches. Inside tissue, it goes the width of a few cells and it is spent. The most powerful weapon ever built, and it only works if you are already standing inside the target. You cannot throw it or shoot it. That is why alpha radiation sat on the shelf for a hundred years. Everybody knew it would kill cancer. Nobody could get it anywhere.
Alpha radiation’s fatal flaw is that it cannot travel. Inside a skull, that is not a flaw. It is the property you would design for.
Somebody just had to notice. In the spring of 2003, a physicist at Tel Aviv University named Itzhak Kelson knocked on the door of an immunologist named Yona Keisari, a man he had never met, introduced himself, and asked whether an idea of his might work on cancer. Keisari did not send him away to write it up. He put his doctoral students on it. Their idea was to stop arguing with the physics. If the radiation cannot travel, do not make it travel. Move the source.
Think of a dandelion clock. The seed head sits still, but every seed it lets go drifts. Alpha Tau’s sources are tiny metal pieces carrying radium-224, and as the radium breaks down it throws off a string of new atoms, each one lasting only days. Those atoms come loose from the metal and drift out into the tumor, and each one fires off an alpha particle as it goes.
The particles still travel almost no distance at all. That stopped mattering the moment the atoms doing the firing were already deep inside the tumor and still moving.
A tumor builds its blood supply in a hurry and it builds it badly, a tangled mess of vessels with no plan. Healthy tissue is plumbed properly so, according to Alpha Tau, the tumor’s tangle traps those drifting daughter atoms and holds them where they are, while orderly healthy tissue just flushes them out. The tumor’s own shoddy construction is what keeps hold of the thing that’s killing it.
That left one problem: Having the right thing to put in a brain is worthless if you cannot get it there without wrecking the brain on the way in, and the answer to that turned out to be sitting in the building already. Every neurosurgery department in the world owns a rig for putting an instrument where the scan says to go, within about a millimeter, through an opening barely wider than a pen. They use it all the time, for ordinary biopsies, and it is easily the least glamorous machine in the place.
That is what puts the sources in. Professor Yigal Shoshan’s whole point about how they designed this is that the rig his team already trusts for biopsies is the same rig that delivers the treatment. Nobody had to buy a new machine, and nobody had to learn one — which is why this can spread to other hospitals, instead of living forever in the one that invented it.
So here’s how the morning actually went, and it is nothing like what you are picturing when somebody says brain surgery. There was no sawing, and no panel of bone lifted out of his head. They drilled a single opening in his skull, about the width of a pen. They took a sample first and confirmed the disease was live. Then they threaded the sources into the middle of the tumor and closed him up. Alpha Tau says that was the first time Alpha DaRT had been used on a glioblastoma in Israel, and the first time anywhere outside the United States.
The next step came after him. A glioblastoma does not grow in any shape a person would have designed, and one straight line through a shape like that leaves corners uncovered, so when a later patient came in the team went at the tumor down two separate paths in the same operation. Two roads into the same town. Alpha Tau’s report on August 10th describes that one as the first time anywhere that a glioblastoma had been treated through two separate paths at once.
And the room was not just neurosurgeons, either. The oncology institute was in there, and so was the radiotherapy institute, and so were the people from neuropathology, whose whole job that morning was to look down a microscope at the sample and say yes, that is live disease, go ahead. The operating room staff set the entire thing up. That is four departments of a major hospital standing in one room on one morning, for one man’s brain.
Professor Aron Popovtzer, who runs the Sharett Oncology Institute, said why: Patients whose glioblastoma comes back have very limited options, so anything new that can be tested properly matters enormously, and the only way anything ever moves for these people is research and clinical experience and departments willing to work together.
There is an American trial running alongside all of the Israeli work, called REGAIN, and it is where the numbers come from. They cut the data on May 3rd with three patients treated, all of them at one hospital, Ohio State University’s Comprehensive Cancer Center, under Dr. Joshua Palmer. The three had been treated in December, February, and March, so the follow-up ran somewhere between two and five months. Against a median survival of six to nine months from recurrence, that is a short look.
In two of the three, every piece of tumor that showed up on the scan was gone, and it stayed gone across repeat scans. In the third, the tumor stopped growing and shrank by about a third. There was one bad reaction to the treatment, serious enough to be graded severe, and it cleared up, and the company has not said what it was.
And, separately, none of the three had the tumor come back where it was treated or turn up anywhere else, and none of them were left with lasting problems from the procedure itself. That is as of that same May cutoff and no further.
Robert Den, who is Alpha Tau’s chief medical officer, made the comparison himself: When a glioblastoma comes back, the drugs doctors reach for almost never shrink the tumor in more than a handful of patients out of a hundred. So two of the three show what he calls “complete disappearance of all enhancing tumor lesions,” which means every part of the tumor that lights up on a scan, is in his words a clinically significant and encouraging pattern.
That is his company and his framing, on the record.
Three patients, against a wall that has held for decades. In June, the U.S. Food and Drug Administration cleared the company to enroll the final seven and to add two more American centers. Professor Yigal Shoshan says Hadassah is already getting ready to try it on cancers that started somewhere else in the body and spread to the brain, in cases where the focused radiation doctors normally use has not held them.
Alpha DaRT has no U.S. Food and Drug Administration approval. It is approved in Israel, and in Japan for head and neck cancer, and everywhere it is being used on brains it is still an experiment rather than a treatment you can be prescribed.
Nobody involved uses the word cure, and I won’t either.
In 1909, an American woman named Henrietta Szold came to see what was not yet Israel and found children going blind from an eye infection and mothers burying babies over things that were fixable. She went home and refused to let it go, founded Hadassah in 1912, and in 1913 sent two nurses to Jerusalem.
In April 1948, a medical convoy heading up to Mount Scopus in northeast Jerusalem was ambushed and 78 people were killed. They buried them and kept going, and in 1961 opened the campus at Ein Kerem where a 77-year-old man had alpha radiation placed in his brain this summer.
The place treats whoever walks in — Jewish, Muslim, Christian, Israeli, Palestinian, paying or not — and Hadassah says it was nominated for the Nobel Peace Prize in 2005, though the Institute seals nominations for 50 years and will not confirm.
Itzhak Kelson died in 2025 without ever seeing it reach a brain. It reached one anyway, which is what he built it to do.
Twenty-three years sat between his walk into a stranger’s office and that operating room in Ein Kerem. The 2008 crash nearly took the whole thing down. Everything after that — the retired CEO who came back for it in 2015, the production line in Jerusalem, the first human in 2017, Japan, the U.S. Food and Drug Administration — happened because nobody let go during the years when there was nothing to show.
There’s a line in the Mishnah, in Sanhedrin, that most people have heard some version of: “Whoever sustains a single life, it is as though he sustained an entire world.” He walked into Hadassah after surgery and radiation and all the drugs that had been used up, and they were ready for him.
Once again Israel providing more benefits to humanity than all 56 Muslim countries combined.
Go ahead Jew haters and boycott that!