‘N of 1’ follows patient around world for a cure

Kayte Hollingsworth

By Cate Marquis, Special to the Jewish Light

What connects a non-Jewish Florida woman with a rare liver cancer with a hospital in India and two surgeons, one Israeli and the other British? A Jewish appliance repairman in Canada, whose passion is finding experimental treatments for hopeless cancer cases.  

That mind-boggling idea is at the heart of the gripping Israeli documentary “N of 1.” The documentary follows Kayte Hollingsworth’s journey from a terminal diagnosis of a rare liver cancer to the chance of a cure, thanks to the efforts of a stranger in Toronto named Howard Simons. It spotlights the unusual work of this Jewish man committed to making a difference in the world and potentially saving lives by scouring medical journals for experimental treatments for terminal cancer.

Diagnosed with fibrolamellar hepatocellular carcininoma, a rare liver cancer, Hollingsworth, at age 23, has had surgery, radiation, and rounds of chemotherapy, until all options were exhausted. Pretty, lively Hollingsworth doesn’t look sick but her liver is full of tumors and doctors have sent her home to die. Unwilling to give up, she contacts Tal Friedman, who runs an online support group for those with fibrolamellar cancer. He, in turn, puts her in touch with Simons. 

Simons has no medical training but he is a natural problem-solver. By scouring peer-reviewed research in top medical journals, he finds overlooked treatments and makes connections that most doctors seem to miss for treating terminal cancers. He first did this for a friend with terminal cancer, but Simons decided to continue doing it free for anyone who asked, a decision influenced by his deep Jewish faith. 

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The documentary’s title refers to the number of patients in a clinical trial. An experiment with an “n of 1” has only one patient, in this case Hollingsworth who will be the first on which the untested procedure Simons uncovers will be tried. It combines a liver transplant from a living donor with a bone marrow donation. If it works, her altered immune system will eliminate any remaining cancer cells and she also won’t need life-long immunosuppression drugs. The treatment could revolutionize all transplants.

For the operation, Simons calls on Israeli Dr. Shimon Slavin in Tel Aviv, a bone marrow transplant specialist, and British-India liver transplant surgeon Dr. Mohamed Rela in London. Because the operation is so experimental, it has to be done in a nation with less restrictive rules, so India is chosen. 

The documentary brings us close to all the people involved, Hollingsworth’s family, Simons and the two surgeons particularly. It also offers insights on medical research and the barriers in medicine to such new procedures, explained well by Dr. Ephraim Fuchs of Johns Hopkins. This involving documentary is both emotionally moving and informative.