Using Technology To Combat Prostate Cancer
As treatments for prostate disease have advanced over the last decade, so has the level of knowledge in the medical research community on the impact of new therapeutic approaches on disease outcomes such as quality of life and survival. As the leading type of newly diagnosed malignancy in US men, very little is known about prostate cancer prevention, and controversy exists as to whether there is over screening and overtreatment of this disease. More extensive research is needed to understand disease development and better identify and treat men whose disease will ultimately act aggressively.
The Center for Prostate Disease Research, a program of the Henry M. Jackson Foundation and Uniformed Services University of the Health Sciences, created a multi-center national database to collect comprehensive data from leading Department of Defense and civilian medical centers (Madigan Army Medical Center, Naval Medical Center San Diego, Walter Reed Army Medical Center, Virginia Mason Medical Center), to advance knowledge and understanding of prostate disease, particularly prostate cancer, and to allow for the development of more effective prevention, diagnostic and treatment strategies for this cancer.
“This database has allowed researchers to capture relevant data points and link them to patient outcomes,” said Jennifer Cullen, Ph.D., MPH, Director, Epidemiological Research Program, CPDR and research assistant professor, Department of Surgery, USU. “This clinical database -- which contains information from more than 25,000 men who have been biopsied for suspicion of prostate cancer based on their prostate specific antigen value, DRE result, and/or symptoms -- connects all pieces of our Center – clinical trials, basic science, and epidemiologic research. Ultimately, these data will help us to focus on quality of life during the survivorship period, as well as other “holy grail” endpoints like patient survival, which is of enormous interest to us as we support the military community.”
According to Dr. Cullen, some of the areas already identified as needing additional study relate to racial/ethnic disparities in treatment outcomes, identifying predictors of metastasis, and better understanding the impact of disease among Asian and Hispanic Americans. “Because there is a greater proportion of African Americans in the military as compared to the nation as a whole, we can dig deeper and examine this subgroup in greater detail,” said Dr. Cullen. Dr. Cullen adds that to be able to examine outcomes like prostate-specific mortality and overall survival, a very large sample size and long term follow up of men is necessary. The current data have been collected since 1992, and provide a breadth of clinical characteristics. The database has propelled the CPDR Basic Science Program in a leadership role in translational research focusing on discovery and evaluation of novel biomarkers and therapeutic targets much needed to enhance prognosis and targeted therapy of prostate cancer.
“The primary strength of the database is that it is a resource that will help us answer tough questions about how best to tailor specific treatments to patients and provide advice regarding the risk of prostate disease progression,” said Dr. Cullen. “Without this resource in our arsenal, we couldn’t answer many of these questions or address these issues effectively.”
The United States Congress established the CPDR in 1991 under the leadership of Colonel David G. McLeod, M.D., the current director of CPDR and Urologic Oncologist at Walter Reed Army Medical Center, to combat increasing prostate cancer incidence. This unique Center integrates basic and clinical science expertise to develop refined detection techniques and promising treatments for prostate disease.
By Ken Frager, Uniformed Services University of the Health Sciences