September is National Prostate Cancer Awareness Month. For the latest on where this disease and new treatments are today, we sat down with Joshi Alumkal, MD, clinician-scientist at the OHSU Knight Cancer Institute.
Alumkal's work focuses on understanding the complex problem of prostate cancer and improving outcomes for patients with this disease. He is the Wayne D. Kuni & Joan E. Kuni Foundation Endowed Chair for Prostate Cancer Research and an associate professor in the OHSU School of Medicine.
What should everyone know about prostate cancer?
Prostate cancer is the most common cancer and the second leading cause of cancer-related death in men in the United States. Not all prostate cancers are the same, and patient management requires an individualized approach.
What is the biggest misconception about prostate cancer? What are the most common questions you encounter?
One of the biggest misconceptions is that prostate cancer is always a slow-growing, non-aggressive cancer. In reality, while some men are diagnosed with this slow-growing type of prostate cancer, one man still dies every 16 minutes in the United States from prostate cancer, clearly demonstrating that prostate cancer can be quite aggressive.
How does philanthropy impact your research?
We have been very fortunate to have received philanthropic support, most notably from the Kuni Foundation. Philanthropy enables my research team to take big risks and tackle some of the most pressing problems. Rather than waiting one year or more to receive grant funding to do experiments, we can start these studies right away. It is high-risk research — like the kind that philanthropy pays for — that can make a huge impact on fields like cancer research.
How is the prostate cancer treatment landscape evolving? What changes have you seen since you started at OHSU in 2007?
When I started here at OHSU, there was only one life-extending treatment for men with advanced prostate cancer, and that was after 70 years of trying. However, a deeper understanding of what makes advanced prostate cancers tick has improved our ability to control this disease. We now have six additional life-extending treatments that we can use in 2018 that were not available in 2007. I think that progress will only accelerate from here.
From your perspective, what does the future of cancer science look like?
I think we will have the ability to deeply understand each individual patient’s tumor and to monitor how cancers evolve and become resistant. This knowledge will translate into tailored combinations of medicines for patients.
In fact, we are testing this idea right now at OHSU through a program called Serial Measurements of Molecular and Architectural Responses to Therapy (SMMART) trials. The SMMART Program, a completely novel precision medicine clinical trial, uses each patient’s unique genomic data to determine an initial treatment, which may be then adjusted based on the results of ongoing tumor testing during their participation in the trial.
How does your role as a clinician-scientist uniquely position your work? How does interacting with patients inform your research, and how does your time in the lab influence your clinical work?
Simply put, patients are the reason that we do what we do. There is no higher calling than trying to help someone who is sick feel better and live longer. By seeing patients each week, I never lose sight of this principle. Moreover, these experiences help us to focus on questions in the lab that are most pressing and whose solutions could make the biggest difference.
What makes you excited to go into work each day?
Having the opportunity to work with passionate people who are all doing everything in their power to create a world without death and suffering from cancer.
We won't rest until cancer is defeated.
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