Tung-Tien (Henry) Sun, PhD; Herbert Lepor, MD, chairman of the Department of Urology; and Xue-Ru Wu, MD, are co-directors of the Center of Excellence on Urologic Disease. (Photo by John Abbott)

In Focus: Center of Excellence on Urologic Disease

Although prostate cancer is being detected earlier than ever, newly diagnosed patients still have only two therapeutic options: surgical removal of the prostate or irradiation of the entire gland, both of which carry significant risk of incontinence and impotence.

“We treat the whole prostate because we can’t be certain where the tumor cells might be,” says Samir Taneja, MD, the James M. Neissa and Janet Riha Neissa Associate Professor of Urologic Oncology. “If we could map exactly where the early-stage cancer is located and treat just that part of the prostate, we’d get the same benefits as radical treatment without the side effects.”

This approach is already used to treat kidney and breast cancer. The difference is that prostate cancer is difficult to locate with imaging technology. That’s why NYU Langone Medical Center’s new Center of Excellence (COE) on Urologic Disease is launching a pioneering program to develop new ways to map localized prostate cancer. Aided by a $5 million gift from Medical Center Trustee Joel Smilow for a new prostate cancer center and a $1 million gift from New York University Trustee Joseph Steinberg to study innovative diagnostic technology, Dr. Taneja and his colleagues are exploring a variety of novel biopsy and imaging techniques.

One, the TargetScan computerized biopsy device, has performed well at detecting prostate cancer and is now being tweaked to see if it can better predict which areas are cancer free. Researchers will also be experimenting with Artemis, a robot that manipulates an ultrasound probe to create a three-dimensional image of the prostate. In addition, NYU Langone is one of just three centers in the country studying Histoscan, a novel technology that uses radio waves to measure tissue density. The Department of Urology recently hired a faculty member who specializes in combining MRI technology with ultrasound to map prostate lesions. One reason for this intense focus is that urologists have discovered that most early-stage prostate cancer is concentrated in a single “index lesion,” which, if it can be mapped precisely, can then be destroyed.

In addition to prostate cancer mapping and treatment programs, says Herbert Lepor, MD, co-director of the COE, the center will focus its new resources on three major biomolecular research initiatives. One will enlist 12 scientists and clinicians from seven departments to investigate the role of androgen receptors in prostate cancer growth, an area pioneered by Anna Ferrari, MD, associate professor of medicine (oncology). The second, a bladder biology initiative headed by co-director Tung-Tien (Henry) Sun, PhD, professor of cell biology, pharmacology, and urology, and the Rudolf Baer Professor of Dermatology, will study how uroplakins—key proteins in the lining of the bladder—form a protective barrier against urine. Funded by the largest NIH grant in the field, the multidisciplinary team is exploring whether alterations in uroplakins contribute to common bladder diseases such as urinary tract infection, interstitial cystitis, and overactive bladder.

The third area is a bladder cancer effort headed by co-director Xue-Ru Wu, MD, professor of urology and pathology, and director of urological research. Seed grants will help support several new investigators in studying the etiology of bladder cancer and engineering therapeutic antibodies and viruses, with the goal of developing new prevention and treatment modalities. “The COE will speed our search for ways to stop bladder cancer on a molecular level,” explains Dr. Wu.

The COE will also support other projects, including studies of a major protein in urine that may protect against urinary tract infections and inhibit kidney stones. “Being named a center of excellence is a sign of confidence in our capabilities to transform the treatment of urological diseases,” says Dr. Lepor, the Martin Spatz Chairman of the Department of Urology and professor of urology and pharmacology. “We’re determined to take these resources and leverage them effectively to improve and extend people’s lives.”