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The Department of Defense Center for Prostate Disease Research

The Department of Defense Center for Prostate Disease Research

In 1991, the United States Congress expressed a
growing concern over the incidence of prostate cancer and the
controversy over the optimal treatment of the various stages of the
disease. Congress also supported the need for both basic and clinical
research in prostate cancer in order to reduce the incidence of this
life-threatening disease and to develop more effective, more
specific, and less toxic forms of therapy for patients in all stages.
Pursuant to discussions at various levels of military medicine,
Congress provided funding in fiscal year 1992 to establish a Center
for Prostate Disease Research. The Uniformed Services University of
the Health Sciences (USUHS), Bethesda, Maryland, was designated to
provide for the establishment and administration of the Center for
Prostate Disease Research (CPDR) as authorized in public law no. 102-172.

The F. Edward Hébert School of Medicine of USUHS directs the
CPDR program, and the Henry M. Jackson Foundation for the Advancement
of Military Medicine in Rockville, Maryland provides administrative
and collaborative support. The CPDR has been directed through the
collaborative efforts of Norman M. Rich, MD, chairman, Department of
Surgery, USUHS, David O. McLeod, MD, chief of urology, Walter Reed
Army Medical Center and Judd W. Moul, MD, associate professor of
surgery. Dr. (Lieutenant Colonel) Moul was named director of the CPDR
program in 1992. An executive board was established to provide
general direction and guidance for the program.

The center initially focused on three major aims:

  1. The establishment of a Clinical Trials Research Center at Walter Reed
    Army Medical Center to serve as a model for other military sites.

  2. The establishment of a Molecular Biology Research Program at USUHS.

  3. The development of a triservice Multicenter National Prostate Cancer
    Longitudinal Database.

An endowment support program and endowed chairs in basic science and
clinical sciences have been established to provide for these
long-term scientific endeavors. The endowments also provide for a
CPDR administrative core to initiate clinical studies and allow for
the translation of the rapid advances in molecular and genetic
medicine to the study of human prostate cancer.

Mission

The Center for Prostate Disease Research will conduct basic and
clinical research programs that strive to combat diseases of the
prostate. It will integrate basic and clinical science studies to
improve early detection and prognostic factors and develop potential
treatments for prostate disease. The center will focus on the natural
history of prostate disease, outcomes research, and behavioral,
psychosocial, and quality-of -life issues as they relate to prostate
diseases. It will also provide physicians, scientists, and medical
and graduate students with training in molecular biology and clinical
research. In addition, the center will support other collaborative
research efforts within the Department of Defense related to prostate disease.

Programs and Progress

While clinical research in prostate disease has been ongoing at
Walter Reed Army Medical Center for many years, to continue being
successful, this effort needed to expand its science, technology, and
support base (which required additional space and personnel). An
entire ward of approximately 5,000 sq ft has been approved for the
establishment of the CPDR Clinical Trials Research Center at Walter
Reed Army Medical Center. Renovation began in early 1999, and the new
facility, when opened, will consolidate all prostate cancer research
in one area (the Clinical Trials Center) within the medical center.
The objective is to combine prostate screening, data collection,
clinical diagnosis, education and counseling, and prostate disease
clinical trial research in an efficient, personal, patient-oriented
center. Plans are also underway to use the Walter Reed Army Medical
Center site as a model for future sites in San Antonio, Texas, and
San Diego, California.

The Molecular Biology Research Laboratory

The Molecular Biology Research Laboratory of the Center for Prostate
Disease Research was established in 1993 with the goal of developing
state-of-the-art basic research facilities where research questions
relating to the molecular mechanisms of prostate tumorigenesis could
be addressed. With the support of the Department of Surgery, School
of Medicine, USUHS, the center has completed its initial phase of
development. One unique aspect of the center’s laboratory
program includes active collaborations between clinicians,
pathologists, and molecular biologists. These three disciplines have
created a superb environment for the development of research opportunities.

Following the recruitment and appointment of a core group of
established scientists under the leadership of Shiv Srivastava, phd,
the CPDR has now achieved the critical mass needed for a competitive
basic research program. The molecular biology research activities at
USUHS have occupied approximately 3,000 sq ft of space (three areas)
but with limited room for expansion. Because of these constraints,
the CPDR program will relocate to a new dedicated, state-of-the-art,
20,000 sq ft building in Rockville, Maryland. This will allow the
program to expand the center’s laboratory activities and
establish the administrative headquarters and support base for all
CPDR activities, including the triservice Multicenter Prostate Cancer
Longitudinal Database. The CPDR will continue to maintain
laboratories at USUHS for animal and other basic science research.

The Triservice Multicenter Prostate Cancer Longitudinal Database

The triservice Multicenter Prostate Cancer Longitudinal Database,
which began as a prospective data collection system at Walter Reed
Army Medical Center in January 1994, has now expanded to 11 other
locations and also includes retrospective data collection back to
1980. Physician investigators and dedicated full-time research data
managers are now located at Walter Reed Army Medical Center, Brooke
Army Medical Center, Madigan Army Medical Center (MAMC), Tripler Army
Medical Center (TAMC), Eisenhower Army Medical Center, Malcom Grow
Air Force Medical Center, Wilford Hall Air Force Medical Center,
Wright-Patterson Air Force Base, Travis Air Force Base, National
Naval Medical Center, Portsmouth Naval Medical Center, and San Diego
Naval Medical Center.

A standardized computer database has been designed and tested and
this triservice, secure, internet-linked relational database
repository will be located at USUHS. The data managers and
participating physicians (urologists, radiation oncologists, and
medical oncologists) have already identified more than 10,000
retrospective cases for entry into the database and prospective data
collection has been underway at many sites for 1 to 2 years.

A tissue and serum bank has also been initiated at CPDR sites in the
Washington, DC, area with the support of the Armed Forces Institute
of Pathology. Frozen tissue, blood, and bone marrow samples have been
collected from prostate cancer patients under institutional review
board–approved protocols at Walter Reed Army Medical Center
since 1993 and at other sites more recently. Specimens from more than
750 patients with prostate cancer or benign prostatic hypertrophy
diagnosed and treated at the sites have been collected and
catalogued. This repository will be linked to the CPDR database by
unique identifiers that meet IRS security and confidentiality
requirements. Plans are being developed to expand the tissue and
serum bank collection to other triservice medical centers.

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