Edward Schaeffer, MD, PhD
Edmund Andrews Professor of Urology
Chair, Department of Urology
Program Director of the Genitourinary Oncology Program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University
- Translational Research in Malignancy (TRIM)
My clinical and scientific focus is in prostate cancer, with an emphasis on at-risk populations, diagnosis, treatment outcomes, and the molecular biology of lethal prostate cancer. Prostate cancer is the second most common cause of cancer-related death in men in the United States, resulting in approximately 30,000 deaths per year. Prostate cancer also accounts for the largest racial disparity in mortality of all common cancers, with African Americans 2.3 times more likely to die from prostate cancer as Caucasian men. Not only is prostate cancer more lethal, it is often more frequent among African Americans, who are 1.6 times as likely to develop prostate cancer as Caucasian men. A major component of my research aims to understand why prostate cancer is more aggressive in African American men.
The Impact of Race on the Biology of Prostate Cancer
Recent technological advances have enabled extraordinary insight into alterations in gene expression patterns and acquired mutations that occur in prostate cancer. The vast majority of our knowledge has come from studying overwhelmingly Caucasian populations. My team has addressed this key unmet need in prostate cancer disparity for the last five years and has conducted large-scale transcriptome analysis of African American prostate cancers. This work has uncovered a more aggressive biologic subset of cancers in African American men, which helps to explain why African-American men are twice as likely to die from prostate cancer as Caucasian men. My team has discovered distinctive anatomic locations of tumors in African American patients, molecular expression signatures of cancers in African American patients that demonstrate decreased reliance on androgen signaling, novel solid tumor gene fusions, and divergent biomarker panels signaling aggressive disease. We have also determined that normally nonaggressive prostate tumor types can be considerably more aggressive and lethal in African Americans. My research shows that in African-American men, the tumors tend to occur in a more anterior location in the prostate, which may account for molecular differences such as decreased reliance on androgen signaling and novel gene fusions in solid tumors. These findings demonstrate that while socioeconomic factors contribute to racial disparities in prostate cancer, prostate cancer is biologically different and more aggressive in African American men. My work on this topic was acknowledged by the American Society of Clinical Oncology as a Clinical Cancer Advance of 2013.
My research demonstrates that true biological factors must contribute to aggressive tumor progression in African American prostate cancers. My team and I plan to expand on this work to uncover additional unique aspects of African American prostate cancers. This has significant potential to improve the identification of prostate cancer in African American men as well as to help inform the selection of treatment (active surveillance versus treatment), or the need for additional adjuvant treatment after surgery. The implications of this work will ensure that men are making the most informed decision about individual prostate cancer management with the added consideration of their ancestry and its impact on the disease.