The Department of Defense wages war on prostate cancer

By Charlie Schmidt

When a young man joins the United States military, a possible future battle with prostate cancer is probably the last thing on his mind. But he has one less reason to worry about it than a civilian does: servicemen with prostate cancer have a fighting advantage when it comes to their treatment. That’s because the Department of Defense (DOD) offers access to clinical trials, experimental therapies, and state-of-the-art care through its Center for Prostate Disease Research (CPDR).

Established in 1992, and recognized as a DOD Prostate Center of Excellence, the CPDR “supplies those services equally to all active and retired servicemen regardless of rank,” says its director, Dr. David G. McLeod. Spouses and children of those who serve in the military are also eligible for CPDR services.

The CPDR is headquartered on the campus of Walter Reed National Military Medical Center, in Bethesda, Maryland. But servicemen can also access CPDR services at four other collaborating sites: the Madigan Army Medical Center, in Takoma, Washington; the Navy Medical Center in San Diego, California; the Virginia Mason Medical Center, in Seattle, Washington; and the Tripler Army Medical Center, in Honolulu, Hawaii.

Apart from conducting trials aimed at treating prostate cancer, the CPDR also helps with quality of life issues. Servicemen who take part in CPDR programs have access to psychological counseling, nutrition classes, help with managing side effects, and monthly support groups. And since their care doesn’t incur out-of-pocket expenses, servicemen tend to go for more doctor’s office visits, and they have longer-term follow-up, than men treated for prostate cancer in civilian hospitals. That benefits their own health, but it also benefits the CPDR’s broader mission to understand what causes cancer, and how best to treat it.

More than 28,000 men have been tracked by the CPDR’s Multi-Center National Database Program, which collects demographic, clinical, treatment, and quality of life data.

And those data are linked with blood and tissue samples housed at the CPDR’s biospecimen repository at Walter Reed. The CPDR’s prostate cancer database is now the largest in the country, “which puts us in an enviable position,” says McLeod. “Scientists from around the world are always knocking on our doors.” Importantly, the database and specimens collection are heavily weighted towards African American men, who face a higher than average risk of prostate cancer.

CPDR scientists using these resources have made important discoveries. They were among the first to connect prostate cancer with defects in a gene called p53 that ordinarily slows or prevents tumors from growing. And they also found many men with prostate cancer have defects in a gene called ERG. Dr. Matthew Freedman, an associate professor of medicine at Harvard Medical School and the Dana-Farber Cancer Institute, is now working with CPDR scientists to understand how ERG activity differs in African American and Caucasian men with prostate cancer.

“The DOD CPDR is an invaluable resource and the work that Dr. McLeod and his colleagues have performed has placed this program at the forefront of prostate cancer research,” said Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and Editor in Chief of HarvardProstateKnowledge.org. “In addition, the DOD graciously and generously supports additional extramural research involving prostate health. It is encouraging that such facilities are available for our servicemen and their families.”