Alan W. Partin, Ph.D.
CHAIRMAN FROM 2004
with Dr. Alan Partin
by Gerald Couzens
The transition from Dr. Walsh to our
new director of the Johns Hopkins department of urology and the Brady
Urological Institute couldn’t have been smoother. Alan W. Partin M.D.,
Ph.D., Professor of Urology at Johns Hopkins, officially took over from
Dr. Walsh in December. Dr. Partin is a busy prostate cancer surgeon and
performs upwards of 200 radical prostatectomies a year. He has both a
basic science and clinical interest in prognosis prediction for men with
prostate cancer. Like Dr. Walsh, he is a dedicated scientist. Over the
years, he has focused his scientific attention on development and testing
of new and existing methods for predicting the aggressiveness of prostate
cancers so that rational treatment decisions can be made by both patients
Dr. Partin is one of the lucky people
who know early on that they want to be scientists. As far back as high
school, he always had a keen interest in biology, chemistry, and physics.
Switching his medical focus from animals—he originally wanted to be a
veterinarian—to humans in his second undergraduate year at the University
of Mississippi, he continued his work in his own laboratory at the university
and worked with one of his chemistry professors on high-level radiation
Dr. Partin later completed a combined
M.D./Ph.D. program at Johns Hopkins and it was here that he first came
under the sway of Don Coffey, his mentor, now colleague and friend. “I
started medical school wanting to be a pediatrician,” recalled Dr. Partin
recently. “I was the guy in anatomy class who never wanted to touch the
cadaver. I would be happy just reading the textbook on the topic. I had
absolutely no interest in surgery. However, that all changed when Don
Coffey lectured to first year medical students. I knew right away I had
to work with him. He eventually brainwashed me into becoming a urologist.
“My thesis work with Don Coffey was
how cells moved around in people. We found out that prostate cancer cells
that did the jitterbug and danced around within the body had a higher
ability to become metastatic and spread compared to those cells that were
fairly inert and doing the minuet. I certainly learned a lot under Don’s
tutelage. By the time I graduated from medical school in 1989, I had 50
manuscripts in peer-reviewed publications, seven book chapters, and I
was looked upon as a leader in the field of prostate cancer.”
Dr. Patrick Walsh was also a major influence
on Dr. Partin’s medical and scientific path. “One of the first projects
I did with Dr. Walsh started one day when I was in the clinic seeing patients
with him. Dr. Walsh was teaching me how to examine prostates and determine
the stage of cancer. He told me that if the nodule in the prostate felt
a certain size, we called it one name but if it felt a little larger,
we called it something else. I looked at him and said, “Don’t you think
it would make more sense if, instead of coming up with descriptive names
we actually figured out what percentage of the prostate the nodule actually
took up? That might give us more important information about the tumor.
For example, if you had a ping pong ball inside a watermelon, that’s not
half as bad as a ping pong ball within a tennis ball.”
“Dr. Walsh looked at me and asked if
I thought I could prove that. This was the first of what turned out to
be the first of many projects we were to work on together over the years.
Our paper came out in 1989 in the Journal of Urology (Partin AW, Epstein
JI, Cho KR, Gittelsohn AM, Walsh PC: Morphometric measurement of tumor
volume and percent of gland involvement as predictors of pathological
stage in clinical stage B prostate cancer.). To this day, it is one of
the most referenced papers in the history of urology.
“With this work, we proved two important
things: that the percentage of the prostate gland that has cancer in it
is more of a predictive probability than the actual size of the nodule;
and second, that as a tumor enlarges, it actually makes less PSA.
“Dr. Walsh is a scientist and he always
kept a detailed database of all the cancer patients he operated on,” said
Dr. Partin. “He kept track of every piece of clinical information. I started
to do the same with my own patients. Over the years that important database
has allowed us to make all of the important prostate discoveries that
The name Partin may be somewhat familiar
to you already because of your use of the Partin tables, the diagnostic
prostate cancer nomograms that Dr. Partin developed in 1993 to help prostate
cancer patients get an accurate prediction of their likelihood of being
A nomogram is a device or computer model
that uses an algorithm or mathematical formula to predict the probability
of an outcome. In describing this important nomogram, one noted medical
oncologist said the Partin tables were the “prognostic paradigm of the
“Looking back,” said Dr. Partin, “these
tables have allowed us to help the most people possible. Unlike what is
being done with so many pieces of intellectual property today, we didn’t
commercialize the tables or copyright them. Our goal from the start was
to help people make important decisions about their health. We wanted
to make the tables available to everyone, spreading them as far and wide
as we could. Every patient, doctor, and medical student the world over
now looks at the tables to see what the probable cancer prognosis is as
soon as a diagnosis is made. The tables are updated every three years.
Even though there are now dozens of predictive nomograms now available,
the Partin tables remain the standard.”
How will Dr. Partin do as director of
the top-rated urology department in the country? Very well, I assure you.
It’s actually the job he wanted ever since he came to Hopkins more than
two decades ago as a medical student. “Once I joined the department, I
knew being head of the department was what I wanted,” said Dr. Partin.
“It is quite an honor when I realize that I am only the fourth person
to sit in this chair in the department. Dr. Hugh Hampton Young started
it all at Johns Hopkins and he was the first urologist in the country.
Of course, I feel daunted. However, I wake up every morning ready and
willing to take every challenge that comes my way. I am young enough and
have enough energy to bring about change and make things happen here.”
Dr. Partin sketched out his ambitious
five- to 10-year plan that he hopes will solidify Hopkins not only as
a place to meet men’s urological needs, but the needs of women as well.
“There is no reason a patient should ever come to Hopkins and be sent
away because we don’t have something we can offer them. We are the best
at surgery, we have a superb radiation oncology department, and our medical
oncology is the best. We should be able to offer every man and woman that
walks through our door, some type of effective treatment to take care
of their needs.
“One of the first initiatives was to
set up our brachytherapy program with Dr. Theodore DeWeese, Chairman of
the Department of Radiation Oncology and Molecular Radiation Science.
We now offer radioactive seeds to those who choose it as their therapy
of choice for prostate cancer and we already have treated several patients.
“We are also working on a protocol
so that men with high risk advanced disease come to Johns Hopkins, they
will get multi-modal therapy consisting of chemotherapy up front, followed
by surgery or radiation as a combined effort to try and treat the disease.
We have had nothing like this before to treat disease and Dr. Michael
Carducci, Co-Director of the Drug Development Program at the Sidney Kimmel
Comprehensive Cancer Center at Johns Hopkins, is working with me on that.
In addition, we have begun a nationwide
search for an expert in kidney and bladder stones, as well as for a top
person in the treatment of prostatitis and cystitis. We are going to bring
these experts to Johns Hopkins and support them in their research and
“Following up on the groundbreaking
work of Drs. Bill Nelson, William Isaacs, and Angelo DeMarzo on the inflammatory
link to prostate cancer, I am also going to hire a clinician who treats
inflammatory diseases in the prostate.
“The goal behind this effort is to link
early clinical changes that we are beginning to see in patients with the
prostate-specific genes. Our goal is earlier and more effective treatment
of these patients who eventually develop prostate cancer.”
Everyone at the Brady Urological Institute
applauds the appointment of Dr. Partin and we look forward to working
together in what will surely come to be known as the Partin Years at Johns