Kenneth J. Pienta, M.D.
We shall not cease from exploration
And the end of all our exploring
Will be to arrive where we started
And know the place for the first time.
—T. S. Elliot
You Can Go Home Again
by Gerald Couzens
Dr. Kenneth Pienta is always prepared and ready for the unexpected. Off on his daily morning run between 5 and 5:30, he's dressed and ready for whatever kind of weather the day will throw at him. With many competitive 13-mile and 26.2-mile marathon runs to his résumé, Dr. Pienta finds that these early morning jaunts along the roadway, oftentimes brightened by the silver glow of a waning moon, offer him the best time to think. The soft rhythmic falls of his many footsteps do not distract as he ruminates about cancer, mostly cancer of the prostate, and how best to uncover new drug targets to keep the disease from advancing.
Winter weather in Ann Arbor, where Dr. Pienta has been a Professor of Internal Medicine and Urology as well as director of Experimental Therapeutics at the Michigan Center for Translational Pathology in the University of Michigan School of Medicine, is quite cold. Early-morning temperatures are often well below zero. This is all about to change, however, when he returns again to Baltimore and Johns Hopkins. For it's in Charm City where winter's weather is relatively mild and snowfall is infrequent that he'll now be accumulating his daily pre-work mileage.
To the delight of many, Dr. Pienta, internationally recognized as a leader in prostate cancer research and translational science, accepted the position as Director of Research at the Brady Urological Institute in January 2013.
"I am excited to announce that such an accomplished scientist is joining us at the Brady," says Alan W. Partin, Chairman of the Brady Urological Institute. "I am looking forward to working with Ken in the coming months and years."
A graduate of the Johns Hopkins School of Medicine in 1986, Dr. Pienta did his medical oncology fellowship at the Brady Urological Institute from 1988 to 1991 and was mentored by Donald S. Coffey, Ph.D., who served as Director of the Research Laboratories in the Department of Urology for thirty years, from 1974 to 2004. His primary work focused on how cell structure and function became altered in cancer cells. Dr. Pienta joined the University of Michigan faculty in 1994 and four years later, he was promoted to full professor. In 2012, he took on additional duties by serving as Associate Vice President for Research, Health Sciences at the University.
While active as a researcher, the author of more than 320 peer-reviewed articles, and the principal investigator on numerous clinical trials, Dr. Pienta still found time in his tight schedule to meet with cancer patients once a week. For the past decade, he has been repeatedly selected as one of America's top doctors, as well as one of America's top doctors for cancer.
"It's been often said that you can never go home," says Dr. Pienta, "but taking on this new position as research director at the Brady represents a real homecoming for me and for so many different reasons. I've now come full circle. Johns Hopkins was where I did my medical training and I am grateful for the opportunity to come back.
"Old friends still remain, and there are plenty of new ones to meet. The number of great investigators and physicians working at the Brady is just unbelievable and it's not matched anywhere in the field of urology. I am looking forward with great enthusiasm to joining that team."
It was at the Brady that Dr. Coffey, the Catherine Iola and J. Smith Michael Distinguished Professor of Urology, originally helped shape and guide Dr. Pienta as a young researcher. "One thing about Don is that he is so generous as a scientist. He always said to make sure to disseminate what you know, and not to worry about being scooped by anyone.
"I have always tried to stay true to Don's philosophy. When we collected prostate tissue through our tissue acquisition program at Michigan, we gave samples freely throughout the world when researchers asked. Over the years, that eventually led to many scientific discoveries."
The Brady Urological Institute, opened in 1915, has a long and storied history and has always been at the center of urological research and treatment, especially when it comes to prostate cancer. The Brady is still viewed throughout the world as a focal point for research in all urological diseases. However, the difference between 20 years ago and today is that there were just a few institutions with such depth and breadth of investigators working in the field.
"In 2013, that has all changed," Dr. Pienta admits, "because so many of the researchers trained at the Brady over the years are now directing or working at top-notch programs at other institutions. This creates strong competition, which is good. No longer number one simply by default, we have to retain the title of being the best by continuing to make new and important discoveries and working even harder."
Dr. Pienta hopes to put his personal stamp on urologic research at Johns Hopkins by implementing what he terms collision science. "I have made no secret of the fact that I am a huge believer in collision science, which means taking folks from disparate disciplines and getting them to work together at solving problems in the field we are interested in.
"For example, although I am a prostate cancer doctor and researcher, one of my closest research collaborators is a dentist. Why? Because dentists are bone biologists and advanced prostate cancer metastasizes to bone. I've worked with him regularly in order to understand and explain why this cancer goes to bone."
Another great non-prostate collaborator with Dr. Pienta has been a professor in the School of Public Policy at Michigan who wanted to understand how cooperation theory could be applied to helping advance cancer research. "Thanks to him, I now have six different projects going with biomedical engineers and we are trying to come up with better ways for us to create little gadgets that will help us get cells out of the blood.
"What I have discovered is that people love to do things outside of what they normally think about and do," he says. "In my administrative role, it's this sort of thinking and collaboration that I will promote. I am confident that it's what will help take the current Brady group to new levels of discovery and improved patient care."
Dr. Pienta, named Distinguished Mentor of the Year in 2009 by the American Urological Association, views himself as a team player who will offer suggestions and guidance about direction and goals in his new role as Director of Research at the Brady. He believes that effective cancer research comes down to understanding what everyone's interests are and then figuring out who can best help each one achieve them.
"It's my job to get everyone together so we can decide what needs to be done and where we should go as a group," he says. "As I get to know all of our Brady researchers and scientists better over the next few months, I will see how I can best help each one, and who we should be recruiting to help them carry out their work."
Dr. Pienta knows that it will take some time to adjust to his new surroundings, but not that much. "Thanks to the generosity of the many donors who have allowed us to expand, we have a changing culture here and I have to learn the new ecosystem," he says. "Twenty years ago, Brady had a single floor devoted to research. Now we are spread out over several floors of the Marburg, Park, and Cancer Center buildings. This changes the environment of the Brady and how our scientists interact with each other. I have to understand that special ecosystem in order to maximize its potential."
While helping set the course for future Brady research efforts, Dr. Pienta will continue his own laboratory projects. At his Michigan lab, he had focused on understanding the biologic mechanisms underlying prostate cancer metastasis and identifying novel targets for treatment. He started with the basic hypothesis that cancer tumors have properties of distinct ecological systems, and that in addition to cancer cells, the tumor microenvironment is also host to a variety of non-cancer cells that interact with them.
"By trying to best understand this ever-evolving ecosystem and how the various cells compete or cooperate with each other, I want to eventually develop what I call ecotherapies, or novel cancer therapies," says Dr. Pienta. "One of the reasons I am coming to the Brady is because I want to accelerate the pace of my own discoveries and come up with an effective ecological therapy that will modify the environment where the cancer cells are found."
When asked to take out his crystal ball and look into the future as it pertains to promising areas of research that will lead to the creation of new prostate cancer breakthroughs over the next five to ten years, Dr. Pienta is extremely optimistic.
"I think there will be monumental changes. For starters, I think we are going to solve the issue of overtreatment of prostate cancer. That will come from the use of molecular diagnostics and new biomarkers that will truly help differentiate non-aggressive from aggressive cancers." This, Dr. Pienta notes, will help reduce the number of surgeries and radiation therapy sessions that ultimately impact a man's quality of life.
When it comes to actual cancer treatment, Dr. Pienta says it will be based on the tumor's genetic and epigenetic profile. "We will get closer to finding therapies that turn off genes responsible for cancer growth and then turn on the body's natural defense mechanisms against prostate cancer."
Dr. Pienta also envisions new drugs for cancer that has recurred following definitive therapy with surgery and radiation, as well as effective medications for more advanced hormone-refractory disease. "We went through a tremendous drought of new drugs for prostate cancer from 1996 and 2008, but now we have so many new medications, with plenty more in the pipeline, including novel vaccines.
"We certainly have the potential for incremental progress in the treatment of advanced prostate cancer but also the great potential for an exponential leap if we solve issues of drug combinations and know how to correctly use targeted therapy.
"Overall, there will be many innovative treatments that we'll be able to transition from bench to bedside. And that's certainly a very good thing."