The medical profession likes to use the phrase “bench to bedside” when emphasizing the importance of translating basic science research into effective clinical interventions. In contrast, Edward M. “Ted” Schaeffer, MD, PhD, the new chair of the Department of Urology at the Northwestern University Feinberg School of Medicine, describes much of his research on prostate cancer as “bedside to benchtop.” Although he studies the disease at a molecular level, his investigations are driven by patient outcomes.
“I’ve always relied on my patients to inform me about important themes in prostate cancer,” says Dr. Schaeffer, who joined Northwestern on December 1 after a distinguished eight-year career on the faculty of the Johns Hopkins University School of Medicine in Baltimore. “I partner with my patients in discovery.”
A world-renowned urological surgeon, as well as a leading investigator, he has made groundbreaking discoveries that help explain why African-American men are twice as likely to die from prostate cancer as Caucasian men. These findings dispel the assumption that socioeconomic factors alone account for this racial health disparity.
“I noticed that my African-American patients with prostate cancer had more aggressive cancers and more aggressive progression after treatment,” says Dr. Schaeffer, who was the director of the prostate cancer program at Johns Hopkins Medicine and a professor of urology, oncology and pathology. “I wasn’t sure at first if this was anecdotal or a true phenomenon. So I developed a whole research enterprise around understanding this better.”
At a time when the medical community is cautioning against over-treating slow-growing, or indolent, prostate tumors and recommending surveillance instead of surgery, Dr. Schaeffer has determined that normally nonaggressive prostate tumor types can be considerably more aggressive and lethal in African Americans. His research team has found 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. In addition, he and other investigators are starting to pinpoint biomarkers specific to this patient population that may predict the development of aggressive disease.
“The essence of what I do is to try and understand prostate cancer better,” he explains. “I’m interested in the molecular biology of aggressive, lethal cancers. And as a subset of that work, I’m focused on studying the unique features of African-American men that make those tumors aggressive.”
Similarly, as a urological surgeon, he concentrates on the diagnosis and treatment of men with prostate cancer. Developing an international reputation for the surgical management of the disease, he performed more radical prostatectomies a year than any other urologist at Hopkins. More than two-thirds of his patients came to him from other states and countries.
“My treatment for each man is tailored to the individual person. There isn’t a one-size-fits-all solution,” says Dr. Schaeffer, who is also a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. “Based on the diagnosis of prostate cancer, we first determine if treatment is needed versus active surveillance. If we decide on treatment, we review the pros and cons of different options. There are some patients who should have an open radical prostatectomy with a traditional surgical approach. And there are others who might be good candidates for a laparoscopic robotic approach.”
While his practice and research are very specialized, Dr. Schaeffer’s skill set is astonishingly broad, notes Kenneth J. Pienta, MD, a professor of urology at Hopkins. “Ted is one of the few urologists in the world who not only has an active research laboratory but also is active in doing outcomes research and is recognized as an elite surgeon,” says Dr. Pienta. “He is a very rare breed.”
Making his own way
Dr. Schaeffer succeeds his father, Anthony J. Schaeffer, ’68 MD, Northwestern’s long-time chair of urology. But as a child, the son had no inkling that he would choose a similar career path.
“My father was a urologist at Northwestern but never really brought his work home with him,” recalls Dr. Schaeffer, who was born in California and raised in Western Springs, Illinois. “One of the things that I always respected about him was that he was my father at home; he wasn’t a doctor at home. So when I was growing up, I didn’t know that much about what he did.”
Dr. Schaeffer’s parents stressed the importance of respecting others, being a good listener and working hard in school. Heeding their advice, he excelled as a student and ended up attending the University of Chicago for his undergraduate and advanced degrees.
“I was always interested in discovery ‒ why things work the way they do,” he recalls. “And because of that, I was naturally drawn to the sciences. I liked the biological sciences better than the physical sciences, so I went down that road in college.”
He decided to become a physician and was admitted into the University of Chicago Pritzker School of Medicine. In 1997, three years into medical school, he took a leave of absence to study basic science at the National Institutes of Health (NIH) in Bethesda, Maryland, receiving a scholarship from the Howard Hughes Medical Institute. He remained at the NIH for two years, enough time to complete a body of work that could be applied toward a PhD degree in molecular biology.
“Although I was initially studying the immune system, it was during my time at the NIH that I was drawn to urology and, more specifically, prostate cancer,” shares Dr. Schaeffer. “In the late 1990s, very little was known about prostate cancer ‒ why it occurred and what made it aggressive. So I decided then that I wanted to become a urologist and a scientist and work to understand the disease.”
After completing his MD and PhD degrees at the University of Chicago in 2001, Dr. Schaeffer pursued a urology residency at Hopkins, which, he says, had the leading prostate cancer program in the country at the time. Finishing his training six years later, he joined the Hopkins faculty as an assistant professor, rising quickly through the ranks.
Dr. Schaeffer, who is 43, has more than 180 scientific publications to his name and has received millions of dollars in NIH and other government and foundation funding. He recently was awarded a $2.5 million NIH grant to study the molecular and cellular characterization of screen-detected and lethal prostate cancer using a multidisciplinary, integrative genomic approach. Building on previous research, the five-year study, which began in October, aims to determine how to better distinguish lethal from indolent prostate cancer in Caucasian and African-American men.
Although he can no longer be the study’s principal investigator (PI), as the grant must remain at Hopkins, Dr. Schaeffer continues to lead this research as a co-investigator. “It’s his baby; I’m just holding it for him, so to speak” says Dr. Pienta, the grant’s new PI. “He’ll do all of the heavy lifting.”
Professional, personal goals
Thrilled to be at Northwestern, Dr. Schaeffer looks forward to taking what is already one of the top urology departments in the country even further. “It’s an ‘A’ program. And I’d like to take it from an ‘A’ to an ‘A++’ program,” he says. “I’d like to develop a more highly organized oncology program that integrates the latest genomic testing and molecular therapeutics into treatment planning.”
He also intends to give more support to other urologic subspecialties. “The faculty members that we have who specialize in reconstruction, male infertility and kidney stones are all superb,” he remarks. “I would like to give them more administrative help to accelerate their programs in their respective fields.”
Dr. Schaeffer, who is married and has three children, concedes that work-life balance is more challenging for him than it was for his father, given the constant connectivity of the Internet era. Still, he tries very hard to be a good husband and father, as well as a notable physician-scientist.
“I try to pay attention and be observant of successful fathers, successful husbands, successful scientists and successful surgeons,” he says. “I try to integrate excellence into my life all the time.”
While continuously striving to improve himself, Dr. Schaeffer also gives selflessly of his time. “Although relatively young, Ted has mentored several faculty members through the ranks, helping them establish their careers,” says Dr. Pienta. “He did this as an associate professor, which is highly unusual. Most people don’t start mentoring until they are full professors.
“That kind of generosity of spirit, especially when he is excelling in so many domains, is an amazing thing to see.”