Peter Chang, MD, PhD
Assistant Professor of Surgery, Harvard Medical School
Director, BIDMC Prostate Cancer Center
Director, BID-Milton Robotic Surgery Program
Catrina M. Crociani, MPH
Adrian Waisman, MD
Andrew Wagner, MD
My research focus is in urologic cancer, and is highly collaborative in nature, most importantly within BIDMC, but also with outside institutions. I work very closely with Andrew Wagner, MD, and together we co-lead the Urology research team and share research personnel. Our team’s research in kidney and bladder cancer are described in Dr. Wagner’s report. As Director of the BIDMC Prostate Cancer Center, I will describe my research efforts to optimize quality-of-life in prostate cancer patients.
Quality-of-life assessment in prostate cancer patients
At BIDMC, we are committed to giving every patient with prostate cancer a chance to have the best quality of life possible. Unfortunately, prostate cancer treatment can cause significant side effects, and doctors tend to underestimate how bad these are, potentially leaving patients with long-lasting quality of life problems. My research focuses on accurate and objective measurement of prostate cancer quality of life using patient-reported outcome questionnaires. I developed a new questionnaire called “EPIC for Clinical Practice (EPIC-CP),” designed to be used by clinicians rather than researchers (Chang P et al, J Urol Sep 2011). I recently showed that EPIC-CP can allow a doctor to estimate the chances of a patient recovering sexual function after prostate cancer surgery (Chipman et al, J Urol Mar 2014). Due to its development here at BIDMC, our institution is at the forefront in using EPIC-CP as part of prostate cancer care. Dr. Wagner and I recently published our results on the “real-world” use of EPIC-CP in post-surgery patients in the Journal of Urology (Wagner AA et al, J Urol Jan 2017). As a next step, I hope to show how using EPIC-CP can improve the practitioner work-flow and improve patient outcomes.
Quality-of-life outcomes after prostate cancer treatment
I am also interested in finding out what problems patients have after different treatments (surgery, external radiation, radioactive seed implants), and determining whether we can use this information to better guide patients toward optimal treatments. I am the Co-overall Principal Investigator of the PROST-QA study; this is a prospective, multicenter, longitudinal study that has the most complete and rigorous collection of prostate cancer quality-of-life data in the world. I recently published the results of a study showing that a subset of patients have improvement in their quality of life after prostate cancer treatment, specifically radical prostatectomy (Chang P et al, J Urol Feb 2017).
Helping prostate cancer patients make treatment decisions
Unlike other cancers, in which options may be limited after initial diagnosis, prostate cancer patients face a seemingly impossible task of choosing among several treatment options. Working with Donna Berry, PhD, RN (Dana-Farber Cancer Institute), I serve as BIDMC site-responsible Principal Investigator for an NIH R01-funded randomized trial called Personal Patient Profile – Prostate (P3P). This unique study investigates the effectiveness of a web-based interactive program that gathers patient characteristics, quality-of-life (using EPIC-CP), personal preferences, and priorities, and uses this information to customize videos that counsel patients on how to discuss these issues with their doctor. We recently published our results in the Journal of Urology (Berry et al, J Urol Jul 2017).
Funding from the Martin and Diane Trust Career Development Chair in Surgery helped me to complete two research studies on prostate cancer quality of life, both of which resulted in primary author publications in the Journal of Urology in 2017.
My leadership of the PROST-QA cohort allowed securing of additional funding from the Movember Foundation to help support further prostate cancer research.
Teaching, Training, and Education
As a proud prior graduate of the Harvard Longwood Program in Urology and the BIDMC Minimally Invasive Urologic Oncology fellowship, I now have the privilege of being the co-director of the fellowship, training the next generation of residents and last year’s fellow, Marc Manganiello, MD.
I was selected to be a faculty member for the 17th Biennial Jerome P. Richie Harvard Urologic Oncology Course, a two-day CME course that takes place every other year.
Selected Research Support
Prostate active surveillance study; Canary Foundation, 2013-ongoing; Co-investigator: Peter Chang, MD, MPH (PI: Daniel Lin, MD)
True Nth International; Movember Foundation, 2017-2019; PI: Peter Chang, MD, MPH
Wagner AA, Cheng PJ, Carneiro A, Dovirak O, Khosla A, Taylor KN, Crociani CM, McAnally KC, Percy A, Dewey LE, Sanda MG, Chang P. Clinical use of EPIC for clinical practice (EPIC-CP) to assess patient-reported prostate cancer quality of life following robot-assisted radical prostatectomy. JUrol 2017; 197(1):109-114.
Chang P, Regan MM, Ferrer M, Guedea F, Patil D, Wei JT, Hembroff LA, Michalski JM, Saigal CS, Litwin MS, Hamstra DA, Kaplan ID, Ciezki JP, Klein EA, Kibel AS, Sandler HM, Dunn RL, Crociani CM, Sanda MG, PROST-QA Consortium. Relief of urinary symptom burden after primary prostate cancer treatment. J Urol 2017; 197(2): 376-384.
Danzig MR, Ghandour RA, Chang P, Wagner AA, Pierorazio PM, Allaf ME, McKiernan JM. Active surveillance is superior to radical nephrectomy and equivalent to partial nephrectomy for preserving renal function in patients with small renal masses: Results from the DISSRM registry. Urol Oncol 2017;35(3):116.
Gay HA, Sanda MG, Liu J, Wu N, Hamstra DA, Wei JT, Dunn RL, Kelin EA, Sandler HM, Saigal CS, Litwin MS, Kuban DA, Hembroff L, Regan MM, Chang P, Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium, Michalski JM. External beam radiation therapy or brachytherapy with or without short-course neoadjuvant androgen deprivation therapy: Results of a multicenter, prospective study of quality of life. Int J Radiat Oncol Biol Phys 2017;98(2):304-317.
Berry DL, Hong F, Blonquist TM, Halpenny B, Filson CP, Master VA, Sanda MG, Chang P, Chien GW, Jones RA, Krupski TL, Wolpin S, Wilson L, Hayes JH, Trinh QD, Sokoloff M, Somayaji P. Decision support with the personal patient profile-prostate: A multi-center randomized trial. J Urol 2018;199(1):89-97.
Taplin ME, Montgomery B, Xie W, Zhang Z, Bubley G, Lin D, Preston M, Trinh QD, Chang P, Wagner A, Mostaghel E, Kantoff P, Nelson P, Kibel A. Post prostatectomy outcomes of patients with high risk prostate cancer treated with neoadjuvant androgen blockade. Prostate Cancer Prostatic Dis 2017 [Epub ahead of print].