Q and A with Cancer Control Program Co-Leader Dr. Sanoj Punnen
Dr. Punnen is improving prostate cancer detection, reducing unnecessary biopsies and using AI to predict disease progression at Sylvester Comprehensive Cancer Center.
When people think about cancer research, they often think first about developing treatments. Cancer control research adds another dimension, discovering ways to help patients, from prevention to survivorship.
“A lot of the research that we do is to holistically improve the lives of patients to reduce the burden that cancer brings,” said Sanoj Punnen, M.D., co-leader of the Cancer Control Program and a professor of urologic oncology at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, and Desai Sethi Urology Institute professor of urologic oncology and vice chair of research.
Dr. Punnen discusses his work in the following interview, which has been edited for length and clarity.
What is your role at Sylvester and what research areas do you focus on?
I’ve been here 12 years and the primary role that I play is in patient care. I see patients who have cancers of the kidney, bladder and prostate, and we treat them with surgery.
My main area of research interest is prostate cancer, specifically detection and prognosis. I study biomarkers and imaging that go into prostate cancer detection and into deciding which patients have a cancer bad enough that they need treatment, versus those that can watch it.
What was your path to specializing in urologic cancer?
My dad was a urologist, so that was the last thing I wanted to do. I knew I wanted to be a surgeon, so I looked at many different specialties. I was an athlete, so I thought I wanted to be in orthopedics. When I eventually got around to looking at urology, I was paired with people that did the cancer side.
I liked the fact that they did cool operations and were able to help patients with good outcomes. There was a lot of research going on in the field and the personalities of the people were suitable to mine.
What projects are you working on in the Cancer Control Program right now?
One clinical trial we have right now is in prostate cancer detection and one is in monitoring. For both of these areas, we do a lot of biopsies. We used to biopsy patients almost every year. You can imagine the burden of getting that done.
A big part of my research has been figuring out how we can reduce these unnecessary procedures. Could we replace them with biomarkers that tell us who really needs treatment or imaging that could tell us what’s really changing?
That’s a perfect example of research that’s not necessarily addressing cancer, but it’s reducing the burden that cancer has on a person’s life.
What other clinical trials are you especially excited about?
One that I’m excited about is one of the first I ever got involved in here. It was a collaboration with people from radiation oncology studying patients monitoring their prostate cancer. There were 205 men and they had MRIs, gave blood and urine for biomarkers and had biopsies every year. We are doing digital pathology on the biopsy cores and we sent positive cores for genomic analysis. For each patient, we had almost five years of follow up.
Now that the trial is finished, we are looking at the data and using AI in each of these areas to see which elements help the most and how we can use all this information to best predict which tumors are likely to progress and which aren’t.
We spent years collecting all this data and now we have the technology and computational tools to do something really cool. We’ve created tools that we now want to test on similar patients to see how we can improve the current standard of care. Unlike a lot of trials, where you’re just trying to answer one question, this study has continued to feed back.
Tell us about your life outside of work.
I have three kids: 12, 10 and 6. The funnest part of my day is when I come home from work and see my family. I remember my mentor, when I was asking him about family and work balance, he said, “Being a good doctor has always made me a better dad, and being a good dad has made me a better doctor.”
I may not have appreciated it in my fellowship, as these things are often at odds. But I think it’s very good advice. Some of the characteristics you gain from being a parent, like patience and compassion, can help you be a better doctor. Some of the things I’ve learned from medicine, like humility and empathy, help me be a better parent.
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Researchers found that metformin raises an exercise‑linked metabolic molecule in prostate cancer patients, offering insight into cancer care.
Dr. Chinmay Jani used serial liquid biopsies to track how metastatic prostate cancer evolves under treatment pressure.
Tags: cancer research, Department of Urology, Desai Sethi Urology Institute, Dr. Sanoj Punnen, prostate cancer, Sylverster Comprehensive Cancer Center, urology