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Dr. Bruce Trock


biological mechanisms of aging, biomarkers of age-related change in the prostate and impact of exposures on such biomarkers biomarkers for early detection in breast fluid and in prostatic fluid chemoprevention and the use of surrogate endpoint biomarkers gene-environment interactions (diet, antioxidant genes, hormones, metals) mechanisms (e.g. oxidative stress, inflammation, environmental exposures


Associate Professor of Urology, Oncology, and Epidemiology


PhD, Epidemiology, Johns Hopkins Bloomberg School of Public Health

Research Summary

Prostate cancer Prostate cancer exhibits the most pronounced increase in risk with aging of any cancer. Migration studies suggest a strong association with lifestyle factors, yet clear associations with preventable risk factors have been difficult to establish. A confluence of findings suggests that reactive oxygen species (ROS), resulting from lipid peroxidation, chronic inflammation, and exogenous exposures may be a dominant factor driving prostate carcinogenesis. Dr. Trock's ongoing research investigates factors (diet, genetic, environmental, normal prostate physiology) that contribute to inflammation and/or ROS as a means of determining the etiology of prostate cancer and its relationship to aging, and identifying mechanisms and targets for prevention. Dr. Trock is also leading a multi-center study among the 11 Prostate Cancer SPORE centers to evaluate promising prognostic biomarkers in prostate cancer. Other biomarker research focuses on methodologic issues in translating biomarker results to the clinic.

Breast cancer Despite the tremendous advances in early detection attributable to mammography, many women are still diagnosed with tumors that will prove to be lethal. The problem may be exacerbated as genetic testing for predisposing mutations will identify large numbers of young women with high risk but for whom mammography is suboptimal. Dr. Trock is investigating the utility of proteomic patterns in nipple aspirate fluid (NAF) as a means of early detection that can serve as an adjunct to mammography. He is also evaluating the use of proteomic patterns to identify mechanisms associated with distinct breast cancer subgroups, such as women with BRCA1 mutations and African women with an aggressive phenotype. Identification of proteomic patterns associated with the earliest stages of breast cancer may also provide clues to etiology or to biological aggressiveness.In addition to his individual research, Dr. Trock heads the Division of Epidemiology in the Department of Urology, which provides epidemiology and biostatistics support to other urology faculty.

Journal Citations

Carter, H.B.; Ferrucci, L.; Kettermann, A.; Landis, P.; Wright, E.J.; Epstein, J.I.; Trock, B.J.; Metter, E.J. Detection of life-threatening prostate cancer with prostate-specific antigen velocity during a window of curability. J Natl Cancer Inst. 2006 Nov 1;98(21):1521-1527.

Gonzalgo, M.L.; Bastian, P.J.; Mangold, L.A.; Trock, B.J.; Epstein, J.I.; Walsh, P.C.; Partin, A.W. Relationship between primary Gleason pattern on needle biopsy and clinicopathologic outcomes among men with Gleason score 7 adenocarcinoma of the prostate. Urology. 2006 Jan;67(1):115-119.

Prowell, T.M.; Stearns, V.; Trock, B. Lipophilic statins merit additional study for breast cancer chemoprevention. J Clin Oncol. 2006 May 1;24(13):2128-2129; author reply 2129.

Trock, B. Applications of gene array technology in prostate cancer. Prostate Cancer: Principles and Practice. New York; 2006.

Trock, B.J.; Hilakivi-Clarke, L.; Clarke, R. Meta-analysis of soy intake and breast cancer risk. J Natl Cancer Inst. 2006 Apr 5;98(7):459-471.

Warlick, C.; Trock, B.J.; Landis, P.; Epstein, J.I.; Carter, H.B. Delayed versus immediate surgical intervention and prostate cancer outcome. J Natl Cancer Inst. 2006 Mar 1;98(5):355-357.

Bastian, P.J.; Palapattu, G.S.; Yegnasubramanian, S.; Lin, X.; Rogers, C.G.; Mangold, L.A.; Trock, B.; Eisenberger, M.; Partin, A.W.; Nelson, W.G. Prognostic value of preoperative serum cell-free circulating DNA in men with prostate cancer undergoing radical prostatectomy. Clin Cancer Res. 2007 Sep 15;13(18 Pt 1):5361-5367.

Duggan, D.; Zheng, S.L.; Knowlton, M.; Benitez, D.; Dimitrov, L.; Wiklund, F.; Robbins, C.; Isaacs, S.D.; Cheng, Y.; Li, G.; Sun, J.; Chang, B.L.; Marovich, L.; Wiley, K.E.; Balter, K.; Stattin, P.; Adami, H.O.; Gielzak, M.; Yan, G.; Sauvageot, J.; Liu, W.; Kim, J.W.; Bleecker, E.R.; Meyers, D.A.; Trock, B.J.; Partin, A.W.; Walsh, P.C.; Isaacs, W.B.; Gronberg, H.; Xu, J.; Carpten, J.D. Two genome-wide association studies of aggressive prostate cancer implicate putative prostate tumor suppressor gene DAB2IP. J Natl Cancer Inst. 2007 Dec 19;99(24):1836-1844.

Leman, E.S.; Cannon, G.W.; Trock, B.J.; Sokoll, L.J.; Chan, D.W.; Mangold, L.; Partin, A.W.; Getzenberg, R.H. EPCA-2: a highly specific serum marker for prostate cancer. Urology. 2007 Apr;69(4):714-720.

Magheli, A.; Rais-Bahrami, S.; Humphreys, E.B.; Peck, H.J.; Trock, B.J.; Gonzalgo, M.L. Impact of patient age on biochemical recurrence rates following radical prostatectomy. J Urol. 2007 Nov;178(5):1933-1937; discussion 1937-1938.

Magheli, A.; Rais-Bahrami, S.; Peck, H.J.; Walsh, P.C.; Epstein, J.I.; Trock, B.J.; Gonzalgo, M.L. Importance of tumor location in patients with high preoperative prostate specific antigen levels (greater than 20 ng/ml) treated with radical prostatectomy. J Urol. 2007 Oct;178(4 Pt 1):1311-1315.

Makarov, D.V.; Trock, B.J.; Humphreys, E.B.; Mangold, L.A.; Walsh, P.C.; Epstein, J.I.; Partin, A.W. Updated nomogram to predict pathologic stage of prostate cancer given prostate-specific antigen level, clinical stage, and biopsy Gleason score (Partin tables) based on cases from 2000 to 2005. Urology. 2007 Jun;69(6):1095-1101.

Parsons, J.K.; Partin, A.W.; Trock, B.; Bruzek, D.J.; Cheli, C.; Sokoll, L.J. Complexed prostate-specific antigen for the diagnosis of biochemical recurrence after radical prostatectomy. BJU Int. 2007 Apr;99(4):758-761.

Wagner, A.A.; Link, R.E.; Trock, B.J.; Sullivan, W.; Pavlovich, C.P. Comparison of open and laparoscopic radical prostatectomy outcomes from a surgeon's early experience. Urology. 2007 Oct;70(4):667-671.

Zheng, S.L.; Sun, J.; Cheng, Y.; Li, G.; Hsu, F.C.; Zhu, Y.; Chang, B.L.; Liu, W.; Kim, J.W.; Turner, A.R.; Gielzak, M.; Yan, G.; Isaacs, S.D.; Wiley, K.E.; Sauvageot, J.; Chen, H.S.; Gurganus, R.; Mangold, L.A.; Trock, B.J.; Gronberg, H.; Duggan, D.; Carpten, J.D.; Partin, A.W.; Walsh, P.C.; Xu, J.; Isaacs, W.B. Association between two unlinked loci at 8q24 and prostate cancer risk among European Americans. J Natl Cancer Inst. 2007 Oct 17;99(20):1525-1533.

Bastian, P.J.; Palapattu, G.S.; Yegnasubramanian, S.; Rogers, C.G.; Lin, X.; Mangold, L.A.; Trock, B.; Eisenberger, M.A.; Partin, A.W.; Nelson, W.G. CpG island hypermethylation profile in the serum of men with clinically localized and hormone refractory metastatic prostate cancer. J Urol. 2008 Feb;179(2):529-534; discussion 534-525.

Deo, D.D.; Rao, A.P.; Bose, S.S.; Ouhtit, A.; Baliga, S.B.; Rao, S.A.; Trock, B.J.; Thouta, R.; Raj, M.H.; Rao, P.N. Differential effects of leptin on the invasive potential of androgen-dependent and -independent prostate carcinoma cells. Journal of biomedicine & biotechnology. 2008;2008:163902.

Hernandez, D.J.; Nielsen, M.E.; Han, M.; Trock, B.J.; Partin, A.W.; Walsh, P.C.; Epstein, J.I. Natural history of pathologically organ-confined (pT2), Gleason score 6 or less, prostate cancer after radical prostatectomy. Urology. 2008 Jul;72(1):172-176.

Hoque, M.O.; Begum, S.; Brait, M.; Jeronimo, C.; Zahurak, M.; Ostrow, K.L.; Rosenbaum, E.; Trock, B.; Westra, W.H.; Schoenberg, M.; Goodman, S.N.; Sidransky, D. Tissue inhibitor of metalloproteinases-3 promoter methylation is an independent prognostic factor for bladder cancer. J Urol. 2008 Feb;179(2):743-747.

Landefeld, C.S.; Bowers, B.J.; Feld, A.D.; Hartmann, K.E.; Hoffman, E.; Ingber, M.J.; King, J.T., Jr.; McDougal, W.S.; Nelson, H.; Orav, E.J.; Pignone, M.; Richardson, L.H.; Rohrbaugh, R.M.; Siebens, H.C.; Trock, B.J. National Institutes of Health state-of-the-science conference statement: prevention of fecal and urinary incontinence in adults. Ann Intern Med. 2008 Mar 18;148(6):449-458.

Magheli, A.; Rais-Bahrami, S.; Trock, B.J.; Humphreys, E.B.; Partin, A.W.; Han, M.; Gonzalgo, M.L. Prostate specific antigen versus prostate specific antigen density as a prognosticator of pathological characteristics and biochemical recurrence following radical prostatectomy. J Urol. 2008 May;179(5):1780-1784; discussion 1784.

Magheli, A.; Rais-Bahrami, S.; Trock, B.J.; Humphreys, E.B.; Partin, A.W.; Han, M.; Gonzalgo, M.L. Impact of body mass index on biochemical recurrence rates after radical prostatectomy: an analysis tilizing propensity score matching. Urology. 2008 Dec;72(6):1246-1251.

Makarov, D.V.; Humphreys, E.B.; Mangold, L.A.; Carducci, M.A.; Partin, A.W.; Eisenberger, M.A.; Walsh, P.C.; Trock, B.J. The natural history of men treated with deferred androgen deprivation therapy in whom metastatic prostate cancer developed following radical prostatectomy. J Urol. 2008 Jan;179(1):156-161; discussion 161-152.

Makarov, D.V.; Trock, B.J.; Allaf, M.E.; Matlaga, B.R. The effect of ureteral stent placement on post-ureteroscopy complications: a meta-analysis. Urology. 2008 May;71(5):796-800.

Pavlovich, C.P.; Trock, B.J.; Sulman, A.; Wagner, A.A.; Mettee, L.Z.; Su, L.M. 3-year actuarial biochemical recurrence-free survival following laparoscopic radical prostatectomy: experience from a tertiary referral center in the United States. J Urol. 2008 Mar;179(3):917-921; discussion 921-912.

Rais-Bahrami, S.; Romero, F.R.; Lima, G.C.; Kohanim, S.; Permpongkosol, S.; Trock, B.J.; Jarrett, T.W.; Kavoussi, L.R. Elective laparoscopic partial nephrectomy in patients with tumors >4 cm. Urology. 2008 Sep;72(3):580-583.

Semins, M.J.; Trock, B.J.; Matlaga, B.R. The effect of shock wave rate on the outcome of shock wave lithotripsy: a meta-analysis. J Urol. 2008 Jan;179(1):194-197; discussion 197.

Sun, J.; Chang, B.L.; Isaacs, S.D.; Wiley, K.E.; Wiklund, F.; Stattin, P.; Duggan, D.; Carpten, J.D.; Trock, B.J.; Partin, A.W.; Walsh, P.C.; Gronberg, H.; Xu, J.; Isaacs, W.B.; Zheng, S.L. Cumulative effect of five genetic variants on prostate cancer risk in multiple study populations. Prostate. 2008 Sep 1;68(12):1257-1262.

Sun, J.; Zheng, S.L.; Wiklund, F.; Isaacs, S.D.; Purcell, L.D.; Gao, Z.; Hsu, F.C.; Kim, S.T.; Liu, W.; Zhu, Y.; Stattin, P.; Adami, H.O.; Wiley, K.E.; Dimitrov, L.; Sun, J.; Li, T.; Turner, A.R.; Adams, T.S.; Adolfsson, J.; Johansson, J.E.; Lowey, J.; Trock, B.J.; Partin, A.W.; Walsh, P.C.; Trent, J.M.; Duggan, D.; Carpten, J.; Chang, B.L.; Gronberg, H.; Isaacs, W.B.; Xu, J. Evidence for two independent prostate cancer risk-associated loci in the HNF1B gene at 17q12. Nat Genet. 2008 Oct;40(10):1153-1155.

Trock, B.J. A clinician's guide to statistical methods in urologic oncology. Urol Oncol. 2008 May-Jun;26(3):299.

Trock, B.J.; Han, M.; Freedland, S.J.; Humphreys, E.B.; DeWeese, T.L.; Partin, A.W.; Walsh, P.C. Prostate cancer-specific survival following salvage radiotherapy vs observation in men with biochemical recurrence after radical prostatectomy. Jama. 2008 Jun 18;299(23):2760-2769.

Xu, J.; Isaacs, S.D.; Sun, J.; Li, G.; Wiley, K.E.; Zhu, Y.; Hsu, F.C.; Wiklund, F.; Turner, A.R.; Adams, T.S.; Liu, W.; Trock, B.J.; Partin, A.W.; Chang, B.; Walsh, P.C.; Gronberg, H.; Isaacs, W.; Zheng, S. Association of prostate cancer risk variants with clinicopathologic characteristics of the disease. Clin Cancer Res. 2008 Sep 15;14(18):5819-5824.

Banez, L.L.; Sun, L.; Trock, B.J.; Han, M.; Partin, A.W.; Aronson, W.J.; Terris, M.K.; Presti, J.C., Jr.; Kane, C.J.; Amling, C.L.; Moul, J.W.; Freedland, S.J. Body mass index and prostate specific antigen as predictors of adverse pathology and biochemical recurrence after prostatectomy. J Urol. 2009 Aug;182(2):491-496; discussion 496-498.

Burnett, A.L.; Strong, T.D.; Trock, B.J.; Jin, L.; Bivalacqua, T.J.; Musicki, B. Serum biomarker measurements of endothelial function and oxidative stress after daily dosing of sildenafil in type 2 diabetic men with erectile dysfunction. J Urol. 2009 Jan;181(1):245-251.

Kader, A.K.; Sun, J.; Isaacs, S.D.; Wiley, K.E.; Yan, G.; Kim, S.T.; Fedor, H.; DeMarzo, A.M.; Epstein, J.I.; Walsh, P.C.; Partin, A.W.; Trock, B.; Zheng, S.L.; Xu, J.; Isaacs, W. Individual and cumulative effect of prostate cancer risk-associated variants on clinicopathologic variables in 5,895 prostate cancer patients. Prostate. 2009 Aug 1;69(11):1195-1205.

Loeb, S.; Schaeffer, E.M.; Trock, B.J.; Epstein, J.I.; Humphreys, E.B.; Walsh, P.C. What Are the Outcomes of Radical Prostatectomy for High-risk Prostate Cancer? Urology. 2009 Nov 19.

Novak, T.E.; Lakshmanan, Y.; Trock, B.J.; Gearhart, J.P.; Matlaga, B.R. Sex prevalence of pediatric kidney stone disease in the United States: an epidemiologic investigation. Urology. 2009 Jul;74(1):104-107.

Schaeffer, E.M.; Carter, H.B.; Kettermann, A.; Loeb, S.; Ferrucci, L.; Landis, P.; Trock, B.J.; Metter, E.J. Prostate specific antigen testing among the elderly--when to stop? J Urol. 2009 Apr;181(4):1606-1614; discussion 1613-1604.

Semins, M.J.; Trock, B.J.; Matlaga, B.R. The safety of ureteroscopy during pregnancy: a systematic review and meta-analysis. J Urol. 2009 Jan;181(1):139-143.

Trock, B.J.; Guo, C.C.; Gonzalgo, M.L.; Magheli, A.; Loeb, S.; Epstein, J.I. Tertiary Gleason patterns and biochemical recurrence after prostatectomy: proposal for a modified Gleason scoring system. J Urol. 2009 Oct;182(4):1364-1370.

Yang, L.; Gaikwad, N.W.; Meza, J.; Cavalieri, E.L.; Muti, P.; Trock, B.; Rogan, E.G. Novel biomarkers for risk of prostate cancer: results from a case-control study. Prostate. 2009 Jan 1;69(1):41-48.

Zhou, J.; Trock, B.; Tsangaris, T.N.; Friedman, N.B.; Shapiro, D.; Brotzman, M.; Chan-Li, Y.; Chan, D.W.; Li, J. A unique proteolytic fragment of alpha1-antitrypsin is elevated in ductal fluid of breast cancer patient. Breast Cancer Res Treat. 2009 Nov 10.

Han, M.; Kim, C.; Mozer, P.; Schafer, F.; Badaan, S.; Vigaru, B.; Tseng, K.; Petrisor, D.; Trock, B.; Stoianovici, D. Tandem-robot Assisted Laparoscopic Radical Prostatectomy to Improve the Neurovascular Bundle Visualization: A Feasibility Study. Urology. 2010 Nov 8;Epub 11/12/10.

Matlaga, B.R.; Schaeffer, A.J.; Novak, T.E.; Trock, B.J. Epidemiologic insights into pediatric kidney stone disease. Urol Res. 2010 Dec;38(6):453-457.

Nielsen, M.E.; Trock, B.J.; Walsh, P.C. Salvage or adjuvant radiation therapy: counseling patients on the benefits. J Natl Compr Canc Netw. 2010 Feb;8(2):228-237.

Semins, M.J.; Trock, B.J.; Matlaga, B.R. Validity of administrative coding in identifying patients with upper urinary tract calculi. J Urol. 2010 Jul;184(1):190-192.

Trock, B.J.; Walsh, P.C. Re: Radiation therapy after radical prostatectomy: impact on metastasis and survival S. A. Boorjian, R. J. Karnes, P. L. Crispen, L. J. Rangel, E. J. Bergstralh and M. L. Blute J Urol 2009; 182: 2708-2715. J Urol. 2010 Jun;183(6):2466-2467; author reply 2467.


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