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Welcome to the Cost Lab
Nicholas Cost, MD
Research Interests
I am a board-certified urologist and faculty member at the University of Colorado School of Medicine. My interest in pediatric urologic oncology developed due to outstanding mentors in the areas of both urologic oncology and pediatric urology as well as my own personal treatment for cancer as a young adult. Thus, I pursued fellowship training in both disciplines with an ultimate goal of creating a novel academic practice focusing on research and clinical care for children, adolescents, and young adults with urologic malignancies.
I am most interested in the impact of cancer care on long term urologic outcomes. Specifically, I have previously published on cisplatin exposure and nephrotoxicity in testicular cancer, the impact of nephron-sparing surgery on long term renal function in children with renal tumors, and also the therapeutic effects on bladder function in children with Sacrococcygeal Teratomas. These projects were all focused on how these curative therapies impact urologic function in the cancer survivor. This thread of investigation set the stage for my current research into the impact of chemotherapy on pediatric lower urinary tract (LUT) function in childhood cancer survivors. This proposal builds on my work which is funded by a K23 from the NIDDK (K23 DK125673) and provides a basis for career-long investigation into the impact of cancer therapy on LUT function. With the support of this K23 award I have gained the necessary skills to become an independent investigator and have emerged as a national and international expert in pediatric urologic oncology.
Active Research Projects
Impact of Chemotherapy of Lower Urinary Tract Function
We are investigating the effects on bladder function of two specific anti-cancer chemotherapies, vincristine and doxorubicin, which are known to cause the side effects of neurotoxicity and myotoxicity, respectively. Surveying childhood cancer survivors treated with these agents for symptoms of bladder dysfunction and studying bladder physiology in a murine model of vincristine and doxorubicin exposure will allow us to take the first steps in understanding chemotherapy-induced pediatric bladder dysfunction.
We have observed that over 40% of childhood cancer survivors treated with these two agents demonstrate signs and symptoms of bladder dysfunction. Additionally, early translational investigation in the laboratory of altered bladder physiology in a murine model of doxorubicin exposure demonstrates detrusor smooth muscle dysfunction by dysregulation in the detrusor contractile-relaxation mechanisms and have led to our current proposed mechanisms underlying doxorubicin-induced detrusor smooth muscle dysfunction. Determining the clinical extent of this problem as well as understanding the mechanisms behind this bladder dysfunction can go towards future goals of treatment and prevention. Data obtained from this work will benefit childhood cancer survivors globally.
For more information, please email Dr. Nao Iguchi, Senior Research Associate, at Naoko.Iguchi@CUAnschutz.edu.