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Our patients can choose from a variety of treatments including surgery, radiation therapy, hormone therapy, chemotherapy or a combination of medical treatments.
In the past, surgical patients rarely retained their potency, and many became incontinent. With the radical prostatectomy or nerve-sparing surgery developed at the Johns Hopkins Brady Urological Institute, 50 to 70 percent of patients retain their potency and 93 percent their continence. The prostate cancer surgical team has earned an enviable record of positive outcomes for both survival and few complications after prostatectomy.
Patients with established metastatic prostate cancer and those at high risk of developing metastasis are offered state-of-the-art treatment, including hormonal compounds and various chemotherapeutic agents.
Kimmel Cancer Center prostate cancer expert Mario Eisenberger, M.D., led a group of institutions that completed a three-year international study showing that docetaxel, a drug made from yew tree needles, decreases the chance of dying by 24 percent in advanced-stage prostate cancer patients resistant to hormone therapy. These results spur hopes that earlier use of the drug alone or together with other agents will provide longer improvements in survival.
Patients who have untreated, biopsy proven localized prostate cancer may be appropriate for our multidisciplinary prostate cancer consultation, where a patient can meet with specialists from each discipline to explore their treatment options in a one-day visit.
H. Ballentine Carter, M.D., runs the Expectant Management Program for prostate cancer at Johns Hopkins, a program designed to select men who are thought to have small-volume cancers. These men have the option to be carefully monitored as an alternative to immediate surgery. Dr. Carter is working with the Baltimore Longitudinal Study of Aging (National Institute on Aging) to further define the age-related events that lead to the development of prostate disease in the aging male. He pioneered the concept of PSA rate of change (PSA velocity) as a marker of prostate cancer presence and the use of free PSA to predict the behavior of prostate cancer. He was the first to publish data demonstrating that an individual’s personal prostate cancer screening program should be tailored to baseline PSA levels performed at an early age instead of using a “one size fits all” approach. Together with investigators at the Baltimore Longitudinal Study of Aging, Dr. Carter has investigated risk factors for development of prostate cancer and prostate enlargement, including diet and life style.