Prostate Cancer - Urological Associates of Savannah

Prostate Cancer

Over the past few years, the management of advanced prostate cancer has become more complex requiring a specialized approach. There have been exciting new and effective treatments for men with advanced prostate cancer, which leads to many questions about how and when to start certain drugs or therapies.

Dr. David Cheng is the Director of our Advanced Prostate Cancer Clinic (APCC). He has been a urologist since 1994, and has been Board Certified in Urology since 1997. He received his medical degree from Cornell University Medical College in New York and performed his internship and residency at Mount Sinai Hospital in New York.

You will see Dr. Cheng in the APCC once or twice a year or more often as your health status requires. Although Dr. Cheng will be directing your prostate care, you will remain under the care of your original urologist here at Urological Associates of Savannah for treatment of any other unrelated (not prostate) urological problems that may develop. Your original urologist will remain fully informed about all developments relating to your prostate cancer treatment.

What is Advanced Prostate Cancer?

When prostate cancer returns after treatment or spreads beyond the prostate, it is often called advanced prostate cancer. Treatment may stop advanced prostate cancer from growing and causing symptoms.

What are the Symptoms of Advanced Prostate Cancer?

Men with advanced prostate cancer may or may not have symptoms. Symptoms depend on where cancer is growing in your body. With advanced disease, you may have problems passing urine or see blood in your urine. Some men may feel tired, weak or lose weight. If prostate cancer spreads to your bones, you may have bone pain. Tell your doctor and nurse about any pain or problem you may have.

Types of Advanced Prostate Cancer

Biochemical Recurrence: Prostate Specific Antigen (PSA) level has risen after definitive treatment(s) with no other sign of cancer.
Metastatic “Hormone Sensitive” Prostate Cancer: Cancer cells have spread beyond the prostate. Imaging tests show that the cancer has spread.
Non-Metastatic Castration-Resistant Prostate Cancer (nmCRPC): Prostate cancer growth is found even after the hormone (testosterone) is blocked in patients who have had biochemical failure. This is found by a rise in the PSA level, while the testosterone level stays low. Imaging tests do not show signs the cancer has spread.
Metastatic Castration-Resistant Prostate Cancer (mCRPC): Metastatic prostate cancer has been treated with androgen ablation therapy lowering testosterone levels; but PSA levels keep rising and/or metastatic spots are growing.