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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. In organizing an Advanced Prostate Cancer Clinic (APCC), we are better able to:

  1. Coordinate and oversee treatments at the appropriate times,

  2. Field your questions,

  3. Handle complications or side effects of medications

  4. Spend the time needed to educate on available clinical trials,

  5. Ensure adherence to nationally recognized clinical pathways specific to prostate cancer

  6. And monitor the stages of your care with improved sophistication

About Dr. Cheng 

APCC Brochure
Dr. David Cheng

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.

David L. Cheng, MD

​    APCC Director 

APCC Support Team 

Dr. David Cheng is supported in the APCC by a designated Physician Assistant , Lindsay Miller, PA, along with Summer Carter (Licensed Practical Nurse), Patricia Smith (Registered Nurse) and other clinical and administrative personnel.

Ms. Miller earned her Masters of Physician Assistant Studies from the Medical University of South Carolina.  She also holds her Bachelor of Science in Health Promotion from the University of Georgia.  She is a Member of the Georgia Association of Physician Assistants and a member of the Academy of Physician Assistants. 

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Lindsay Miller, PA-C

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?  


Summer Carter, LPN

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.

What are the 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.

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Looking for a

Local Prostate Cancer Support Group?

UsToo Savannah/Hilton Head Prostate Cancer Support Group meets:


The October meeting will take place at 6:00 p.m. on Wednesday, October 11, at The Anderson Cancer Institute at HCA/Memorial Health located at 4700 Waters Avenue in Savannah.  Dinner will be provided courtesy of HCA Memorial Health.  


For more information, contact Jerry Thomas:
478-569-6118 - Text also

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