Modern care for advanced disease
Prostate cancer that is high-risk, has come back after treatment (PSA recurrence) or has spread is treated very differently today than a decade ago. New imaging finds disease earlier, and new medicines extend life while preserving quality of life. Dr. Neal Patel coordinates these options with medical and radiation oncology colleagues so each patient has one clear plan.
PSMA PET imaging
PSMA PET scans detect prostate cancer cells that carry a protein called prostate-specific membrane antigen. They can find small areas of disease that CT and bone scans miss, which helps guide surgery, radiation and systemic therapy. Dr. Neal Patel has co-authored research on how PSMA PET imaging changes prostate cancer management.
Hormone therapy and androgen receptor agents
- Androgen deprivation therapy (ADT) lowers testosterone, which fuels most prostate cancers. It can be given by injection, implant or, for some options, by mouth.
- Next-generation androgen receptor pathway inhibitors, such as abiraterone, enzalutamide, apalutamide and darolutamide, are often added to ADT and have been shown in major trials to improve survival in several stages of advanced disease.
Radioligand therapy and other treatments
For metastatic castration-resistant prostate cancer that expresses PSMA, radioligand therapy (lutetium-177 PSMA) delivers radiation directly to cancer cells through the bloodstream. Other options can include chemotherapy, PARP inhibitors for cancers with certain genetic changes, bone-protecting medicines, and targeted radiation to specific sites. Genetic testing is recommended for many men with advanced disease.
Focal therapy for localized cancer
For men whose cancer is still confined to the prostate, newer focal treatments may treat only the cancerous area. One example is Vanquish steam ablation focal therapy.
Clinical trials and coordinated care
Clinical trials offer access to promising treatments before they are widely available. Dr. Neal Patel helps eligible patients find appropriate studies and keeps your primary care physician informed with a summary letter after every visit. Call 678-344-8900 for a consultation or second opinion.
Preparing for your visit with Dr. Neal Patel
Bring a list of your current medications and supplements, any prior urine, blood or PSA results, and the reports (or discs) from recent imaging. If you can, arrive with a comfortably full bladder, because a urine sample and a bladder scan are often part of the first visit. Write down your main questions so nothing is missed. A family member is welcome to join you. If you prefer Spanish or Korean, let the office know when you book so language support is ready.
Your chart is reviewed before you arrive, and insurance requirements for likely imaging or procedures are checked up front so approvals can move sooner. Before you leave, your orders, prescriptions and follow-up plan are reviewed with you, and you receive education materials tailored to your condition.
At the end of the visit you will receive a written summary in your preferred language that explains what was found, what was ordered and what happens next. Your primary care physician or referring doctor receives a clear update letter with findings, plan and next steps, so everyone caring for you stays informed. Appointments are available at the Johns Creek, Cumming, Decatur and Braselton offices; call 678-344-8900.
Reviewed by Dr. Neal Patel, MD, board-certified urologist. This page is general information and not a substitute for medical advice.