Finding prostate cancer accurately
The first step in prostate cancer care is an accurate diagnosis. If your PSA is higher than expected or an exam is abnormal, Dr. Neal Patel, a board-certified urologist, starts with a careful review of your PSA history and, in many cases, a prostate MRI. MRI can show areas that look suspicious and helps many men avoid a biopsy they do not need. Learn more about the elevated PSA evaluation.
3D MRI-fusion ultrasound transperineal biopsy
When a biopsy is recommended, Dr. Neal Patel uses 3D MRI-fusion ultrasound to guide a transperineal prostate biopsy. Your MRI images are combined with live ultrasound to build a three-dimensional map of the prostate, so the areas that looked suspicious on MRI can be sampled directly, along with standard samples from the rest of the gland. AI-enhanced technologies help improve detection and targeting accuracy.
With a transperineal biopsy, the biopsy needle goes through the skin between the scrotum and anus rather than through the rectum, so the risk of infection is lower. Before the biopsy you will receive clear instructions, and afterward your results are explained in person, including the Grade Group (Gleason score) and what it means for you.
Active surveillance
Many prostate cancers grow slowly and may never cause harm. For low-risk and some favorable intermediate-risk cancers, active surveillance is often the recommended first choice. Instead of treating right away, the cancer is monitored closely with regular PSA tests, MRI and repeat biopsies when needed, and treatment is offered if the cancer shows signs of changing. Active surveillance lets many men avoid or delay the side effects of treatment.
Treatment options when treatment is needed
- Robotic radical prostatectomy. Removal of the prostate through small incisions, with nerve-sparing when appropriate. Surgery is one option among several, and the choice depends on the cancer, your health and your priorities. Learn about robotic urologic cancer surgery.
- Vanquish focal therapy. For selected men with localized cancer that is visible on MRI and confirmed by biopsy, Dr. Neal Patel offers Vanquish water vapor (steam) ablation, which treats only the targeted area of the prostate. It requires close follow-up. See the Vanquish focal therapy page for its FDA and study status.
- Radiation. Radiation therapy is another established option and is coordinated with radiation oncology colleagues.
- Hormone and advanced therapies. For cancer that is high-risk, has come back after treatment or has spread, options include hormone therapy, newer androgen receptor medicines, PSMA PET imaging and other advanced treatments. Learn more about advanced prostate cancer therapies.
Choosing the right plan
There is rarely a single right answer for prostate cancer. Dr. Neal Patel reviews the grade and extent of the cancer, your age and overall health, and how you weigh cancer control against possible effects on urinary control and sexual function. Every option is discussed, including its benefits, risks and follow-up, so you can decide together. Second opinions are welcome.
Life after treatment
Urinary leakage and erection changes can follow some prostate cancer treatments. Most men improve over time, and effective help exists when they do not, including pelvic floor therapy, erectile dysfunction treatment and, for persistent leakage after surgery, ProACT adjustable continence therapy. Call 678-344-8900 to book, or book online with Advanced Urology.
Frequently asked questions
What is a transperineal prostate biopsy? It is a prostate biopsy in which the needle goes through the skin between the scrotum and anus rather than through the rectum. Because the needle does not pass through the rectum, the risk of infection is lower.
What is an MRI-fusion biopsy? Your prostate MRI is combined with live ultrasound during the biopsy to create a 3D map of the prostate. This lets the areas that looked suspicious on MRI be sampled directly instead of relying only on standard samples.
How is AI used in prostate cancer diagnosis? AI-enhanced technologies help improve detection and targeting accuracy. They support, and do not replace, the review of your images and results by your doctor.
Do all prostate cancers need treatment right away? No. Many low-risk cancers grow slowly and can be safely monitored with active surveillance, which includes regular PSA tests, MRI and repeat biopsies when needed.
What treatment options are there for prostate cancer? Options include active surveillance, robotic prostatectomy, radiation, focal therapy for selected men, and hormone and advanced therapies for cancer that is high-risk, has come back or has spread. The right choice depends on the cancer and on your health and goals.
Where Dr. Neal Patel sees patients
Dr. Neal Patel sees patients from across metro Atlanta at two Advanced Urology offices:
- Johns Creek: 10730 Medlock Bridge Rd, Ste 110, Johns Creek, GA 30097
- Cumming: 4150 Deputy Bill Cantrell Memorial Rd, Ste 180, Cumming, GA 30040
His Advanced Urology team also sees patients in Decatur and Braselton. Call 678-344-8900 to book. Same-day and next-day appointments are often available.
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. Dr. Neal Patel sees patients at the Johns Creek and Cumming 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.