The Duke Cancer Institute (DCI) Center for Prostate and Urologic Cancer expanded its team of renowned genitourinary (GU) oncology experts practicing at DCI locations in Raleigh and Cary. Medical oncologists Jeffrey W. Shevach, MD, and Sundhar Ramalingam, MD, collaborate with Duke’s extensive group of urologists, radiation oncologists, radiologists, pathologists, and surgeons to provide patients in Wake County with the latest therapies. 

“Some of our treatments are only available at a few centers nationwide,” says Ramalingam. 

Duke’s prostate-specific membrane antigen (PSMA) PET scan and multiparametric 3T prostate MRI support significantly improved prostate cancer detection and treatment. “In addition to a PSA test, many patients get a 3T MRI before recommending a biopsy. “If we don’t identify a higher-risk lesion, the patient may not have a high risk of significant prostate cancer,” says Ramalingam.

“For patients who need a biopsy, surgeons can use MRI-fusion guided prostate biopsies, which support a more precise biopsy and diagnosis,” says Shevach.

Further supporting more precise care at Duke is the team’s use of the PSMA PET scan, which can aid in the detection of metastatic prostate cancer. These methods better risk stratify patients with more aggressive cancers that need treatment.

The DCI Center for Prostate and Urologic Cancer team dedicates significant resources to provide the full spectrum of GU cancer care from diagnosis, through treatment, and survivorship.

“We approach cancer care differently than other centers; we look at each patient individually to understand their cancer. Then, we work as a coordinated team to provide patients with the most personalized treatment plan,” says Ramalingam. 

“We also collaborate with multiple specialists through our GU oncology tumor board to discuss advanced cases and the best path forward for those patients,” says Shevach. 

Patients in Wake County also benefit from access to expert urologic oncology surgeon Tara N. Morgan, MD, and Jeffrey Gahan, MD, a urologic oncology surgeon, who will soon join the team. Morgan has advanced training in minimally invasive robotic treatments of common urologic issues such as prostate and kidney cancers. 

“Duke has a strong multidisciplinary approach to cancer care and fellowship-trained oncology providers who are up-to-date on the latest in GU cancer care,” says Morgan. Morgan strives to deliver the highest quality care with the shortest recovery time and the best functional outcomes for each patient: “For prostatectomies, I emphasize nerve and muscle preservation to limit surgical risks and maximize patients’ quality of life.” 

In coordination with surgical interventions, patients in Wake County receive convenient, leading radiation therapy techniques and treatments, including intensity-modulated radiation therapy (IMRT) and stereotactic body radiotherapy (SBRT) to the prostate and other primary and oligometastatic disease sites. 

Patients also benefit from the team’s portfolio of over 20 clinical trials offering the latest and newest treatments for GU cancers. “We can offer most trials at Cary and Raleigh, and seamlessly transition patients to Durham trials, which provides more treatment options,” says Shevach. 

Shevach is also preparing to lead an upcoming phase 3 trial to study genetic mutations that may increase prostate cancer risk. “I’m very interested in in clinical genetics and how identifying certain mutations could lead to better gene sequencing and targeted therapies.”

The comprehensiveness of the GU oncology program offers patients a breadth of clinical and support services. “Treating patients with a whole-person care approach is important to us,” says Ramalingham. 

At all Wake County locations, patients have access to a dedicated GU oncology support team, including:

• experienced nurses administering chemotherapy and managing radiation
• structured patient education 
• GU oncology nurse navigators
• access coordinators
• oncology-specialized nutritionists
• dedicated pharmacists 
• oncology mental health counseling 

“We also offer convenient telehealth appointments and a prostate cancer support group that a provider always attends,” says Ramalingham.