Dr. Carter, Professor of Urology and Oncology, is an internationally recognized expert in the diagnosis and treatment of prostate disease. He is the former editor of the Prostate Bulletin and the current editor of the Prostate White Papers that provide patients with up to date information about diseases that affect the prostate gland.

Dr. Carter runs the Expectant Management Program for prostate cancer at Johns Hopkins- a program designed to select men who are thought to have small volume cancers. These men then have the option to be carefully monitored as an alternative to immediate surgery.

In his surgical practice, Dr. Carter has performed more that 2000 radical prostatectomies to treat men with prostate cancer. These patients participated in a quality of life survey before and after surgery using validated quality of life instruments. The graph below shows quality of life outcomes over 4 years in 704 men who underwent surgery by Dr. Carter. These data demonstrate that only a small percentage of men have long term urinary leakage requiring protection, and that most men have return of sexual function that mirrors their baseline function as measured using a validated questionnaire. These data enable Dr. Carter to give new patients an accurate picture of their post operative experience and recovery.

Quality of Life Outcomes after Radical Prostatectomy

Based on 704 men, median age 57 yrs (range, 40-74); ED is erectyle dysfunction

A patient undergoing the surgery described above could expect to have a carefully performed operation with the best chance of total cancer removal using visual magnification and tactile feedback rarely requiring blood transfusion, and that can be performed in just over an hour. The operation is performed through an incision below the umbilicus measuring 6-8 inches. A 1-2 night hospital stay and return to office work by 2-3 weeks from the date of surgery is the norm. Once back to work it is not necessary to refrain from vigorous activities. After careful consideration of techniques for performance of radical prostatectomy, Dr. Carter believes that these results are superior to those obtained by standard laparoscopic surgery or robotically assisted techniques.
Many patients who are faced with decisions about treatment for prostate cancer benefit from talking to others who have already been through this experience. A list of patients that have indicated their desire to help others, and that spans more than a decade of practice, is provided to patients seeking this type of help.

Dr. Carter is working with the Baltimore Longitudinal Study of Aging (National Institute on Aging) to further define the age related events that lead to the development of prostate disease in the aging male. He pioneered the concept of PSA rate of change (PSA velocity) as a marker of prostate cancer presence and the use of free PSA to predict the behavior of prostate cancer . (For more information read "Deciphering the Results of a Prostate Test "). He was the first to publish data demonstrating that an individual’s personal prostate cancer screening program should be tailored to baseline PSA levels performed at an early age instead of using a “one size fits all” approach . Together with investigators at the Baltimore Longitudinal Study of Aging, Dr. Carter has investigated risk factors for development of prostate cancer and prostate enlargement including diet and life style.