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H. Ballentine Carter

CarterHBallentineDr. H. BALLENTINE CARTER trained in urological surgery at New York Hospital-Cornell Medical Center and at the Brady Urological Institute at Johns Hopkins. He is the only surgeon at Johns Hopkins to have ever collected 4 years of quality of life information on consecutive patients undergoing radical prostatectomy using validated questionnaires. As a surgeon, these data allow him to know how he is doing, and also to allow patients to know what to expect. After performing more than 3500 radical prostatectomies on men from all over the world, he can help men and their partners navigate through a difficult time in their lives, and in most cases return to a life that was present before the diagnosis of prostate cancer.

One of the most important aspects of practicing surgery is to understand which patients don’t need an operation. As a result, in 1995, Dr. Carter began a large prospective study to evaluate what is now referred to as Active Surveillance for prostate cancer – a program designed to select men who are thought to have small volume cancers that may never need treatment. These men then have the option to be carefully monitored as an alternative to immediate surgery. He believes that men today that are diagnosed with Gleason score 6 cancer are asking the wrong question “What treatment is best”, when they should be asking “Do I need to be treated at all”. In counseling patients regarding the decision to treat or not, Dr. Carter emphasizes the importance of a man’s personal preferences and concerns. For example, many men are willing to accept large declines in quality of life to be rid of a cancer that has minimal chance of causing harm over a decade or more; while others would rather live with a cancer and maintain their quality of life for now. Understanding these patient specific preferences plays a large part in the decision to monitor or treat a cancer when the decision is not a “slam dunk”.

Dr. Carter is an internationally recognized expert in the diagnosis and treatment of prostate disease, both cancerous and non- cancerous. He led a panel of experts that wrote the American Urological Association guidelines in 2013 for prostate cancer detection. His book –The Whole Life Prostate Book– is the only comprehensive prostate book for laypeople that offers patients not only up to date information on management options for prostate disease (including cancer), but also approaches to prevention of male health disorders including prostate disease.

He was recently nominated to be a Trustee of the American Board of Urology by the American Association of Genitourinary Surgeons. His term extends from February 2012-February 2018. Dr. Carter’s election as a Trustee to the American Board of Urology is a recognition of his exemplary patient care and innovative research in the field of prostate cancer.

The concept of PSA rate of change (PSA velocity) as a marker of prostate cancer presence and aggressiveness, was introduced by Dr. Carter in collaboration with investigators at the Baltimore Longitudinal Study of Aging. He also first described 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 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.