Dr. Philip Walther is a urologic cancer surgeon and clinical trials investigator at Duke University Medical Center and Staff Physician of the Duke University Comprehensive Cancer Center. His focus has always been to deliver the most comprehensive care of the individual patient - predominantly patients with prostate cancer, bladder cancer, kidney cancer, and testis cancer. Bucking the recent trend of delegated patient care responsibilities, Dr. Walther maintains a "hands on" manner in patient care, providing the most experienced, individualized care to his patients and by example, passing on his perspectives in patient management to residents in training.

Dr. Walther's training and 20 years of experience have provided him expertise in the following interventions:

Prostate Cancer:

• Nerve-sparing radical prostatectomy (radical retropubic prostatectomy)
• Radical perineal prostatectomy
• A recent new innovation includes the use of a surgical robot ("robotic prostatectomy") to perform laparoscopic radical prostatectomy.
• High-Risk Prostate Cancer: Combined chemotherapy and surgery for patients who have highly malignant ("high Gleason grade") or locally extensive disease.

Bladder Cancer:

• Radical cystectomy (surgical removal of the bladder).
• Continent diversion [reservoirs, both catheterizable and "orthotopic" (a new bladder reconstructed but still draining through the urethra)] can be constructed in carefully selected patients.
• High-Risk Bladder Cancer: In some patients, the extent of disease and degree of malignancy predicts a high likelihood of rapid recurrence of the cancer despite the surgery. In these patients, use of chemotherapy either immediately before or after the surgery is important and need to be carefully individualized.

Kidney Cancer (including cancer of the ureter):

• Open radical nephrectomy for large or locally extensive cancers, including those with cancer extending into the vena cava ("tumor thrombus") which may require concurrent use of cardiopulmonary bypass (heart-lung machine)
• Laparoscopic nephrectomy for low risk lesions
• Partial nephrectomy for small lesions or multiple lesions
• Ureteral replacement/reconstruction

Testis (Testicular) Cancer:

• Nerve-sparing retroperitoneal lymph node dissection, possibly with adjuvant chemotherapy