Urology of St. Louis established the Advanced Prostate Cancer Center of Excellence to provide a special multidisciplinary approach to treatment using guidance from a dedicated urologist with subspecialty interest in prostate cancer.

The advanced prostate cancer center was created solely for men with advanced prostate cancer and their families. A team of dedicated urologic subspecialists, nurses, and radiation oncologists bring a special focus to helping you navigate all options for your best individualized treatment plan. Working together, the USL team will develop a treatment plan using the best available cutting-edge therapies specifically tailored for your unique situation.

Meet the Advanced Prostate Cancer Doctors

Jacob Ark

Dr. Jacob Ark

Dr. Greg Auffenberg Urology of St. Louis

Dr. Gregory Auffenberg

David Bryan

Dr. David Bryan

Steve Schneider 015

Dr. Steven Schneider

Seth Strope

Dr. Seth Strope

Chris Vulin

Dr. Christopher Vulin


Prostate cancer that’s detected early has the best chance of successful treatment and cure. Most prostate cancer is found via a blood test called prostate specific antigen (PSA) and/or a digital rectal exam (DRE). If your urologist suspects cancer, the diagnosis will be confirmed by a prostate biopsy performed with a small ultrasound probe or sometimes fused with MRI images.

Risks and symptoms

You have a higher risk of developing prostate cancer if you are African American, older than 50, or have a family history of prostate cancer. Typically, prostate cancer does not cause symptoms, but some men with prostate cancer may experience difficult or frequent urination, weak urine stream or blood in the urine.

advanced prostate cancer center


Advanced prostate cancer care often requires an individualized treatment plan using a combination of multiple therapies. As treatment options are always being developed, we continually monitor you and your prostate cancer to determine if you are a candidate for newly-offered beneficial therapies. Additionally, we participate in clinical research trials.

Allison Palladino, RN
APC Nurse Navigator

Allison Palladio is a loving wife and mother of three children. Before joining Urology of St. Louis, Allison was an ER nurse at Mercy St. Louis. Although she will always have a place in her heart for the emergency room and the patients she’s helped, Allison is eager to help those afflicted with advanced prostate cancer. Several of Allison’s close family members have experienced their own battle with cancer. She has a holistic view in helping her patients because of her experience and knowing that a cancer diagnosis doesn’t stop with the affected organ or the patient. She is excited to help patients and their family maneuver through these difficult times and provide advocacy and support for her patients as if they were her own family.

When she’s not chasing around her children, Allison is chasing down fellow athletes in triathlon competitions. Allison loves being outside with her family, whether that is hiking, biking, running, or enjoying a campfire. She loves playing board games with her family and trying new recipes.

Allison is excited to help you navigate through your treatment and will be a ray of sunshine on days when you need it most.

Looking for a second opinion?

We understand how overwhelming it can be to face a recent urologic cancer diagnosis. Our team of experts is here to provide a second opinion, empowering you to make well-informed decisions about your treatment and giving you the peace of mind you deserve. Schedule an appointment with us today, and let’s explore your options together.

Treating Your Advanced Prostate Cancer

Prostate cancer uses male testosterone to grow. ADT, or hormone therapy, works by lowering the body’s testosterone level to slow prostate cancer growth. ADT is often used to treat prostate cancer that has spread to other sites in the body. Side effects are possible, including fatigue, weight gain, weakened bones, muscle reduction, sexual dysfunction, and possible susceptibility to hot flashes.

Advanced prostate cancer as well as the treatments for it can weaken the bones and increase the risk of fractures. Prolia® and Xgeva® (denosumab) are bone-strengthening drugs that slow down the bone-weakening process. Vitamin D, calcium supplements, and regular exercise are also important for bone health.

Chemotherapy is sometimes combined with hormone therapy to treat prostate cancer that has spread into bones or other organs. 

There are a number of medications for treating cancer that has spread beyond the prostate: Nubeqa® (darolutamide), Erleada® (apalutamide), Xtandi® (enzalutamide), Zytiga® (abiraterone acetate). Often, these drugs are used when the cancer is no longer responding to androgen deprivation therapy or can be used if prostate cancer has spread outside of the prostate.

Radiation therapy can help relieve pain from prostate cancer that has spread to bones. It is also used to treat prostate cancer that has limited spread to other parts of the body. Radiation therapy is delivered by a radiation oncologist. Urology of St. Louis partners with various radiation centers of excellence for prostate cancer in the St. Louis metro area.

Provenge® is a medication used to treat prostate cancer that has spread outside of the prostate to other parts of the body. It is a unique medication for prostate cancer in that is a type of immunotherapy that activates the body’s immune system to find prostate cancer cells to attack them.

Xofigo® is a type of radiation therapy used to treat prostate cancer that has spread to bone and causes pain. It is delivered through an IV by a radiation oncologist. 

About Dr. Ark

Clinical Focus
Localized and advanced prostate cancer, urologic oncology, laparoscopic and robotic surgery, kidney stone disease, benign prostatic hyperplasia, general urology

Board Certification
Board Certified – American Board of Urology

General Surgery – Vanderbilt University, Nashville, Tennessee

Urologic Surgery – Vanderbilt University, Nashville, Tennessee

Prior Academic Appointments
Instructor – Vanderbilt University, Nashville, Tennessee

Castle Connolly Top Doctors Award, 2022


About Dr. Auffenberg

Dr. Auffenberg is originally from St. Louis with deep family roots in the area. He is thus a huge fan of all things STL. After graduating from SLUH (to get the famous St. Louis question out of the way), he completed undergraduate studies at Boston College and then medical school at Northwestern University. Following residency training in urology at Northwestern, he pursued three years of advanced training in the management of prostate, bladder, kidney, testis, and other genitourinary cancers that took him to the University of Michigan and Memorial Sloan Kettering Cancer Center in New York City. 

He was on the faculty at Northwestern’s Feinberg School of Medicine for three years after completing training where his clinical practice and research focused on urologic cancer. He is passionate about partnering with patients to help them work to solve whatever issue they are facing. Dr. Auffenberg recently moved back to the St. Louis area with his wife and three children and is very excited to return to this great city. 

 His primary practice focus is on the management of urologic cancers with advanced endoscopic, minimally-invasive, robotic, and open surgical strategies.

About Dr. Bryan

General Surgery – Indiana University School of Medicine, Indianapolis, Indiana

Urologic Surgery – Indiana University School of Medicine, Indianapolis, Indiana

Board Certification
American Board of Urology

Clinical Focus
Robotic prostate and kidney surgery, prostate cryotherapy, sacral neuromodulation for incontinence, minimally-invasive surgery for BPH and stone disease, advanced prostate cancer

Voted to Best Doctors by peers, 2016-present

Castle Connolly Top Doctors Awards, 2021 and 2022

About Dr. Schneider

Dr. Schneider is a devoted husband and father of 4 children. He is an athlete-engineer turned surgeon who stays physically fit through running, strength training, climbing, and exploring the outdoors. Originally from New Orleans, Louisiana, he is an avid Saints fan but has adopted a love for both the Cardinals and the Blues. He enjoys chess, economics, and solving complex problems. His practice focuses primarily on the minimally-invasive treatment of kidney stones, enlarged prostates (BPH), and urologic cancers. He is a provider in our advanced prostate cancer center.

Kidney stones, BPH, kidney cancer, prostate cancer, laparoscopic and robotic surgery, UroLift, endourology

General Surgery – Mayo Clinic, Rochester, Minnesota

Urologic Surgery – Mayo Clinic, Rochester, Minnesota

About Dr. Strope

Clinical Focus
Urologic oncology, laparoscopic and robotic surgery, kidney and ureteral stone disease, benign prostatic hyperplasia

Urologic Surgery – Mount Sinai School of Medicine, New York, New York

Urologic Oncology and Endourology – University of Michigan, Ann Arbor, Michigan

Board Certification
American Board of Urology

Castle Connolly Top Doctors Award, 2021 & 2022


About Dr. Vulin

Clinical Focus
Minimally-invasive urology, robotic kidney and prostate surgery, laparoscopic surgery, urologic oncology, general urology

General Surgery – Washington University School of Medicine, St. Louis, Missouri

Urologic Surgery – Washington University School of Medicine, St. Louis, Missouri

Former Clinical Facility
Washington University School of Medicine, St. Louis, Missouri

Board Certification
American Board of Urology

Best Doctors, 2012-present
Castle Connolly Top Doctors Award, 2021 & 2022