Prostate cancer
Diagnosis, staging and robot-assisted radical prostatectomy, with treatment planned through a multidisciplinary tumour board.
What it is
Prostate cancer is common and often slow-growing. Many men diagnosed with low-risk disease will never need an operation at all, and are followed carefully instead. Others have disease that should be treated promptly. Telling those two groups apart is the whole point of modern staging.
Where surgery is the right answer, robot-assisted radical prostatectomy allows precise dissection around the nerves and sphincter that control potency and continence.
Symptoms you may notice
- Often none at all in early disease — it is usually found on a PSA test
- Slow stream, hesitancy or incomplete emptying
- Getting up at night to pass urine
- Blood in the urine or semen
- Bone pain in advanced disease
Get seen promptly if
- A PSA that is rising steadily over successive tests
- A hard or irregular prostate on examination
- New bone pain with a known raised PSA
How it is assessed
- PSA, with density and velocity where relevant
- Digital rectal examination
- Multiparametric MRI of the prostate before biopsy
- MRI-fusion targeted biopsy
- PSMA PET or bone scan for staging in higher-risk disease
- Discussion at a multidisciplinary tumour board
What the options actually involve
Other conditions
Kidney cancer
Partial and radical nephrectomy, with nephron-sparing surgery wherever the tumour allows it.
Symptoms and treatmentBladder cancer
TURBT, intravesical therapy and radical cystectomy with urinary diversion, staged properly from the outset.
Symptoms and treatmentProstate enlargement (BPH)
Medical therapy through to laser enucleation and TURP, chosen against your symptom burden rather than prostate size alone.
Symptoms and treatmentHave a scan or report about this already?
Send it before your appointment. The consultation then starts from your findings rather than from scratch.