Prostate Cancer

Diagnosis and Treatment

Prostate cancer may be detected through screening PSA (prostate specific antigen) blood tests done by your GP or occasionally due to urinary symptoms or bone pain.

At your appointment with Mr. Sewell, he will take a thorough history and will organise an MRI scan of your prostate to further assist with diagnosis.

Confirmation of a prostate cancer diagnosis involves a biopsy of the prostate, called a transperineal prostate biopsy. Transperineal prostate biopsy is a procedure used to obtain tissue samples from the prostate gland for further examination. It is a day procedure performed under anaesthetic. 

Here are the key points to know about transperineal prostate biopsy:

- Procedure: During a transperineal prostate biopsy, a biopsy needle is inserted through the perineum, which is the area between the scrotum and anus. Ultrasound imaging is used to guide the needle to the targeted areas of the prostate. Multiple samples are taken to ensure accurate diagnosis and staging of the cancer, and any lesions present on your MRI scan will be specifically sampled.

- Purpose: The main purpose of a transperineal prostate biopsy is to determine if cancer is present in the prostate gland and to gather information about the cancer's aggressiveness and stage. It helps in making treatment decisions and developing an appropriate management plan.

- Recovery: After the procedure, you may experience some discomfort, mild bleeding, or blood in the urine or semen. Occasionally the urine stream can be weaker for a few days, and some people notice a decrease in the strength of erections for a few days. These effects are usually temporary and resolve within a short time. 

For patients with confirmed prostate cancer, Mr. Sewell will have an in-depth discussion with you and any support person you would like to have present at the consultation. Mr. Sewell is committed to providing an individualised treatment plan that takes into account your preferences and the specifics of your health and your disease.

One curative treatment for localised prostate cancer which Mr. Sewell performs is robotic-assisted radical prostatectomy (RARP). RARP is a surgical procedure used to remove the entire prostate gland and surrounding tissues. It is a minimally invasive technique that offers enhanced precision and visualisation when compared with a traditional open or laparoscopic approach. 

Here are the key points to know about radical prostatectomy:

- Procedure: During a robotic-assisted radical prostatectomy, small incisions are made in the abdomen to insert robotic arms and a camera. The surgeon controls the robotic arms from a console, allowing for precise movements. The prostate gland is removed, which involves disconnecting the prostate from the bladder and the urethra, and removing a small segment of urethra. The bladder and urethra are then joined back together. The procedure is performed under general anaesthesia.

- Benefits: Robotic-assisted radical prostatectomy offers several benefits over open surgery, including smaller incisions, reduced blood loss, shorter hospital stay, faster recovery, and improved cosmetic outcomes. It may also result in less post-operative pain and a lower risk of certain complications.

- Recovery: After the procedure, you will spend 1-2 nights in hospital for monitoring and recovery. You may experience temporary urinary incontinence (inability to control urine) and erectile dysfunction (difficulty achieving or maintaining erections), but these issues usually improve over time with appropriate treatment and rehabilitation.