The current management of localized prostate cancer lies between active surveillance and radical treatment, and it’s known that 48 additional men have to be treated in order to prevent the death of 1 man with prostate cancer at 10 years. This means that most men treated with radical surgery or radiation therapy would have to survive for at least 10 years to benefit from radical treatment. (Cochrane Prostatic Diseases and Urologic Cancers Group 2009).

Radical surgery and radiation therapies carry significant side-effects (50% impotence, 10% incontinence, 5-20% bowel dysfunction) which impact significantly on quality of life.

Radical Prostatectomy histopathology reports on the removed prostate gland, indicate that up to 1/3 of men with Gleason 6 and 7 and PSA<10, have unilateral cancer, that is cancer on one side of the prostate.

Focal HIFU treatment involves a more conservative approach, treating only the side of prostate proven to have cancer. This is referred to as hemiablation or TFT/Targeted Focal Therapy.

A prospective trial using HIFU hemiablation at University College London has demonstrated feasibility, safety and encouraging functional outcomes (95% preservation of urinary/sexual function) and encouraging early cancer control (90% absence of any prostate cancer on protocol mandated biopsies). A further Multicentre Phase II Prospective Trial assessing Focal Therapy for Localised Prostate Cancer is underway in the UK.

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A/Prof Peter Royce has over 20 years experience with more than 1000 Radical Prostatectomy procedures, the surgery performed for removal of prostate cancer. His surgical outcomes have been independently audited by histopathology specialists and indicate a world’s best practice in terms of negative surgical margins for cancer. Negative surgical margins means the prostate cancer has been completely removed, this relates directly to cancer free survival for the patient.

In the last 100 Radical Prostatectomy patients the results were;

- For pathological stage T2 M0 prostate cancer, the negative surgical margin rate is 93%

- For pathological stage T3 M0 prostate cancer, the negative surgical margin rate is 78%

Patients have the right to enquire about their surgeon’s experience and negative surgical margin rate with Radical Prostatectomy.

A/Prof Royce has trained in Robotic Radical Prostatectomy, having completed a da Vinci Robotic Surgery course at Celebration Hospital, Florida, USA under the instruction of Dr Vip Patel, one of the leading robotic surgeons in the USA.

Robotic Radical Prostatectomy has been proven to reduce the hospital stay, blood loss, and time to return to normal activities of daily life, compared to open surgery.

A/Prof Royce is accredited for da Vinci Robotic Radical Prostatectomy at Cabrini Hospital, Melbourne.

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