020 3150 2282

Consultant Urological Surgeon · GMC 7030583

Am I a Candidate for Robotic Prostatectomy?

Who robotic prostatectomy is and is not for, and how to confirm whether it is right for you.

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Key takeaways

  • Robotic prostatectomy is an option for men with localised or locally advanced prostate cancer who are fit for surgery.
  • Suitability depends on the stage and risk of the cancer, your anatomy and any previous surgery, and your general fitness rather than your age alone.
  • It is usually not advised for cancer that has spread beyond the prostate, or for very low-risk cancer that is better watched with active surveillance.
  • A consultation is the way to confirm whether it is right for you.

Who it is, and isn’t, for

Robotic surgery is mainly for men whose cancer is localised or locally advanced, without evidence of having spread to distant parts of the body.

It is generally not the right option in two situations. The first is when the cancer has already spread to the lymph nodes or beyond (stage N1 or M1), which a scan such as a PSMA PET or bone scan can show; removing the prostate alone would not cure the disease, and treatment instead focuses on whole-body therapies. The second is very low-risk, slow-growing cancer, for example Gleason 3+3 (also called ISUP Grade Group 1), where immediate surgery would add risk for little benefit and active surveillance is usually advised instead.

Your anatomy and surgical history matter too: extensive scarring or adhesions from previous major abdominal surgery can make the robotic approach difficult or unsafe, which is one reason open surgery is sometimes the safer choice.

A word before you decide

A cancer diagnosis can leave you feeling anxious or numb, and flooded with questions. Whether or not robotic surgery turns out to be right for you, you will leave the consultation understanding exactly where you stand. If it is the right path, we also go through what recovery involves and the fees and going private.

Mr Ashwin Sridhar
My job is to give you the clarity you deserve. I will always give you an honest, realistic assessment of your diagnosis and your options, explained in plain English, and you will never feel rushed.
Mr Ashwin Sridhar Consultant Urological Surgeon

Frequently asked questions

Am I too old for robotic prostatectomy? +
Age alone is no longer a barrier. Curative surgery is usually offered to men with a life expectancy of more than 10 to 15 years, because localised prostate cancer tends to progress slowly. Fit, healthy men of 75 or older can have outcomes and complication rates similar to younger patients. Rather than judging by age, Mr Sridhar uses formal assessments such as the G8 screening tool or the Clinical Frailty Scale to tell fit patients from more vulnerable ones.
What if I have had other treatment for prostate cancer? +
If you have already had a non-surgical treatment such as external beam radiotherapy, brachytherapy or a focal treatment (HIFU or cryotherapy) and the cancer comes back within the prostate, surgery may still be possible. This is called a salvage robotic radical prostatectomy. Radiation and focal treatments cause scarring and inflammation that make this operation more technically demanding than a first-time prostatectomy. To be suitable, the recurrence must be confined to the prostate, confirmed on a highly sensitive PSMA PET scan, and your life expectancy more than 10 years. Mr Sridhar will counsel you carefully, as salvage surgery carries a higher risk of long-term effects such as erectile difficulties.
Is robotic surgery suitable for high-risk or locally advanced cancer? +
Often, yes. Robotic prostatectomy is intended for cancer that is contained in or around the prostate, including locally advanced disease, as long as there is no evidence it has spread to distant parts of the body. Mr Sridhar uses your scans and biopsy to judge whether surgery is the right option for your case, and will tell you honestly if another treatment would serve you better.

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Continue exploring

Fees & insuranceConsultation and surgery costs, and cover.Robotic vs openComparing the two surgical approaches.Recovery & aftercareWhat to expect, week by week.Risks & side effectsIncluding nerve-sparing techniques.Common questionsAnswers to what patients ask most.Harley Street146 Harley Street, W1G.
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