Localised Prostate Cancer

Localised prostate prostate cancer refers to prostate cancer that has spread to areas outside the prostate gland, but remains in the prostate region, that is in the prostate gland and the seminal vesicles.

As with all treatments choosing a treatment for localised prostate cancer, or cancer that is described as T1 or T2, depends on the individual's circumstances – such as his age, stage and grade of cancer. In general patients have the choice of surgery, a radical prostatectomy, radiotherapy or watchful waiting.

Click here for the video, 'What are the treatment options?'.

A radical prostatectomy can be done in a number of different ways including open surgery and robotic surgery and is the removal of the prostate and the seminal vesicle. The aim is to remove the cancer and not damage the adjacent tissue whilst achieving the trifecta – cure, continence and potency as well as minimal complications.

Click here for the video, 'Radical prostatectomy routes and techniques'.

Today with a lot of experience and a lot of skill it is possible to preserve both neurovascular bundles, the nerve supply to the penis, in most men depending on the extent of the cancer.

The aim of the surgery is to cure the cancer and reduce the risk of incontinency and impotence. Having performed over 4,000 open surgery cases to date, the most in the Southern Hemisphere, I have been able to refine this technique to ensure exceptional outcomes in terms of cure, continency and minimal complications. 

Robot assisted laparoscopic prostatectomy is performed in less than two hours, there is minimal blood loss and the procedure is done through tiny incisions leading to a quicker recovery. Many  patients are up and walking the same day and  home within two days.

Radiotherapy is an important management option for patients with localised prostate cancer. Radiotherapy uses targeted x-rays to destroy cancer cells with radiation and can cure cancer in many sites of the body.

Low dose rate brachytherapy, commonly known as SEEDS, involves the implantation of radioactive pellets or seeds into the prostate. Depending on the size of the prostate between 75 and 100 seeds are used.

High dose rate (HDR) brachytherapy involves the placement of wires into the prostate to deliver high doses of radiation directly into the prostate. Three treatments are given over a 36-hour period and are intended for patients with advanced prostate cancer.

Active surveillance involves the careful monitoring of prostate cancer progression in patients with less aggressive tumours. An increasing proportion of patients with Gleason 6 cancers, particularly in the older age group, are having their tumours monitored.

Focal therapy for selective patients with prostate cancer is an emerging new treatment for a select group of patients for the treatment of localised prostate cancer.

About Phillip

Phillip is the Chairman of the Department of Urology, St Vincent's Private Hospital and Clinic since 2003, and a Director of the St Vincent's Prostate Cancer Centre.

The Australian Prostate Cancer Research Centre in New South Wales recently appointed him as clinical director. He is also a member of the National Prostate Cancer Research Centre

Philip is currently the highest volume robotic surgeon in Australasia

He is perhaps best known for his work developing nerve sparing techniques to help patients maximise potency