Searching for the best possible outcomes, every patient I have treated since 1989 has been monitored. Tissue and more recent blood samples have been kept on everybody. We follow up each patient through my research team to see how he is travelling in his journey to recovery and beyond. My major research initiative currently is to look at optimising quality of life in patients after each one of their treatments, correctly selecting the right treatment to tailor treatment, bringing in new treatments which are less invasive with less side effects selectively, improving diagnostic tools using multiparametric MRI and improved targeting of cancers with precision biopsy. A summary of the projects that I am looking at carefully at the moment are given below.

Not only focusing on my patients, I believe that collaboration is needed in the global fight against prostate cancer. Working with a range of individuals and organisations, I drive a research fellowship program to ensure that we continue to learn about prostate cancer and improve diagnosis, treatment and prevention. Recently, I was appointed the Clinical Director of the Australian Prostate Cancer Research Centre – New South Wales by the Federal Government of Australia and this allows me to coordinate prostate cancer research across the St Vincent's Campus, Garvan Institute,Kinghorn Cancer Centre , Royal Prince Alfred and Royal North Shore and in collaboration with our Melbourne, Queensland, Adelaide and South Australian colleagues. In addition, I work with the Memorial Sloan-Kettering Centre in New York, Cornell University and the Robotic Institute in Florida as well as Beth Israel in New York and the University College Hospital in England.

Working with the Garvan Institute of Medical Research, I have assisted in the establishment of a massive prostate tissue bank and database. This is the largest in the southern hemisphere. Funded through a $2 million NH&MRC enabling grant, the Australian Prostate Cancer Collaboration via resources is assisting in research into the diagnosis, treatment and prevention of prostate cancer as it makes fresh tissue and more so the clinical data essential for research.

Currently, I work with Memorial Sloan Kettering Cancer Centre, New York, Cornell University and the Robotic Institute in Florida.

Working with the Garvan Institute of Medical Research, I have assisted in the establishment of a massive national prostate tissue bank. Funded through a $2 million National Health and Medical Research Enabling Grant, the Australian Prostate Cancer Collaboration Bio-Resource is assisting in research into the diagnosis, treatment and prevention of prostate cancer, as it makes available fresh tissue, and more so the clinical data essential for research.

Current 16 Key Research ProjectsResearch

Throughout your journey and beyond, you are not alone. Here are some of my patients who want to share their experiences.

Following a blood test, radio broadcaster Alan Jones was diagnosed with prostate cancer. Alan learnt of available treatments and underwent a robotic prostatectomy – a form of surgery appropriate for his diagnosis.

Steve Callister underwent an open radical prostatectomy. Steve speaks of his confidence in choice of treatment, as it took the prostate away and the concerns he faced. Since his diagnosis, in December 2004, and treatment Steve has become an advocate for support groups and values the education provided throughout his treatment.

Diagnosed with prostate cancer in 2007, RADM Chris Oxenbould AO RAN initially engaged in the active surveillance program, within 12 months a further tumour was found. It was clear something had to be done.

Max Lyon describes how seed brachytherapy reduced his PSA.

Following an annual medical check up Max Gosling, Chairman Cure Cancer Australia Foundation, was diagnosed with prostate cancer. With his levels of PSA trending upwards Max viewed the results as an alert and a sign for further investigation.

Undergoing high dose rate brachytherapy and external beam radiotherapy, Dr Robert Cummings was confident of eliminating the cancer and preventing re-occurrence.


I continue to perform open radical prostatectomy in several situations. Firstly, where robotic prostatectomy is difficult to perform, such as a patient who has extensive adhesions. Robotic is also not the best option where the cancer is extremely extensive and tactile sensation is beneficial. Having performed over 3,500 open radical prostatectomies I have noticed that, to date, patients are more comfortable with the open approach.

I also currently perform many cases referred from other urologists with specifically difficult aspects of the case such as with failed radiotherapy or very advanced cancers.

It is important to me to present patient reported outcomes for my open radical prostatectomy series. I have done this frequently at national and international meetings, and these are often published.

My current results in open radical prostatectomy are:

  • Early stage cancer: Clearance 96%.
  • Overall cancer: Clearance 86%.
  • Cancer reoccurrence
  • T2 positive margin rate, 4%.


  • Average blood loss, 350 mL - 1-2% transfusion rate.
  • Operating time: One and one half to two and a half hours.
  • Complications - major: 1%.
  • Complications - minor: 8%


Leave hospital: Greater than 90% of patients leave within four days.

  • Catheter removal: 97% of patients have the catheter removed on day seven.
  • Readmission rate: 1%
  • Urethral stricture rate: 2%
  • Return to normal activities: 2 to 6 weeks.

Sexual function

Three factors have a strong influence on the recovery of erectile functioning following open radical prostatectomy; the age of the patient, the preoperative status of the sexual function and the surgical technique.

Erection recovery
Age Recovery Time
40 - 50 92% 12 - 18 months
50 - 60 80 - 85% 12 - 18 months
60 - 70 70% 12 - 18 months

In this review, the potency was defined as the ability to have intercourse on most occasions with or without the use of Viagra-like substances.

I have focussed on developing expertise in performing incremental nerve-sparing even in the presence of more advanced cancers. (British Journal of Urology International 2011, Ben Moore).

Urinary continence

Incontinence after surgery is a major concern shared by many patients. In Associate Professor Stricker's hands with his open series, 98-99% gain near perfect continence after open radical prostatectomy. Some patients due to unusual anatomy or physiology may never fully regain continence. The vast majority of patients regain their continence within three months and almost 80% have recovered within six weeks.

Current early continence outcomes for open radical prostatectomy
Time 0-1 precautionary pads
6 weeks 75%
3 months 90%
6 months 95%
12 months 98%

As a doctor I need to have objective and validated data on my results. Without it I could not really qualify any success I have or improve my ability to choose the most effective treatment for a particular patient. By the careful collection and analyses of treatment outcomes I have been able to do this.

I am entirely transparent about my results because I see it as an obligation I have to my patients. It helps demystify both the relationship I have with my patients and treatment choice. Do take a moment to check the graphs below.

Surgery, potency and continence.

I have developed my own technique which is now internationally acclaimed for preserving continence and potency. The evidence comes from an ongoing study where all of my patients receive questionnaires to assess their health related quality of life (HRQOL) in addition to their cancer outcomes. This study is done in conjunction with the Garvan Institute of Medical Research, and is amongst the largest follow-up studies in the world today.

Recently one of our fellows, Dr Sam Chopra, presented the findings in a poster format at the Annual Scientific Meeting of the Urological Association of America. The remakable thing about the results, other than the fact they were exceptionally good, was that they were strictly evidence-based and rigorously compared the short, medium and long term effects of all the therapies we offer ( by the way, Sam's presentation was awarded first prize. Read the news story).

Absolute continence
Sexual potency
Sexual function

Recently we reviewed a group of patients that I had treated between 1998 and 2000. We followed the patients up for a minimum of 10 years and compared it to a similar surgical series. Results were outstanding and in truth out-performed my surgical results in the very high-risk population by about 20% ( these results will shortly be the subject of a publication). It is worth noting, however, that surgery with follow up radiotherapy is challenging these results (see graph below).

Results of HDR

Generally, the cure-rate for high-dose rate brachytherapy in combination with external beam radiotherapy depends on how many high-risk factors ( Gleeson score 8-10 , PSA >20 , Clinical stage T3 )are involved. If there is:

  • One risk factor - 90% 10-year cure rate
  • Two risk factors - 70% Cure rate
  • Three risk factors - 60% Cure rate
  • Impotence - 50%
  • Incontinence - 1%
  • Rectal damage - <1%
  • Urethral stricture rate- 5%

Once again, high-dose brachytherapy is generally reserved for those patients with extremely extensive prostate cancer where surgical cure is difficult, particularly in more middle-aged and older patients, where urinary symptoms are not dominant and where there is a dominance of apical disease or where I am concerned that the cancer is not resectable.


Robotic results

In my hands there is a 96.5% clearance rate in the eradication of early stage prostate cancers and 86% clearance rate in overall cancers.


Incontinence after surgery is a major concern shared by many patients. In my hands, 99% of patients gain near perfect continence after robot radical prostatectomy. Some patients due to unusual anatomy or physiology may not recover full continence. However, the vast majority recover continence within three months and almost 80% within six weeks.

My technique, which was recently presented internationally, has resulted in:

Current early continence outcomes
Time 0-1 precautionary pads 0 pads
6 weeks 78% 33%
3 months 95% 72%
6 months 98% 92%
12 months 99% 94%

Sexual recovery

The nerves responsible for proper erectile functioning are small fragile fibres attached to the back of the prostate requiring experience and special skills to protect them from damage – this has been a passion of mine for over 20 years.

Three factors have a strong influence on the recovery of sexual function following radical prostatectomy:

  • The age of the patient
  • The pre-operative status of sexual function.
  • The surgical technique.

One of the potential advantages of robotic surgery in the hands of an experienced surgeon over conventional open surgery is the preservation of these delicate nerves and the ability to regain early sexual function.

The ability to preserve nerves is dependent upon the cancer and on the surgeon's experience and assessment during surgery. Over the years I have developed a special technique to maximize potency.

Clearly potency recovery is variable in each patient but over 90% of my patients with normal function have full bilateral nerve preservation, particularly in the younger age group, thus regaining sexual function.

A patient outcome study has evaluated the status of my patients post radical prostatectomy. With follow up between 12 and 24 months, 73% of patients were potent following nerve sparing surgery, while in the under 60 year old age group 84% of patients were potent.

Potency was defined as the ability to have intercourse on most attempts with or without the use of Viagra like substances.

Erection recovery
Age Recovery Time
40 - 50 92% 12 - 18 months
50 - 60 85% 12 - 18 months
60 - 70 72% 12 - 18 months

Seeds continue to be utilised in his practice with outstanding results in the appropriately chosen patients. Generally, these patients are people with a low-risk prostate cancer, with minimal urinary symptoms, in middle-age, particularly those wanting a less invasive form of therapy and a very rapid recovery.

Recently he did a review of his cases where there was at least a two-year follow-up and up to 14 year follow up.. In looking at over 500 of his cases the results were as follows:

  • Cancer-specific survival 100%.
  • Local recurrence 3%.
  • Urinary incontinence (mild) 1%.
  • Erectile dysfunction 30%.

Ideal patients - Gleason 3 + 3 or Gleason 3 + 4 cancer with 50% of the biopsies cores tended to fare less well. Furthermore, patients with PSAs of >15 or patients with Gleason >3 + 4, also did not do as well with seed therapy alone (see Table 1).

SEEDS results

Seed therapy therefore remains an excellent option for middle-aged patients with low-risk or intermediate-risk low-volume disease in patients wishing a less invasive treatment option and a rapid recovery.


Key aspects

From diagnosis and treatment to rehabilitation and research, I believe my highly experienced team and I bring a multifaceted approach to understanding and helping our patients. A summary of these key aspects of that approach is available here in PDF format. If you are suffering from prostate cancer or have reason to believe you might be, you are welcome to contact us or, intially, complete our comprehensive second opinion form.