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Understanding Prostate Cancer
What is it?
Prostate cancer develops in the prostate — a small walnut-shaped gland located below the bladder in males. It is one of the most common forms of cancer in men. Why exactly cells grow abnormally is not yet fully known.
Who is at Risk?
- Increasing age (especially over 50)
- Family history of prostate cancer
- Being overweight or physically inactive
- Unhealthy diet (high in fats)
Symptoms You May Notice
- Weak or slow urine flow
- Frequent urination, especially at night
- Blood in urine or semen
Warning Signs
- Rapid increase in PSA (prostate marker) levels in the blood
- Difficulty in passing urine
- Bone pain (advanced stage)
How is it Diagnosed?
- Physical rectal exam — your doctor physically checks your prostate
- Blood tests — looks for specific PSA levels
- MRI — takes images of the prostate gland
- Biopsy — tissue sample studied under a microscope
Treatment Options for Prostate Cancer
- Regular check-ups to see if the cancer is growing (active surveillance)
- Radiation therapy
- Hormone-related medicines to stop cancer growth
- Medicines including immunotherapy
- Radical prostatectomy (complete removal of the prostate gland) — performed as open surgery or robotic radical prostatectomy
Overview of the Procedure
Radical prostatectomy is an important treatment for prostate cancer because it can completely remove the cancer when detected early. The entire prostate gland is removed. In some cases, nearby lymph nodes are also removed to check if the cancer has spread.
Clinical Need for Radical Prostatectomy
- Remove the cancer completely
- Help determine how advanced the cancer is
- Offer high chances of cure when found early
- Reduce the risk of the cancer spreading
- Allow faster recovery with robotic-assisted surgery
Who Needs It?
- Men over 50 years of age
- Men diagnosed with early-stage prostate cancer
- Certain patients where the cancer has grown slightly beyond the prostate
Procedure Details
Before Surgery
- Blood tests and scans are done
- Biopsy results are reviewed
- Patient's fitness level is assessed
- Instructions for fasting are provided
During Surgery
- Small cuts are made to insert robotic tools
- The surgeon controls the robot from a console
- The prostate is removed and the urinary passage is rejoined
- A temporary urine tube (catheter) is placed
Open vs Laparoscopic vs Robotic
| Feature | Open | Laparoscopic (Keyhole) | Robotic (Robot-Assisted) |
|---|---|---|---|
| Cut | Large | Small | Very small |
| Blood Loss | Higher | Moderate | Lowest |
| Healing | Slow | Faster | Fastest |
| Accuracy | Moderate | Good | Highest |
Robotic Surgery is Associated With
- Less blood loss
- Shorter hospital stay
- Better urine control recovery
- Better recovery of sexual function
- Smallest incisions — minimal scarring
Risks and Complications
Common (Temporary)
- Urine leakage
- Difficulty in getting erections
- Mild bleeding or infection
Rare
- Blood clots
- Injury to nearby organs
Recovery Depends On
- Age and cancer stage
- Other existing health conditions
- Surgeon's experience and technique
Benefits and Outcomes
Cancer Control
Better cancer control with complete removal
Cure Rate
>90% cure in early-stage prostate cancer
Blood Loss
Less blood loss with robotic approach
Recovery
Faster return to normal daily activities
Quality of Life
- Less worry about cancer recurrence
- Gradual improvement in urine control
- Better return to normal daily activities
Hospital Stay & Aftercare
Monitoring During Hospital Stay
- Urine output, pain, and vital signs monitored
- Early walking encouraged to improve recovery
Follow-Up
- PSA blood test at 6 weeks after surgery
- Regular PSA monitoring thereafter
Care at Home
- Keep wound clean
- Do pelvic / bladder control (Kegel) exercises
- Avoid heavy lifting
Lifestyle and Prevention
- Balanced diet and adequate hydration
- Regular walking
- Follow-up PSA tests as directed
When to Contact a Doctor
- Fever
- Heavy bleeding
- Severe pain
- Difficulty passing urine
Myths vs Facts
The robot performs the radical prostatectomy surgery alone.
The surgeon controls every step of the procedure. The robotic system is a precision instrument operated entirely by the surgeon.
Radical prostatectomy leads to permanent sexual problems.
Sexual function improves over time post-surgery in many patients.
Robotic procedures lengthen the recovery time.
Recovery is often fastest with robotic prostatectomy — many patients return to normal activities within weeks.
Frequently Asked Questions
Will this surgery cure my prostate cancer?
If found early, surgery can cure prostate cancer in many cases. Your doctor will also keep checking your PSA (prostate blood test) after surgery.
How long will I take to recover?
Most patients recover within 2–6 weeks, although this can vary depending on overall health and healing.
Will I need a catheter after surgery?
A temporary urine tube (catheter) is placed after surgery and is usually removed in 7–10 days.
Will I have urine leakage or sexual problems?
Some patients may experience temporary urine leakage or changes in sexual function, but these often improve over time with recovery and proper care.
When should I contact my doctor after surgery?
Contact your doctor if you have fever, heavy bleeding, severe pain, or difficulty passing urine.
References
- 1. Eastham JA, et al. Clinically localized prostate cancer: AUA/ASTRO guideline. J Urol. 2022;208(1):10–18.
- 2. Cleveland Clinic. Prostate cancer. https://my.clevelandclinic.org/health/diseases/8634-prostate-cancer
- 3. Mottet N, et al. EAU Guidelines on Prostate Cancer. Eur Urol. 2024.
- 4. Rawla P. Epidemiology of prostate cancer. World J Oncol. 2019;10(2):63–89.
- 5. Huynh LM, Ahlering TE. Robot-assisted radical prostatectomy outcomes. J Endourol. 2018;32(S1):S28–S32.
- 6. Ilic D, et al. Laparoscopic and robotic-assisted vs open radical prostatectomy. Cochrane Database Syst Rev. 2017;9:CD009625.
- 7. Mottrie A, et al. Robot-assisted versus open radical prostatectomy. Eur Urol. 2023;84(6):625–637.
- 8. Smith AB, et al. Long-term prostate cancer-specific mortality following robotic versus open radical prostatectomy. J Clin Oncol. 2025;43(5):412–420.
- 9. Patel VR, et al. Comparative outcomes of robotic, laparoscopic, and open radical prostatectomy. Urology. 2025;185:45–52.
- 10. Yaxley JW, et al. Robot-assisted laparoscopic prostatectomy versus open radical prostatectomy: a randomized controlled trial. Lancet. 2024;403(10430):1135–1145.