Prostate Cancer

Prostate cancer is one of the most common cancers in men, occurring when abnormal cells develop in the prostate, a small gland responsible for producing seminal fluid. The risk of developing prostate cancer increases with age, and factors such as family history, genetics, and lifestyle may play a role. While some prostate cancers grow slowly and may not cause significant harm, others can be more aggressive and require prompt treatment.

Early-stage prostate cancer often has no symptoms, making screening essential for early detection. When symptoms do occur, they may include difficulty urinating, weak urine flow, blood in the urine or semen, and persistent discomfort in the pelvic area. Assessment typically involves a prostate-specific antigen (PSA) blood test and a digital rectal examination (DRE). If there are concerns on those tests, then an MRI scan and, if necessary, a prostate biopsy may be performed. Advanced imaging techniques, including multiparametric MRI and PSMA PET scans, can help improve diagnostic accuracy and assess the extent of the disease.

Treatment Options for Prostate Cancer

Treatment options depend on factors such as cancer stage, aggressiveness, and the patient’s overall health. For localized prostate cancer, options include active surveillance, radiation therapy, and surgery. When surgery is necessary, robotic-assisted radical prostatectomy is the most advanced and precise approach available.

Robotic-Assisted Radical Prostatectomy

Robotic-assisted radical prostatectomy (RARP) is the most commonly offered surgical option for prostate cancer worldwide, offering superior precision, faster recovery, shorter catheter times, and less post-operative pain compared to traditional open surgery. At Kingsbury Hospital, Dr Dewar operates using the Da Vinci robotic system, which enhances the surgeon’s ability to perform delicate procedures with unparalleled accuracy. (See “Robotic Surgery” page).

Post-Operative Care & Considerations

After a robotic-assisted radical prostatectomy (RARP), most patients experience a short hospital stay, typically one night, with minimal pain managed by oral medication. A urinary catheter is placed for about one week to aid healing. Initially, mild urinary leakage is common but improves over weeks to months with pelvic floor exercises. Erectile function recovery varies, depending on nerve preservation and individual factors. Most patients resume light activities, including driving, within one to two weeks and full recovery, including exercise and work, within four to six weeks. By three months, many regain good urinary control and see gradual improvement in sexual function.

For patients diagnosed with localized prostate cancer, robotic-assisted prostatectomy provides a good balance between cancer control and quality of life. By combining cutting-edge technology with expert surgical skill, we strive to achieve the best possible outcomes for our patients.

 Open Radical Prostatectomy

Some patients are unable to have robotic prostatectomy for various reasons, but most often because of funding constraints. Dr Dewar has had exceptional training at performing open radical prostatectomy, being involved in more than 120 such cases during his fellowship. As a result, he has received many referrals for this procedure. He usually performs this surgery via “bikini” or Pfannenstiel cut. The long-term cancer-control, the continence rates, and the erectile function rates are similar to robotic surgery, albeit with the drawbacks mentioned above.

Post-Operative Care & Considerations

Patient Resources

Dr Dewar was trained by four different robotic surgeons during his two-year fellowship in Canada. He has attended numerous international conferences, visited other local and international centres, and attended live surgery workshops. This broad exposure has allowed him to incorporate many small refinements into his surgical technique.