Prostate Cancer Treatment Melbourne
Comprehensive prostate cancer care using the latest evidence-based approaches. Dr Brendan Dias specialises in advanced robotic surgical techniques including Retzius-sparing and nerve-sparing prostatectomy, offering patients the best chance for cancer cure while preserving quality of life.
Understanding Your Treatment Options
A prostate cancer diagnosis can feel overwhelming, but with proper guidance, you can make an informed decision about your treatment. The right approach depends on your cancer's characteristics—including stage, grade (Gleason score), and PSA level—as well as your age, overall health, and personal preferences.
Active Surveillance
For low-risk, slow-growing cancers. Regular monitoring with PSA tests and biopsies allows treatment to begin if the cancer shows signs of progression, avoiding unnecessary side effects.
Learn about prostate biopsy →Robotic Surgery
Gold standard for localised prostate cancer offering cancer cure with minimal invasiveness. Advanced techniques preserve continence and sexual function.
Learn about robotic prostatectomy →Radiation Therapy
An effective alternative to surgery using high-energy beams to destroy cancer cells. Options include external beam radiotherapy (EBRT) and brachytherapy (internal radiation). Often combined with hormone therapy for better outcomes.
Hormone Therapy
Also called androgen deprivation therapy (ADT). Used for advanced cancer or in combination with other treatments. Works by reducing testosterone levels that fuel cancer growth.
Advanced Robotic Surgical Techniques
Dr Dias employs the latest robotic surgical techniques to maximise cancer control while preserving urinary continence and sexual function. These approaches represent the cutting edge of prostate cancer surgery.
Retzius-Sparing Robotic Prostatectomy
The Retzius-sparing approach is a revolutionary technique where the prostate is accessed and removed from a posterior (behind) approach rather than the traditional anterior route. This preserves the Retzius space—the area between the pubic bone and bladder—along with all its supporting structures.
Key Benefits:
- Faster continence recovery: Many patients regain urinary control within days to weeks rather than months
- Preserved puboprostatic ligaments: These structures support the urethra and are critical for continence
- Intact Santorini plexus: Less bleeding and better visualisation during surgery
- Equivalent cancer control: Studies show no compromise in oncological outcomes
Ideal for patients prioritising rapid return of urinary continence, particularly those with lower-risk cancers where anterior structures can be safely preserved.
Nerve-Sparing Robotic Prostatectomy
The neurovascular bundles that control erectile function run alongside the prostate. In nerve-sparing surgery, Dr Dias carefully dissects these delicate structures away from the prostate, preserving them while ensuring complete cancer removal.
Approaches:
- Bilateral nerve-sparing: Preserves nerves on both sides when cancer location permits—best outcomes for erectile function recovery
- Unilateral nerve-sparing: Preserves nerves on one side when cancer is close to or involving the nerve bundle on the other side
- Non-nerve-sparing: Both bundles removed when cancer control requires it—erectile aids can still help achieve erections
The decision on nerve-sparing is made based on your cancer's location, pre-operative MRI findings, and intraoperative assessment. Cancer control always remains the priority.
Detrussor Apron Sparing Technique
The detrussor apron refers to the muscle fibres of the bladder (detrussor muscle) that extend down and wrap around the bladder neck and proximal urethra. Preserving these fibres during prostatectomy helps maintain the natural muscular support for urinary control.
Combined with Retzius-Sparing:
When the detrussor apron sparing technique is combined with the Retzius-sparing approach, the result is maximal preservation of all anatomical structures that contribute to continence. This comprehensive preservation approach represents Dr Dias's commitment to functional outcomes.
- Preserves bladder neck anatomy and function
- Maintains muscular support of the proximal urethra
- Works synergistically with other continence-preserving techniques
Dr Dias's Personalised Approach
Every patient's cancer is unique, and so should be their treatment. Dr Dias combines these advanced techniques based on your individual situation:
- Thorough pre-operative assessment including MRI review and biopsy results
- Honest discussion about what techniques can be safely used given your cancer
- Da Vinci robotic system with 10x magnification and 3D HD visualisation
- Comprehensive post-operative care including pelvic floor rehabilitation guidance
What to Expect: Recovery & Follow-Up
Immediate Recovery
- Hospital stay: 1-2 nights
- Catheter removal: 7-10 days post-surgery
- Return to light activities: 1-2 weeks
- Full recovery: 4-6 weeks
Long-Term Follow-Up
- First PSA test: 6-8 weeks post-surgery
- Regular PSA monitoring: 3-6 monthly for first 2 years
- Continence recovery: Progressive over 3-12 months
- Erectile function: Continues improving up to 24 months
Rehabilitation Support
Dr Dias provides comprehensive guidance on pelvic floor exercises (Kegel exercises) and can refer you to specialised pelvic floor physiotherapists. For erectile function recovery, various options are available including oral medications, vacuum devices, and penile rehabilitation programs.
Frequently Asked Questions
Related Procedures
Robotic Prostatectomy
Detailed information about the da Vinci robotic surgical procedure.
Prostate Biopsy
MRI-guided biopsy for accurate prostate cancer diagnosis.
Artificial Urinary Sphincter
Gold-standard treatment for post-prostatectomy incontinence.
Male Sling
Effective treatment for mild to moderate post-surgical incontinence.
Robotic Cystectomy
Advanced robotic surgery for bladder cancer treatment.
HoLEP
Laser treatment for benign prostate enlargement (BPH).