Hi doctor, My father is 58 years old. He suffers from frequent urination and urgency to urinate. An ultrasound, blood tests, biopsy, and a bone scan was conducted. Bone scan did not show any metastasis. He was advised to take a pelvis MRI 15-20 days after the biopsy. He was diagnosed with prostate cancer. Initial PSA was 45.4. It was suggested that a radical prostatectomy should be performed. I am in need of a second opinion now. I would also like to know the difference between open surgery and robot-assisted surgery.
Hi. From the reports submitted (attachment removed to protect patient identity), it is clear that your father has prostate cancer. From MRI, we can know the exact size of the tumor. It will also help in staging and we can get to know is there any spread to the nearby lymph nodes. As the bone scan is normal, there are no distant metastases. Plan of treatment is usually drawn after MRI, but it is most likely that your father has a localized, moderate grade prostate cancer (based on ultrasound report). The best option would be surgery that is the removal of the prostate and pelvic lymph nodes which can be done by open or robotic methods. The robotic method has the advantage that it gives better access for the surgeon with magnification and so the chance of complication is less, but it also depends on the surgeon. If the surgeon is experienced and well trained in a robotic way, then it is better to go with it or else open method of surgery can also be done. By chance, if the MRI reveals extension of cancer beyond prostate, surgery may not be possible, and radiotherapy would be preferred.