Richard's prostate cancer story 

After a routine health assessment with health insurance provider Bupa, Richard was shocked to discover that he had stage IIIA prostate cancer.

Following this diagnosis, Richard sought care from specialists at The Princess Grace Hospital, part of HCA Healthcare UK, where he underwent robotic-assisted prostate surgery. Here Richard shares his story.

The assessment involved a rectal examination and a blood test to check Richard’s PSA (prostate specific antigen) levels. The tests revealed that his prostate was enlarged, and his PSA levels raised, a key sign of prostate cancer. Having never experienced any symptoms linked to prostate cancer, naturally the results came as a huge shock.

Richard was swiftly referred to Mr Marc Laniado, Consultant Urological Surgeon at The Princess Grace Hospital and The Wellington Hospital, both part of HCA Healthcare UK. Mr Laniado confirmed the results, and after an MRI scan and a transperineal targeted biopsy, it was revealed that Richard had Stage T3a prostate cancer, a high grade, advanced cancer which is likely to grow and spread. A PSMA PET scan was then arranged, which thankfully showed that the cancer had not spread beyond the prostate.

Commenting on his diagnosis, Richard added: “I was shocked to discover that I had stage 3a prostate cancer and was extremely lucky that it did not spread further. When they confirmed I had cancer, it felt as though the room just closed in on me.”

Faced with a difficult treatment decision

Richard was presented with two options for treatment, radiotherapy or surgical removal of the prostate. He was aware that prostate surgery carries the risk of significant side effects, such as erectile dysfunction due to nerve damage and sometimes loss of urinary control, and potentially the need to wear pads. On balance, he wanted the security of knowing that the prostate was out.

After extensive research, he opted to have robotic surgery at The Princess Grace Hospital, part of HCA Healthcare UK. On 31st October 2020, less than 12 weeks after his initial health assessment, Richard underwent minimally invasive robot-assisted prostate removal surgery with Consultant Urological Surgeon, Mr Laniado using the new da Vinci© Xi surgical robot, a computerised system controlled entirely by Mr Laniado from a nearby console. 

The new Xi robot was used for Richard’s surgery as it is more dexterous than earlier robots and uses even smaller incisions than before. It makes it easier for surgeons to consistently complete complex surgical steps to a high standard – thus helping to get rid of cancer yet keep erections and bladder control. 

However, Richard’s case was not without its challenges. As the cancer was located along the side of his prostate, in the area where the nerves that control erection run, Mr Laniado used a relatively new technique, the Retzius-sparing prostatectomy, to better preserve the nerves necessary for erections. A major advantage of Retzius-sparing is that it lowers the chances of having urinary incontinence problems after the surgery, compared to other techniques.

To reduce the risk of cancer being left behind and the need for radiotherapy after surgery, which would render Richard impotent, Mr Laniado also used the NeuroSAFE technique. This enabled him to carry out a pathological examination to check for exposed cancer and confirm in the operating theatre if the cancer had been successfully removed.

Recovery and follow-up

The surgery, which took less than two hours, was a success. Richard had his prostate with its surrounding lymph nodes removed and was back in his own home within two days. He is now dry (meaning he has no issues with urinary incontinence), and was therefore able to get back to work and on his bike within a few weeks. As he had high risk cancer, he will have to undergo a PSA check every three months for the year following his operation and less frequently after.

Following his experience, Richard is urging others to go for a prostate screening. He said: “I would advise anyone in a similar position to ensure they do not put off their routine PSA tests simply because they don’t have time or there is too much going on in the world. Even if you don’t have symptoms, the tests take just ten minutes a couple of times a year. For me, a small silver lining resulting from the COVID-19 pandemic was finally finding the time to make the test a priority. I dread to think what could have happened if I had left it any longer.”

His surgeon, Mr Laniado, Consultant Urologist at The Princess Grace Hospital and The Wellington Hospital said: “Richard is very lucky. Tumours are graded from one to five. His was grade five, which is the fastest growing, but his PSA levels were just above what would have been expected. If he hadn’t caught the cancer when he did, it would almost certainly have spread and been much more difficult to treat. His prostate has now been removed, and as the cancer was confined to the specimen, he should now be cancer free.”

Learn more about prostate cancer and its treatment at our hospitals