Prostate cancer: robotic surgery, brachytherapy or protons

Localised prostate cancer poses a delicate balance: eradicating the tumour without destroying quality of life. Urinary continence and sexual function depend on millimetric nerve structures around the gland, and team experience matters more there than technology alone.

Robotic radical prostatectomy allows very precise nerve dissection and markedly reduces incontinence and impotence rates compared with traditional open surgery, while shortening hospital stay. It is preferred when the goal is removing the gland and obtaining complete pathology.

Radiotherapy alternatives avoid the operating room. Brachytherapy implants radioactive seeds inside the prostate, and proton beam therapy delivers lethal doses with a very sharp dose fall-off that protects rectum and bladder. Cure rates exceed 95% in organ-confined disease; side effects differ: surgery concentrates risk in the first weeks, radiotherapy in late rectal or urinary irritation.

Germany is a historic pioneer in deploying cyclotrons for proton therapy. South Korea has refined ultra-precise robotic surgery and Turkey handles massive volumes of robot-assisted urology with JCI accreditation. The range is EUR 12,000 to 25,000, with ten to fifteen day stays.

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