When a man is diagnosed with prostate cancer, one of the first questions is often: “Do I need surgery?” Soon after, more practical concerns follow. How large will the wound be? How long will recovery take? Will urinary control be affected? What about sexual function? For international patients considering treatment in Taiwan, these questions may strongly influence whether they seek a second opinion abroad.

Prostate cancer treatment is not the same for every patient. Depending on cancer stage, PSA level, Gleason score, imaging findings, age, general health, and personal expectations, treatment options may include active surveillance, surgery, radiation therapy, hormone therapy, or combined treatment. For selected patients with localized or locally advanced prostate cancer, radical prostatectomy may be one treatment option. However, the best approach should always be determined through specialist evaluation.

Does Prostate Cancer Always Require Surgery?

Not always. Some low-risk and slow-growing prostate cancers may be managed with active surveillance. This means regular monitoring with PSA tests, imaging studies, and repeat assessments when needed. If the cancer shows signs of progression, active treatment may then be considered.

For intermediate-risk or high-risk prostate cancer, more active treatment may be recommended. This may include surgery, radiation therapy, hormone therapy, or a combination of treatments.

Therefore, the key question is not simply “Should I have surgery?” but rather:

“Which treatment option best balances cancer control, urinary function, sexual function, recovery, and long-term quality of life?“

Traditional, Laparoscopic, and Robotic Prostate Surgery: What Is the Difference?

Traditional open prostate surgery usually requires a larger lower abdominal incision. It allows the surgeon to remove the prostate under direct vision. This approach has a long clinical history and remains important in certain situations, but the wound is larger and recovery may take longer.

Laparoscopic surgery uses several small incisions to access the pelvic area. Compared with open surgery, it may reduce wound size and support faster recovery. However, instrument movement can be limited, especially in the narrow pelvic space where prostate surgery requires fine dissection and suturing.

Robotic-assisted prostate surgery provides high-definition 3D visualization and wristed instruments that allow precise movement in a confined space. During prostate cancer surgery, the surgical team must consider cancer removal, bladder-urethra connection, urinary sphincter preservation, and the possibility of nerve-sparing surgery when medically appropriate.

What Is da Vinci Single Port Prostate Surgery?

The da Vinci Single Port, or SP, robotic system integrates the camera and surgical instruments through a single access channel. Unlike multi-port robotic surgery, which usually requires several incisions, SP surgery is designed to operate through one small incision in selected cases.

In urologic surgery, one important feature of the da Vinci SP approach is the possibility of using an extraperitoneal route. This means the surgeon may access the prostate through the space outside the abdominal cavity instead of entering the abdominal cavity directly.

This may be particularly meaningful for patients who previously had abdominal surgery and may have intra-abdominal adhesions. By using an extraperitoneal pathway, the surgical team may reduce interference with previous adhesion areas and lower the risk of involving the bowel or other intra-abdominal organs. However, whether this approach is suitable depends on the patient’s surgical history, imaging results, tumor condition, and specialist assessment.

What Matters Most After Prostate Cancer Surgery?

For many patients, the decision is not only about removing the cancer. It is also about life after surgery. Three major concerns are usually discussed.

The first is cancer control. The medical team must evaluate whether the cancer is localized, whether it extends beyond the prostate, whether lymph nodes may be involved, and whether additional treatment may be needed after surgery.

The second is urinary function. After radical prostatectomy, the urinary tract must be reconstructed. Some patients may experience a period of urinary leakage or control recovery after surgery. The recovery process varies depending on age, preoperative function, tumor status, and surgical conditions.

The third is sexual function and quality of life. When oncologically safe, nerve-sparing techniques may be considered. However, cancer control remains the first priority. Patients should discuss both potential benefits and possible risks before choosing a surgical approach.

A Patient Scenario: Prostate Cancer Surgery and Recovery Quality

An 86-year-old man was found to have an elevated PSA level and was later diagnosed with prostate cancer. Although he was older, he remained physically active and valued the ability to return to daily life after treatment. After evaluation by a urologic specialist, he underwent single-port prostate surgery.

His postoperative recovery was smooth, and he was able to gradually resume eating, movement, and daily activities within a short period. This type of patient story highlights an important point: prostate cancer treatment should not be decided by age alone. It should be based on cancer risk, physical condition, treatment goals, and the patient’s expectations for recovery and quality of life.

For international patients, a second opinion before traveling may help clarify whether surgery, radiation therapy, active surveillance, or another treatment plan is more appropriate.

Who May Be Considered for Minimally Invasive or da Vinci SP Surgery?

Patients who may consider evaluation include those with localized or locally advanced prostate cancer, patients comparing surgery and radiation therapy, those concerned about wound size and recovery time, and patients with a history of abdominal surgery who are worried about adhesions.

However, da Vinci SP surgery is not suitable for every patient. Patients with extensive disease, clear distant metastasis, severe medical conditions that make anesthesia unsafe, complex pelvic surgical history, or a condition requiring another treatment priority may be advised to consider a different strategy.

The final recommendation should always be individualized.

What Should International Patients Prepare for a Second Opinion?

Before seeking a prostate cancer second opinion in Taiwan, patients are encouraged to prepare:

These documents allow the urology team to better understand the disease status and provide a more meaningful preliminary assessment.

International Medical Support in Taiwan

FORMOSA TUNGS+ IMedS assists international patients with medical record review, urologic specialist appointment coordination, online consultation, outpatient and inpatient arrangements, and communication support before and after treatment in Taiwan.

For patients and families unfamiliar with Taiwan’s healthcare system, a dedicated international medical coordinator can help reduce uncertainty and make the medical journey clearer.

Conclusion: Compare Your Options Before Choosing Surgery

There is no single best prostate cancer surgery for every patient. Traditional open surgery, laparoscopic surgery, multi-port robotic surgery, and da Vinci Single Port robotic surgery each have their own suitable clinical situations.

The most important goal is to balance cancer control, surgical safety, urinary function, sexual function, wound size, recovery time, and the patient’s personal priorities.

If you or a family member has been diagnosed with prostate cancer and is considering treatment abroad, you may request a second opinion before traveling to Taiwan. By preparing pathology reports, PSA results, and imaging studies, the specialist team can help evaluate which treatment direction may be appropriate.