Prostate Cancer
Reviewed by Mr Neil Haldar – August 2026
Prostate cancer diagnosis and treatment
I am a Consultant Urological Surgeon specialising in the diagnosis and surgical treatment of prostate cancer, including robotic prostatectomy and open prostatectomy for complex cases.
I have over 20 years’ experience and have performed more than 1,000 radical prostatectomies. I see patients from across Buckinghamshire, Berkshire, West Hertfordshire, Oxfordshire and London, including those seeking specialist advice and second opinions.
Read more about my experience as a prostate cancer surgeon.
GMC: 3683914 | BUPA Platinum Consultant | MBBS MD FRCS (Eng) FRCS (Urol)
Diagnosis, treatment options and robotic surgery
Prostate cancer is the most common cancer in men in the UK, with over 58,000 new diagnoses each year. The majority of men diagnosed with prostate cancer will not die from it, particularly when it is caught at an early, localised stage. The key is prompt investigation, accurate staging, and careful, personalised treatment planning.
I have dedicated a significant part of my surgical career to prostate cancer. Over more than two decades, I have performed over 1,000 radical prostatectomies, and in 2023, I led the introduction of the da Vinci robotic prostatectomy surgery programme at Buckinghamshire NHS Trust.
1,000+
Radical prostatectomies performed
For a detailed explanation of PSA, MRI, biopsy, Gleason grade, staging and treatment options, read my complete guide to understanding prostate cancer.
Symptoms and when to seek help
Early prostate cancer often causes no symptoms. When symptoms do occur, they typically relate to urinary function:
- Increased frequency of urination, particularly at night
- Difficulty starting or stopping urination
- A weak or interrupted urinary stream
- A sense of incomplete bladder emptying
- Blood in the urine or semen
If you have an elevated PSA, urinary symptoms, or a family history of prostate cancer, please do not wait. Early diagnosis significantly improves treatment options and outcomes.
Diagnosis
PSA blood test
PSA is a protein produced by the prostate. An elevated level does not confirm cancer, but it is an important indicator that warrants further investigation.
If your PSA has already been found to be raised, see my Rapid Access Elevated PSA Clinic.
Read more about when men should consider PSA testing and prostate cancer screening.
Read more about what it means if you have a raised PSA
Read more about PSA test alternatives
Multiparametric MRI (mpMRI)
Multiparametric MRI is usually the first imaging investigation for men referred with suspected localised prostate cancer.
Transperineal biopsy
I perform transperineal prostate biopsy under local or general anaesthesia. The transperineal approach significantly reduces the risk of infection compared to the older transrectal method, and allows more accurate targeting of suspicious lesions identified on MRI.
Read our transperineal biopsy guide
PSMA PET CT scan
Some men with higher-risk or recurrent prostate cancer require additional staging to look for disease outside the prostate. PSMA PET-CT may be used in selected circumstances to assess lymph nodes, bones and other sites.
Treatment options for prostate cancer
Treatment depends on the stage and grade of the cancer, as well as individual patient factors.
Options may include:
- Active surveillance
- Robotic prostatectomy
- Open prostatectomy (in selected cases)
- Radiotherapy
- Hormone therapy
- Focal therapy
I provide personalised advice to help patients understand these options and choose the most appropriate treatment. All treatment decisions are made as part of a multi-disciplinary team (MDT)
Active surveillance
For low-risk, slow-growing cancers, active surveillance — regular monitoring with PSA tests, MRI, and repeat biopsy — avoids the side effects of treatment while catching any progression early. Many men remain on surveillance for years without ever requiring treatment.
Read my article: Active Surveillance for Prostate Cancer: Who It Is For, How Monitoring Works and When Treatment May Be Needed.
Robotic prostatectomy
Robotic prostatectomy is a minimally invasive operation using the da Vinci robotic system to remove the prostate.
It offers:
- Smaller incisions
- Reduced blood loss
- Faster recovery
For more detailed information, please read my page on robotic prostatectomy for prostate cancer
Further reading:
Recovery after robotic prostatectomy
Side effects of robotic prostatectomy
Prostate cancer and erectile dysfunction
Robotic prostatectomy cost in the UK
Open Radical Prostatectomy
While robotic prostatectomy is suitable for most patients, some men are not ideal candidates due to:
- Previous abdominal surgery
- Adhesions
- Complex anatomy
I offer both robotic and open radical prostatectomy, which allows me to tailor the surgical approach to the individual patient, including men with previous abdominal surgery, adhesions or complex anatomy.
Radiotherapy
External beam radiotherapy or brachytherapy can achieve excellent cancer control in localised disease. I work closely with radiotherapy teams at GenesisCare Oxford and across the Thames Valley Cancer Network.
Read my article: Is it better to have surgery or radiotherapy for early-stage prostate cancer?
Rectal spacer procedure
I perform SpaceOAR and Barrigel hydrogel insertion — a protective spacer placed between the prostate and rectum before radiotherapy, significantly reducing side effects.
Read more on the rectal spacer procedure
Frequently Asked Questions
What is the best treatment for prostate cancer?
The best treatment depends on the stage and aggressiveness of the cancer, as well as the patient’s overall health. Options include active surveillance, surgery (radical prostatectomy), radiotherapy and hormone therapy. In my practice, I tailor treatment to achieve the best cancer control while preserving quality of life.
What is robotic prostatectomy?
Robotic prostatectomy is a minimally invasive surgical technique used to remove the prostate gland using the da Vinci robotic system. It allows for greater precision, reduced blood loss and faster early recovery. In suitable patients, enhanced visualisation and fine instrument control may support careful nerve sparing, which can help preserve continence and erectile function.
How do I choose a prostate cancer surgeon?
Choose a surgeon with significant experience and a high surgical volume. Outcomes are closely linked to the number of procedures performed. Patients should also consider the surgeon’s complication rates, functional outcomes and communication style.
What is recovery like after prostate surgery?
Most patients can return home within a day or two of surgery. Recovery typically involves a short period with a catheter, followed by a gradual return to normal activities over several weeks. Minimally invasive techniques help reduce recovery time.
Read my detailed guide to recovery after robotic prostatectomy.
When should I seek a second opinion?
A second opinion is advisable when considering major treatments such as surgery or radiotherapy, or when you are unsure about the best management approach. It helps ensure that all options are fully explored.
Useful Resources:
- The Pelvic Specialists: Please read my patient information articles on prostate cancer
Second opinions for prostate cancer
I regularly see men who have already been diagnosed with prostate cancer and want their PSA history, MRI, biopsy findings or proposed treatment reviewed. Read more about arranging a prostate cancer second opinion.
Why choose Mr Neil Haldar?
- Over 20 years’ experience in urological surgery
- More than 1,000 prostate cancer operations performed
- Specialist in robotic and minimally invasive surgery
- One of the few UK surgeons offering open prostatectomy
- Trusted for complex cases and second opinions
Read more about my experience as a prostate cancer surgeon.
If you have been diagnosed with prostate cancer or would like a second opinion, I would be pleased to help.
I see patients privately across Buckinghamshire, Berkshire and London.
I am recognised by all major private health insurers, including Bupa, AXA Health, Aviva, Cigna, Vitality Health, WPA and Standard Life. Cover depends on your insurer, policy terms, excess and prior authorisation, so patients should confirm their individual cover before treatment.
