Why a treatment name is not enough
A list such as 'hormone therapy, then radiotherapy' tells a surgeon almost nothing about your current situation. The same treatment name can describe very different results. One patient may have a prostate-specific antigen (PSA) level that fell and stayed low; another may have a PSA level that never normalised or rose again. One may have no lasting bowel or urinary symptoms; another may still need pads or have rectal bleeding. The treating team needs those differences to judge whether surgery is appropriate and what risks it may carry.
Radical prostatectomy removes the prostate for selected prostate cancers, and robotic instruments are controlled by the surgeon. Whether it is suitable after previous treatment depends on factors the team must review, including cancer control, prior radiation dose and field, current urinary and bowel function, and the pathology of the original cancer. None of that can be read from a treatment name alone.
When you write your summary, replace 'I had radiotherapy in 2021' with a short factual statement: what was treated, when, what the PSA response was, what imaging showed before and after, and what side effects remain now. That is the information a surgeon can act on.
What to record for each previous treatment
Build a simple table or list with one row per treatment episode. For surgery, record the date, the operation performed, the pathology result including Gleason score and margin status, and whether any lymph nodes were involved. For radiotherapy, record the dates, the technique used if known, the total dose and the treated area, and the PSA level before and after. For hormone therapy, record the drug or drugs, the dates, and the PSA response during and after treatment. For chemotherapy or newer agents, record the regimen, number of cycles, and the reason it was stopped.
For each episode, add a short statement of the result in plain terms. Examples: 'PSA fell below detection and stayed there for three years'; 'PSA never normalised and has risen steadily since'; 'treatment stopped early because of bowel toxicity'; 'no imaging since treatment'. These statements are more useful than the treatment name because they describe the disease course.
Also record the side effects that remain today, not only those that occurred during treatment. Urinary leakage, urgency, nocturia, erectile function, bowel habit, rectal bleeding, fatigue and any pain all matter. If you use pads, state how many per day. If you have erectile dysfunction, state whether it is partial or complete and whether any treatment has helped. These details shape the discussion about surgery and recovery support.
Cancer control and functional priorities: two separate conversations
Ask the team to review two things separately. First, cancer control: what does the current PSA trend, imaging and any biopsy or pathology material suggest about where the cancer is now and how aggressive it appears? Second, functional priorities: what matters most to you after surgery, and how might previous treatment affect urinary continence, erectile function and bowel function? These are different questions and may lead to different recommendations.
For cancer control, the team will want to know whether the disease appears confined to the prostate or has spread, and whether previous treatment has changed the anatomy in a way that affects surgery. For functional priorities, the team will want to know your baseline function before any treatment, your current function, and what you hope to preserve. A patient whose main goal is cancer control may accept different trade-offs from one whose main goal is preserving erectile function.
Write down your own priorities before the appointment. For example: 'I want the best chance of cancer control even if continence is affected'; or 'I want to avoid a stoma if possible and preserve erections if the cancer allows'. Giving the team this context helps them explain the trade-offs in terms that matter to you. No outcome is guaranteed, and the team must confirm what is realistic in your case.
Records that support the description
Your written summary is only as good as the records behind it. Gather the pathology report from the original biopsy and any surgery, the imaging reports (MRI, CT, bone scan or PSG), the radiotherapy planning and completion summary, and the serial PSA results with dates. If you have had a repeat biopsy, include that report. If you have had genomic testing, include it.
For an overseas review, ask how the hospital wants records shared. A brief summary by the enquiry form, email or WhatsApp is enough to start; detailed records can follow once the team explains what it needs. Do not send passport numbers, card details or a complete medical archive in the first message. Ask whether translated copies are needed and whether the hospital accepts digital files or requires physical slides and blocks for pathology review.
If some records are missing, say so clearly rather than guessing. For example: 'I do not have the radiotherapy dose record; I can request it from the treating centre.' The team can then tell you whether the missing item changes the review or whether it can proceed with what you have. Do not delay urgent local care while gathering records for an overseas enquiry.
Questions that turn a treatment list into a useful review
Prepare a short list of questions that force the team to engage with the results, not just the names. Ask: 'Given my PSA trend and imaging, does the cancer appear confined to the prostate?' 'How might my previous radiotherapy affect the surgical plan and the risk of complications?' 'What is my current urinary and erectile function, and how might surgery change it?' 'Do you need the original pathology slides, or is the report enough?' 'What follow-up will I need after surgery, and how will that be arranged if I return home?'
Also ask what the team cannot determine from the records you have. A surgeon may say that the PSA trend is reassuring but that the radiation field details are needed to assess rectal risk. Another may say that the pathology is clear but that a repeat MRI is needed to assess local extent. Knowing the gaps helps you decide what to request next.
If you are considering care in China, ask how the hospital reviews cancer control and functional priorities together, and whether a multidisciplinary review is available for a complex case. Ask about catheter care instructions, when the catheter is removed, and who provides follow-up after discharge. These are practical questions that affect planning, and the answers must come from the treating team.
What the review can and cannot establish
A records-based review can clarify whether robotic prostatectomy is worth considering, what additional tests or records are needed, and what questions to discuss with the surgeon. It does not establish final eligibility or hospital acceptance. The hospital decides suitability after reviewing your case, and the treating clinician must confirm the risks, alternatives and restrictions that apply to you.
Be cautious about any service that promises a surgical date or a specific outcome before the hospital has reviewed your records. Robotic prostatectomy is a major operation, and previous treatment can change the risks. The team must assess cancer control, anatomy, baseline function and your priorities before recommending a plan. No cure, continence or erectile function result can be guaranteed.
If you want to start, send a brief summary of your diagnosis, previous treatments with dates and results, current PSA, and your main question. The initial enquiry is free and does not require buying a proxy consultation. The team can then explain what records to share and what the next step is. For confirmed services, see the robotic radical prostatectomy reference page.
Sources & scope of this guide
References and official service information relevant to this guide.
This is general planning information and has not been individually reviewed by a doctor. Medical decisions and personal treatment advice come from your treating clinicians.