Prostate Cancer Treatments in 2026
Professor Phillip Stricker AO, MBBS(Hons), FRACS(Urology) is a urologist and one of the leading experts in the management and treatment of prostate cancer in Australasia. He is the Director of the St Vincent’s Prostate Cancer Centre, Chairman of the Department of Urology at St Vincent’s Private Hospital and Clinic and the Clinical Director of the Australian Prostate Cancer Research Centre in New South Wales (NSW). He is also a professor and associate professor at numerous recognised Institutions, University of Western Sydney, University of NSW and University of Sydney.
His clinical practice is dedicated to the management and treatment of prostate cancer, focusing on personalised care. This includes initial consultation, second opinions, therapy and follow-up of all post-treatment side effects, including erectile dysfunction and incontinence.
In 2006, Prof Stricker commenced the first robotic program using the latest technology (Da Vinci Si) in NSW at St Vincent’s Private Hospital. He has since performed almost 3000 robot-assisted radical prostatectomies. This is the second largest experience in Australia and the largest in NSW. In addition, previously, he has performed over 4000 open radical prostatectomies. This combined experience is the most in Australia. He also has extensive experience in performing high-dose rate brachytherapy (over 1000 cases), low-dose rate brachytherapy (over 1000 cases), designing and managing structured active surveillance programs and transperineal biopsies (over 10,000 cases).
Prof Stricker was the Head and Chairman of the Uro-oncology Multidisciplinary Team meetings for over 20 years.
He has been one of the Australian pioneers in the use of multiparametric MRI and PSMA-PET scan imaging and the introduction of focal therapy using irreversible electroporation-IRE (Nano-Knife) to treat prostate cancer, and has performed over 800 cases.
He mentors nationally and internationally, and has published over 40 articles on nanoknife technology and outcomes. He also has extensive experience in dealing with impotence and incontinence assessment, and treatments including penile prosthesis, sling surgery and artificial urinary sphincter surgery.
Professor Stricker’s area of research focuses on the collection of quality of life data following treatment in order to refine surgical techniques, the development and assessment of novel surgical techniques which are less invasive, the introduction of new technologies for treating prostate cancer, and the utilisation of medical imaging for the detection and evaluation of prostate cancer.
Professor Stricker was the driving force in setting up the St Vincent’s Prostate Cancer Clinical Database and Tissue Bank in conjunction with the Garvan Institute, which is currently housed at The Kinghorn Cancer Centre. These resources contain extensive clinical and pathological outcome data and have resulted in a comprehensive scientific and clinical resource that has been acknowledged both nationally and internationally.
Professor Stricker was a Member of the Australian Cancer Network working party that developed guidelines for the management of localised prostate cancer, metastatic prostate cancer, and PSA Testing. These guidelines have been published and are used as the evidence base in many publications. Professor Stricker has authored over 400 peer-reviewed publications.
Prostate Cancer Treatments in 2026
Minimally Invasive Treatments for Prostate Cancer
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A review of the latest minimally invasive treatments for prostate cancer
Prostate cancer has become a very, very common cancer. Indeed, it's the commonest male cancer. And I think when you're making a choice between all the different treatment options, you need to be aware that there's a lot of minimally invasive options that are now available to you. And you need to really think about those and make sure that you've considered them all. Those minimally invasive options are firstly robotic keyhole surgery to remove the prostate. Secondly, low dose rate brachytherapy to minimally irradiate the prostate. Thirdly, even active surveillance, just monitoring the prostate. Fourthly, focal therapy, where you treat only a section of the prostate. And finally, newer technologies such as tulsa, which minimally invasively treat the whole prostate. Now, radiotherapists have also brought in a new minimally invasive treatment called MR Linac, which is radiation inside an MRI machine. Now, all of these options may be suitable for you, but you need to understand them. So if I just expand minimally on them, then you can do the rest in terms of researching them and getting much more detail and speaking to different people about them. So let's start with simple active surveillance. Active surveillance means that you've been diagnosed with an early non-life-threatening cancer which can be monitored. Now the monitoring process may be six monthly blood tests, an MRI every year or two, and a biopsy every four or five years. Now this is just keeping an eye on something which is not likely to cause a problem. Another minimally invasive treatment is brachytherapy or MR linac radiotherapy. These are two forms of radiotherapy. Brachytherapy has been around for 30, 40 years, and MR Linac radiotherapy, which is radiotherapy inside an MRI machine, improving accuracy, has only been around for five years. Now these less invasive radiotherapy techniques avoid collateral damage. Now what does that mean? It means that the old days of damaging your rectum are gone. It also means that we can try and tailor it to get rid of cancers by increasing the dose of radiation to that cancer. Now, not everybody has these and not everybody has the expertise, but you need to be aware that they're around and that they are a potential option. As with all radiotherapy options, there are downsides of them down the track, such as you can't then fall back on surgery. And another problem that we've got is that they can cause cancer in adjacent organs. So you need to bring those topics up with your radiation specialist. Another option which is minimally invasive is focal therapy. I've been quite passionate about this for the last 13 years, and the technique that I've used has been irreversible electroparation, or what's commonly known as nanonyme. I've done almost 800 of these now, and the advantage of focal therapy as a group is that it causes minimal damage and has minimal effect on quality of life, such as urinary control and erectile functioning. The disadvantage is that it doesn't treat the whole prostate, so it means ongoing monitoring. And it doesn't have quite the track record of surgery and radiotherapy because it's only been followed for 10 to 15 years so far. But it's worth considering if you happen to be a suitable candidate and everything lines up, such as the MRI, PSMA, and biopsies, that you've got a localized intermediate risk prostate cancer. Finally, there are new minimally invasive treatments on the horizon, and one of them is called Tulsa, T U L S A. It's a transurethral, high-intensity focused ultrasound inside an MRI machine to destroy the prostate and minimize the chance of erection problems and incontinence. It's quite new, doesn't have a long track record, but it is undergoing fairly vigorous trials at the moment worldwide. And I've been impressed with the early results and am cautiously introducing it in Australia. I think this is also something you need to keep on your radar. And if you're a person who simply will not accept surgery or radiotherapy, but you've got multifocal intermediate risk cancer, this may be an option for you. So minimally invasive treatments for prostate cancer are becoming commoner and commoner. And as a result, I think you need to be aware of them and consider them and to find out whether you're suitable. And if you are suitable, then maybe even go to the most experienced person who may offer them.