Second opinions for prostate cancer

Prostate cancer remains the commonest cancer in men and the second commonest cause of male cancer death. Our approach is firmly based on providing the patient and his family with the time, care and attention required for fully informed, shared decision making to achieve the best possible results.

We pay particular attention to obtaining and providing the patient with all the decision making tools necessary to safely choose active surveillance if appropriate for the patient with less serious or likely indolent cancer or the best form of treatment with curative intent for the more aggressive cancers.

A/Prof Cozzi and his team aim to provide individualized, personalized and comprehensive care tailored to the patient’s needs, preferences and the nature of the cancer.

Our multidisciplinary team offers comprehensive cancer care with state of the art prostate cancer treatments. We are the only true multidisciplinary centre in New South Wales offering patients a comprehensive assessment with the full range of treatment options available.

Many studies have shown that the optimal outcome is achieved in experienced units and we are pleased to be able to offer investigations and treatments at several centres of excellence including St George Private and Public Hospital, Hurstville Private, Kareena Private and the Kingsway Day Surgery in Miranda for the St George, Sutherland Shire and Illawarra patients.

At The Mater Hospital in North Sydney our patients from Sydneys’ North are always satisfied with level of care provided and with the advance technology including the DaVinci Xi robotic platform.

Patients may elect to proceed to biopsy at a local facility close to home for their convenience and then travel to a larger facility for surgery should it be necessary.

A/Prof Cozzi has access to two of the latest DaVinci Xi robotic platforms in NSW at The Mater in North Sydney and St George Private. He also regularly performs robotic surgery on the Si robot in a dedicated and purpose built robotic operating theatre at Hurstville Private in Sydneys’ South with a more affordable platform as the cost of robotics can be concerning for some patients.

Regardless of the choice of facility, patients’ can be re-assured our team have chosen the best inpatient and outpatient setting where our experienced teams will achieve the best possible outcomes.

A/Prof Cozzi has pioneered the latest techniques for preservation of potency, including nerve sparing surgery both via open and robotic approaches. A/Prof Paul Cozzi completed extensive training in a Fellowship position in urologic oncology in the USA at Memorial Sloan Kettering Cancer Centre in New York.

A/Prof Cozzi was fortunate to spend more than 2 years (1998-2000) working with Dr Peter Scardino in New York to learn about the subtleties and complexities of prostate cancer diagnosis and management. Dr Scardino is recognized as a leader in prostate cancer with particular interests in optimizing surgical outcomes and the use of active surveillance.

Accordingly ACTIVE SURVEILLANCE forms a large part of Dr Cozzi’s practice and fully a third of patients have been safely managed with this approach thereby avoiding the side effects of surgery and radiation therapy.

Fully a third of Dr Cozzi’s patients are managed with this approach with very careful and diligent follow up including molecular marker studies, genomics and MRI to ensure serious cancer are not missed.

Many patients choose to have surgery via OPEN or ROBOTIC ASSISTED approaches and Dr Cozzi has some of the largest experience and volume of both approaches in Sydney.

A/Prof Cozzi maintains his skills for both OPEN and ROBOTIC ASSISTED surgery to optimize outcomes, as patients can sometimes be unsuitable for one approach or the other.

In contrast to recently graduated surgeons (many of whom can only perform robotic surgery), Dr Cozzi can safely and competently complete the surgery via an open approach should the robot approach fail or be abandoned.

To date, in more than 520 cases, Dr Cozzi has not had to convert any robotic cases to open fortunately.

Our radiation oncology team includes radiation oncology experts in North Sydney at Royal North Shore and The Mater, St George Hospital and the Prostate Cancer Institute at Kogarah and Wollonging Hospital- all of these units have an international reputation for the delivery of state of the art radiation therapy including low dose seed brachytherapy and high dose rate brachytherapy

We have an excellent team of nursing staff at St George Private Hospital, St George Hospital, Hurstville Private and The Mater in North Sydney as well as nursing staff within the practice who assist in the preoperative evaluation and postoperative care of patients undergoing surgery.

A/Prof Cozzi feels very strongly about involving allied health professionals and refers all patients for pre-op pelvic floor physiotherapy to either Zoe Mills in Wollongong (www.illawarra-physiotherapy.com.au), Annette Rich in Sans Souci in Southern Sydney (www.sanssouciphysiotherapycentre.com.au) or Elizabeth McDonald in Neutral Bay (www.neutralbayphysio.com.au ). Sexual function rehabilitation is assisted at these locations as well as utilization of the skills of Patrick Lumbruso (www.sexafterprostatecancer.com.au).

Equally, should you choose to continue to be cared for by our team, we will ensure careful and timely follow up with a strict protocol for follow up which Dr Cozzi insists on. Office visits following surgery are generally scheduled at 6 weeks, 3 months, and then every 6 months to 2 years and annually thereafter out to 5 years. Some patients may require more or less frequent follow depending on progress.

Our protocol for assessment includes a second opinion from an expert prostate cancer pathologist and therefore it is imperative that we receive a copy of the pathology from your prostate biopsy. If you could please fax a copy of the pathology report to 02 9570 5578, our staff will organise for the pathology to be reviewed by Dr Warwick Delprado from Douglas Hanly Moir who has an international reputation as a prostate cancer pathologist.

There is a small fee for this service from the pathologist however many studies have shown the importance of an experienced pathologist reviewing the biopsy specimen and it is best if this can be achieved prior to your visit.

We are very proud of our team results and in particular, we have some of the largest experience in Australia in nerve sparing surgery with excellent results in terms of preservation of potency whilst maintaining the best chance of cure of the cancer.

You will also find questionnaires and it is important that these are completed and returned to us so that we can constantly measure outcomes to maintain a high standard of care.

Please be sure to bring to the appointment any scans you may have including MRI, CT and Bone Scans, lists of your medications and any correspondence relating to your condition or general health.

Please be reassured that we have an internationally trained team of experts to help you and your family through the decision making process to choose the most appropriate treatment for you, in your own individual circumstances.

If there are any further questions prior to your appointment, please do not hesitate to contact us on 9570 5510