The UK has begun testing a new robotic procedure that could transform how early-stage prostate cancer is treated by reducing the often life-altering side effects of standard surgery. The study, funded by the National Institute for Health and Care Research (NIHR), will evaluate whether Aquablation—a technique that combines robotics, AI assistance, and real-time ultrasound imaging—can match or outperform the outcomes of current surgical methods.
Right now, many patients with prostate cancer that hasn’t spread far undergo a radical prostatectomy, in which the entire gland is removed. Although effective in many cases, this operation can result in significant complications, including infections, urinary difficulties, and impacts on sexual function. These risks have become a growing concern for doctors and patients alike.
Aquablation takes a less invasive route. Instead of manually removing the whole gland, surgeons use a robotic system to direct a precisely controlled high-pressure water jet. Real-time imaging allows them to target cancerous tissue while avoiding nearby structures that are crucial for bladder control and sexual health. While the method is already used in some clinics for treating an enlarged prostate (benign prostatic hyperplasia), it has not yet been proven for cancer treatment.
The new clinical trial—run across seven countries and sponsored by the U.S. company Procept BioRobotics—aims to recruit 280 participants with localised prostate cancer who have already opted for surgery. Four major NHS centres in the UK are participating: the Royal Marsden, Guy’s and St Thomas’, the Royal Free London, and Norfolk and Norwich University Hospitals.
Mr. Philip Charlesworth, a consultant surgeon at the Royal Marsden, said that although existing treatments cure many men with early prostate cancer, the medical community is increasingly focused on reducing the long-term consequences of treatment. He described the trial as an exciting step toward offering patients a high-tech surgical option that could preserve both continence and sexual function—two outcomes that heavily influence quality of life after surgery.
If Aquablation proves successful, it could join or even reshape the list of treatment options for men with localised prostate cancer, which currently includes surgery, targeted radiation, and monitored “active surveillance” programs.
The trial comes at a time when UK prostate cancer diagnoses are rising. According to Prostate Cancer UK, about one in eight men will develop the disease, and more than 58,000 cases were recorded in England last year—almost 9% more than the year before.
Meanwhile, the debate over whether to introduce a national screening programme continues. Scientific advisers recently recommended against routine screening for most men, arguing that it could lead to unnecessary treatments that may cause more harm than benefit. Instead, they suggested targeted screening every two years for people with high-risk BRCA1 or BRCA2 genetic mutations between ages 45 and 61. Health Secretary Wes Streeting expressed surprise at the recommendation.
Public pressure for broader screening has grown, driven in part by high-profile figures such as Sir Chris Hoy and Dermot Murnaghan, who were both diagnosed with advanced prostate cancer. Former Prime Minister Lord Cameron has also supported calls for improved screening after receiving treatment himself.
