Hunter couple fights for public robotic surgery at John Hunter Hospital after prostate cancer battle

Mark and Dee Sales, of Kurri Kurri, believe Hunter residents are being denied the chance of a faster recovery following prostate cancer surgery in the public system, and they are on a mission to make it more accessible for more people.

When Mr Sales was diagnosed with prostate cancer earlier this year, the couple began researching the different options for surgery.

"When you get operated on the old fashioned way, which is a radical prostatectomy, they cut you from your navel to your pubic bone, and you can be off work for about six weeks," Mrs Sales said.

"But when they use the robot, it is less invasive and it changes the whole dynamic, and the men might only be off work for about three weeks instead."

Mr Sales decided he would like to have robot-assisted prostate surgery - which only required keyhole cuts. But they were told he would have to have that procedure done privately in Newcastle, or in Sydney - as robotic surgery wasn't an option at the John Hunter Hospital.

"I actually got cranky," Mrs Sales said. "I started writing letters to politicians and making phone calls, questioning why every public hospital in Sydney - which are only roughly half an hour to 45 minutes apart - have robots or have a robotic program, but the John Hunter - which is the biggest urological department in NSW, that covers the biggest area - doesn't.

"I was a bit of a smart arse. I told the Premier's office that I was actually going to put an invoice into him for three weeks' worth of pay for my husband.

"People that get cancer work for a living too. And you can't determine that you're gonna have six or eight weeks of holidays or sick leave to be able to take that much time off."

The lack of surgical robotics technology at John Hunter Hospital was one of the concerns raised by surgeons in a letter put before the Medical Staff Council, and signed by 46 clinicians.

The letter says this technology is now considered "standard of operating care".

An article published on the Nepean Blue Mountains local health district website in December, 2021, says that for the past decade, surgeons at the public Nepean Hospital have used robot technology to "help reduce the average length of hospital stay for a prostatectomy from 8 days to just 1.3 bed days".

"This has resulted in a massive saving of 7000 bed days at Nepean Hospital since 2012 - allowing more patients to access lifesaving care at Nepean," the article, on a NSW Health website, says. "While it was first used to treat prostate cancer, the Nepean Hospital robot is now also used by other departments including the ear, nose and throat, colorectal and gynaecology teams."

In the same article, Nepean Blue Mountains Local Health District director of innovation and strategy, Professor Mohamed Khadra AO, says that due to the precision of the technology, they could reach areas of the body that were "far more difficult to access" by traditional means.

"As a result there is a dramatic decrease in blood loss during surgery," he said.

"This allows the patient to experience less pain, recover faster and get back to things they love doing."

Mrs Sales said her complaint made it to the NSW Health Minister's office, and her agitating led to her husband being offered robot-assisted surgery at Lake Macquarie Private Hospital as a public patient in July.

"Why aren't we getting the same treatment and opportunities in the Hunter as they are in Sydney?" she said.

"They don't even have to drive more than half an hour, or 45 minutes, between hospitals to get operated on with the robots there. We have men here that fly in from out west or drive six and seven hours to get to the John Hunter Hospital, because it's the major hospital that they have to use, and so the farmer has to have six to eight weeks off because we don't have a robot."

The Newcastle Herald understands Nepean Hospital, Westmead, Liverpool, Royal North Shore, Prince of Wales, Royal Prince Alfred, St George and St Vincent's hospitals all offer a public robotic program - either on site or via an agreement with a private facility. These are Level 6 hospitals, like John Hunter Hospital.

Mrs Sales said she was told the machines cost about $4 million.

She has considered trying to raise the money to fund the robot herself.

While her husband managed to get his procedure done - and returned to work three weeks later "to the day" - they felt for others who wanted the option but couldn't afford to have it done privately in Newcastle, or weren't in a position to travel or spend weeks in Sydney.

A Hunter New England Health spokesperson said the district, in collaboration with the NSW Ministry of Health, continues to monitor emerging technologies, such as robotics, and assess their clinical and financial value according to local needs and demands for these services.

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