For Mount Sinai’s Ash Tewari, MBBS, MCh, FRCS (Hon.), a world leader in robot-assisted prostate surgery, each day offers opportunities to realize his passion: saving the lives of patients with aggressive prostate cancer and preserving quality of life for the vast majority of men who have a less advanced stage of the disease.
“Prostate cancer is very common, and 95% of the time, my patients live for 10 or 20 years,” said Dr. Tewari, Kyung Hyun Kim, MD, professor and chair of the Milton and Carroll Petrie Department of Urology, and director of the Center of Excellence for Prostate Cancer at The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai. “For those patients, quality of life is paramount, and that is my goal.”
“The bladder, the urethra, the sexual nerves—all delicate structures—are around the prostate, which is located deep within a man’s body,” explained Dr. Tewari, who is also surgeon-in-chief of the Tisch Cancer Hospital at Mount Sinai. “So those of us who treat the prostate are working in a very sensitive zone.”
Robotic Prostatectomy Pioneer
The challenge of navigating that zone, working to save nerves, muscles and continence, is what drew Dr. Tewari to urology as a young surgeon in India, where he received one of only eight seats in the specialty nationwide. From there, he came to the United States and was part of the team that performed the first robotic radical prostatectomy—removal of the prostate—in this country. This surgery is minimally invasive, performed through small incisions as opposed to conventional open surgery.
Since then, Dr. Tewari has performed the procedure close to 10,000 times, and he is widely recognized as a pioneer in its use. “As a surgeon, I rely on what I can see, on my hand-eye coordination, on my judgment and on my understanding of anatomy,” he said. “The robot gives me a much more magnified vision of the prostate. My eyes can see inside the patient’s body even at awkward angles. I can use very precise tools that let me do my work without cutting the patient open and with minimal blood loss.
“I am most frequently reminded when I enter the operating room that the magic of an operation’s success requires a complex combination of two or more elements, and I like to think that is built on the foundation of what I call ‘the three AIs’,” Dr. Tewari continued. “There is anatomical intelligence, the constant and thorough study of complex structures; there is artificial intelligence, which makes my colleagues and me as efficient as possible in our activities, directing our work and guiding our decisions. Finally, we have what I call art intelligence, the essence of which is a combination of art and science based on experience, which makes it possible to design treatment plans for each individual patient.”
Dr. Tewari has trained more than 30 fellows and residents in robotics, some of whom have gone on to establish successful prostate cancer programs in Canada, Great Britain, India, Japan and Singapore. He also serves as chair of the Royal College of Physicians and Surgeons of Glasgow North America Committee.
A Stellar Team
Dr. Tewari has assembled a top team of colleagues to serve urology patients at Mount Sinai. To name only a few, the team includes Mani Menon, MD, also a robotic surgery pioneer, who now serves as chief of strategy and innovation in the department of urology; Peter Wiklund, MD, PhD, co-director of the Bladder Cancer Program at the Mount Sinai Health System; and Ketan K. Badani, MD, FRCS (Hon.), who has created a new paradigm in robot-assisted kidney surgery. The bladder program also includes leading doctors Reza Mehrazin, MD, and John Sfakianos, MD. “We are also thrilled to have newer additions to our team of experts, including specialists like Mitchell Benson, MD,” Dr. Tewari said.
“Our people are what make Mount Sinai special,” he said. “We have all kinds of experts. Each of us has a different skill, but together we complement each other. And we are friends who share a common vision and calling, which is one of the reasons that we have been so successful.”
The team’s expertise means Mount Sinai can offer men with prostate cancer a comprehensive array of effective treatment options. If the cancer is indolent (slow growing), clinicians may simply monitor the patient very closely over time. If the cancer is located in only one part of the prostate, “we can use focal therapy, destroying just the affected area,” Dr. Tewari explained. That can be done with an electric current, with heat, or with a laser. The area can also be frozen by a treatment called cryotherapy. These methods can also be combined with targeted immunotherapy.
A Community Effort
The earlier a man is diagnosed with prostate cancer, the greater his chance of benefiting from one of the many treatment options Mount Sinai offers. In Dr. Tewari’s experience, it is often the women in men’s lives who take the lead by persuading them to go to the doctor.
“Men pretend to be strong, but they often become very vulnerable the moment they find something concerning,” he said. “But women are matter-of-fact and proactive. So, a lot of men owe their first diagnosis to a nudge from the women in their lives.”
To facilitate early diagnosis, Dr. Tewari has spearheaded several wide-reaching initiatives. In 2022, he launched the Mount Sinai Robert F. Smith Mobile Prostate Screening Unit. Funded by a $3.8 million donation from philanthropist Robert F. Smith, the van has traveled more than 15,000 miles through neighborhoods in the New York metropolitan area and beyond, providing prostate cancer screening. As of spring 2025, 10,000 patients were screened with cancer detected in 150 patients.
An outgrowth of the mobile project is the “Million Strong Men” initiative, which aims to expand from the men served locally by the van to a global program, with units currently planned for Atlanta, Georgia, and Delhi, India. Dr. Tewari is also developing an electronic assessment for prostate cancer that men worldwide can use to calculate their risk based on factors such as their age, weight, race, family history and personal health history. He expects the tool to become available this year.
“I have seen thousands of patients reduce their risk of recurrence through lifestyle measures and the procedures that my outstanding team and I can provide,” Dr. Tewari said. “For me, this has been a pleasure and a privilege.”
To learn more, please go to mountsinai.org/care/urology/ services, or email Dr. Tewari at ash.tewari@ mountsinai.org
