What to Look for in a Prostate Cancer Surgeon

Things to consider when choosing a prostate cancer surgeon.

prostate cancer surgeonAs a patient, you must be comfortable with your prostate cancer surgeon. It’s important that a patient knows the experience level of their prostate cancer surgeon and trusts them. Typically, prostate cancer surgeons that have done many procedures are more likely to produce a good outcome but hundreds or thousands of procedures are not necessary for adequate experience. Ask to see your prostate cancer surgeon’s history of potency numbers, continence numbers, and their cure rates.

The extent of the spread of disease, the Gleason score, the aggressiveness of the tumor and are some things that must be considered in choosing a prostate cancer surgeon.  A patient must feel comfortable with their prostate cancer surgeon and it is also important that you ask any potential prostate cancer surgeon what their experience is with a given surgical technique.

David Albala, M.D.:  What should a man having a prostatectomy look for in their surgeon? For me, I think establishing a good patient relationship is extremely important.  As a patient, you need to feel comfortable with your surgeon.  You need to understand the disease that you have, the surgeon should have gone through the disease that you have.

So, you understand the extent of the disease, the Gleason score, the aggressiveness of the tumor and so on and so forth.  You have to feel comfortable with your surgeon and I also think it is important that you ask the surgeon what their experience is with a given surgical technique.  Clearly from the literature, the more surgery that a surgeon has done, the better he is at performing that surgery.

So, when you look at a surgeon that has done 50 prostatectomies and compare to a surgeon that has done 800 prostatectomies, one would find that the surgeon that has done more surgery probably will have better outcomes.  Now that is not to say that one needs to have 800 or 1000 prostatectomies to be a competent surgeon.  Actually in the literature, it takes about 20 procedures based on what has been written to be competent with this operation.

But I really believe when you look at the robotic surgeons around the country, the more experience they have, the better the outcomes they are.  So, the surgeons that have done the most cases will have the best outcomes.  So, you need to ask the number of cases that they have done and you need to ask them their specific outcomes, how many of those patients are cured with surgery alone, what is the positive margin rate, in other word when the surgeon does the procedure, does the disease, is the disease contained within the prostate and will they require additional therapy such as radiation therapy or hormonal therapy.

You should ask your surgeon what their continence numbers are.  Knowing how many pads and what the average length of pad use is extremely important and looking at the quality of life after surgical intervention.  And then for many men, potency is an extremely important issue and you should ask the surgeon what the potency numbers are.  Those numbers with the continence numbers, with the cure numbers are all important numbers that you as a patient need to know when choosing a surgeon, but most importantly you have to have the trust and feel comfortable with your surgeon.  You may find the terrific surgeon, but if you don’t trust him, you are not going to have a good outcome.

Dr. David Albala
Dr. David M. Albala is Chief of Urology at Crouse Hospital in Syracuse, New York and Medical Director for Associated Medical Professionals. He is considered a national and international authority in laparoscopic and robotic urological surgery and has been an active teacher in this area for over 20 years.

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