One of the biggest problems with cancer is that, despite the best efforts of your surgeon, it has a bad habit of returning in a number of cases. In the case of prostate cancer following the total removal of the prostate through radical prostatectomy recent studies have revealed that, while the chances of a recurrence are about 18 percent when surgery is carried out by a fairly inexperienced surgeon, this figure falls to less than 11 percent in more experience hands. So just what do we mean when we talk about 'experienced hands'?



A recently conducted study examined just under 8,000 prostate cancer patients who underwent radical prostatectomy in the United States between 1987 and 2003 involving no fewer than 72 surgeons from 4 major academic cancer centers around the country.

Interestingly enough the study found that there is an extremely steep learning curve when it comes to carrying out prostate surgery and that it takes a significant amount of practice to master this particular surgical technique. Indeed, the study revealed that it was not until surgeons had carried out at least 250 operations that a marked improvement in outcomes was witnessed.

So just what can we learn from this study if we are faced with the prospect of requiring prostate surgery?

First and foremost it is extremely important that patients select a surgeon who regularly performs this type of surgery. Indeed, it may well be advisable to select a surgeon who specializes exclusively in prostate surgery, or whose work involves a significant proportion of such surgery. In many general settings surgeons will carry out such surgery infrequently, perhaps as rarely as just once a year, and this is not enough to provide them with the expertise needed to provide you with the best possible change of a low recurrence rate.

In the light of this therefore your first choice should without doubt be a specialist cancer treatment center and a surgeon whose work involves exclusively, or at least very largely, prostate surgery.

The study also revealed however that there is a marked improvement in recurrence rates not merely for specialist cancer centers, but also for teaching facilities. This is because, within an academic setting, a great deal of emphasis is placed upon supporting mechanisms designed to assess the outcome of procedures as well as to provide feedback in an effort to create an environment of continuous improvement. This tends not always to be the case in non-academic environments. Also, academic centers have a tendency to attract people who are particularly interested not simply in the outcome of their work but in correcting their errors and improving their technique.

So, if you find yourself in the position of needing prostate surgery then you would be well advised to elect to undergo surgery with an experienced and practiced surgeon working in a specialist cancer center housed within a major teaching facility.