A major problem with cancer is that, in spite of the best efforts of your surgeon, it has a nasty habit of returning in a number of cases. In the case of prostate cancer following the removal of the prostate by radical prostatectomy recent studies have deomstrated that, while the chances of a recurrence are approximately 18 percent where surgery is performed by a relatively inexperienced surgeon, this figure falls to under 11 percent in more experience hands. So just what do we mean when we talk about 'experienced hands'?

A recent study examined 7,800 prostate cancer patients who underwent radical prostatectomy in the United States between 1987 and 2003 involving some 72 surgeons from 4 major academic cancer centers around the country.

The study showed that there is a very steep learning curve when it comes to performing prostate surgery and that it takes a significant amount of practice to master this particular surgical technique. Indeed, the study showed that it was not until surgeons had performed at least 250 operations that a marked improvement in outcomes was seen.

So just what can we learn from this study if we are facing the possibility of requiring prostate surgery?

First and foremost it is extremely important for patients to select a surgeon who regularly performs this form of surgery. Indeed, it could well be advisable to select a surgeon who specializes solely in prostate surgery, or whose work revolves largely around such surgery. In many general settings surgeons will carry out such surgery infrequently, perhaps as rarely as just one or twice a year, and this is not sufficient to provide them with the expertise needed to provide you with the best possible change of a low recurrence rate.

Against this background therefore your first choice should undoubtedly 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 only for specialist cancer centers, but also for teaching hospitals. This is because, within the academic setting, a great deal of emphasis is placed on supporting mechanisms to assess the outcome of procedures as well as to provide feedback in an effort to create an environment in which continuous improvement is seen. This is not always the case in non-academic environments. Also, academic centers tend to attract people who are particularly interested not only in the outcome of their work but in both correcting their errors and improving their surgical technique.

So, should you find yourself in the unfortunate position of needing prostate surgery then you would be well advised to choose to undergo surgery at the hands of an experienced and practiced surgeon who is employed in a specialist cancer center within a major teaching facility.