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With most things in life it is fair to say that the more practiced and experienced you are the better your performance will be and this would certainly seem to be the case with prostate cancer surgery. One of the biggest problems with cancer is that, despite 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 total removal of the prostate through radical prostatectomy recent studies have deomstrated that, while the chances of a recurrence are about 18 percent where 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 recent study examined 7,800 prostate cancer patients who underwent radical prostatectomy in the United States between 1987 and 2003 involving a total of 72 surgeons from 4 major academic cancer centers around the country. Interestingly enough the study found that there is a very steep learning curve when it comes to performing prostate surgery and that it requires considerable 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 seen. So just what can we learn from this study if we are facing the possibility of having to undergo prostate surgery? First it is extremely important that patients choose a surgeon who regularly carries out this type of surgery. Indeed, it might well be advisable to choose a surgeon who specializes solely in prostate surgery, or whose work revolves largely around such surgery. In most general settings surgeons will perform such surgery infrequently, perhaps as rarely as just one or two times a year, and this is simply insufficient 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 that of a specialist cancer treatment center and of a surgeon whose work involves exclusively, or at least very largely, prostate surgery. The study also revealed however that there is a significant improvement in recurrence rates not simply for specialist cancer centers, but also for teaching facilities. This is undoubtedly because, within the academic setting, a great deal of emphasis is placed upon supporting mechanisms designed to evaluate 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, should you find yourself in the unfortunate position of requiring prostate surgery then you would be well advised to elect to have surgery with an experienced and practiced surgeon working in a specialist cancer center within a major teaching facility.
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