One of the biggest problems with cancer is that, in spite of the best efforts of your surgeon, it has a nasty habit of recurring in a number of cases. when it comes to prostate cancer following the removal of the prostate by radical prostatectomy recent studies have revealed that, while the chances of a recurrence are around about 18 percent where surgery is carried out by a fairly 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 looked at nearly 8,000 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.

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 a minimum of 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 having to undergo prostate surgery?

First and foremost it is extremely important that patients choose a surgeon who frequently 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 involves a significant proportion of such surgery. In the majority of general hospital settings surgeons will carry out such surgery infrequently, perhaps as rarely as just one or two times a year, and this is not enough to give them the expertise necessary to provide you with the best possible change of a low recurrence rate.

In the light of this 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 showed however that there is a significant improvement in recurrence rates not only for specialist cancer centers, but also for teaching hospitals. This is undoubtedly because, within an academic setting, a great deal of emphasis is placed upon supporting mechanisms designed to assess the outcome of procedures and to provide feedback in an effort to create an environment of continuous improvement. This is not always the case in non-academic environments. In addition, academic centers tend to attract people who are particularly interested not just 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 needing prostate surgery then you would be well advised to elect to undergo surgery at the hands of an experienced and practiced surgeon working in a specialist cancer center within a major teaching facility.