The truth and how to prevent cancer


The Questions You Should Ask Your Surgeon

Treatment for prostate cancer is one of thecontrol erections and the muscle which holds
most rapidly developing areas in medicine,and  releases  urine.
providing men with a wide and sometimes
confusing  range  of  treatment  options.Having undertaken more than 800
prostatectomies, I know the benefits this
While our scientific understanding of theexperience brings to my work in terms of
disease is marching forward, the culture ofoutcomes  for  patients.
the doctor patient relationship in the UK is
changing  more  slowly.I was one of the first surgeons in the UK to
carry out keyhole prostatectomy in 2003; a
Some patients remain reluctant to ask theirfar less invasive procedure with reduced
doctor  many  questions.bleeding and risk of complication. I have now
completed more than 400 keyhole
Others may grill their doctor a little more,prostatectomies.
but steer clear of the question I see as the
most important of all: how many of theseI have also been able to develop my
procedures  have  you  carried  out?nerve-sparring techniques, reducing the
margins between the removal of the tumour and
In America for example, patients are wellthe  erectile  nerves.
practiced in researching treatment options
then asking doctors about their experienceThis kind of precision work is dependent upon
and outcomes. Much of this data is widelythe surgeon continuously using and developing
available  on  the  internet.his or her skills by undertaking a large and
regular  caseload.
However in the UK, this approach remains
rather alien. I do see a growing number ofTo set this into a broader context, the
patients who have found my clinic throughrecent publication of cardiac surgery
their own research, rather than a GP orstatistics is a major development for the
consultant  referral.public  scrutiny  of  surgery.
But patients rarely ask how many procedures IHowever, this is only one, relatively small
have carried out. This is possibly due to afield, where poor performance of surgeons
sense of respect; a perception that it maycan,  in  some  cases,  contribute  to death.
suggest  a  lack  of  trust.
In prostate surgery post-operative mortality
Yet it is so important. Your ability tois almost non-existent. But there are very
perform a procedure safely, effectively, withsignificant differences for patients in terms
the optimal outcome for your patient isof the quality of life they can enjoy after
based, to a very significant extent, uponsurgery.
your  experience  of  that  type  of surgery.
You are dependent upon the skills of your
The number of procedures undertaken bysurgeon to not only remove all the cancer
individual surgeons varies dramatically. Acells, but in doing so, cause as little
surgeon may be trained and skilled to performdamage as possible to the adjacent erectile
a particular operation. That does not meannerves  and  the  bladder.
that  he  or she is the best surgeon for you.
You are most certainly within your rights to
Prostate surgery is a field in whichask your surgeon how many procedures he or
experience can make a critical difference toshe has completed and whether your operation
outcomes. The removal of a prostatecan be undertaken as keyhole and
(prostatectomy) is technically verynerve-sparing  surgery.
challenging because there is a functional
aspect  to  it.I welcome all questions from my patients and
their families as this is as critical to
You are not only removing a tumour; you mustmaking an informed choice about the right
do as little damage to the nerves whichtreatment option for them.



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