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The Questions You Should Ask Your Surgeon

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




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