Written by admin on 2009-03-30T07:57:24+0000">March 30, 2009 – 7:57 am
Doctor A is a nice, personable young doctor, whose empathy for your condition appealed to you immediately.
That’s great. Now what else do you know about him? Is he a board-certified urologist? What training has he had? Does he know—and use—the nerve-sparing techniques, the anatomical approach to radical prostatectomy? How many of these operations does he do a year? What success has he had in preserving potency and continence? (If he can’t or won’t give you his rate of success as compared to reports from other surgeons, or to results published in medical journals, this may be a red flag, and perhaps you should look elsewhere.) You should be able to get a good idea of his success rate, in numbers or percentages. And if he hasn’t done very many of these operations—at least 150—you might want to find a more experienced surgeon. Look at it this way: Do you want to be one of the patients he’s learning on?
When you’re looking for a surgeon, you don’t necessarily want some name-brand academician or a specialist in other areas of urologic surgery. You want to find a doctor who performs this particular operation. Often. Preferably, a doctor who does this operation every day, or several days a week.
Doctor B is another nice doctor, a respected, fatherly man who’s been operating in this town as long as anybody can remember. Just looking at him inspires confidence.
Swell. But does he also keep up with the latest research? Does he continue his education regularly, brushing up on old surgical skills as well as mastering new techniques?
Does he operate on nearly every man he treats who has prostate cancer? (This is not a desirable quality in a surgeon.) Or does he screen his patients carefully, making every attempt to spare any man with cancer that can’t be cured by surgery the unnecessary ordeal and expense of an operation?
Remember: Radical prostatectomy is a tricky operation, and you don’t want a surgeon who’s “pretty good” at it. Also, you can’t assume that every urologist does this well. There are no second chances here; this is a one-shot operation. You are looking for the one surgeon who will perform the one radical prostatectomy you will ever receive in your life, the one operation that will cure your cancer. You want a surgeon who isn’t going to leave some cancer behind, who knows how to control excessive bleeding so you don’t wind up incontinent, impotent or both. (Note: Unexpected trouble can crop up in any operation; nobody can help that. But the unexpected is less likely to happen with an experienced surgeon.)
So ask questions. Find out how often your doctor’s patients require radiation therapy after surgery, or treatment with hormones. If the number is greater than 15 percent, this suggests that the doctor either doesn’t do a very good job selecting surgical candidates, or is not completely removing all the cancer during surgery. It also suggests that you need to get a second opinion. But you should get a second opinion anyway. Always get a second opinion.
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