How to Choose the Right Prostate Surgeon

How to Choose a Prostate Cancer Surgeon

If you have been diagnosed with prostate cancer, surgery might be the best treatment for you, especially in younger men less than 65 years old who have higher risk disease and overall good health. But, before you undergo an operation, you need to feel confident that you are using a surgeon you can trust.

Read on to learn what factors you should consider, as well as what you should avoid, when choosing the right prostate surgeon.

Factors You Should Consider

When it comes to choosing a prostate surgeon, experience is the primary concern. While there is no "magic number" of years a doctor needs to have practiced necessarily, one who has performed prostate surgery hundreds of times is better able to put your mind at ease than someone who does not perform prostate cancer surgery very often. A doctor who has had extra fellowship training focusing on prostate cancer treatment is beneficial, too.

Additionally, a multidisciplinary team can help you get the best treatment. Since the decision between surgery and radiation is not always black and white for patients, the surgeon you choose should offer a consultation with a radiation oncologist to determine if radiation is the better option.

Red Flags to Avoid

First and foremost, avoid a surgeon who seems to push or market the surgery they offer. Also, if they say they can do the surgery tomorrow or next week, it’s probably because they are not very busy and don’t do many surgeries.

It is always wise to ask the doctor about patient outcomes. If the surgeon cannot answer or doesn’t know, this is a concern. It indicates that they do not engage with patients enough during their journey beyond treatment, and are not following their own outcomes. In short, these surgeons simply can’t know what they don’t know. Similarly, if you meet with a doctor who quotes outcomes that seem too good to be true, they probably are.

For example, if a surgeon claims that 95 percent of all patients have no trouble with erectile function after surgery, he is probably not giving you an honest or realistic picture of typical outcomes, or outcomes specific to your condition. They may only be considering young men with low-risk disease and good preoperative erectile function, who also have bilateral nerve sparing to preserve erections.

These patients realistically only consist of about half of men seeking treatment.

Why Your Prostate Surgeon Choice Matters

Prostate cancer surgery is not a procedure that can be done well by just any surgeon, especially when it comes to preserving your long-term health. Nearly any urologist can remove the prostate safely, but there may be side effects that reduce quality of life in the long run. For example, surgery can not only affect erectile function, but it can also disturb urinary function, depending on the surgeon’s skill.

So don't let the pressure of a prostate cancer diagnosis rush you through this decision-making process; take your time and make the right choice. See as many practitioners as you can to explore all of your treatment options and gather as much information as possible before you get prostate cancer treatment.

Also, remember that there is a lot of misinformation about prostate cancer out there. For example, a common misconception heard in our clinics is: “I didn’t think prostate cancer could kill me."

This is simply not true, as it remains the second leading cause of cancer death in men. It is, however, generally slow-growing if caught in time. So there is time to make the correct decision for you, which may even be no treatment at all.

While prostate cancers may be slow-growing — which is why you don’t need to make a treatment decision in one day — avoiding treatment altogether is not recommended without expert guidance and input from a trained doctor or surgeon. At the same time, some low-risk cases require no treatment at all. So do your research and be mindful of your choice in prostate surgeon, and you'll increase your chances of positive outcomes.

We are here to help.

If you have questions about the MedStar Georgetown Cancer Network or are ready to schedule a consultation with one of our specialists, call us at 855-546-1815 or click the request a consultation button.

Keith Kowalczyk, MD, is board certified in urology, with fellowship training in urologic oncology and robotic-assisted surgery from Brigham and Women’s Hospital/Harvard Medical School. Dr. Kowalczyk focuses his practice specifically on urologic malignancies such as prostate, kidney, testicular, and bladder cancers. While skilled in performing traditional open surgery, his special expertise is in robotic-assisted surgery, and he has performed hundreds of procedures using this technology.