Here is a piece of health advice for any men about to undergo prostate cancer surgery. In most cases, you would focus on getting an experienced surgeon, so that nothing goes wrong. But, in fact, another factor is more important. Read on for the best health advice in this situation.
If you are older, sicker and at high risk, you’ll get better results for common prostate cancer surgeries in busier hospitals. That’s right: aim for the busier, bigger hospital rather than the most experienced doctors.
The results, gathered from around the U.S., were presented last week at the American Urological Association Annual Meeting.
We’ve long known that both high hospital volume and higher surgeon volume lead to better surgical results. But the two have never been compared side by side for the surgery “radical prostatectomy” (RP). In an RP, the entire prostate gland is removed. It is the most common treatment for prostate cancer, though is highly complex and the results can have serious effects on quality of life.
Researchers focused on more than 19,000 Medicare patients who had an RP between 1995 and 2005. Then, looking at the outcome for each patient within 30 days after surgery, the researchers analyzed the effect of both hospital volume and surgeon volume in predicting complications. These included blood transfusion, scarring and narrowing of incision lines, long-term incontinence, and impotence.
Drum roll, please, for the results:
— Both higher hospital volume and higher surgeon volume led to fewer complications
— Hospital volume and surgeon volume were each related to fewer respiratory and vascular complications
— Higher surgeon volume led to less need for bloodtransfusion
— Both hospital volume and surgeon volume were associated with lower rates of scarring, urinary incontinence, and impotence
Based on this, the researchers conclude that having a busy hospital matters more about preventing complications and deaths than a surgeon who has decades of experience. Overall, it is a hospital’s intensive care unit, the nursing staff, and other such factors that matter more than the actual surgeon’s skills.
Of course, risk of recurrence likely still depends on the skill of the surgeon to remove the cancer properly. Still, hospital volume is a better predictor of positive 30-day complication rates — especially for those who are older and sicker.
So the advice is: make sure you are comfortable with the hospital where your procedure is taking place. Make sure it is a well-respected place where many of these surgeries are performed routinely.