Many guides list questions to ask a prostate cancer surgeon, and preparing them is a sensible first step. The harder part is judging a surgeon's answers once you hear them. A confident, experienced specialist will welcome close questioning, and how they respond can tell you a great deal. This article explains what good answers sound like in each area and which replies are worth exploring further.
Why the answer matters as much as the question
Prostate cancer surgery is not the same for every patient. Results vary between surgeons, hospitals and techniques. Asking detailed questions helps you understand your options, but only if you can tell a clear, specific answer from a vague one. If you have not yet drawn up your list, our guide to essential questions to ask your surgeon is a good place to start.
Experience
Ask: how many radical prostatectomies do you personally perform each year, and how long have you specialised in prostate cancer?
A good answer gives a specific number, refers to the surgeon's own caseload rather than the hospital's, and describes experience with cases similar to yours. A surgeon who hesitates or offers only general reassurance has not answered the question. Our article on why surgeon experience matters explains the reasons behind it.
Technique
Ask: which approach do you recommend for me, and why? Is nerve-sparing possible in my case?
A good answer links the recommendation to your scan and biopsy results, explains the reasoning in plain language and is honest about whether nerve-sparing is safe for you. It should also explain the trade-offs. Our robotic prostatectomy page describes the most common approach, which will help you follow the explanation.
Outcomes
Ask: what are your continence results at three, six and twelve months? What are your erectile function outcomes after nerve-sparing surgery? What is your positive margin rate?
A good answer gives figures at defined time points and puts them in context. Phrases such as "outcomes are generally very good" without supporting numbers deserve a follow-up question. National context is available from the National Prostate Cancer Audit.
Risks and complications
Ask: what are the main risks for someone like me, and how would complications be managed?
A good answer is balanced. It acknowledges real risks without minimising them, explains how likely they are for you specifically and describes what support is in place. Independent information from the NHS on prostate cancer treatment can help you judge whether you are getting a fair picture.
Alternatives to surgery
Ask: what other options do I have, and why do you recommend surgery over them?
A good answer discusses active surveillance and radiotherapy openly, even if the surgeon believes an operation is the best choice. A specialist who presents only one option is not giving you the full picture.
Care team and follow-up
Ask: who will review my case, who do I contact after surgery and how will my PSA be monitored?
A good answer names a multidisciplinary team, a specialist nurse contact and a clear schedule of follow-up tests.
Answers that need a closer look
A few responses are worth noting: reluctance to share personal figures, dismissal of your questions, pressure to decide quickly or discouragement from seeking a second opinion. None of these automatically rules a surgeon out, but each deserves careful thought.
Using what you learn
Clear, specific and honest answers are the best sign that you are in good hands. Remember that you can take time to decide and seek another opinion if you need one.
Professor Dasgupta is happy to answer every question in detail. Please get in touch to arrange a consultation, or read about his experience first.