Being diagnosed with prostate cancer brings many decisions, often under time pressure. Choosing who will treat you is one of the most significant. The best surgeon for one man may not be the best for another, because the right choice depends on the details of your diagnosis. This guide explains how matching a surgeon to your diagnosis helps you choose with confidence.
Start with your diagnosis
Prostate cancer is not a single disease. Your PSA level, Gleason score or grade group, the stage of the cancer and your general health all influence which treatments are suitable. They also influence the kind of expertise you need.
NICE guidance on prostate cancer groups localised prostate cancer into risk categories. Knowing which group you are in is a useful first step. Ask your team to explain your results, and our overview of prostate cancer can help you understand the terms used.
Low-risk disease
Many men with low-risk cancer are offered active surveillance rather than immediate treatment. This involves regular PSA tests, MRI scans and sometimes repeat biopsies, with treatment offered if the cancer shows signs of change. In this situation, you need a specialist who is comfortable recommending monitoring and who will not push you towards surgery you may not need. Monitoring of this kind means many men avoid or delay the side effects of treatment, while keeping the option of treatment open if it is needed.
Intermediate-risk disease
For intermediate-risk cancer, surgery and radiotherapy are both common options, and active surveillance may be suitable for some. Here, matching a surgeon to your diagnosis means finding someone experienced in robotic prostatectomy who can explain honestly how surgery compares with radiotherapy for you. Nerve-sparing technique is often particularly relevant at this stage. Our robotic prostatectomy page describes what the operation involves.
Higher-risk or more complex cases
If your cancer is higher risk, or your anatomy is more complex because of a large prostate or previous surgery, experience becomes even more important. These operations are more demanding, and a surgeon with a high caseload is better placed to handle them. Our article on why surgeon experience matters explains the link between volume and results.
Questions to ask about fit
When matching a surgeon to your diagnosis, useful questions include:
- How often do you treat cancers like mine?
- Is nerve-sparing likely to be possible in my case?
- How does surgery compare with radiotherapy for my risk group?
- What would happen if I chose active surveillance instead?
NHS and private routes
Most men in England are referred to a urology team through their GP. Within the NHS, you can usually choose which hospital you are referred to, so you can request a particular centre. NHS information on prostate cancer explains how the pathway works.
Private treatment gives you a direct choice of consultant and usually shorter waits between diagnosis and surgery. Many senior NHS surgeons also practise privately, so similar expertise is often available through either route. Our article on the private surgery pathway covers this in more detail.
Checking the wider picture
Once a surgeon's experience fits your diagnosis, consider the rest of their care. Do they work within a multidisciplinary team? Do they share personal outcome figures? Is specialist nursing support available after surgery? These factors complete the picture, and each is worth asking about directly.
Making your decision
The best choice combines clinical fit with personal confidence. You need a surgeon whose experience matches your diagnosis and with whom you feel able to talk openly throughout treatment and recovery.
If you would like Professor Dasgupta to review your diagnosis and discuss whether surgery is right for you, please contact the clinic to arrange a consultation.