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Bruce L. Dalkin, MD

Dr. Dalkin is a urologic oncologist with 20 years of experience in the diagnosis and treatment of bladder and prostate cancer. He has performed over 1,300 open nerve-sparing radical prostatectomies during his career.

Patient Care Philosophy:

In order to provide high quality patient care, physicians must be able to read and accurately interpret new information and stay current in the field. Physicians must have clinical decision-making skills that provide appropriate diagnostic and treatment education and recommendations for patients. In addition, physicians must have exceptional technical skills to provide the highest quality results for patients.

I have always loved the fact that in patients with urologic cancers, we evaluate, diagnose, educate and treat patients for their potentially life-threatening problems, and then provide life-long care after these treatments. This is truly rewarding and unlike many other surgical specialties.

Dr. Dalkin's Resume


Title

  • Professor, Department of Urology, University of Washington School of Medicine

Clinical Expertise

  • Open nerve sparing radical prostatectomy
  • Other urological cancer surgery: bladder, testis, and penile cancers

Education And Training

  • BS: University of Michigan, Ann Arbor, MI 1981
  • MD: Northwestern University, Chicago, IL 1985
  • Resident in General Surgery: Northwestern University, Chicago IL 1985-1987
  • Resident in Urology: Northwestern University, Chicago, IL 1987-1990
  • Chief Resident in Urology: Northwestern University, Chicago, IL 1990-1991

More Information

  • Dr. Dalkin was recognized as a 2012 "Top Doctor" in Seattle Magazine's 2012 annual survey.
  • Visit PubMed for full listing of Dr. Dalkin's journal articles.
  • For more information about Dr. Dalkin's clinical and research expertise, click here.
  • Quality of Life Studies by Dr. Dalkin

Dr. Dalkin's Story


Working to improve prostate cancer treatment outcomes

Bruce Dalkin, MD, is a urologic oncologist interested in health-related quality-of-life outcomes research.

“Many years ago I decided that I wanted to more accurately learn about what happens to people after surgery for prostate cancer, find out how well I was doing for my patients, so I would be able to tell future patients what to truly expect,” Dr. Dalkin said. Working as an associate professor of surgery at the University of Arizona, he initiated a prospective quality-of-life survey study of his patients before and for up to eight years after surgery. The surveys were completed anonymously by the participants and collected and tabulated by an independent third party. The return rate was more than 90 percent. The data manager reviewed the results each year with Dr. Dalkin.

“The interview questionnaire looked at things like sexual and urinary health—big issues for men after this type of surgery,” he said. “This study was an optimal way to find out if we really were doing well for our patients.”

Fortunately for him and his colleagues, the answer was yes. According to the study results, published in Urologic Oncology, Journal of Urology, and Cancer, Dr. Dalkin’s patients fared very well after surgery. However, if they had not, modifications to treatment and surgical approaches would have been examined and refined.

Better-than-typical results

Using the surveys, Dr. Dalkin’s results were as follows:

  • In the general health domains of the survey, there was rarely any change after surgery.
  • In bowel function and other domains, there was no significant change after surgery.
  • In urinary health, by two years after surgery 89 percent of men were pad-free and returned to baseline in their domain score, 7 percent wore a safety-liner in their undershorts (a mini-pad that could remain all week), and 4 percent needed a pad. Also, 93 percent of men stated they were as good as before surgery. Overall in the United States, the percentage of men needing pads after surgery is around 20 to 30 percent.
  • In Dr. Dalkin’s patients, the rate of surgery for severe urinary leakage is less than 1 percent. Overall in the United States, the percentage of men with severe urinary leakage who then have further surgery is around 8 percent. “Other surgeons have published similar results to those I have found, none truly better,” Dr. Dalkin said, “but many far worse. There are clear differences in the rates of urinary incontinence after surgery between surgeons, due primarily to their technical skills.”
  • According to Dr. Dalkin’s surveys, among men under the age of 60 with good preoperative sexual health who underwent bilateral nerve-sparing surgery, at two years 65 percent were able to have erections adequate for intercourse without the need for any pills or treatments. In those having only one nerve spared due to concern about cancer control, 48 percent were able to have erections adequate for intercourse without pills or treatments.

At present, there are fewer than 20 urologic surgeons or radiation oncologists in the United States who know their own results. Dr. Dalkin believes there have been few studies to date of this nature because not all physicians have equal outcomes and if a doctor doesn’t do well in the study it can have a negative impact on patient referrals.

“If problems exist, we can define what the differences are and how to correct them, if possible, and then teach all doctors to perform well. This would lead to more cost-effective outcome-based medicine and would be better for both patients and their doctors,” Dr. Dalkin said.

At University of Washington Medical Center, Dr. Dalkin has a larger patient volume to continue his research.

“Robot-assisted surgery has not been shown to have any advantages over well-done open surgery with regards to recovery, urinary continence, and sexual health,” Dr. Dalkin said. “There is a lack of well-designed quality-of-life survey studies with robot-assisted surgery. Seattle is the perfect city to look at how open and robot-assisted surgery and radiation oncology are doing for patients’ outcomes and quality of life.”

Dr. Dalkin received his medical degree and residency training in general surgery and urology at Northwestern University in Chicago. He served as a urologic oncologist at the University of Arizona for 12 years and as the director of Urologic Oncology at the Arizona Cancer Center for seven years. He also worked in private practice in Tucson for six years prior to beginning his position at the University of Washington. His other research interests include treatment of men with low-risk and high-risk prostate cancer. Referrals can be made by calling (206) 598-6088 or (206) 288-6542.