"Invasion of the Prostate Snatchers"

By John Ballard

This is a book non-review. I haven't read it, but I might.
Gary Schwitzer says Invasion of the Prostate Snatchers is on his list of books to buy and Dana Jennings' NY Times review is positive.
That's a good sign since Jennings is a Stage 3 prostate cancer survivor. It's an old topic in a new wrapper: over-treatment of prostate cancer. 

About 200,000 cases of prostate cancer are diagnosed each year in the United States, and the authors say nearly all of them are overtreated. Most men, they persuasively argue, would be better served having their cancer managed as a chronic condition.

Why? Because most prostate cancers are lackadaisical � the fourth-class mail of their kind. The authors say �active surveillance� is an effective initial treatment for most men.

They add that only about 1 in 7 men with newly diagnosed prostate cancer are at risk for a serious form of the disease. �Out of 50,000 radical prostatectomies performed every year in the United States alone,� Dr. Scholz writes, �more than 40,000 are unnecessary. In other words, the vast majority of men with prostate cancer would have lived just as long without any operation at all. Most did not need to have their sexuality cut out.�

Unlike many others, the comments thread makes provocative reading. This is not an issue with easy answers, illustrating why we use the term "practice" when referring to medicine. I like this one.

The good thing about prostate cancer is that it is sensitizing men to the similar hysteria being promoted in the name of fighting breast cancers in the profligate diagnoses of DCIS. [Ductal Carcinoma in Situ, a similarly controversial diagnosis of breast cancer often "not the real thing."] Funny thing how American Medicine has zeroed in on cancers linked to the psychological roots of sexuality and identity converting it into cash. Oh, and spare me all you doctors weighing in with your pious, �even if only one out of fifty was truly saved, we�d never have known otherwise!� Garbage medicine worthy of a Goya cartoon.

Three take-aways from me.

?My father was diagnosed with prostate cancer over a year before he died from other causes. His doctor wisely advised that his cancer was slow-growing and he would almost certainly die from other causes... which he did. 

?If and when I am confronted with a diagnosis of prostate cancer you can be sure I won't settle for one doctor's opinion. A week or two delay to study alternatives before deciding a course of treatment (or watchful waiting) will not change the end result in any important way. If my cancer is that virulent I will opt for hospice. 

?The difference between major surgery and minor surgery is this: If it's happening to you it's minor but when it's happening to me it's major. 

Here is the link to the National Cancer Institute about the PSA test and how it relates to prostate cancer.

(Anybody else see how this matter is related to health care inflation???)