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Book review: “Invasion of the Prostate Snatchers: No More Unnecessary Biopsies, Radical Treatment or Loss of Sexual Potenc

Posted Sep 13 2010 3:50pm

By Ralph H. Blum and Mark Scholz, MD

Review by Scott Keith

As a man gets older, he has a greater chance of getting prostate cancer. It’s a scary moment. The man may wonder if his cancer is fatal. Not too many years ago, a cancer diagnosis was thought of as an automatic death sentence. Unfortunately, some cancers are diagnosed at a late stage, but evolving technology is making it easier to treat early-stage cancer.

Prostate cancer is a strange breed of disease. Long-term survival is a very good bet if the tumor is low-grade and confined to the prostate. In many cases, there is no need for a man to panic and schedule a prostatectomy the following week. You could almost say that if you had the misfortune of getting cancer, the prostate variety would be the choice. The newly-diagnosed man would be well served to read a fascinating, engaging book on prostate cancer, written by a doctor who is board certified in medical oncology and internal medicine and a patient who has spent a couple of decades living with the disease.

Ralph H. Blum and Dr. Mark Scholz have co-written “Invasion of the Prostate Snatchers: No More Unnecessary Biopsies, Radical Treatment or Loss of Sexual Potency.” Blum should know. He has avoided surgery to remove his prostate and today concentrates on carefully monitoring his disease.

The book is riveting and instructional on many levels. Blum and Scholz write alternating chapters. In chapter one, Blum introduces the reader to Prostate Country. Blum writes, What follows is a two-man show-and-tell, the result of an alliance between a prostate oncologist and his Refusenik patient. We will have accomplished what we set out to do if this book informs you, calms your fears, entertains you and leaves you with good reasons for hope. And that’s the focus of this remarkable book: To allow the newly-diagnosed prostate cancer patient to think through the disease and treatment options, minus panic and anxiety. In an interview with Men and Health: It’s a Guy Thing, Blum, a cultural anthropologist and author, who has written for a number of nationally-recognized magazines, says he went in for a regular check-up around 1990. “It was time for the infamous DRE (digital rectal exam) where he just said ‘drop ‘em and bend over,’”recalls Blum. The doctor found a palpable lump and Blum’s PSA had been a little high. After a prostate biopsy, they could not read the results. Blum turned down a repeat biopsy. In what he later called a risky move, he didn’t have another biopsy for nine years, although he continued monitoring his PSA blood level.

During this time, a friend suggested Blum touch bases with Dr. Scholz. “We started a relationship that eventually turned into a partnership. It’s an interesting kind of “no man’s land” to operate in where you are both the writing partner and the patient,” says Blum.

Chapter two delves into an area men constantly struggle with. Do I remove the prostate, even if the cancer is low-grade, or not too aggressive? Scholz, also interviewed by Men and Health, says the book has some fairly straightforward messages. One is that there are different types of prostate cancer. Scholz makes the argument that, “specialists that run this business are surgeons, so the default recommendation is an operation.” He adds that quality of life is an issue. “Even the “quote” bad types of prostate cancer generally are not fatal, so people usually live a normal life expectancy. They have to live with the consequences of the treatment that they pick. For us guys, surgery causes impotence. Even if you go to the finest surgeons, you’re going to be impotent more than half the time,” says Scholz.

Scholz stands by the statement that low-risk prostate cancer “can be watched, period.” The contention for that point of view, according to Scholz, is based on science published by urologists. “The idea of active surveillance, at the academic level, is really not controversial. But when you get out into the back alleys of prostate cancer treatment, there are a number of doctors that haven’t bought into the concept,” says Scholz.

“The book also makes the point that if you have intermediate or high-risk (disease), and you need treatment, modern state-of-the-art radiation technology is both less toxic and more effective at controlling cancer than surgery,” says Scholz. “We’re not a one-trick pony saying everyone should just watch their cancer. We know that some types do need treatment. When treatment is required, we believe there are better ways than surgery to treat it.”

The idea is for men to take personal responsibility and learn all they can about the disease and treatment options, then talk it out with medical experts. Scholz says, “In the book, we want to provide a map, or a way to empower patients…there’s a need for unbiased information that people can peruse in the privacy of their homes…and reflect on… and pray about…then take that information to different experts and be able to query them in a professional, pointed way about some of these hard questions.”

If you are diagnosed with prostate cancer, consider some wise advice from Blum: “Do as little as possible. Consider all the alternatives, which means do your homework. Take a trusted person (a cherished loved one) with you to all your doctor appointments. Let them take notes for you. Learn about collateral damage. Get second and third opinions. Remember that urologists are surgeons.” Perhaps most important, Blum says, “stay calm.”

Hardcover, 293 pages, $24.95, Other Press, Available at Amazon.com and bookstores.

Prostate Cancer Research Institute is at www.pcri.org


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