Invasion of the Prostate Snatchers: Revised and Updated Edition: An Essential Guide to Managing Prostate Cancer for Patients and Their Families—August 31, 2021
The title of this book harkens back the 1950s science fiction book and movie The Invasion of the Body Snatchers, in which aliens “snatch” humans and take over their bodies and minds for insidious purposes. The reference is apt, since the authors wish to draw attention to the overuse of surgery as a first-line treatment of prostate cancer. In addition to accomplishing that objective, they provide information on more effective, and less invasive, approaches to the screening, diagnosis, and treatment of prostate cancer.
The two authors come from very different backgrounds and experiences. Ralph Blum, a professional writer, tells his story of being diagnosed and treated for prostate cancer. He relates how, over a span of decades, he staved off potentially harmful therapies, and eventually found a prostate oncology specialist, Dr. Mark Scholz, to help guide his treatments.
Dr. Scholz is one of the few oncologists in the US who specializes in prostate cancer. We learn in the book that most doctors who diagnose and treat prostate cancer are urologists. Urologists, who are trained as surgeons, favor surgical solutions, and in fact surgery has historically been the most widely used first-line treatment for prostate cancer—too often for cancers that didn’t need to be treated.
The authors want to change this paradigm.
As they point out,
“Out of the 75,000 radical prostatectomies performed every year in the United States, more than 40,000 are unnecessary. In its heyday surgery was called the ‘gold standard.’ However, research now confirms that many who were ‘cured’ by surgery had a form of the disease that was never destined to threaten them anyway.”
Chapter by chapter, the authors alternate between Ralph’s personal story and Dr. Scholz’s explanations of the fundamentals of prostate cancer and how to use medical advances in screen and diagnosis to take control of treatments.
Prostate cancer screenings typically start with a blood test for the chemical PSA, heightened levels of which can indicate the possible presence of cancer. If PSA is elevated, patients are usually sent to a urologist for evaluation and, most likely, a surgical procedure called a random biopsy to search for cancer. If no cancer is found, and the PSA stays elevated or rises further, random biopsies will be continued on periodic basis.
If cancer is found, then all too often some form of treatment is immediately initiated—whether surgery (removal of the prostate) or radiation. It can be difficult for a patient, who has been newly diagnosed with cancer, to make an informed decision about the best approach to take.
In contrast with this approach, Dr. Scholz points out that prostate cancer generally progresses quite slowly. The authors therefore argue that active surveillance, which is to say close monitoring by the doctor, should be the initial treatment approach for most men with low- and many intermediate-risk cancers.
Additionally, rather than random biopsies, research is showing that screening using highly accurate MRI imaging technology is the best, and least invasive, approach to detect the presence of prostate cancer. If detected, then a targeted (non-random) biopsy can be done to confirm there is cancer and what level of risk it carries.
Only when surveillance reveals the need should more active treatment in the form of hormones, radiation or, in rare cases, surgery be considered. Dr. Scholz notes,
The information Ralph and I assembled amounts to a road map for safe passage through this treacherous medical terrain. Our aim is to present a better, more accurate way of thinking about prostate cancer that deals effectively with the disease and still preserves a man’s quality of life.
This book arms men with information and resources to take better control of the treatment plan during an emotional challenging time. If you have a prostate, or care about someone who does, those are weapons well worth having in your defense arsenal.
