Invasion of the Prostate Snatchers- Book Review

Invasion of the Prostate Snatchers: No More Unnecessary Biopsies, Radical Treatment of Loss of Sexual Potency may turn out to be one of the most important books you will ever read.  Frankly, this is not a book I would have picked up had I not been given the invitation to review it for Amazon.com.  Fortunately, for me, I was asked to review it. Prostate cancer is fairly common among men, particularly among African-American men.  Within the past couple of years both my father and an uncle have had their prostates removed due to a diagnosis of cancer.  I'm about to turn 50 and the chances of me being diagnosed with prostate cancer increase with each passing year (as they do for all men).  I wish I had read this book before my father was diagnosed.  My father suffered from minor complications from the surgery (as far as I know).  My uncle nearly died from a problem with his surgery, major blood loss.  Unfortunately, we're not the type of family to discuss this stuff in intimate details.  And, the complications from prostate surgery gone wrong are pretty intimate.  So, I will probably never know if they have long term complications. I do know my father suffered from the two most common complications for at least a while after his surgery. Those complications, temporary and permanent, are way too common for my taste.

The book is co-written by an oncologist who works with a lot of prostate cancer patients and a lay person who has lived with prostate cancer for 20 years.  The cancer patient, Ralph Blum, has a great sense of humor and keeps the book light enough to be almost enjoyable reading.  The book is packed with statistics and medical facts, as is necessary.  But, the human side of coping with this disease is never forgotten.  

Before reading the book, I realized that prostate cancer was generally a slo moving cancer.  I had heard that most men diagnosed with prostate cancer in their 60s or 70s will die with the disease rather than from the disease.  However, as I've been wondering how I'd deal with the diagnosis, I knew that my attitude would be a "just get it out of me" attitude.  I don't want to live with prostate cancer, I want to get rid of it.   I know, if I hadn't read this book, I would say "Just get it out of me.  NOW!"  I think that attitude is common among men.  Another common thing for us to do when sitting across from an expert is to ask the question "Doc, what would you do?"  I sat down with my uncle a few weeks ago and asked him to tell me a little about his experience.  He told me that after the urologist confirmed his prostate cancer, he immediately said "OK, if you were me and you had just been told what I was  just told, what would you do?"  What I didn't realize, and I don't think a lot of men really think about is, a urologist is a surgeon.  If you ask a surgeon what he would do and surgery is an option, what do you think he's most likely to say?

Prostate cancer can be divided into three types, low risk disease, medium risk disease and high risk disease.  With current diagnostic methods, you can pretty much determine which type of cancer you have.  Only if you have high risk disease do you need to be in any hurry to do any treatment at all.  On the other end of the scale, low risk disease is probably best treated with "active surveillance".  In other words, no radiation, no surgery, no chemicals, just monitoring it. The book describes treating this type of prostate cancer as a chronic condition and even goes so far as to say it might be better to come up with another name other than "cancer" because of the terrifying connotation of the word cancer.  In the case of low risk prostate cancer, the cure is worse than the  disease.  Whether you go with surgery or radiation, the chances of permanent side effects like impotence and urinary incontinence are extremely high- shockingly so to me (and there are some other pretty bizarre complications that are possible).  Even with the newer ways of doing radiation and with robotic surgery, the chances of permanent side effects are still pretty great.  In most cases, the chances of those complications are much greater than the chance of actually dying from prostate cancer.  When we hear cancer, I think most of us immediately think "death" and anything is better than death. So, when we hear there's say a 60% chance that we'll be impotent for at least 18 months after surgery, we might think "Better to be impotent than dead."  But, what if you didn't have to be either?

Ralph was diagnosed at the age of 58.  He's one of those guys who asked a bunch of questions before undergoing any procedure.  Turns out, that was a good thing. In the 20 years since he was diagnosed prostate cancer treatment has grown by leaps and bounds.  He's had a few treatments over the years but nothing radical.  He's had 20 good years with his wife because of his refusal to rush into treatment.  Sure, there is a chance that if he had the surgery 20 years ago, he might have had a good outcome. But, the chances are greater today than they were than and he has more treatment options.  The treatments available today weren't even thought of 20 years ago.  One of the most important messages of this book is that, if you get a diagnosis of prostate cancer, time is actually on your side.  The advances in treatment are growing at a rate faster than the disease in most men.  For example, there are ways of blocking testosterone (fuel for prostate cancer) that virtually halts the disease in its tracks.

Hopefully, I won't need this book anytime soon.  But, just in case I do, I'm going to keep it tucked away.  There is a ton of information on different treatments, everything from the truly bizarre to the conventional to cutting edge advances.  There is information on the right type of diet to eat should you be diagnosed.  One thing I know for sure now, if and when I am diagnosed I don't intend to panic and rush into surgery or radiation therapy or even a biopsy.   And, I won't ask a urologist "What would you do?"  I recommend that every man over the age of 40 read this book and get informed about prostate cancer.  If there's a type of cancer you do want to have, this is the one.  It's important to make sure that you don't make a mistake and opt for a treatment that is actually worse than the disease.   For any man in your life that's really important to you, this book would make an excellent gift.