In December, my step-father was diagnosed with prostate cancer. It’s a very minor case of the disease so I’m not particularly worried. His prospects of being cured are excellent. However, I knew very little about the cancer. At the same time, LibraryThing’s Early Reviewers program included the book Winning the Battle Against Prostate Cancer by Gerald Chodak. I thought highly of a book that Demos Health published about A.L.S. (my mother died from that illness) so I selected Dr. Chodak’s book to review.
Before I delve into the book, I need to specify a caveat. I am not in the slightest qualified to determine the accuracy of Dr. Chodak’s information about the disease or its treatment options. Although I strongly doubt he’s lying about anything in the book, everyone has biases. He warns about biases generally in the book, though I didn’t see anything about his particular biases. It stands to reason that he will be susceptible. In particular, I worry that he cherry-picked information unconsciously. This is not a problem with Dr. Chodak specifically. It’s just that everyone has these biases and I don’t have the background to point them out.
The other caveat that I can think of is that while the information may be correct right now, the book will almost certainly be out of date within a year or two.
I have to say this appears to be quite a good book. I am a skeptic by nature. I’m the guy who reads news stories and disbelieves anything that doesn’t appear to be backed up by facts. Dr. Chodak’s approach in the book is much the same. His second paragraph in the book proper, in a chapter on preventing prostate cancer, cautions against believing news reports on the latest vitamin or food item that may prevent prostate cancer. This is not because he’s a disbeliever in the effect of dietary changes on cancer, but because these reports are based on backward looking epidemiological studies, rather than randomized experiments. A study that shows that people who eat garlic (for instance) have less prostate cancer. But perhaps a percentage of people who eat garlic also are taking a medication that has two effects: it prevents prostate cancer and it causes people to crave garlic. The garlic itself has no effect.
A major portion of the book is a series of chapters, one on each of the major treatments for prostate cancer and their variants. These consist roughly of active monitoring, prostate removal, radiation therapy, and cryotherapy. In each, he repeatedly quotes the randomized prospective studies that show the treatment’s effectiveness on quality of life and their ability to cure or treat the prostate cancer.
Most importantly, he covers each treatment’s survival rates. The last one is particularly important because curing prostate cancer isn’t always the most important goal. Many men who suffer from prostate cancer will see no appreciable symptoms, will have it for a number of years, and will die from something completely different (like old age). If the cancer would not kill a person anyway, curing it doesn’t help and the side effects of treatment might be worse than the disease.
According to the author, those statistics are actually fairly limited. Despite decades of treatments, there has been only one randomized experiment that studied the survival rate of one treatment compared to another (radical prostatectomy vs.
watchful waiting if I remember correctly). There have been a number of studies that compared stand-in statistics, such as P.S.A. levels. That measures the level of chemicals a person’s body manufactures in response to growth in the prostate. So they can tell if the treatment has been effective against the cancer, but don’t take into account whether the cancer would have had any impact on the sufferer’s life.
One chapter near the end covers alternative treatments. Dr. Chodak is not entirely dismissive of the usefulness of various herbal supplements. None of them will cure prostate cancer, but some of them might increase the odds of beating the disease. He does not cover in depth the studies that have been done as he does for the primary treatments. However, even more so than standard treatments, the data in support of their helpfulness is very thin. Dr. Chodak categorizes a few of them as possibly helpful and not likely to hurt nonetheless.
Dr. Chodak does relate a number of these studies and statistics, and they could be quite useful in helping to understand prospects in fighting the disease. He gives them very clearly, so that someone without a lot of science background can understand them. I think some science background is helpful to getting through the book, but it certainly doesn’t require a college degree. Dr. Chodak writes a nice summary at the end of each chapter explaining the bottom line.
The bottom line from me is that it’s a pretty damn good book.