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Old 10-14-2010, 05:33 PM   #1
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Thumbs up "Invasion of the Prostate Snatchers" - review of new book

I've just finished reading this new book. In a word, it's awesome! I believe this book will be a game changer for many patients, both newly diagnosed and veterans.

It was published in August with the full title "Invasion of the Prostate Snatchers -- No More Unnecessary Biopsies, Radical Treatment Or Loss of Sexual Potency. It's by Ralph H. Blum, a prostate cancer survivor and noted author, and Dr. Mark Scholz, MD, a well-known medical oncologist whose practice has specialized in prostate cancer for the past fifteen years.

It offers a broad view of strategies for dealing with prostate cancer as well as many valuable insights into coping with the prostate cancer experience. The format is a dual track, with Dr. Scholz writing about half the chapters and his patient, Ralph Blum, writing the remainder. While it is packed with current and leading edge, highly expert thinking and information about the disease, it is also an easy and entertaining read. I particularly like Mr. Blum's sense of humor, something that comes through on many pages. (He does not pull any punches either. Despite going for cryosurgery to a doctor who is very high on Dr. Scholz's list, Blum is thoroughly spooked by the pre-op briefing and says to hell with this, walking away and not coming back. I imagine there might be one or two of us who can identify with that! )

There are a number of special strong points. Perhaps most prominent is the powerful emphasis on doing what is wise in the circumstances, which often means avoiding unnecessary treatment and even biopsies. This involves a lot of important information about active surveillance. However, this emphasis is balanced by advice to get on with biopsies and treatment when that is wise.

Another special strong point is the attention to androgen deprivation therapy, also known as hormonal therapy or hormonal blockade therapy, or in this book as TIP, which stands for Testosterone Inactivating Pharmaceuticals. Dr. Scholz is one of the foremost experts in this field, and the book covers a multitude of key facts, insights and tips. Moreover, Ralph Blum, though successful with active surveillance for a long period, underwent a period of triple hormonal therapy, which he writes about in several chapters. It is especially meaningful that Dr. Scholz has now prominently endorsed TIP as a legitimate first line therapy option for many men, even men with low-risk disease.

While the book devotes enough attention to the various therapy options, even including a chapter on quack approaches, another special strong point is its attention to medical imaging. There's a chapter on "Nikola Tesla's Mgical Myster Machine," which is actually about endo rectal MRI and spectroscopy. There's a chapter on color Doppler ultrasound, which is particularly welcome as that topic is not extensively covered in other leading books, such as "A Primer On Prostate Cancer" and "Beating Prostate Cancer: Hormonal Therapy & Diet." (The text on active surveillance is also more extensive than is available elsewhere.) There's a chapter on Combidex, the extremely accurate but nearly unavailable imaging technology for lymph nodes.

Another strength is the information and insights about side effects and how to counter them, especially side effects from TIP, an area in which Dr. Scholz, a leading expert, gives us priceless advice.

Other welcome topics are also well covered, such as the relationship of insulin and prostate cancer, the immune system, and prostate cancer as a wake up call to our general health.

The reader who absorbs all this information will be in a far better position to make treatment and strategy decisions for dealing with his case. This impact on our analysis and decision making ability for prostate cancer is another extraordinary strength of this book.

The book has an excellent recommended bibliography with comments on the strengths of the books (and, if you read between the lines, their shortcomings). For folks like me that like to know the research behind the statements, the book is well footnoted, with a chapter containing all the footnoted references. The index is also excellent.

I believe this book will quickly take its place with the Primer and "Beating Prostate Cancer: Hormonal Therapy & Diet." In my opinion all three belong in our personal libraries.

I expect others of us will want to comment on what the book has meant to them and perhaps to raise questions about some of the issues, but I wanted to share my excitement with this post. I expect to include some specific high points in future posts on this thread, but I'll just say for now that I learned a number of points that will help me with my own case.

Thanks to Mr. Blum and Dr. Scholz for giving us this awesome book!

 
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Old 10-15-2010, 10:25 AM   #2
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Re: "Invasion of the Prostate Snatchers" - review of new book

Jim,
I found the book very helpful, but I found that Blum's part was a distraction and posters on other sites have cited some of Blums actions and statements as a reason to discount the entire book.
I'm very familar with Dr Scholz and wish I had found him 10 years earlier. I had rising psa from 4 to 40 over a ten year period, free psa ranging from 7-15%, seeing experts at UCI, UCSF and UCLA and had 13 negative biopsies and a negative endorectal MRIS. All doctors (6 urologist oncologists)) Dxed me as BPH. I was finally Dxed with a G6 <5% on my 13th, 26 core biopsy and scheduled surgery as recommended. By chance of fate my wife's oncologist told her that I should see Dr Scholz before doing anything. He took one look at my history and said there was no way I had a G6 <5% and was certain I had a much more serious cancer that was yet undetected in spite of all the tests I had, and what was indicated on my biopsy was clinical insignificant. He sent me to Dr Bahn for a Color Doppler and also gave me PAP and PCA3 tests. Dr Bahn found a G4+3 large (2.5cm) tumor in the anterior with nerve involvement. Both Scholz and Bahn said it was highly probable that surgery would result in a positive margin and incontinence because of the location. Dr Scholz also recommended getting a Combidex so radiation could be targeted to suspected nodes. The Combidex came up clear (his only patient to be found clear), so I underwent seeding and IMRT. At 1.5 years I have a 0.1 psa and no side effects. I personally owe a lot to Dr Scholz, and his knowledge of PC and how it acts put my other 5 expert doctors to shame. None had ever heard of the Combidex and when I asked about color doppler they said it doesn't work. No one ever suggested a PCA3. The book stresses futher testing before making a treatment decision and I for one can testify to the validity of this approach and would recommend that everyone Dxed with PC get a 2nd opinion from an unbiased oncologist specializing in PC before making a treatment decision. I think the the book makes a very imortant point in that PC is the only cancer that is still diagonosed and treated by a surgeon. In all other cancers an oncologist specializing in that specific cancer is the lead doctor.
JohnT

 
Old 10-15-2010, 05:04 PM   #3
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Re: "Invasion of the Prostate Snatchers" - review of new book

Hi John,

Thanks for providing that dramatic account of your own case. Whew! Close call there! Your story once again illustrates how so many doctors who you think would be savvy are capable of making some awful mistakes in judgment. It took me a while to learn that. I still find it odd that there is such a gap in expertise between the leading experts and doctors who pretty much stick with standard practice.

Wasn't that something that your wife's oncologist would mention Dr. Scholz before it was too late for you? I had a moment like that too, back about May of 2000 when I was well on the way toward external beam radiation (three consults into the process, with tattooing scheduled in two weeks). I was already on Lupron and Casodex, but someone on a message board (now extinct) I had just discovered mentioned Dr. Bob Leibowitz to another responder. I checked into his published papers and found what I needed. As I'm sure you are aware, he is another of the leading exponents of one-cycle or intermittent hormonal blockade therapy (with finasteride maintenance, in his case, unless he has recently switched to Avodart). I then learned about Drs. Strum and Scholz and their work with hormonal blockade, and I was on my way. I had been reading Dr. Myers newsletters for some time, but I don't recall that he was that into advocating intermittent triple blockade back then, though he was then on it himself, as well as having other therapy, for his own challenging case.

From time to time I think about what would have happened to me if I had not run across that single message back in May of 2000. Radiation was no where near as mature then as it is now, and I suspect the low odds of success I'd been given would have panned out with an early recurrence, coupled with a substantial burden of long-term side effects from the heavy pelvic radiation that was planned. In fact, though I had tried to confirm I would be given 3D conformal beam radiation - then coming on strong - instead of the older version, I had not received straight answers and suspect most or all of the delivery would have been under the older, less capable system.

I guess your post has made me philosophical tonight. I'm not much into thinking that God saves me but not a lot of other guys, but now and then in quiet moments I do wonder if God was acting in the place in my life I had made for him on the day I came across that message. Have you had similar thoughts?

I too have had contact with Dr. Scholz, though no where near as direct or extensive as yours. I spoke to him on two occasions over the years at conferences, getting a useful tip once and reporting my progress last year. The key interaction was when I got a response from him on a group email service way back in 2000 when I was trying to decide whether to rely on triple hormonal blockade. He and Dr. Strum had not really looked into success of ADT3 with very high-risk patients like me, but he told me he thought it had a chance of working, and I decided to go that route, working with my local oncologist. IADT3 has since worked very well for me.

Well, back to the book - your case is an almost made-to-order example of many of the points discussed in the book. Only a few guys I know of have actually had a Combidex scan, and I'm glad for your account. It's too bad that some of us have been turned off by Mr. Blum's chapters. To me, he comes across as an Everyman, not savvy at the outset, reacting to fears, placing hopes in quack approaches, and burrying his head in the sand until he finally gets it right. I can see why some readers would consider some of his reactions pretty stupid, but to me he contributes a very human dimension to this technology oriented book. I don't see that anyone can fault him for honesty and forthrightness.

Take care,

Jim

 
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