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Hopkins Medicine Magazine - More Books

Hopkins Medicine Winter 2013

More Books

Date: February 1, 2013


More Books

The Whole Life Prostate Book: Everything That Every Man—at Every Age—Needs to Know About Maintaining Optimal Prostate Health

H. Ballentine Carter, MD, with Gerald Secor Couzens (Free Press, 2012)

In the old Hollywood studio system’s heyday, certain movies were ballyhooed as being “ripped from the headlines!” The Whole Life Prostate Book by H. Ballentine Carter, professor of urology and oncology and director of adult urology at Hopkins, easily could be promoted in a similar fashion. Instant controversy erupted last May when the U.S. Preventive Services Task Force (USPSTF) pooh-poohed the value of routine prostate-specific-antigen (PSA) testing for early detection of prostate cancer.

The task force—which did not include a single urologist or oncologist—concluded that PSA tests too often led to false positive results and were more harmful than helpful.

Writing months before the latest brouhaha, but in response to earlier questioning of the PSA test’s value and anticipating more criticism of it, Carter emphatically disagrees with those who call for the end of mass PSA screening. “PSA screening of men between the ages of 50 and 69 can reduce the rate of death from prostate cancer by as much as 20 to 40 percent even without treating all men” in whom the disease may be found, says Carter in his new book.

Although Carter is a strong advocate of PSA testing, he also encourages non-invasive care for prostate cancer whenever possible. Sixteen years ago he helped to create and continues directing Hopkins’ groundbreaking active surveillance program for men found to have low-grade prostate cancer. This was the first program of its kind to meticulously re-examine men with prostate cancer, rather than treat them, he writes. “Almost 1,000 men diagnosed with low-grade prostate cancer have enrolled, choosing for now to avoid surgery or radiation therapy and taking the alternate approach of careful monitoring of their cancer.” 

Carter’s hefty (480-page) but eminently readable book maintains a similarly judicious, balanced, easily understandable approach to what can be a controversial subject—even though prostate cancer is diagnosed some 200,000 times annually and is the No. 1 killer of men after lung cancer.

 Collaborating with veteran science writer Gerald Secor Couzens, Carter emphasizes that although he has performed thousands of prostatectomies, his focus now is on prevention of prostate cancer. The book’s main theme is that by educating themselves, men can change their living habits to prevent developing the disease—and also make informed decisions about what to do if they get it.

 The book’s 16 chapters are divided into four parts. These include three chapters detailing what every man should know about his prostate when it’s healthy and how to keep it that way; a four-chapter section (wittily titled “Water Works”) on what goes on in the urinary tract and how to address problems that arise there; and a 28-page chapter on chronic pelvic pain syndrome (CPPS) and revolutionary new ways for treating it. The eight-chapter fourth section deals with every aspect of prostate cancer—its diagnosis, its treatment, how to avoid side effects from that, and what the consequences can be of its recurrence.

Conversationally written, this book gives physicians and patients alike an immensely engaging—and valuable—education on the “complex little powerhouse of a gland,” all of 0.7 ounces, that can affect a man’s life so dramatically.  NAG

 

Transylvanian Dinosaurs

David B. Weishampel, PhD, and Coralia-Maria Jianu (JHU Press, 2011)

The Transylvania of which David B. Weishampel and fellow researcher Coralia-Maria Jianu write is not the mythical, murky realm of Bela Lugosi’s Dracula, but an isolated region, perhaps an island, of the Late Cretaceous period 72 million years ago, before the eons-long tectonic shifts in Earth’s land masses formed what now is southeastern Europe. The area’s insularity apparently led to a peculiar evolutionary development among the dinosaurs that lived there: They slowly became dwarfs—between 4 to 6 meters long, compared with the 15- to 20-meter length of their counterparts elsewhere.

Weishampel, who also illustrated the book, is a professor in Hopkins’ Center for Functional Anatomy and Evolution. In Transylvanian Dinosaurs, he and Jianu credit Franz Baron Nopcsa (1877-1933) with the discovery of Transylvania’s unexpected evolutionary development in dinosaurs.

The authors give a brief account of Nopcsa’s life but concentrate on providing a broader historical overview of paleontology and detailed descriptions of the extensive research that they and others have done in recent years to build substantially upon Nopcsa’s discoveries. Their goal is to unravel the mystery of how these incredible creatures lived and why their size changed. The authors point out that studying the dwarf dinosaurs of Transylvania could provide key insights to evolutionary theory itself.  NAG

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