Health and Prostate

J. Curtis Nickel; Richard W. Norman
Grosvenor House Press Inc, King West Centre, 2 PardeeAve, Suite 203, Toronto, 0NM6K3H5. Available through the Canadian Medical Association, PO Box 8650, 1867 Alta Vista, Ottawa, ON K1G 0G8, 1993, 88 pp

This attractive softcover manual is part of the Canadian Medical Association’s Disease Management / Patient Counselling series. Written by two urologists, the chapters, though short, cover essential material in enough depth that readers do not feel shortchanged or patronized. References are sufficient and up-to-date, and the text is well written, well organized, well presented, and well illustrated.

Topics covered include the definition, pathology, pathophysiology, and natural history of benign prostatic hyperplasia. Symptoms and signs are lucidly explained. Investigative procedures that are sometimes necessary are explained, but needless investigations are discouraged. A variety of therapeutic options are described, including “watchful waiting”; medical therapy with α-adrenergic blockers, such as terazosin; 5-alpha reductase inhibitors, such as finasteride; luteinizing hormone-releasing hormone analogues and androgen antagonists; and many traditional and more innovative surgical procedures.

The book is well balanced, and there is no evidence of bias in favour of surgical treatment. Even the references to prostate-specific antigen (PSA) testing, while inevitably encouraging it (the authors are urologists), includes the statement: “Whether earlier detection (of prostate cancer) will be beneficial can only be determined by long-term (ie, 10-year) studies of screened populations.”

This is a fine monograph, which is both useful and easy to read. Drs Nickel and Norman are to be congratulated for doing a first-class job.