Prostate Cancer: A Comprehensive Guide for Patients


J Smith et al
Published by TFM Publishing (2002)
ISBN:  1-9033-7810-9.   106 pages plus index.
RRP:  GBP£9.99

This book is written for patients by three urologists and a medical writer.  The book comprises 106 pages and consists of 12 chapters.  Four appendices conclude the book.  The first appendix helpfully summarises the different types of treatment, including the potential for each to cure the disease, side-effects and the positive and negative aspects.  As such, the appendix serves as a useful stand-alone item of information. 

The book is commendable for being easy to read and for providing an adequate overview of each of the topic areas.  Information on test procedures and treatments as well as advice on self-care immediately after treatment would be particularly welcome for patients about to undergo these procedures.  The information about tests, treatment, and pain control is especially helpful in demystifying a subject area that can be very confronting and threatening.

The book does not reference its material, however.  Therefore, it is unclear upon what evidence the authors base the information (for example, the likelihood of cure and side-effects associated with treatment). Notably, the book does not conform to the standards developed by the Ottawa Health Decision Centre, a centre that specialises in developing patient information and decision-aids. Therefore, my concern is whether the information is based upon the best available evidence and is able to facilitate informed decision-making.  Another concern is that the book may be seen to persuade and influence patients’ decisions. For example, this statement: “although the final decision about whether or not to undergo surgery is yours, do bear in mind that your doctor probably feels this offers the best chance of curing your prostate cancer and that its benefits are outweighed by the risk of impotence”.  Such statements may counter the tenet of patient autonomy by suggesting that doctors, and not patients, are better able to make trade-offs between the benefits and risks of treatment. 

The diagrams and layout of the book are somewhat bland, giving the appearance of a textbook. While the language is simple to understand, information seeking to reassure men about the effect of prostate cancer on quality of life, psychological aspects and relationships may have been more vividly conveyed by the use of patient testimonials. 

Nonetheless, the book represents a good attempt at covering the range of issues about prostate cancer, including its prevention, early detection, diagnosis and treatment. All chapters, except the final chapter on hospice care in the UK are relevant to an international audience. The book would best serve the interests of patients who have already made their decisions; the practical advice on dealing with immediate and long-term effects of treatment and explanations of procedures are especially valuable. However, the book may be less relevant to those men struggling to make treatment decisions after diagnosis. 

M Gattellari
Division of Population Health
South Western Sydney Area Health Service
Liverpool, NSW

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