His review of prostatitis, PIN and prostate cancer, and BPH includes the effect of cell mutation early in life, environmental factors and lifestyle as possible reasons for carcinoma of the prostate. He also considers that minute cell changes internally over time could be a second view point, but diet could be a culprit. Lycopene, an antioxidant found in tomatoes, may help prevent prostate cancer. Studies on family relationships to prostate cancer are ongoing. His discussion on grading versus staging as well as radical prostatectomy versus external beam radiation, cryo-surgery and implants speak to the many difficult decisions that the prostate cancer patient faces.
Most cancers have a diversity of grades.
Identifying one's cancer type is extremely important in choosing the aggressiveness of one's treatment. Until this data is completed we have to rely on early detection. Dr. Kantoff also explores the many other alternatives to surgery such as hormone therapy, adjuvant or neo-adjuvant, as well as implants with or without external beam radiation. The author does not avoid some of the obvious controversies, i.e. the neurologic surgeons' bias is the radical, radiologists vote for implant, external beam or both and cryo-surgeons believe in freezing. They point out that surgery as a cure to treatment only works in organ-confined disease and many men face rising PSA's after this definitive treatment.