Synopsis
This multimedia textbook covers the complete field of diagnosis and surgical treatment of prostate cancer with emphasis on surgical procedures. The most important techniques are demonstrated in a video CD-ROM step by step. Learn about surgical procedures by world authorities in prostate surgery - acquaint yourself with all useful hints.
Reviews
Over the course of the past two decades, dramatic gains in knowledge have led directly to improvements in the early diagnosis of prostate cancer and to more effective treatment with fewer adverse effects. Even so, prostate cancer continues to kill tens of thousands of men each year. Unless practical strategies for the prevention of prostate cancer can be developed, the evolution, expansion, and dissemination of diagnostic and therapeutic technologies for this disease will be necessary and welcome. This book is an up-to-date summary of diagnostic and therapeutic methods in the clinical management of prostate cancer, and it is intended primarily for the practicing urologist. Accordingly, 14 of the 27 chapters deal with various aspects of surgical anatomy, surgical techniques, or surgical outcomes related to the treatment of prostate cancer. The book is accompanied by a CD-ROM with narrated video clips describing 10 surgical procedures. The initial section of this book presents a comprehensive overview of salient features of the cellular biology and genetics of prostate cancer and its precursor lesion, high-grade prostatic intraepithelial neoplasia. The next section covers diagnosis and clinical staging. A single cursory and disappointing chapter on prostate biopsy is followed by a thorough review of prostate-specific antigen, the tumor marker that is perhaps the single most important development in the field of prostate cancer in the past half-century. Successive chapters provide excellent discussions of the interpretation of prostate-biopsy specimens, the use of preoperative imaging techniques, and the identification of lymphatic metastases and staging lymphadenectomy for prostate cancer. The central portion of the book deals with the surgical treatment of prostate cancer. All the operative procedures are succinctly described by a single author and illustrated with black-and-white anatomical drawings that appear to be the work of a single artist, resulting in a consistent presentation. This section could stand by itself as an operative atlas. Although the same versatile author describes three surgical approaches for radical prostatectomy, including antegrade and retrograde retropubic techniques as well as perineal prostatectomy, a unique opportunity to compare and contrast these operations is missed. Moreover, there is no discussion of perioperative management or acute operative complications. Of note, in addition to the chapters on prostate surgery, descriptions of the procedures for implantation of penile prostheses and artificial urinary-sphincters are included. Later in the book, other chapters consider quality of life and the management of erectile dysfunction and urinary incontinence after radical prostatectomy. The section on radiotherapy for localized prostate cancer contains a cursory examination of teletherapy but an excellent and thorough discussion of brachytherapy, perhaps reflecting the overall surgical orientation of this book. Although the title of the book emphasizes diagnosis and surgical therapy, essays on hormonal therapy and chemotherapy for advanced prostate cancer are also included. The chapter on hormonal therapy is a particularly thorough review of the current literature and includes an excellent exposition on combined androgen blockade as well as succinct examinations of controversial topics, such as intermittent hormonal therapy and the timing of hormonal intervention. As might be predicted in such a rapidly changing field, the portions of the book delineating nonhormonal and chemotherapeutic options for advanced prostate cancer are already outdated. An interesting aspect of this compendium is that 36 of the 44 authors are from western Europe; only 8 Americans are represented. This affords some differing perspectives and insights and also emphasizes a number of European clinical studies and reports with which many U.S. practitioners may not be familiar. Some of the chapters, written primarily by authors for whom English is a foreign language, suffer from translation, with decreased readability at times. The CD-ROM is of high quality and is a considerable value, independently of the text. Ten operative procedures are depicted in full detail, and there are two videos describing the new technique of laparoscopic radical prostatectomy, which is not described in the book itself. John N. Kabalin, M.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
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