Clinical Trials

This was in an issue of the New York Times this week.  It's sort of an op-ed advertisement for Mt. Sinai hospital.   The authors call for increased funding for clinical trials for breast cancer.

Clinical trials are a crucial part of all cancer research.  I'm reading The Emperor of All Maladies: a Biography of Cancer by Siddhartha Mukherjee right now (highly recommended, by the way) and just happen to be on the part that describes how clinical trials for cancer came to be.  He opens with a quote by H.J. Koning: "Randomised screening trials are bothersome.  It takes ages to come to an answer, and these need to be large-scale projects to be able to answer the questions.  [But...] there is no second-best option."



Indeed, many cancer trials never get off the ground because they lack participants.

Kindle - a portable prostate cancer library?

I just got a Kindle--quite an amazing piece of technology.  Far lighter than an actual book, it can hold thousands of titles.  I started looking at what prostate cancer books are available in Kindle format, and there are quite a few.  Not all, but a lot of the ones I like and refer to often.  I will probably load up with a few, so I always have a reference library at hand.

If you haven't held a Kindle, you should give it a try.  The display is not a computer screen.  It's not LCD. There is no light shining from it.  It uses real ink particles on a surface that looks like real paper.  Battery life is impressive, since after arranging the text on the page, the device isn't using any energy to display it.  Books on Amazon are cheaper than the paperback versions (Walsh's book, for example, is $11.55 in paperback, but $9.99 in Kindle format) and they download very quickly.  I bought and downloaded a novel last night--Game of Thrones, about 600 pages--in a minute.  You can literally think of a book and be reading it in a few moments.  Want to read a major newspaper?  You can buy today's copy--just today's, if you want--for the newsstand price and take it on the plane with you without messing with newsprint and all the rest.

I got the one that is $139.  It doesn't connect via 3G, only Wi-Fi, which is fine with me, since I have wireless at home, work, and it seems to be in most coffee shops now as well.  I also bought the leather cover. 



Here are some prostate cancer books available in Kindle format.

Patrick Walsh

I checked out the 2007 edition of Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, co-written with Janet Farrar Worthington. This is an excellent, very accessible text and I highly recommend it. My only quibble is that while Walsh revised the section on salvage radiation to include a statement by Danny Song of Johns Hopkins:"Even men with Gleason 8-10 disease, if they had positive margins, a longer PSA doubling time, and received early salvage radiation, were able to attain four-year control rates of 81%," Walsh still ends the chapter with a large, bolded box that says if you have ANY of these things--Gleason 8 or higher, positive seminal vesicles/lymph nodes, PSA recurrence within a year--you're not likely to benefit from radiation! Not only does Walsh contradict Song's statement, but he ignores some landmark 2004 and later research by Andrew Stephenson that shows even if you have a high risk factor like a high Gleason OR fast PSA doubling time, it is very likely you will benefit from radiation as long as it is started before your PSA gets too high.

I'll get blood drawn in the next week or two for my 9 month post-salvage PSA test. I'll go see the doc in early January.