It has been about five years since “The Decision” has been published. I am working, minimally I might add, on the next edition. Minimally because very little has changed in the decision process. Yes there are new treatments, the robotic removal is performed better with less problems by more experienced urologists, but this fact remains. You are told you have prostate cancer. You have three options: you can have it removed, you can have some sort of energy to treat it and avoid surgery, or you can do nothing. It really is not about what is new out there it is about the process of getting there and that is why the book “The Decision” is still relevant really without another edition. If you have read this book and it helped…do a review on Amazon.com.


A smart man learns from experience…a wise man can learn from advice….


As the course of water changes over the changed landscape with time, so too should you and strive to embrace change.

Insanity: Doing the same thing over and over and expecting different results.-Einstein


A patient can have fleas and ticks at the same time.- Osler


Why would you remove the prostate for prostate cancer and why did Robert E. Lee attack up hill at Gettysburg by a frontal assault? And why did Will Sutton rob banks?

Well…that’s where the cancer is, that’s where the enemy is and that is where the money is.


It is much more likely that there is only disease going on at a time.


Not all referring physicians are created equal!


Funny thing, even though the prostate nodule is the thing that urologists are checking for with a rectal exam…the most common rectal finding in the man who has prostate cancer is a normal feeling gland. With the advent of the PSA prostate cancers are being found before the gland has a palpable finding. A nodule means most probably that the cancer has penetrated the capsule…which is an unfavorable diagnostic finding.


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