Let sleeping dogs lie? What men should know before getting tested for prostate cancer

Prostate cancer is an emotive topic and, driven by media reporting, is filled with misinformation, particularly in the area of screening. What is true and widely reported is that prostate cancer is a leading cause of male cancers and a leading cause of male cancer deaths, particularly in older men. As our community seeks a more proactive and preventive approach to health, male patients are keen to be active doers and many see getting a test as a clear vindication of ‘doing the right thing’. However, like all heated and controversial debates, there is a lot more to it once you delve more deeply. Given the complexity of the information, it is the role of the general practitioner to assist male patients to make an informed decision about whether to screen, to describe any limitations to screening, and to address issues relating to management. Chapman and his co-authors, through this well written book, provide the reader with a balanced commentary and navigate the reader through the basics of prostate cancer, management issues, and finally to the issue of that of prostate cancer screening. The authors also clearly illustrate these complex issues through deconstructing numbers and figures that are easily understood for both GPs and patients. Particularly striking is the first chapter in which the authors describe the reasons for writing this book. Of interest is the fact that no national or international cancer institution currently advocates population wide screening for prostate cancer. An additional notable feature of ‘Let sleeping dogs lie?’ is also how it addresses arguments made by pro-screening urologists and research papers that look favourably to prostate cancer screening. This book provides a counterpoint that will provide the busy GP with answers that may be asked of them by their male patients. Given the current media and community based interest in prostate cancer screening, this book can assist both the patient and the busy GP to make a fully informed decision in the area of prostate cancer screening and management. What is clear is that until we have definitive evidence to advocate a population wide screening program, GPs will need to assist their male patients in making a decision that is right for them.