An eloquent account of the medical profession’s sometimes cautious approach to advancement.




Thoughtful review of a cancer-preventing drug that doctors don’t use—probably for good reasons.

Finasteride (sold by Merck as Proscar) blocks conversion of testosterone into the even stronger dihydrotestosterone. Blocking this conversion shrinks the prostate gland, which swells as men age, often obstructing the urinary passage. In 1992 the FDA approved finasteride to treat benign prostatic hyperplasia. Researchers immediately wanted to learn if a drug that repressed normal prostate cells might do the same to malignant cells. In 1993, nearly 19,000 volunteers aged 55 and older began a study in which half took finasteride and half didn’t. After ten years, the men taking finasteride were shown to have a 25 percent lower chance of developing prostate cancer. That was the good news. The bad news was that among the smaller number who did get cancer while taking finasteride, a higher percentage developed more aggressive, less curable cancers. Given a drug that prevents cancer in many patients but might harm a few, doctors have made a choice: They don’t prescribe it. Since finasteride may save lives, some authorities accuse doctors of focusing too much on individual patients to the detriment of society. Justman (English/Univ. of Montana) maintains that this is the right choice. He recounts cautionary tales of occasions when physicians or other experts decided individuals must suffer for the greater good; his evidence includes the Tuskegee study, in which African-American sharecroppers were denied treatment for syphilis. He agrees with general medical opinion that it’s wrong to conclude, if the number of cancers prevented by finasteride exceeds the number induced, that the drug has a “net benefit.” A unique glory of scientific medicine is a vivid awareness of our ignorance, Justman writes. Until doctors understand what causes prostate cancer and how finasteride works to prevent it, they prefer to observe a guiding principle of the Hippocratic Oath: “First, do no harm.”

An eloquent account of the medical profession’s sometimes cautious approach to advancement.

Pub Date: April 4, 2008

ISBN: 978-1-56663-627-8

Page Count: 256

Publisher: Ivan Dee/Rowman & Littlefield

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: Jan. 15, 2008

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Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and...


A dense, absorbing investigation into the medical community's exploitation of a dying woman and her family's struggle to salvage truth and dignity decades later.

In a well-paced, vibrant narrative, Popular Science contributor and Culture Dish blogger Skloot (Creative Writing/Univ. of Memphis) demonstrates that for every human cell put under a microscope, a complex life story is inexorably attached, to which doctors, researchers and laboratories have often been woefully insensitive and unaccountable. In 1951, Henrietta Lacks, an African-American mother of five, was diagnosed with what proved to be a fatal form of cervical cancer. At Johns Hopkins, the doctors harvested cells from her cervix without her permission and distributed them to labs around the globe, where they were multiplied and used for a diverse array of treatments. Known as HeLa cells, they became one of the world's most ubiquitous sources for medical research of everything from hormones, steroids and vitamins to gene mapping, in vitro fertilization, even the polio vaccine—all without the knowledge, must less consent, of the Lacks family. Skloot spent a decade interviewing every relative of Lacks she could find, excavating difficult memories and long-simmering outrage that had lay dormant since their loved one's sorrowful demise. Equal parts intimate biography and brutal clinical reportage, Skloot's graceful narrative adeptly navigates the wrenching Lack family recollections and the sobering, overarching realities of poverty and pre–civil-rights racism. The author's style is matched by a methodical scientific rigor and manifest expertise in the field.

Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and Petri dish politics.

Pub Date: Feb. 9, 2010

ISBN: 978-1-4000-5217-2

Page Count: 320

Publisher: Crown

Review Posted Online: Dec. 22, 2010

Kirkus Reviews Issue: Jan. 1, 2010

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Authoritative and, most helpfully, accessible.



Self-help guide for diabetes sufferers, mostly in question-and-answer format, with an emphasis on helping racial and ethnic minority diabetics.

Coleman is a pharmacist with a doctorate in her specialty, Gavin a Ph.D. and M.D. Aside from acknowledgments and a foreword signed by Gavin alone, their voices and expertise are indistinguishable, offering lucid, simple solutions for diabetes patients. Gavin relates watching his great-grandmother endure debilitating pain as a result of diabetes while he visited her as a youngster. He remembers hearing adults mention that sugar killed her, and he wondered how something that tasted sweet could cause so much harm. As an adult, he realized that his great-grandmother's affliction could be controlled through treatment. The authors focus on Type 2 diabetes, the most common form in minority populations. An estimated 18.2 million Americans are diabetic, with perhaps 5 million unaware of their situation. About 11 percent of U.S. diabetics are African-American, and about 8 percent are Latino. The question-and-answer format begins with an overview section about diabetes, with an emphasis on risk factors. Section Two covers management of the disease, including nutrition, exercise, blood-testing, oral medications and insulin use. In addition, the authors continually recommend smoking cessation, as well as instructing patients on the readiness of self-treatment. Section Three explains the complications—high blood pressure, high cholesterol and heart disease—that could arise if the condition remains untreated or treated ineffectively. The questions in all of the sections are worded simply, and the answers are usually free of medical jargon. Though the sudden shifts in tone and voice are occasionally jarring, the writing remains clear enough to distill the facts. The real downside here, though: patronizing, laughable illustrations that degrade the overall product.

Authoritative and, most helpfully, accessible.

Pub Date: Jan. 31, 2004

ISBN: 0-9746948-0-0

Page Count: -

Publisher: N/A

Review Posted Online: May 27, 2010

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