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 19, 2010
Kirkus Reviews Issue: Jan. 15, 2008
BOOK REVIEW
An absorbing, wide-ranging story of humans’ relationship with the water.
A study of swimming as sport, survival method, basis for community, and route to physical and mental well-being.
For Bay Area writer Tsui (American Chinatown: A People's History of Five Neighborhoods, 2009), swimming is in her blood. As she recounts, her parents met in a Hong Kong swimming pool, and she often visited the beach as a child and competed on a swim team in high school. Midway through the engaging narrative, the author explains how she rejoined the team at age 40, just as her 6-year-old was signing up for the first time. Chronicling her interviews with scientists and swimmers alike, Tsui notes the many health benefits of swimming, some of which are mental. Swimmers often achieve the “flow” state and get their best ideas while in the water. Her travels took her from the California coast, where she dove for abalone and swam from Alcatraz back to San Francisco, to Tokyo, where she heard about the “samurai swimming” martial arts tradition. In Iceland, she met Guðlaugur Friðþórsson, a local celebrity who, in 1984, survived six hours in a winter sea after his fishing vessel capsized, earning him the nickname “the human seal.” Although humans are generally adapted to life on land, the author discovered that some have extra advantages in the water. The Bajau people of Indonesia, for instance, can do 10-minute free dives while hunting because their spleens are 50% larger than average. For most, though, it’s simply a matter of practice. Tsui discussed swimming with Dara Torres, who became the oldest Olympic swimmer at age 41, and swam with Kim Chambers, one of the few people to complete the daunting Oceans Seven marathon swim challenge. Drawing on personal experience, history, biology, and social science, the author conveys the appeal of “an unflinching giving-over to an element” and makes a convincing case for broader access to swimming education (372,000 people still drown annually).
An absorbing, wide-ranging story of humans’ relationship with the water.Pub Date: April 14, 2020
ISBN: 978-1-61620-786-1
Page Count: 288
Publisher: Algonquin
Review Posted Online: Jan. 4, 2020
Kirkus Reviews Issue: Feb. 1, 2020
BOOK REVIEW
BOOK REVIEW
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
BOOK REVIEW
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