Do No Harm: How a Magic Bullet for Prostate Cancer Became a Medical Quandary [Hardcover]

Stewart Justman (Author)

Book Description

ISBN-10: 1566636272 | ISBN-13: 978-1566636278 | Publication Date: January 28, 2008 | Edition: 1

A fascinating medical detective story about the unusual reception for a promising new drug by a skeptical medical community reluctant to abandon its age-old Hippocratic Oath of "Do No Harm." Stewart Justman explains how a pill called finasteride, proven to dramatically reduce the incidence of prostate cancer, was found to be also associated with a distinctly higher rate of aggressive cancer. As urologists and oncologists were presented with a strange mix of eurekas and cautionary notes, physicians adhered to their best principles and remained wary of massive application. For now, the drug is deemed too risky: the medical dictum of avoiding harm has inhibited its use on a grand scale, though statistically there is much in its favor. Do No Harm is engrossing reading about medical science and, finally, a reassuring tale of the triumph of tradition over novelty.

Editorial Reviews

From Publishers Weekly

In 2003 a medical study reported that a steroid called finasteride (approved as a treatment for hair loss) significantly cut the incidence of prostate cancer in men at low risk. But it also had a dark side: clinical studies indicated that men who did develop cancer while taking the drug tended to get more aggressive tumors. English prof and PEN Award winner Justman (Seeds of Mortality) examines why, despite finasteride's potential, American doctors have shied away from giving it to their male patients, and attributes it to the traditional oath to do no harm. Justman claims that the oath is outdated and paternalistic, dating to a time when doctors often did more harm than good. He also cites those who say the benefits of finasteride far outweigh its risks. But he acknowledges that the FDA has not approved finasteride for cancer prevention, and he neglects to consider adequately as a contributing factor the sword of Damocles that swings over so much of modern life: liability lawsuits. Justman tends to be prolix and repetitious. This book may appeal to readers interested in medical ethics and the history of science, but is unlikely to have much draw for general readers. (Apr. 4)
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From Booklist

A few years ago, the New England Journal of Medicine reported on a Prostate Cancer Prevention Trial testing the new chemopreventive drug finasteride. The results left the drug’s overall efficacy rather in question. While it appeared to reduce the incidence of prostate cancer in low-risk men, it conversely exposed those same men to increased risk of developing much more aggressive malignancies. To this day, finasteride is not routinely prescribed as a cancer preventive. The road to that decision has not been a straight one, thanks to the current trend of valuing public health more than individuals’ health and the fact that a modified Hippocratic Oath no longer requires physicians to “do no harm.” If they do not actually cause harm, many common medical interventions entail some risk of harm. Justman employs his literary background and keen research skills to explain the thought processes surrounding the decisions to make such interventions. As in Seeds of Mortality (2003), English professor and prostate-cancer-survivor Justman rewardingly performs the alchemy of mixing science, medicine, and literature. --Donna Chavez

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Product Details

• Hardcover: 256 pages
• Publisher: Ivan R Dee; 1 edition (January 28, 2008)
• Language: English
• ISBN-10: 1566636272
• ISBN-13: 978-1566636278
• Product Dimensions: 8.7 x 5.8 x 0.9 inches
• Shipping Weight: 14.4 ounces (View shipping rates and policies)
• Average Customer Review: 5.0 out of 5 stars  See all reviews (1 customer review)
• Amazon Best Sellers Rank: #2,612,632 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews

4 of 4 people found the following review helpful:

5.0 out of 5 stars An excellent choice for either leisure readers or medical students., April 3, 2008

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Midwest Book Review (Oregon, WI USA) - See all my reviews

This review is from: Do No Harm: How a Magic Bullet for Prostate Cancer Became a Medical Quandary (Hardcover)

DO NO HARM: HOW A MAGIC BULLET FOR PROSTATE CANCER BECAME A MEDICAL QUANDARY explores a modern medical detective mystery revolving around finasteride, a 'magic bullet' proven to reduce the incidence of prostate cancer dramatically. The same clinical trial also showed it was associated with a higher rate of aggressive cancer, negating its benefits. DO NO HARM is more than study of one drug's pros and cons; it outlines the drug marketing and research industry and the medical dilemmas of treatments which harm as well as help. Both general interest and medical libraries will find it an excellent choice for either leisure readers or medical students.