The article describes John MacMahon’s struggles about what to do. In the end, his friend won’t even get a PSA test so he won’t have to think about considering impotence and incontinence, while Mr. MacMahon apparently schedules surgery.

Mr. MacMahon only brings one new insight to the table, which is that when it comes to sex 90 percent is not a passing grade.

I wrote a letter-to-the-editor of the Wall Street Journal, assuring 34 y.o. John MacMahon that I would not undergo a radical prostatectomy at his age or any age, based on the studies we have today, which show that if you really need to be cured surgery fails, and if you don't need to be cured, because you have slow-growing prostate cancer, surgery is claimed as a success. The radical prostatectomy has failed to extend overall survival in two randomized controlled studies and the harm from the operation is well documented. I will try to track down John MacMahon to send him a complimentary book.

My book explains that there are many less harmful ways to treat prostate cancer than surgery.

Dear Wall Street Journal Letters’ Editor,

I can assure John MacMahon that I would not undergo a radical prostatectomy for prostate cancer at his age or any other age ("Burden of Proof: At 32: A Decision: Is Cancer Small Enough to Ignore" by Amy Dockser Marcus). Radical surgery for prostate cancer has failed to extend overall survival in two randomized controlled studies. Over 80 percent of men have survived in watchful waiting studies without dying of prostate cancer, and the largest and best case series data have failure rates over 20 percent. The only thing that appears certain is that those who really need to be cured of prostate cancer by surgery aren't cured. I have had five uncles with prostate cancer, so I share Mr. MacMahon's concern.

Bradley Hennenfent, M.D.
Author of SURIVIVING PROSTATE CANCER WITHOUT SURGERY
Roseville Books 2005