Abstract
Imagine yourself 50, famous, at the height of your career, about to go on a holiday to Puerto Rico, when you are suddenly seized with excruciating pain each time you try to empty your bladder. You decide to go on the trip anyway, but the pain persists and after a few days you have to return home to see your family doctor. He diagnoses prostatitis and prescribes a succession of urinary antiseptics, but your symptoms continue. At last the doctor palpates a small hard nodule in the prostate and sends you to see a urologist. The biopsy specimen shows adeno carcinoma; and the surgeon brusquely informs you in the presence of your wife that you need a radical prosta tectomy and orchiectomy; that you will be impotent and may become incontinent; and that, although his opponents will tell you that prostatectomy is not needed, it is the only known cure. You must, moreover, make up your mind immediately, because he can operate the day after tomorrow but must make arrangements to cancel his planned vacation.
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