I am writing with a very heavy heart to report the death of our dear Board Member, Advisory Board Member, Moderator, Participant and my good buddy, Herb Geller PhD G-d Rest His Soul.
The loss of dear Herb z”l is already reverberating around AnCan and will undoubtedly amplify as more learn of his demise. Herb touched many well beyond his Advanced Prostate Cancer ‘Brains Trust’, Moderators, Peers and Participants. The Blood Cancer group got to know him well when he attended regularly on behalf of his brother. The Pancreatic Cancer folks met him when he showed up for his next door neighbor. Our Men Speaking Freely Group loved and respected him for sharing his fears and concerns. Members of our Advisory Board got to interact with Herb as did Medical Academics and others who participated in AnCan’s research projects.
Here are a few of the words I already see bandied around –
“kind, smart, caring, thoughtful”
“My heart is heavy and I’m at a loss for words. There is something I’m feeling that I can’t express sufficiently”
“this is the deepest hurt since we lost Dominic (2015)”
“Thanks to each of you for your loving support of him and all of us for each other.”
Herb passed away from advanced prostate cancer that had evidently morphed into small cell/neuroendocrine like (NEC) disease. A late diagnosis just one day before he entered the NIH, his place of work, identified this. Herb was scheduled to undergo tests for his highly elevated endocrine markers, however the source was now evident on admission. The NIH never appeared to acknowledge or treat him for this diagnosis. It finally added a neuroendocrine oncologist to Herb’s team after 21 days after repeated AnCan prodding from the date of admission. Herb underwent research procedures related to Cushing’s Disease and its symptoms. In due course, AnCan will follow up as appropriate.
Never one to give up the opportunity to sail anything from a small dinghy to an ocean-going yacht, Dr. Herb Geller was a nationally recognized expert in neuro-biology; a profile is available on the NIH site. Herbie loved a a good Scotch, in Skye or anywhere else. On his request, AnCan did its best to sneak in a wee dram just to wet his lip in the final days but the ‘powers that be’ prevented us. I’ll have one for you tonight, Herb! And, we’ll make sure both your AnCan posters get written up for submission with credit to you.
Herb is survived by his wife of 55 years, Nancy, Director of the Office of Biostatistics for the National Heart, Lung and Blood Institute at the NIH. Also his younger brother, Ken, an eminent Supreme Court Advocate kennethsgeller@gmail.com. We wish Herb’s family and many friends, especially his “AnCan Family”, much comfort. May Herb’s memory always be a blessing – it certainly will be here at AnCan.
For our Jewish readers, Herb’s z”l Hebrew name is Chanan Moshe ben Aaron v’Sara; he died on 25th Nisan.
WEBINAR – ‘The Invasion of the Prostate Snatchers: 13 years Later’: An Evening with Dr. Mark Scholz
By Howard Wolinsky, Peter Kafka and Ben Nathanson
Dr. Mark Scholz, author of Invasion of the Prostate Snatchers, drew a record audience to his AnCan webinar on January 30, 2023.
Registration worldwide was close to 1,000 — nearly double the previous record — with more than 600 watching live.
Scholz’s talk, “Invasion of the Prostate Snatchers: 13 years later” discussed how prostate cancer treatment — and overtreatment — has progressed since the book’s original publication in 2010. The book took aim at a urological-industrial complex performing surgeries on hundreds of thousands of low-risk patients, leaving many impotent and incontinent.
Half those men, he argued, could safely have been followed without aggressive treatment. Scholz, a medical oncologist, coauthored the book with patient Ralph Blum. A new edition was issued in 2021.
While urologists today still unnecessarily “snatch” prostates, Scholz said, the number is far fewer since active surveillance was endorsed in 2007 as a safe and effective strategy. And he said radiation therapy, which he had criticized in the past, also has become safer and more effective.
Still, men come to him thinking they have only two options: surgery or radiation. In fact, they have more than a dozen options, based on the severity of their disease and their preferred balance of treatment and side effects. He urges patients to “obtain facts and apply principles” — replacing assumptions about cancer with informed decisions.
Even for the smaller, but significant segment of men diagnosed with more serious grades of prostate cancer including metastatic, Scholz explained that there has been so much progress in new treatment modalities with limited side effects that many men are living long productive lives living with their disease and not dying from prostate cancer. Dr. Scholz stressed that unlike other cancers, prostate cancer is much slower growing and the rush for treatment in most instances is not necessary.
After the talk, Scholz answered 40 minutes of audience questions.
AnCan moderator Joe Gallo produced the webinar, and moderators Peter Kafka, Howard Wolinsky, and Ben Nathanson relayed questions. Alexandra Scholz, CEO of Prostate Cancer Research Institute, the nonprofit education initiative run by Scholz, edited the video, and she and Peter Scholz lent production assistance.
Invasion of the Prostate Snatchers: An Essential Guide to Managing ProstateCancer for Patients and Their Families by Mark Scholz, MD & Ralph H. Blum (Other Press, New York; August 2021)
Summary: “Invasion of the Prostate Snatchers” is a guidebook for prostate cancer patients and their partners. It is of great interest to patients with low-risk to favorable intermediate-risk cancers considering early disease Active Surveillance (AS) since it critically evaluates types of treatment. AS is close monitoring of lower-risk prostate cancers. A patient with prostate cancer (Blum) and a medical oncologist (Scholz) present information patients can use in making key decisions in their care throughout the prostate cancer disease path.
My experience: This book was a just-in-time godsend for me. It was released in August 2010. I was in a holding pattern awaiting a follow-up biopsy at that time.I wasn’t diagnosed until Dec. 4, 2010. My cousin, Maxim Schrogin in Berkeley, California, who was diagnosed in January of that year and was on AS, told me the next day that the first thing I needed to do was get this book. I had it in hand within minutes via Kindle. I devoured “Prostate Snatchers” as I prepared for a second opinion on what, if anything, to do about this cancer.
I went against my first urologist’s advice to go on AS and avoid the side effects of active treatment because AS was not the mainstream approach then. My first urologist tried to rush me into the OR though I only had a single core of less than a millimeter of very low-risk Gleason 6 cancer. That’s the lowest level of prostate cancer,
What I liked about the book: This book helped give me the courage to consider AS and go off the then unbeaten path. It helped prepare me to see Scott Eggener, MD, at the University of Chicago, he told me I didn’t need surgery and was “the poster boy for AS.” A new edition of the book, which came out in August 2021, covers these changes and more. The world has changed since 2010 as reflected in the new edition.” Now,,
multiparametric MRIs have been accepted as the first step when PSAs rise, followed by targeted biopsies. The interval between biopsies is generally longer. Genetic and genomic testing has become more common in the U.S. to help determine whether biopsies are needed and which cancers are likely to become aggressive.
Authors Ralph and Mark plus my wife Judi and cousin Maxim were my “support group” as I became an “active surveillor.” There were no support groups devoted to AS then. I would not meet another patient on AS for seven years. We now have support and educational groups devoted to AS, including those from AnCan and Active Surveillance Patients International.
AS patients are not so rare anymore. We now make up the majority of low-risk patients.
Tips from the book: The book is chock full of background on prostate cancer and actionable information. For example, Scholz weighs in on prostate-specific antigen blood testing: “A PSA is considered a ‘cancer test.’ One savvy patient’s advice is to think of PSA as a nonspecific indicator, like the ‘check engine’ light on your dashboard. An elevated PSA may be due to harmless inflammation, recent sexual activity or even a laboratory error. The first step toward investigating the cause of a high PSA is to repeat the test. If the PSA remains high, the next item to consider is that the prostate may be enlarged (BPH).” The authors point out that if PSA is rising, patients should consider multiparametric MRI and targeted biopsy. Back in 2010, those weren’t quite on the table for discussion.
Nitpicks: No book is perfect. The authors, I think, missed an important discussion on the pros and cons of transperineal vs. transrectal biopsies. Transrectal biopsies can lead to sepsis or other
infections and can miss certain areas in the prostate that may harbor cancers. Also, the authors stressed that patients should seek out MRIs with 3-Tesla magnets. To get into the weeds, some new models with 1.5-Tesla magnets can work just as well and are used routinely at the National Cancer Institute. Discuss these matters with your doctor.
In conclusion:“The Invasion of the Prostate Snatchers” provides a critical look at the prostate cancer “industry” and serves as a bible for newbies considering AS and a reminder to those of us who have been on AS for many years of just why we took the now mainstream approach to low-risk prostate cancer. You can live with these “lame” cancers and not die from them. But you need to maintain
surveillance to detect if your cancer is becoming more aggressive.
Reviewed by Howard Wolinsky, editor of TheActiveSurveillor.com and AnCan moderator
AnCan can’t say this enough times … nothing gives us more pleasure than when our Peeps meet up. Our survey last year found that some 35% of our participants make new and lasting friendships outside our groups. That’s our gift to you as well as to ourselves!
Late last month two of our sterling Volunteers met up. Capt. Jim Marshall (USAF) headed south from Alexandria, Virginia to spend a month in Melbourne, Florida, home of our Active Surveillance Prostate Cancr Moderator, Garry Tosca. Here’s what Captain Jim had to say about their lunch meeting:
During my visit down in the Melbourne, FL area in November I got to meet up with fellow AnCan Vet, Garry Tosca and his lovely partner, Trish, for lunch on the edge of the Indian River at the Old Fish House. Both of us are Vietnam Vets where my time was spent in Saigon at Tan Son Nhut Air Base in Computer Operations.
Garry did less than two years in the Army with just enough time to be in the thick of fighting in numerous locations in Vietnam. He is my hero earning the National Defense Service Medal (received by all of us just for joining or drafted & affectionately known as the “pizza stain,”), Vietnam Service Medal with a couple of Bronze Stars for fighting in Campaigns, Republic of Vietnam Campaign Medal and the prized Bronze Star.
Bronze Star Medal — a highly respected military decoration given to service members who distinguish themselves while engaged in action against a foreign force
I do understand his most coveted award is the Combat infantry Mens Badge.
The Combat Infantryman Badge (CIB) is a United States Army military decoration. The badge is awarded to infantrymen and Special Forces soldiers in the rank of Colonel and below, who fought in active ground combat while assigned as members of either an Infantry or Special Forces unit of brigade size or smaller at any time after 6 December 1941.
I did learn something I had never thought about concerning VA Disability Ratings associated with Prostate Cancer (PC). With me and the StageIV Metastatic PC plus Vietnam, it is an automatic 100% Permanently Disabled Rating; a real no brainer with a minimum of paperwork needed. Garry is on Active Surveillance now for a number of years, is also considered 100% Disabled even though he is Gleason = 6(3+3).
It now makes sense for when a Vet is undergoing treatment, he/she is rated at 100% until some kind of resolution either one way or the other. Therefore documenting in excruciating detail all that happens during Active Surveillance can be shown as undergoing treatment, actually “continual treatment“. Hopefully he will stay at 100% Temporarily Disabled for the duration even if his PC never goes beyond Gleason 6.
I want to thank Garry & Trish for being such gracious hosts and when I return in the Spring, hopefully we can get caught up on things.
Just a reminder that AnCan now runs a Veterans’ Health Navigation Support Group, attended by both Jim and Garry and expertly moderated by Capt Joe Gallo (USMC). The group includes a vast amount of experience including administrators and physicians who worked in the VA for decades. It can help with everything from ratings and benefits to treatment. We also have folks using TriCare adn Tricare for Life. Sign up to receive a Reminder at https://ancan.org/contact-us/
Live performances: Many of us have missed them for two long COVID years. New Orleans has especially missed them. And while AnCan may have never missed them, given our virtual model, Herb Geller still rocked a standing-room-only, live crowd at the American Urological Association (AUA) Annual Conference last Friday the 13th (a good omen, in this case).
A number of you with prostate cancer will remember helping us by taking one or two online surveys last year, which made this research possible. Parts of this research had already been accepted at two other conferences, the European Society for Medical Oncology (ESMO) and American Society of Clinical Oncology (ASCO). While we were pleased to be recognized by those forums, COVID turned those conferences virtual, and there’s nothing like a live performance. Herb presented our greatest hits combining both the overall survey and our Active Surveilance specific questionnaire.
Survey participants said this about AnCan groups:
83% agreed the information is useful
67% discussed the information with their care teams
61% changed or informed their treatment path or strategy
71% found help navigating treatment path or strategy
80% became better advocates for themselves
Strikingly, AnCan participants have improved their lifestyle habits:
58% improved exercise habits
38% improved diets
50% reported reduced stress
AnCan helped participants make connections with each other:
85% found the groups to be welcoming
43% connected with others
30% developed friendships with other participants
Among those who attend early diagnosis, low-risk Active Surveillance meetings:
68% said that attendance helped them be their own best advocate
23% said that attendance informed them of new insights and treatments
AnCan concluded that:
The AnCan Support Group model increases patient knowledge, positively impacts treatment planning, and promotes lifestyle improvements while providing support to reduce stress, boosts confidence in navigating the disease, and improves quality of life.
AnCan empowers patients to self-advocate and improve their disease experience. This is integral to optimize physician/patient interactions and improve outcomes.
We advocate that virtual peer group attendance, based on our model, be included in (National Comprehensive Cancer Network) NCCN treatment recommendations for prostate cancer patients, especially with advanced disease.
If you took part in one of the two surveys, thanks again. And thanks especially to Rick Davis, Herbert M. Geller, James Schraidt, Howard Wolinsky, (and yours truly) for designing the surveys, crunching the data, and developing and presenting the insights from the data.
During my visit down in the Melbourne, FL area in November I got to meet up with fellow AnCan Vet, Garry Tosca and his lovely partner, Trish, for lunch on the edge of the Indian River at the Old Fish House. Both of us are Vietnam Vets where my time was spent in Saigon at Tan Son Nhut Air Base in Computer Operations. 
