Welcome to Prostate Cores, my new Substack newsletter
Abstracts on Active Surveillance, low- to favorable intermediate-risk PCa, BPH, prostatitis and cancer survivorship will be the focuses in this newsletter. First issue coming soon
Check out the first edition of the Prostate Cores Substack newsletter linked here. Why not subscribe?
By Howard Wolinsky
Three years ago, I launched TheActiveSurveillor.com on the popular Substack newsletter platform. And I am announcing here a companion blog, Prostate Cores, abstracts not only on Active Surveillance but also BPH, prostatitis and cancer survivorship.
Prostate Cores is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
Subscribed
Some background: About 2,000 readers from more than 60 countries and 49 states have subscribed to the Surveillor, whose readers include some of the top prostate cancer researchers in the world as well as everyday patients on Active Surveillance and even some men with advanced cancer.
Substack lists the Active Surveillor newsletter as a “best seller.” Doesn’t seem like many to me when you consider 300,000 men in the U.S. alone are diagnosed with prostate cancer—up to half of them have low-risk PCa and would be candidates for AS,
But Substack know better about readership of the blogs it publishes.
I am grateful to the readers I have. The Active Surveillor has even gone viral with 62,000 readers of a post on King Charles III being diagnosed with a still undisclosed cancer—not prostate though he had issues with BPH— a year ago.
The Active Surveillor campaigns for, among other things, avoiding unnecessary biopsies, diagnoses and unnecessary surveillance, safer transperineal biopsies to avoid deadly sepsis and infections, making AS available in the inner city and rural areas, and redefining Gleason 6 as a noncancer.
The Surveillor recently expanded its horizons and hosted its first event: “AS 2025: The Year In Review” featuring top prostate experts on Jan.4. I’ll soon be making the video available and reporting on highlights.
The webinar was supposed to be 1 1/2 hours. But most of the experts and patients stuck around for an extra half hour. And then after the gurus were gone, 100 of 135 attendees remained in the Zoom session for yet another hour.
And we mainly talked about BPH. You don’t have to be royalty like King Chas to be coping with BPH.
The hunger these men have for health information struck me. because men usually are portrayed as being uninformed about health issues. These men had loads of questions, and they want answers.
Not just for AS, but especially for BPH or enlarged prostates. BPH is the most common prostate problem in men over 50. It affects about 50% of men between the ages of 51 and 60.and that number increases with age:
Age 60 to 69: 70% of men have BPH
Over 70: Around 80% of men have BPH
This is huge. And I have largely ignored it because I am not affected.
Urologic oncologist Adam Weiner, assistant professor and urologist at Cedars-Sinai Medical Center in Los Angeles, said, “While there is no direct connection between BPH and prostate cancer, the chances of finding prostate cancer at the time of a BPH surgery ranges from 3-17%.”
Enter Prostate Cores
So I decided to launch this newsletter, Prostate Cores, to cover AS material not covered in the Active Surveillor, as well as BPH, prostatitis and some men’s health issues and cancer survivorship in general.
Prostate cores of course are the tiny biopsy samples used to determine whether we have prostate cancer or whether it is advancing. I could have called it prostate chips, after the tissue removed from the prostate during BPH surgery.
But I like Cores better because these cores sample the prostate. Prostate chips sounds like a gross type of snack. Feh, as my grandmother would say.
How will this work?
I oplan to inform and educate a aklittle and give you the links you need to go deeper if you wish.
Things will be different in this blog. The emphasis will be on short and fast. This will be a quick read with nuggets of information for readers who want to get their information fast and move on.
I may run an occasional in-depth article, but the main focus will be on abstracts, short summaries, of research, and also of interesting blogs and articles related to being a patient with prostate disease. I’ll provide links if readers want to explore the topics in more detail.
I will publish once a month. The Active Surveillor is published as news happens and when I think it should be published, two to three times a week. Please, give it a whirl and see if it meets your needs.
People tend to think information on the internet is free. I can assure you, it’s not. I am at my word processing for hours every week. My own choice, but I have passed up lucrative work in favor of this passion project.
I want to keep up these newsletters but can’t go broke doing it.
I ended up in the red with The Active Surveillor because I was timid about charging for my time and overhead. An AS friend suggested that I charge $1,000/year like some stock tip newsletter. But I couldn’t do it.
This information can have an impact on people’s lives so I am reluctant to not share it with everyone. But I hope they can help me by paying something to keep the lights on in the growing Surveillor empire,
A long-time reader/supporter told me: “I appreciate you and your work, my friend. I would not be bashful in charging for what you provide to all of us and getting your work covered adequately so you can also cover not only your costs but your time and then some to make it worthwhile.”
I agree. But I want to keep charges as low as possible for a monthly publication.
I plan to charge: $5/month, the least Substack allows. You can save money by paying $40/year.
There will be the usual free subscriptions with the same content available as to paying subscribers. I couldn’t do it another way.
First newsletter linked here. Send me a note if you’re having difficulty subscribing: howard.wolinsky@gmail.com
Howard Wolinsky
P.S. Let me know if you run into a study you think should be shared. I’m at howard.wolinsky@gmail.com
(Note: Get a preview of the MRI-invisible issue in Medscape: https://www.medscape.com/viewarticle/mri-invisible-prostate-lesions-are-they-dangerous-2025a10000cw)
MRI-invisible lesions: A good sign—like a Gleason 6?
By Howard Wolinsky
Did you know that it’s possible for prostate cancer can spotted by a pathologist but the lesion can be invisible in an MRI?
Is this a good thing? Many researchers think it is a good thing.
Dr. Mark Emberton, Professor of interventional oncology at University College London and Dean of its Faculty of Medical Sciences, will be speaking to the ASPI webinar on Saturday, January 25, 2025, from noon – 1:30 p.m. Eastern (5:00pm-6:30pm UK time), about MRI-invisible lesions. Emberton is a pioneer on the use of MRIs in diagnosing, classifying and monitoring prostate cancer.
Don’t be invisible. Register here: https://zoom.us/meeting/register/tJYldu-qqzojGNEzCkgPQuTOWYGhcL80Dhec'
MRI-invisible lesionms are considered a good thing comparable to Gleason 6.
(Are you having an MRI-invisible lesion adventure. Let me know.)
Professor Emberton’s clinical research is aimed at improving the diagnostic and risk stratification tools and treatment strategies for prostate cancer (PCa). He specializes in the implementation of new imaging techniques, nanotechnologies, bio-engineering materials and non-invasive treatment approaches, such as high intensity focused ultrasound and photo-dynamic therapy.
His research has been published in over 300 peer-reviewed scientific papers in journals including BMJ, Lancet Oncology and European Urology. He has also contributed to the development of guidelines for the management of PCa and lower urinary tract symptoms, published by the International Society of Geriatric Oncology and the European Association of Urology.
If you have questions, please send them to: contactus@aspatients.org