Dear Ann Landers, s a physician and researcher at the National Cancer Institute, I was surprised to read your column recommending the PSA test to screen for prostate cancer. That column wandered into one of the biggest medical controversies of our time. Numerous professional organizations and advisory groups, includ-ing the U.S. Preventive Services Task Force and the American Acad-emy of Family Physicians, have recommended against using the PSA for screening men who have not shown any symptoms. It is important to understand that many prostate cancers do not need treatment. Un-fortunately, although we are getting much more proficient at diag-nosing prostate cancer, we are not very good at distinguishing the prostates that need treatment from those that are best left alone. Ten- year follow-ups of patients with prostate cancer who received no treat- I 9 II i ANN LANDERS ment showed very similar outcomes to those who were treated. Treat-ment of prostate cancer is associated with a significant incidence of both incontinence and impotence. A small number of men die from the treatment. Clinical trials are currently taking place to determine the effective-ness of the PSA test. Hopefully, these trials will settle the ongoing de-bate. Until then, please, Ann, let your readers know that a conservative approach is best for some.
Hi! It's Margo here. I'd love to know what you think of the letters -- and the answers!
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Our Reader to Reader Question of the Week:
Dear Readers, , as they say on 17 4 ANN L A NIIE R S TV, “minor aches and pains,” arthritis is our country’s No. 1 chronic disease. Nearly 200,000 American children suffer from some form of juve-nile arthritis. At least half of the population over 65 is affected. Many disabling forms of arthritis strike between the ages of 20 and 40, the crucial years for establishing families and careers. This condition not only causes pain and stiffness but diminishes the quality of life and can lead to disability, disfigurement and premature death. Too many people think that because there is no cure for arthritis, nothing can be done to treat it. That is a false assumption. There are things that can be done to control it, and the Arthritis Foundation can help. It has many programs, including some self-help courses, exercise classes and patient forums. For free information on how to cope more effectively with arthritis, contact the Arthritis Foundation, P.O. Box 7669, Atlanta, GA 30357- 0669, or call the toll-free Arthritis Foundation Information Line at (800)283-7800. Please, Ann, let people know it’s not “just arthritis,” and that help is available. -Marilynn J. Cason, chairman, Arthritis Foundation, Illinois Chapter
