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 1 II ANN L A N IIE R S 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. -Otis W. Brawley, M.D., National Cancer Institute, Division of Cancer Prevention and Control, Bethesda, Md.

Dear Dr. Brawley,
There is a great deal of controversy among physicians on this subject, and since I printed another point of view, I felt obligated to print yours. Readers can now discuss this with their own physicians and make up their minds. Thank you so much for writing. One of the single most important columns I have ever written was in 1971 when I asked my readers to support the National Cancer Act: Dear Readers: If you are looking for a laugh today, you'd better skip Ann Landers. If you want to be part of an effort that might save millions of lives-maybe your own-please stay with me. Who among us has not lost a loved one to cancer? Is there a single person in my reading audience so incredibly lucky that his life has not been changed in some way by this dread disease? More Americans died of cancer in 1969 than were killed in the four years of World War II. Of the 200 million Americans alive today, 50 million will develop can-cer. Approximately 34 million will die of it. Cancer claims the lives of more children under 15 years of age than any other illness. How many of us have asked the question, "If this great country of ours can put a man on the moon, why can't we find a cure for cancer?" One reason is that we have never launched a national campaign, a united effort, against this killer disease. Another reason is money. The funds designated for medical research in America are grossly inade-quate. Government grants for medical research have virtually dried up. The lion's share of the tax dollar is going to defense. WAKE UP A MII SMELL THE CIIFFEE! I 9 I The following statistics shook me. They tell an interesting (and shameful) story about the priorities in this country. In 1969, for every man, woman and child in the United States, our government spent: $125 on the war in Vietnam $19 on the space program $19 on foreign aid 89 cents on cancer research Soon a bill will come before the U.S. Senate that calls for the estab-lishment of a National Cancer Authority. This bill, S-34, will be spon-sored by Senators Edward Kennedy and Jacob Javits. The proposed National Cancer Authority would be an agency similar to the National Aeronautics and Space Administration (NASA), which put men on the moon. This Conquest of Cancer bill demands that the highest priority be given to devise better methods of prevention, diagnosis and cure of cancer at the earliest possible date. Today, you have the opportunity to be a part of the mightiest offen-sive against a single disease in the history of our country. If enough cit-izens let their senators know they want bill S-34 passed, it will pass. I urge each and every person who reads this column to write to his two senators at once-or better yet, send telegrams. The senators for Illinois are Adlai Stevenson III and Charles Percy. Address your letter or telegram to: Senator , Senate Office Building, Washington, DC 20510. Your message need consist of only three words. "Vote for S-34." And sign your name, please. No one can do everything, but each of us can do something. It is en-tirely possible that this one small act could reshape the lives of mil-lions. Get moving. My telegrams to Senators Percy and Stevenson went out last night. Thanks-and God bless. I was counting on my readers to come through, and you certainly did. Here is what happened: Dear Readers: Thank you for your magnificent response to my suggestion that you wire or write your senators in support of S-34, the 112 ANN LANDERS Cancer Conquest bill. An unprecedented blizzard of letters has hit Washington. The already overworked secretaries who must answer the mail have posted signs saying, "Impeach Ann Landers!" They quietly concede, however, that the response is heartwarming. Judging from the telegrams and letters already received, it is estimated that that sin-gle column will generate a million pieces of mail. I am immensely grateful that President Nixon has announced his support of some of the principles of S-34. The battle will not be won, however, until legislation passes both houses of Congress establishing a National Cancer Authority and making the conquest of the disease a specific national goal. It will not be enough merely to utilize the exist-ing machinery for cancer research. The existing machinery has been around since 1937, and it is a jun-gle of red tape. The proposed National Cancer Authority would be an agency similar to the National Aeronautics and Space Administration, which put the first man on the moon. If we stay with "the existing ma-chinery," it is doubtful that we will reach our national goal. Your wires and letters in support of S-34 are letting Washington know we want a sharp realignment of priorities. We are no longer going to remain silent while medical research picks up the crumbs from the table after the military has finished its gourmet meals. The answers to the scourge of cancer can and will be found. I say a massive, unified assault on this killer disease is long overdue. The National Cancer Act was signed by President Nixon in 1971, with $100 million going directly to cancer research. What Cancer Cannot Do Cancer is so limited ... It cannot cripple love, It cannot shatter hope, It cannot corrode faith, It cannot destroy peace, It cannot kill friendship, It cannot suppress memories, It cannot silence courage, It cannot invade the soul, It cannot steal eternal life, It cannot conquer the Spirit. WAKE UP AMI SMELL THE CIIFFEE! m For more information, contact: American Cancer Society 1599 Clifton Road NE Atlanta, GA 30329 (800) ACS-2345 Reach to Recovery American Cancer Society 1599 Clifton RoadNE Atlanta, GA 30329 (An organization for women who have had mastectomies) National Cancer Institute (800) 4-CANCER What appears below is from a 1992 Department of Health and Human Ser-vices report. No frills. No baloney. Just the facts. About 1 million Americans are now infected with the HIV virus that causes AIDS. In the last ten years, more than 200,000 Americans have been diagnosed with AIDS. Approximately 64 percent of them have died. World-wide, an estimated 8 million to 10 million people are now HIV-infected. The average time between HIV infection and the development of full-blown AIDS is ten years. Although engaging in male-to-male sexual contact and intravenous drug use remain the highest risk factors, heterosexual trans-mission is showing the greatest rate of increase. In the United States, AIDS is now the second-leading killer of men 25 to 44 years old and the fifth-leading killer of women in the same age group. It has hit some minority populations the hardest. More than one fourth of those diagnosed with AIDS are black, and 16 percent are Hispanic. As of December 1991, there were 40,362 reported cases of AIDS among men and women 20 to 29 years old. There were 789 cases of AIDS reported among people 13 to 19 years old. The most disturbing fact in this report is that the incidence of HIV infection is growing rapidly among teenagers. In spite of efforts by the government, the medical community, and civic- minded groups, high-risk behavior among U.S. teens is widespread. More than 40 percent of high school students polled say they have had multiple sex partners. Although condom use has increased significantly, only one third of the sexually active teenagers say they use them. It should be noted that only latex condoms can provide protection against sexually transmitted disease. And condoms are not 100 percent effective: They can leak, break, or come off. 19 4 ANN LANIIEKS The two most common forms of transmission are sexual intercourse-anal, vaginal and oral-and the sharing of needles. The virus also can be acquired through blood transfusion. Such occurrences have been rare since 1985, when careful screening of blood began. HIV is not transmitted through casual contact-by kissing, by touching door handles, phones, drinking fountains or toilet seats, or by getting an insect bite. At this moment, there is no vaccine to protect a person against the HIV virus and no acre for AIDS. A massive effort, however, is in progress in re-search laboratories all over the world. The drugs AZT and ddl have proven successfiil in delaying the onset of AIDS, improving the quality of life dramatically for some AIDS sufferers and extending their life expectancy. What can you do to protect yourself against AIDS? Do not share needles. Have a monogamous relationship with a person who is healthy and totally trustworthy.