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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-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.

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Dear Readers,
, she has re-mained free from the infection. 7 h ANN LANDERS It is important to point out that scientists now believe people in-fected with genital herpes release substantial amounts of infectious virus even while displaying no physical signs of the infection. This is known as “asymptomatic shedding.” That means people with herpes can transmit the virus even when no symptoms are present. Some researchers suspect that as many as 60 to 70 percent of new cases of herpes result from sexual contact with an infected person dur-ing periods of asymptomatic shedding. Please make this clear to your readers so they will understand that they cannot rely on the absence of physical signs of herpes as a guarantee that they will not be infected. Data presented in October 1994 at the 34th Interscience Confer-ence on Antimicrobial Agents and Chemotherapy in Orlando, Fla., showed that asymptomatic shedding could be reduced by 95 percent through daily treatment with acyclovir, an antiviral drug currently used to treat herpes. Scientists, however, cannot yet say for certain if this also prevents infection. You have an excellent track record of informing readers about geni-tal herpes, Ann. With more than 30 million Americans infected with this virus, those not infected may unknowingly continue, like “Wis-consin Woman,” to place themselves at risk. Please keep giving us solid information. -North Carolina Reader

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"Keep in mind that the true measure of an individual is how he treats a person who can do him absolutely no good."
-Ann Landers