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Prostate Cancer Screening

July 04, 1999

Re "We Should Stamp Out This Medical Misinformation," Commentary, June 28: Steven Woloshin and Lisa Schwartz are critical of the post office for embarking on a prostate cancer educational campaign. Although the efficacy of prostate cancer screening is uncertain, the same can be said for nearly all cancer screening methodologies.

Despite extensive screening regimens for many years, the overall mortality for breast cancer remains at approximately 25 deaths per 100,000 population, a figure that has not substantially changed since 1930. Although there have been studies demonstrating the efficacy of breast cancer screening, the fact that the overall mortality has not changed in the population suggests that screening is not as effective as many have assumed it to be. The message in this is that we do not know the true effect of any screening modality. Men should discuss prostate cancer screening with their physicians and decide for themselves how to proceed.

The post office is not promoting any particular prostate cancer treatment. The aim is solely to inform men that screening exists and that they should seek advice from their health care team.

EDWARD H. LIVINGSTON MD

Director, Surgical

and Perioperative Care

VA Greater Los Angeles

Health Care System

*

I write in vehement protest to the ill-conceived, if not mean-spirited, commentary. The issue of the commemorative stamp is hardly worth discussing. I am a 67-year-old prostate cancer survivor. My prostate was surgically removed five years ago, and there are no signs of recurrence. I have been periodically checked these past five years.

Were it not for screening, I would probably be dead by now, or terminally ill. The first screenings were followed by ultrasound tests and biopsies, where it was determined that I had cancer. I was followed for two years by my choice, when the Gleason Scale (a test for aggressiveness and intensity) determined I was at risk. For these two doctors to ignore the use of biopsies and the Gleason Scale says much about their reliability. I can only wonder what their agenda might be, these two internists.

IRWIN H. MOSS

Los Angeles

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