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Cancer risks and diagnoses

October 27, 2009

Re "With cancer, it's always personal," Oct. 25

Thank you for running Paul Lieberman's Op-Ed article on prostate and breast-cancer screening.

I would, however, retitle his article, "With Cancer, it's never real until it's personal." My point is that one only comes to terms with cancer after we, personally, are diagnosed. The danger with the current discussion over prostate cancer testing is that the continual focus on possible post-treatment problems may drive the annual PSA testing rate below the current meager rate.

The principal issue with PSA testing is not with the number of men tested but with the treatment decisions made by cancer patients and their physicians. What men need is better information about prostate cancer risk and treatment options, but with real statistics about post-treatment side effects attached.

And, of course, the ability of physicians to be able to reliably differentiate between benign and aggressive forms of prostate cancer.

Robert W. Hess

Manhattan Beach

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I am sorry about Lieberman's prostate cancer and about his wife's breast cancer, but he has done a great deal of reading about the over-diagnosis of these diseases without absorbing the main message: Many people diagnosed with either breast or prostate cancer would have died of something else before their cancer would have made itself clinically apparent.

People who undergo surgery, radiation and/or chemotherapy for diseases that would have had no effect on their lives are undergoing suffering and sometimes death as a result of their unnecessary diagnosis. It is not possible to tell which tumors we treat would have become clinically apparent, as the articles quoted make very clear.

Every patient would like to think that he or she is the one whose life was saved, but in fact, they might well have been the one who would have lived happily ever after until they died of something else.

Debra Grubb

La Canada Flintridge

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