Pubdate: Wed, 22 Sep 1999 Date: 09/22/1999 Source: Saint Paul Pioneer Press (MN) Author: Paul B. Dickinson, M.D. Ounce -- even pound -- of prevention I'm really too busy doing the unnecessary procedures referred to by syndicated columnist Tad Bartimus ("Maybe it's the doctors who are hypochondriacs," Aug. 27) to respond to her uninformed babbling. Nevertheless, I cannot resist a teachable moment. All of the dreaded afflictions of our bodies have a beginning -- an asymptomatic phase. The trick is to discover those life-threatening problems when they can be effectively treated. Consider yourself fortunate if your doctor cares enough about your welfare to advise screening. A doctor in St. Paul recently referred a patient to me for colonoscopy because, in the course of a routine exam, he observed unusual pigment in the patient's retina. This sharp diagnostician knew that type of retinal pigment [can signal] familial polyposis gene defect, a major cause of colon polyps that can [become] cancer. I located and removed a totally asymptomatic precancerous tumor. Luckily, the procedure was accomplished before the patient had a chance to be influenced by the juvenile whinings of Ms. Bartimus. When we discover an affected family member, we are also obliged to advise colonoscopic screening of the patient's first-degree relatives (siblings, parents, children). I enjoy humorous commentary as much as the next person, but I'm worried that some of your readers with symptom-free tumors will reject the good advice of their doctors, and the golden door to successful treatment may slam shut before the disorder is detected. Paul B. Dickinson, M.D. St. Paul