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Se polymorphisms directly affect psa levels in men or whether they increase the risk of prostate cancer and thereby (indirectly) increase psa levels. Clearly, the role of psa in prostate cancer detection needs further exploration. buy viagra mexico Further confounding this issue are the high rate of undetected, microscopic disease and our inability to distinguish between prevalent prostate cancers that will lead to morbidity or death and indolent tumors that are of little biologic consequence to the patient. The cramer et al. buy generic viagra online in usa Study ( 14 ) is important on several levels. First, it sends a strong message that these psa polymorphisms should be examined prospectively with respect to their impact on psa as a predictive biomarker, perhaps in one of several ongoing large-scale prostate-related trials. If the entire breadth of the psa screening issue is to be examined, serious consideration should be given to the conduct of a trial that examines constitutional and lifestyle factors along with potential biomarkers and links these results not with the detection of prostate cancer but with disease that proves to be biologically consequential. Second, although psa has had a profound effect on the identification of prostate cancer, this study demonstrates the need to constantly refine and improve this important diagnostic tool and to explore other diagnostic modalities. Ian thompson , robin j. Leach , brad h. Pollock and susan l. Naylor affiliations of authors: i. generic viagra Thompson (division of urology, department of surgery), r. generic viagra without prescription J. Leach, s. viagra for sale L. buy viagra Naylor (department of cellular and structural biology), b. H. viagra use without ed Pollock (the center for epidemiology and biostatistics), university of texas health science center at san antonio, and the prostate cancer program, san antonio cancer institute, san antonio, tx. buy generic viagra online Correspondence to: ian m. Thompson, m. buy cheap viagra D. , division of urology, the university of texas health science center at san antonio, 7703 floyd curl dr. , san antonio, tx 78229 (e-mail: thompsoni{at}uthscsa. Edu ). ⩠oxford university press references ↵ wang mc, valenzuela la, murphy gp, chu tm. buy viagra mexico Purification of a human prostate specific antigen. can buy viagra bangkok Invest urol 1979;17:159–63. Medline web of science ↵ thompson im, ernst jj, gangai mp, spence cr. Adenocarcinoma of the prostate: results of routine urological screening. J urol 1984;132:690–2. Medline web of science ↵ stamey ta, yang n, hay ar. buy viagra mexico How we eat determines to a considerable extent how the world is used . . . land that is in human use must be lovingly used; it requires intimate knowledge, attention and care.
--Wendell Berry