Dear Dr. Gott: I am a 71-year-old male. Last fall, my PSA reading was 4.2, and the urologist suggested a biopsy of the prostate.

The results were negative. My latest PSA reading was 2.2, and the urologist wants to do another biopsy. Is this necessary when the previous results did not show abnormal conditions, and now the PSA is within normal limits?

Dear reader: Were I in your shoes, I would refuse another biopsy unless the PSA test exceeds 4 or your urologist feels an abnormality when he examines you. Continue your annual check-ups.

To give you related information, I am sending you a copy of my Health Report "The Prostate Gland." Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, Ohio 44092. Be sure to mention the title.

Dear Dr. Gott: I am writing to you about the letter in a recent column from a 36-year-old man with problems of flushing, palpitations, abdominal pain and diarrhea.

These symptoms have been mentioned in other letters, along with the same problem of finding a diagnosis. I, too, went through these difficulties for many years and finally have been diagnosed with carcinoid cancer.

This is a relatively rare endocrine cancer, with very small tumors secreting hormones that cause these "attacks."

This cancer, depending on its location, which is often difficult to find, can be alternately active or quiescent over many years. Surgery can often be a stressor, which can bring on symptoms as this gentleman described.

Because it is difficult to diagnose, a specialist should be consulted.

Helpful information can be found at www.carcinoid.org. Although tumors can be slow-growing, they can also develop quickly and cause serious illness, heart damage from the hormone release and even death.

However, there is treatment available, and much research is being done in this area. I urge you to share this information with your readers, as many carcinoid patients waste years with wrong diagnoses.

Statistics are showing that this is an underdiagnosed illness. Physicians are trained, and rightly so, to "think horses, not zebras, when you hear hoof beats." But, in this case, you have to suspect it to diagnose it.

Dear reader: You are absolutely correct, and I am grateful for your letter.

Carcinoid is serious and is often tricky to diagnose with blood and urine analyses and imaging studies. The cause of carcinoid is unknown; however, surgical treatment is usually successful.

Dear Dr. Gott: I am on 10 milligrams of Lipitor per day. When I have had blood work done, it has shown something abnormal about my liver. My doctor then sends me in for another blood test, and that comes back OK.

Shouldn't that be an indicator to stop the Lipitor?

If I stop taking the medicine now, will it hurt me?

Dear reader: Among other side effects, Lipitor (and other statin drugs) can cause serious liver inflammation.

Forget the blood test. Go off the Lipitor, and wait a month or two before having the testing done again. You also may wish to examine treatment options for your elevated cholesterol.

This would include niacin, flaxseed, and omega 3 fish oil. No more statins.

Doctor Gott is a retired physician and the author of the new book "Dr. Gott's No Flour, No Sugar Diet," available at most chain and independent bookstores. If readers would like to contact Dr. Gott, they may write him at Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York, NY 10016.