I use one for photo manipulations with Paintshop Pro X4. I've had similar-sized Wacoms for almost as long as I can remember, and I'd wouldn't know what to do without them. Actually I don't like the Pen and Touch that much, the touching gets in the way of my pen use; it seems the pad responds to my hands being on the pad when I'm using the pen, and I don't want that.
Way back I had a Wacom that had a wireless and battery-less mouse that used the drawing pad as a mousepad, I wish they brought that one back. It was brilliant.