To Your Good Health
Dear Dr. Roach: My daughter-in-law has stage 1 breast cancer and has just started her chemotherapy. I am concerned about her decision to fast for two days before and one day after each treatment. She weighs only 90 pounds, and fasting while you are trying to fight cancer does not sound like a good idea. What is your opinion of fasting during chemotherapy? K.B.
Answer: In theory, fasting may make cancer cells more susceptible to chemotherapy, and there have been studies in mice suggesting this approach might have value. However, during chemotherapy, the whole body needs good-quality nutrition, and I could not recommend fasting for someone who weighs so little, nor could I recommend two full days of fasting before chemotherapy. Until there is clear evidence that intermittent fasting is of benefit, I dont recommend it. Your daughter-in-law, in particular, is not a good candidate, being so very thin (assuming she is of near-normal height).
Dear Dr. Roach: My dermatologist suggested that I get the HPV vaccine, as it will help my body fight warts of various kinds. Ive had plantar warts and warts on my fingers and hands. They go away with treatment, but seem to come back in a different spot over time. I am a 62-year-old male in good health otherwise. Is getting the vaccine a good idea? Thank you. K.L.
Answer: The HPV vaccine was approved for use in women to prevent cervical cancer, which is caused by certain high-risk types of human papillomavirus. Other types of this same virus are responsible for cutaneous warts, the kind on the plantar surface (sole) of your foot, or on your hands and fingers.
Several recent case reports and one small series have shown that difficult-to-treat warts occasionally have gone away completely after people were vaccinated with the HPV vaccine, such as Gardasil. It is thought that the vaccine stimulates the immune system so that the body can fight off the infection. This is a bit surprising, since it had been thought that giving the vaccine after exposure would not be effective.
On the other hand, the success seen so far is encouraging, and hopefully there will be a trial to look at this problem which is a real one, since some warts are very hard to get rid of.
For right now, discuss the upsides and the downsides with your physician. On the upside, some people who failed treatment with salicylic acid, duct tape, liquid nitrogen, imiquimod (a cream used to stimulate the immune system), laser treatment, oral Tagamet, 5-FU (a type of chemotherapy) and glutaraldehyde (a powerful medicine used for resistant warts) had complete success with the vaccine. On the downside, the vaccine is expensive, and the three doses are not covered by insurance for people over 26. Local reactions to the vaccine, such as a sore arm, are common. Fainting is the most common serious reaction.
