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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 don’t 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: A couple of years ago, a letter writer asked if you knew anything about the effect of Advil on men with enlarged prostates. It seemed that ibuprofen decreased his trips to the bathroom. I have found the same thing myself. Taking two Advil allows me to wait five to six hours before having to urinate. Has there been more research on why this happens? – S.Z.
ANSWER: There is some more information. Men with symptoms of enlarged prostate often have increased urinary frequency, combined with incomplete emptying. This makes sense; if you can’t empty your entire bladder, you will have to empty it more frequently. So it seems the ibuprofen is letting you empty the bladder more completely. There are two major reasons for incomplete emptying, and different theories for why ibuprofen might work on each.
Benign (not cancerous) enlargement of the prostate is one reason. In this case, it is hypothesized that ibuprofen stops the growth of cells in the prostate, but the exact mechanism isn’t clear. Reducing the size of the prostate can allow better, more complete urine flow.
The other common cause of the prostate symptoms is inflammation of the prostate. In this case, ibuprofen’s anti-inflammatory effect reducing symptoms is easier to understand. The fact that it works so quickly for you suggests that the anti-inflammatory effect is more important in your case.
Ibuprofen does have possible side effects, but two ibuprofen once a day is unlikely to cause significant problems.
DEAR DR. ROACH: My teen likes vegetables and eats right. He also drinks a lot of water, works out and doesn’t like soda. He and my sister have chronic constipation. They both now take a magnesium supplement and feel great. Is that OK? – T.M.S.
ANSWER: Magnesium is a common and safe treatment for constipation. A healthy diet, exercise and drinking plenty of water are good ideas for anyone with constipation, but some people do need additional help. I have previously mentioned prunes (or prune juice) as an option, but magnesium, if taken at a dose to ensure regular but not excessive bowel movements, is a fine treatment.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
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