Get the drop on allergies – under the tongue
Q: A friend of mine says that taking drops under her tongue for her allergies has changed her life. Is it safe and effective? — John W., Boynton Beach, Fla.
A: Glad the sublingual immunotherapy — or SLIT is what it's called — is working for her. With the right doctor, this may be a safe and effective way to control allergies. Here's how it works:
First, you get tested to identify what you are allergic to: tree pollen, mold, pets, dust mites, the whole roster of possible allergens. That's generally done with a scratch test. You are checked for a reaction to as many as a dozen allergens at the same time, and get results in about 20 minutes. Sometimes a blood test is given first, but it's not always a reliable way to ID what's bothering you.
Once the allergist knows what you are reacting to, he creates a regimen of drops that contain small amounts of those allergens. You give them to yourself at home every day; no weekly office visits for immunotherapy injections (that's the standard approach). Over many months, your exposure to the allergens is increased, and you may become less allergic (desensitized) to them. For some people, allergy symptoms don't go away, for others they become milder or even disappear.
The World Health Organization says SLIT is a viable alternative to immunotherapy injections, and it's been used successfully for years in Europe. The safety record is very good, and major studies have demonstrated its effectiveness.
So why isn't SLIT used more often in the U.S.? Well, although the ingredients in the drops are Food and Drug Administration-approved (they're the same as what's in immunotherapy injections), the delivery method is not. It's considered off-label use.
Is it right for you? If you have allergies year-round and they interfere with your daily routine, immunotherapy may provide enormous relief, and you should explore your options, whether it's shots or drops.
Q: My sister recently died from ovarian cancer. I'm terrified that I will get it. Now they say that getting checked out for it regularly isn't a good idea. What should I do? — Patricia M., Canton, Ohio
A: Ovarian cancer has never had the research funding that breast cancer gets. But when the screening tests for ovarian cancer — the CA-125 blood test that looks for cancer antibodies and transvaginal ultrasound — were introduced, everyone was really hopeful that it would become easier to diagnose the disease in its early stages.
Now, the U.S. Preventive Services Task Force has declared that "there is at least moderate certainty that the harms of screening for ovarian cancer outweigh the benefits."
Confused? Let us clarify: These screening tests are still recommended for a woman at high risk. That's anyone who has had breast cancer; who has the BRCA-1 and BRCA-2 gene; who has a relative who has had breast, colorectal or ovarian cancer; or anyone who is obese (the heaviest women have a 50 percent increased risk).
So why is the USPSTF warning against screening tests for everyone else? Because they result in too many false positives. In the words of the USPSTF: "Screening for ovarian cancer can lead to important harms, including major surgical interventions in women who do not have cancer."
So how about some good news? Many companies are working on diagnostic tests that may be more reliable: blood tests that look for multiple cancer markers, not just CA-125; monoclonal antibodies that target ovarian cancer cells types; and gene-based and protein-based tests.
Until they become available, women should have regular gynecological check-ups and adapt an anti-cancer lifestyle: stress reduction, weight control, plenty of physical activity and a diet high in fruits and veggies, lean proteins and healthy fats (olive oil, omega-3s found in salmon). And ask your doctor about reducing the risk of ovarian cancer by taking two baby aspirins and drinking six (really, that's the science) cups of coffee a day.
Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Medical Officer at the Cleveland Clinic Wellness Institute. Submit your health questions at doctoroz.com.