Q: I have T1 bladder cancer and am being treated with BCG immunotherapy.
I dye my hair dark brown every four weeks, as I have been for 20 years. I heard that hair dye is linked to bladder cancer. Should I stop using color?
A: Your question is surprisingly difficult to answer. For decades, epidemiologists have been debating whether hair dye increases the risk of cancer. The problem is that studies often are contradictory.
One large meta-analysis (Annals of Epidemiology, February 2014) concluded that there was no excess bladder cancer risk from using hair dye. Hairdressers, on the other hand, had an increased risk for bladder cancer attributed to their exposure to hair dyes (Occupational and Environmental Medicine, May 2010).
A case-control study of Finnish women reported that the use of hair dye increased the risk for breast cancer (PLOS One, Aug. 11, 2015). Two recent studies show how dark hair dyes alter cells to make them more prone to cancerous growth. According to the authors of one study (Food Chemistry and Toxicology, December 2015), “These results point to the hazard of the hair dye exposure to human health.”
The risk, if it exists, appears to be small. Given the confusion and your diagnosis, you may wish to discuss your concerns with your oncologist.
Q: I had asthma for many years and was treated with Advair. During flare-ups, I also used an albuterol inhaler.
Last year, I came down with a terrible respiratory infection. My doctor prescribed two courses of azithromycin. By the time I finished the second one, my breathing was fine.
I now have no asthma symptoms at all. This antibiotic was a miracle cure for my asthma.
A: Respiratory-tract infections like the one you suffered are often associated with worsening of asthma (PLOS One, Apr. 22, 2015). There is increasing evidence that persistent low-grade infections with Mycoplasma pneumoniae or Chlamydia pneumoniae bacteria may lead to asthma symptoms in some people (Current Allergy and Asthma Reports, December 2013).
Research in mice suggests that treatment with azithromycin (Zithromax, Z-Pak) ameliorates inflammation and improves airway remodeling (Pulmonary Pharmacology and Therapeutics, February 2016). Young children with repeated asthmalike symptoms benefited from azithromycin treatment (Lancet Respiratory Medicine, January 2016).
Dr. David Hahn, M.D., M.S., has written about using azithromycin for hard-to-treat asthma in his book, “A Cure for Asthma? What Your Doctor Isn’t Telling You and Why.” In it he discusses the pros and cons of this approach and his protocol. Those who are interested can buy the book online at www.PeoplesPharmacy.com.
Q: The person who wrote you that pharmacies receive their drug orders the same way mail-order companies deliver to individuals (via UPS, FedEx, USPS) was mistaken. My husband and I own an independent pharmacy. We receive our drug order daily via a courier service from our supplier. Any refrigerated items are in an insulated tote with ice packs, so they are indeed delivered in a temperature- and humidity-controlled vehicle.
A: Thank you for the clarification. What you describe is the correct way for drug delivery. We hope that all pharmacies follow your good example. We suspect that mail-order drug delivery cannot meet such rigorous standards.
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