A new strategy to fight allergies
BY MICHAEL ROIZEN AND MEHMET OZ www.doctoroz.com May 1, 2012 10:48AM
Updated: May 2, 2012 11:08AM
Q. A friend of mine says that taking drops under her tongue for her allergies has changed her life. Is it safe and effective?
A. Glad the sublingual immunotherapy or SLIT — that’s what it’s called — is working for her. With the right doctor, this may be a safe and effective way to control allergies.
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.
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). 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 United States? 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.
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?
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. 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.
King Features Syndicate