ArcaMax

DEAR DR. ROACH: I read your recent column where you said that ivermectin has not been proven to be an effective treatment for cancer. I feel that you need to be further informed on the positive aspects of Ivermectin. I have on file dozens of testimonials about the cancer-curing properties of ivermectin. -- J.A.

ANSWER: Testimonials are not how medical science advances. Medical science advances when careful studies show that a new treatment is proven superior to existing treatments. These need to be done to eliminate the bias of hopefulness (on the part of both the researchers and research subjects), and they need to use objective measures of outcomes. Only after multiple studies have been done (that are often confirmed by other researchers) do new treatments get widely accepted and used.

I don't even trust testimonials when I am shopping online. I go to objective sites that give an honest review. I strongly recommend against listening to testimonials for your medical care. What works for one person may not work for another based on complex information an individual patient might not know.

In this column, I get multiple letters from readers saying that a treatment is fantastic and should be used by everybody, with others saying that it is horrible and nobody should use it (and sometimes that its proponents should lose their licenses).

Ivermectin may end up being an effective treatment for some types of cancer, but it is not yet proven to be. So, I strongly recommend against it for the treatment of cancer except as part of a research trial. I found a trial at Cedars-Sinai, for example, that looked at ivermectin versus a placebo along with the standard therapy for breast cancer.

DEAR DR. ROACH: My 24-year-old grandson has had digestive issues all his life, including frequent, large bowel movements, pain, and nausea. He's also malnourished. The diagnosis has been that it's due to stress, but having such problems could certainly be a cause of stress.

His mother wonders if it's because of an antibiotic shot that he received as a young infant (while he was still nursing) when his siblings contracted strep throat. Is this a likely scenario? If so, would a fecal implant help? -- N.D., Ph.D.

ANSWER: I do not think it is likely that a single course of antibiotics as an infant has anything to do with persistent digestive complaints. If I saw a 24-year-old with these complaints, my biggest worry would be inflammatory bowel disease, but this does reflect the fact that I trained in a referral center where we saw a great deal of Crohn's disease and ulcerative colitis.

Irritable bowel syndrome (IBS) is a much more common cause, but the number of medical issues that can cause these symptoms is immense, including celiac disease and food allergies. If he has not done so, he would benefit from a visit with a gastroenterologist, who may recommend a colonoscopy in addition to a careful exam and appropriate laboratory blood and stool tests.

A fecal microbiota transplant (FMT) is occasionally used in C. difficile infections but is not the standard of care for other conditions. Although an FMT has been studied in people with IBS, it hasn't shown much benefit.

Finally, a registered nutritionist, who works alongside his gastroenterologist, might be able to identify dietary causes of his symptoms and design a program to identify the cause -- or at least find him a diet that relieves his symptoms.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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