Is lung cancer lurking in your dryer?
DEAR DR. ROACH: I heard that air fresheners and fabric softener sheets may cause lung cancer. Is this true?
These products release volatile organic compounds, according to a 2011 study. VOCs encompass a large group of chemicals, some of which will increase the risk of cancer if ingested at high-enough dosages for a long-enough period of time.
Some of these include alcohol and acetaldehyde, both of which are known definite or probable carcinogens. Nonetheless, people ingest alcohol at high levels, and acetaldehyde is found in ripe fruits, among other places.
The study found products listed as “organic,” “green,” “natural” or “nontoxic” that had similar amounts of potentially toxic or hazardous chemicals. The type of study precluded any assessment of the magnitude of risk from exposure to these chemicals.
The Environmental Protection Agency has estimated less than a one in 100,000 chance of developing cancer from continuous exposure to acetaldehyde. The effect of multiple volatile organic compounds acting together hasn’t been studied.
Saying that “air fresheners cause lung cancer” is sensational, and doesn’t really address the factors a person should concern themselves with, such as the level of exposure to something that’s necessary to develop risk, and the amount of risk of getting lung cancer from using fabric softeners with the laundry.
It is clear these products can lead to allergic reactions. I see respiratory symptoms and rashes fairly frequently. However, my best guess from the studies I have read is that the risk of developing cancer from these products is very, very low.
DEAR DR. ROACH: I am writing on behalf of my 91-year-old father, who has been diagnosed with carpal tunnel syndrome. He has seen a specialist, who is ready to proceed with surgery. My father’s symptoms include numbness in the fingers to the point that he can’t button shirts and tie laces easily.
Is there a treatment you could recommend that would deal with the numbness? My father feels little pain and has no problem gripping. He wonders if nerve compression could be coming from his neck and shoulder, and if chiropractic care, massage or range of motion physical therapy may be the answer. He is hesitant to go ahead with surgery.
ANSWER: Carpal tunnel syndrome is caused by nerve compression in the wrist. The carpal tunnel is a literal tunnel of space bordered by the carpal (wrist) bones and their ligaments, and by a connective tissue structure called the flexor retinaculum.
The compression is alleviated by surgical release of the retinaculum, which gives the nerve adequate room. Surgery is the definitive therapy for carpal tunnel syndrome, but surgery is not always necessary. Lifestyle changes, such as wearing a wrist brace, and medications can sometimes keep a person from needing surgery.
You haven’t expressed any good reason why your father needs surgery now. Surgery in any 91-year-old should not be taken lightly, even carpal tunnel release, which is a very effective surgery with a low complication rate. But low complication rate doesn’t mean zero.
Before surgery, the surgeon should be completely certain the nerve compression is happening in the wrist, not the shoulder or neck.
Your father will need an EMG study. If surgery is necessary, I highly recommend contacting a hand surgeon, who has special expertise in this surgery.
DEAR DR. ROACH: My mother-in-law just had what they thought was a TIA, but her MRI was normal. What does that mean?
ANSWER: A transient ischemic attack is like a stroke, only symptoms are temporary because the brain tissue is not irreversibly damaged.
An MRI scan using a technique called diffusion-weighted imaging can identify the affected area of the brain after a TIA about half the time, if done within 24 hours. Once a TIA is confirmed, treatment, such as medication to dissolve clot and improve blood flow, can be appropriately guided.
Most people with a TIA and stroke also should be on optimum medical and lifestyle therapy to reduce the risk of a stroke. This includes a healthier diet, stopping smoking, regular moderate exercise, limited or no alcohol consumption, weight control, and often medication to control blood pressure.