DEAR DR. DONOHUE: I have been diagnosed with a malignant tumor of the bladder. The treatment I am getting is BCG. Please tell me about it. – G.P

ANSWER: BCG – bacillus Calmette-Guerin – is a very weak version of a germ closely related to the TB germ. In some countries, BCG is given as a vaccine to prevent tuberculosis. How does it figure into cancer treatment? Instillation of BCG into the bladder stimulates the immune response of bladder cells to prevent new cancers from growing and to treat any cancer that has escaped detection. In the United States, around 67,000 new cases of bladder cancer are diagnosed yearly. The average age when it appears is 65. It is three times more common in men than in women. Cigarette smoking is an important factor in leading to it.

Blood in the urine is a sign of bladder cancer. Cancer isn’t the most common reason for blood in the urine, but it is the most important cause of it. Increased frequency of urination and a great urgency to promptly empty the bladder are two additional signs. However, more often than not, bladder cancer produces no signs or symptoms in its early stages.

Quite often, this cancer is detected early, but one of its sinister traits is its tendency to recur. That’s where BCG comes into the picture and that’s why regular scope examinations of the bladder are such an important aspect of treatment after the diagnosis has been made.

DEAR DR. DONOHUE: I am an 87-year-old man, and I have had vertigo for about two months. I have been to two doctors who have not been able to help me so far. I had this condition five or six years ago. I went to a doctor in my hometown, and he cured me right away. He laid me down on a table and then turned my head to both sides and then back to the middle and had me get up quickly. I was better immediately. I have been trying to find that doctor again, but to no avail. So I am stuck. Can you help? – V.M.

ANSWER: The doctor who cured you performed the Epley maneuver on you. It works for one kind of vertigo (dizziness), benign positional vertigo. It’s a common cause of dizziness. What happens is that crystals in one part of the inner ear are dislodged from their normal position and find their way into a part of the inner ear that has to do with balance. There they trigger nerves that transmit a mishmash of signals to the brain with the result being an attack of dizziness. The Epley maneuver coaxes those inner-ear crystals into returning to their own home.

Ear, nose and throat doctors know this procedure cold. So do many other doctors. Keep in mind that benign paroxysmal positional vertigo is only one cause of dizziness. The Epley maneuver doesn’t work for other causes. Why not see an ear, nose and throat doctor? Such a specialist is an expert in ferreting out the causes of dizziness and treating them.

The booklet on dizziness explains the various causes of this annoying condition and how they’re treated. To obtain a copy, write: Dr. Donohue – No. 801, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I would like to add to your answer to the person who had water dripping from the nose. I had the same problem 15 years ago. One side of my nose constantly ran, especially when I bent down. A friend told me her sister-in-law had the same condition and it turned out to be a leak of cerebrospinal fluid. My family doctor had me tested for spinal fluid, and sure enough that’s what it was. An ear, nose and throat doctor sealed the leak. – F.Z.

ANSWER: I don’t want everyone with a runny nose to think they are leaking cerebrospinal fluid, but it can be a rare cause of it. The nose and the brain are in close proximity. Fractures of the nose or sinuses, surgery in that area or a birth defect can cause such a leak. The fluid can be tested, and the diagnosis is then made.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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