DEAR DR. ROACH: My question is in regard to organ donation. The current status on my driver’s license is as an organ donor. However, I have cancer. I was diagnosed with stage 4 ovarian carcinoma almost two and a half years ago, and I am doing well with various courses of chemotherapy. Although the disease has affected numerous internal organs, there is no evidence of disease in others (clear head/neck, musculoskeletal, lymph nodes). Am I still able to be an organ donor (for certain parts/tissue, such as eyes and skin), or should I change the status on my license? My doctor suggested that limited donation may be a possibility. What is your opinion? — P.D.

ANSWER: I am sorry for your diagnosis, hopeful that you will continue to do well for more years and grateful that you have decided to become an organ donor. In general, organs are not accepted from people with cancer that had spread; however, corneal transplants are accepted from most people with cancer.

We need more organ donors. It’s easy to sign up at www.organdonor.gov in the United States, or www.cantransplant.ca in Canada.

DEAR DR. ROACH: I am wondering if you can give me advice about lowering my bad cholesterol level without the use of a drug. My total cholesterol is 198, and my LDL is 111. My HDL is 64, for a ratio of 3.1-to-1. — B.L.

ANSWER: I don’t think you need to worry about lowering your cholesterol. From the standpoint of cholesterol, you are at lower-than-average risk for heart disease. Of course, a good diet and regular exercise are good for everybody for many reasons, but I certainly wouldn’t recommend treatment with any drug or supplement based on the information you are giving me.

DEAR DR. ROACH: Today I refused to eat food at a church that serves the homeless and hungry due to the fact that they required each person to use hand sanitizer before receiving their food. I told them that I used soap and water prior to standing in line. I was diagnosed with Guillain-Barre syndrome 18 years ago, and I heard that some hand sanitizers have been linked to disrupting the immune system. I read a current website, and it gave eight reasons why hand sanitizers should not be used as a substitute for soap and water. What is your opinion? — J.A.

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ANSWER: I think that washing with soap and water is preferable, but if it isn’t available, alcohol-based hand sanitizers are better than nothing. I looked to see what reasons might be given for not recommending sanitizer, and I found some commonsense ones, like not ingesting it, but otherwise it is pretty safe. Sanitizers don’t kill all germs, especially Clostridium dificile (”C. diff”), which is another reason to use soap and water when available.

The issue with the immune system has to do with kids, in that a germ-free environment prevents a child’s immune system from developing normally. Being around dirt, with its attendant bacteria, probably strengthens the immune system and reduces allergies later in life. However, washing off the dirt and possibly unhealthy bacteria before eating still is a good idea.

I could find no reason to be concerned about hand sanitizers in people with Guillain-Barre syndrome or other autoimmune diseases. So while the insistence on hand sanitizers may have seemed officious, the offer probably was made in good faith and was harmless to you.

READERS: Questions about breast cancer and its treatment are found in the booklet on that subject. To obtain a copy, write: Dr. Roach Book No. 1101, 628 Virginia Dr., Orlando, FL 32803. 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.

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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 or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.

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