My husband died aged 72 from prostate cancer. He used talcum powder daily for 50 years and I read recently that it was linked with cancer in women. Is there the faintest chance this could have contributed to his illness, too?
Linda Witten, Brighton.
Dr Martin Scurr replies: My condolences for your loss. And it must be upsetting to think that this might have been linked to something your husband used, believing it was safe to do so.
Talc is a naturally occurring mineral that contains silicon and magnesium, which is ground to form a soft powder.
Its use by women for ‘personal hygiene’ was first linked to ovarian cancer many years ago – the explanation being that the female genital tract is an open pathway from the vagina directly to the ovaries.
Since then, talc particles have been detected in ovarian tissue and tumours, supporting the theory that using talc in the genital region might be implicated.
Although this did not necessarily prove the mineral is carcinogenic, it has triggered litigation in the US (with women in the UK now planning legal action, too), and the International Agency for Research on Cancer (part of the World Health Organisation) has ruled talc used in the genital area is ‘probably carcinogenic’. But it’s still not clear-cut.
With men, although there is an open tract between the bladder and the urethra (which carries urine out), there is no evidence that talc can migrate along that channel. So far, the research has been focused on ovarian tissue.
Talc is a naturally occurring mineral that contains silicon and magnesium
Prostate tissue biopsies are frequently examined under the microscope and it is likely that if talc particles were present, they would have been observed; pathologists are well aware of the concerns about the feared carcinogenesis of talcum powder.
In conclusion, I do not think your husband’s long-term use of talc was a factor in his illness.
My granddaughter, aged 15, has been diagnosed with chronic urticaria. This condition has been ongoing for about a year. The medical people have yet to come up with an answer.
Jim Logan, Airdrie, Scotland.
Dr Martin Scurr replies: Chronic urticaria – or hives – is relatively common, affecting around 1 per cent of the population at any time.
It causes itchy raised welts, while some patients also experience more widespread symptoms including headache and fatigue, joint pain, palpitations, wheezing and abdominal symptoms.
Not surprisingly this can affect daily life.
Hives generally are a common symptom of an allergic reaction, but chronic cases may be linked to autoimmune disorders such as rheumatoid arthritis and type 1 diabetes. Although the exact mechanism is unclear, it’s thought to be due to the immune system overreacting.
Specialised blood cells, called mast cells, help protect us against infection. But in some people these cells respond inappropriately – producing chemicals, mainly histamine, that lead to itching and swelling.
The first-line treatment prescribed by doctors is usually a high dose of an antihistamine (drugs such as azelastine or fexofenadine) that targets H1 histamine receptors. It is likely that your granddaughter will have been given drugs of this class.
If this doesn’t help, H2 receptor antagonists (such as famotidine or ranitidine) are added.
Another drug that might be included is Montelukast, which works in conjunction with antihistamines to suppress an overactive immune response.
If the above treatments are ineffective, guidelines recommend Omalizumab, which ‘mops up’ an antibody called IgE that drives allergic reactions. This is given by injection every four weeks. There are other immunosuppressant options, too.
My opinion is that this young patient should be under the care of an expert dermatology team in order for a specialist input into the risks and benefits of the more complex treatments.
