Dear Dr. Donohue: I have an 8-year-old grandson who wets the bed every night. This is becoming a difficult problem for him and his parents, as he cannot go to the Scout camp or stay overnight with friends.
I have read that there is a hormone treatment for this situation. Can you tell me something about it? I should add that the boy has been checked by a urologist, who says that he has a small bladder but no serious kidney problems.- M.H.
Answer: By age 5, roughly 85 percent of children have achieved nighttime bladder control. Almost all the remaining 15 percent make it through the night dry by the end of puberty. Only a small fraction have persistent control problems into adulthood.
Those statistics are of no consolation for your grandson, I realize.
As the urologist said, a small bladder is one explanation for delay in bladder control. Another explanation is a lag in nerve connections to the bladder.
Time corrects both a small bladder and nerve connections.
The hormone treatment you ask about is the nasal spray DDAVP - desmopressin acetate. It's an artificial version of a normal body hormone that slows nightly urine production.
Often it is used in conjunction with an alarm that is activated by the first few drops of urine.
DDAVP can allow your grandson to go on Scouting trips and stay with his friends overnight without fearing the embarrassment of bed-wetting. He would not have to take an alarm with him.
Above all, there should be no punishment for bed-wetting. It's not the child's fault.
Dear Dr. Donohue: What is the essence of cancer? It seems to occur when conditions, inherited or en-vironmental, are conducive. Will finding a preventive medication, like the polio vaccine, be impossible?
- W.W.
Answer: Your question is a tall order for a short answer.
For reasons only partially known, a single body cell undergoes a genetic transformation. That cell, formerly a model citizen, becomes an out-and-out sociopath, producing similar, lawless offspring. The outlaw cells refuse to obey the code of body law and order. They grow more rapidly. They spread to distant body sites, a process called "metastasis."
What causes such a transformation in body cells? Smoking, exposure to cancer-causing chemicals, inherited genes, radiation and ultraviolet light are some of the known causes. Viruses might be involved. There is a huge gap in our knowledge of most causes.
Will there ever be a vaccine for cancer? If a viral cause can be found, then the possibility for vaccine control exists.
Researchers continue to hunt for the elusive cancer causes. I have no doubt that their search will bear fruit in time.
Dear Dr. Donohue: I would like to know what skin tags are.
- R.M.
Answer: They're skin adornments that are common after age 50. They dangle from the skin like miniature stalks of asparagus. Their preferred locations are under the arms, on the neck, in the groin region and on the eyelids.
They are not cancerous. If clothing or jewelry irritates them, your doctor can snip them off without any fuss.
Annually a debate arises whether skin tags are a sign of colon cancer. The issue has not been resolved. But a check of stool for hidden blood is not an unreasonable request of those with skin tags. Why not play it safe?
You can find a full discussion of colorectal cancer in the Health Letter that addresses the subject. Readers can order the report by writing to: Dr. Donohue - HL 33-10, P.O. Box 5539, Riverton, NJ 08077-5539. Enclose $3 and a stamped (55 cents), self-addressed No. 10 envelope.