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Dear Dr. Roach: I’ve been diagnosed with midstage prostate cancer. I understand that sugars feed cancer, but what about sugar alcohols?

D.P.

Dear D.P.: Cancers are very good at using whatever energy supply they can get, including sugar. However, even if you eat no sugar at all, your body will make sugar, which is necessary for your brain. There is no way to change your diet so effectively that it can prevent a cancer, of any type, from using sugar to grow.

However, excess sugar isn’t good for anyone, especially someone fighting off cancer, and particularly so in someone being treated with radiation, chemotherapy or recovering from surgery. So, most cancer experts recommend a diet high in fruits and vegetables and low in refined grains and simple sugars. The natural sugars found in fruits will not adversely affect your cancer treatment.

You asked also about sugar alcohols. Sugar alcohols, like xylitol and sorbitol, are poorly absorbed sweeteners. They almost certainly are less harmful than plain sugar, but some people can be sensitive to their laxative effects. While they will not cause problems with cancer treatment, foods that have these products are generally less nutritious than the diet above.

Dear Dr. Roach: You wrote about spinal stenosis. My doctor tried everything, including a spinal stimulator and steroid shots. Finally, he said I should get a rolling walker, lean forward on it, and see if that will “unpinch” the nerve. It seemed strange, but I did it, and I have had no pain since 2007.

M.E.

Dear M.E.: Spinal stenosis is caused by a mixture of abnormal growth and the position of bony and soft structures in the back pressing directly on the spinal cord or on the nerve roots as they exit the spinal column. This causes pain and sometimes numbness or even weakness. Relief of symptoms upon leaning forward is an important diagnostic point. Your pain doctor made a great suggestion for you, and it may help others, but I think you are more fortunate than most to have found such long-lasting pain relief. Spinal stenosis is often a progressive condition.

Dear Dr. Roach: I read your column on vertigo. I had vertigo, but stopped eating anything with MSG and now am OK.

A.R.

Dear A.R.: I also have read reports of people noticing the same thing. I have three hypotheses why this might happen. The first is that some people are sensitive to the flavor enhancer monosodium glutamate, and dizziness is one of the less-common reactions to it. The second is that foods high in MSG also tend to be high in sodium, and sodium is a trigger for Meniere’s disease, a possible cause of vertigo. The third is that some people with migraine can have symptoms triggered by MSG, and vertigo is a less-known symptom of migraine in some people. Since there is no need for MSG in the diet, it can’t hurt to try avoiding it to see if it helps.

Email questions to ToYourGoodHealth@med.cornell.edu.

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