Doc: Nose strips and other nighttime congestion aids

Dear Dr. Roach: I have allergies and am congested a lot at night. I have read about over-the-counter clips and adhesive tapes.

Would they help me breathe better? Are they safe for the long term?

M.V.M.

Dear M.V.M: There are many different types of external devices that are designed to open the nasal passages during sleep to make breathing easier. Some of them are more like adhesive tape; others are inserted into the nostrils. They are marketed both for nighttime use and to improve sports performance.

A few years ago, a comprehensive review of studies on safety and effectiveness on these types of devices was published showing modest effectiveness, with as much as 75 percent improvement in symptoms.

However, reviews at an online retailer were decidedly mixed. I believe that a person’s individual anatomy may be suited to only a particular type of device, or perhaps none at all. Fortunately, these devices are relatively inexpensive and safe, and may have significant benefit, so it may be worth a try. They almost certainly are safer than prescription or even over-the-counter medication.

Dear Dr. Roach: I took my 79-year-old mother to the emergency room in December because she had been suffering from a sharp pain in her lower-right abdomen since the day before.

They discovered a 12-cm tumor, which was biopsied and determined to be gallbladder cancer that already was eating into the liver. We were told that her condition did not support surgery, nor was radiation or chemotherapy an option. We were told that this is a rare cancer and, as such, not much research money is spent on finding treatments.

She had a CT scan in April 2017 after being admitted for severe diarrhea; it showed gallstones. But she was asymptomatic, so the doctor said they would just monitor her.

How did she develop such a cancer without any symptoms or pain until it was too late? This blindsided us.

As her daughter, am I susceptible to the same sort of cancer? Any insight into this terrible diagnosis is appreciated.

L.J.B.

Dear L.J.B.: I am sorry to hear about your mother.

Gallbladder cancer is a rare disease in North America, with only about one case per 100,000 people. Most people do not have symptoms for a long time, which is why your mother didn’t know about it until the tumor was very advanced, making it similar to pancreatic cancer. Pain is the usual first symptom, but people may have nausea, vomiting or loss of appetite. The cancer can be hard to see on sonogram or CT, which is probably why the doctors missed it in April.

Gallstones, especially large gallstones, are a clear risk factor for gallbladder cancer. Other risks include chronic infection (Salmonella can live in the gallbladder after an infection), gallbladder cysts and polyps, and some occupational exposures.

Having a family history does increase your risk for developing this cancer; however, even as her daughter, your risk is still very small. One study from Sweden, where this disease is a little more common, showed that 5 people per 100,000 with a family history of the disease will develop it.

Email questions to ToYourGoodHealth@med.cornell.edu.