DEAR DR. ROACH: I had an abdominal X-ray to check on my gallstones, and was surprised to find an enlarged spleen. I was told it might be leukemia or lymphoma! I was sent to an oncologist, who reassured me that I did not have cancer and recommended I get checked again in six months. My doctor checked it after three, and my spleen had gone back down!
What is all this with the spleen? People have it removed after injuries, like accidents. It seems to be insignificant, but can it be an omen for cancer? -- M.K.
ANSWER: The spleen is an under-appreciated abdominal organ. Its major job is to filter and remove old or damaged red blood cells, but it also removes bacteria. In addition, the spleen acts as a very large lymph node, allowing infection-fighting white blood cells to gather and activate. Removal of the spleen leaves people at a higher risk of some kinds of bacterial infections.
Enlargement of the spleen has many potential causes. Both liver and heart disease can cause passive congestion of the spleen with blood. Cancer, especially lymphoma, is a common cause, but infection is one cause to consider in a person in whom the spleen enlarges and then returns to normal. There are many less-common causes as well.
If the spleen is removed or is nonfunctional (this is almost universal in adults with sickle cell disease, for example), then infections are common, and vaccinations have a different and more intensive schedule, ideally given when the spleen is still in place and working.
It is probably worth it for your doctor to continue to keep an eye on.
DEAR DR. ROACH: An acquaintance has recently (within the past two years) been diagnosed with Parkinson's disease. She is now using a "cell membrane stabilizing" diet. Is this likely to help her? Is there any evidence that it works? -- S.P.M.
ANSWER: Although I wasn't able to find anything about a specific diet with that name, I reviewed the literature on the effects of diet on Parkinson's disease, and the data are still preliminary. For most of the recommendations I have, there are conflicting reports.
Of the dietary factors with the best data, I found that fruits and vegetables are likely to be helpful and to protect against damage to the part of the brain affected by PD. Omega-3 fatty acids were found to be helpful in animal models of PD. Products high in soy protein and caffeine (especially from tea) may have some benefit. Again, these data are not strong, so I am not recommending a dramatic change in the diet solely to protect against PD. However, fruits and vegetables are certainly of benefit for multiple systems, and I am comfortable recommending a diet high in those.
Milk and other dairy products have been shown in some, but not all, studies to have a detrimental effect on PD.
Diet is of importance in many areas of health, but the role in PD seems to be modest, based on current literature. As always, a visit with a registered dietitian nutritionist is worthwhile to get specific and personalized information.