Dear Doctors: We heard a story on the news that bee venom can cure breast cancer. Is that really true? How does stuff like that even get researched?

Dear Reader: It’s true that recent research has shown that an active component found in the venom from honeybees is toxic to certain types of cancer cells. Before we get any deeper into this topic, though, it’s important to note these results were obtained in laboratory tests. So, while bee venom has indeed shown promise in killing a range of cancer cells, a treatment based on these findings that can be used in humans will take years more study and testing.

It may seem that using bee venom to fight cancer comes out of left field, but the idea actually reaches back to the dawn of medicine. The pharmaceutical use of honeybee products, known as apitherapy, dates back at least 5,000 years to ancient Egypt, China and Greece. Medical practitioners of the time used honeybee venom to treat joint inflammation and pain, and the antibacterial properties of honey were harnessed in approaches as various as treating wounds, easing indigestion and embalming the dead. In modern medicine, bee venom has become a subject of interest in the treatment of rheumatoid arthritis.

The venom that honeybees inject when they sting is a complex mixture of proteins, enzymes, sugars, lipids and other bioactive agents. The bulk of it is made up of short chains of amino acids, known as peptides, which are the building blocks of proteins such as collagen, elastin and keratin. The most abundant of these is a peptide called melittin, which is responsible for most of the medicinal effects of bee venom. (Don’t worry, bee lovers: Melittin can be synthetically produced.) Scientists have been interested in the anti-tumor properties of melittin for many years, including in the fight against melanoma, the most virulent and deadly of the skin cancers.

The study you’re asking about was conducted by scientists at the Harry Perkins Institute of Medical Research in Western Australia and was recently published in the journal Precision Oncology. The researchers evaluated the venom from 312 honeybees and bumblebees and found it to be surprisingly effective at destroying certain types of cancer cells, including those in some subtypes of breast cancer. These include triple-negative breast cancer and HER2-enriched, each of which has limited treatment options.

At a certain concentration, the serum formulated from the bee venom killed the cancer cells within an hour, and at the same time did limited damage to the surrounding healthy cells. The peptide melittin, which is already known for its ability to break down lipid membranes, was also able to disrupt the growth of the cancer cells. The researchers found that the peptide achieved this by disrupting the signaling pathways that cancer cells use to replicate, thus significantly slowing tumor growth.

These findings hold promise, but challenges remain. Compounds that kill cancer in a petri dish don’t always translate into successful medications. More research is needed to create a safe and effective drug.

(Send your questions to askthedoctors@mednet.ucla.edu. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: My wife and I are lending my parents a hand during the lockdown. They’re in their 80s, and one thing we’ve noticed is how many meds they are taking. They’re from a bunch of different doctors, and some may even be duplicates. How do we get things organized?

Dear Reader: You’re not alone in being surprised to discover how many medications an older parent is taking. As people age, they often begin to experience a variety of ills and health conditions that lead them to seek out specialists. This can result in multiple diagnoses, each accompanied by prescriptions for medications to help manage the problems. If a patient isn’t well-versed in the medications they are taking and there is limited or no communication between their physicians, it is indeed possible for them to wind up with prescriptions that overlap, or that lead to adverse interactions. Taking more pills than one actually needs is known as polypharmacy, which has become increasingly common as a large portion of the population reaches older age.

The good news is that, with just a bit of detective work and a few organizational tools, you can tame the medication tangle. Start by gathering all the medications that each parent takes. Note the name of the drug and its purpose, the dosage, the prescribing doctor and contact info, and the directions for taking it. Be sure to include over-the-counter meds, vitamins and supplements, as these can contribute to adverse interactions. If possible, make an appointment with each parent’s primary care physician for them to evaluate the meds list and, if needed, recommend changes. We know that immediate office visits can be difficult to schedule, so if you have pressing concerns, your local pharmacist can identify problematic combinations. However, don’t make any changes without first checking with a health care provider.

Once the necessary and appropriate meds have been identified, create and print out a master list for each parent. Have them take their own list to each medical appointment and share it with that health care provider. This creates a scenario where the meds list gets reevaluated on a regular basis, which greatly reduces the risk of duplicate prescriptions or an adverse drug interaction. When changes are made, be sure to update the master list.

Meanwhile, invest in weekly pill organizers. They come in a variety of sizes and formats, so you should be able to find one that works best for each parent’s needs. Once you’re filling the boxes, it’s just as easy to set up two or three weeks’ worth of meds as it is to do a single week. Keep all of the medications in one safe location, away from heat, moisture or direct sunlight, and -- this is crucial -- secure from children. It’s also important to keep an eye on expiration dates, which are printed on the labels. Yes, there’s debate over when meds actually expire, but we recommend honoring those dates. Also, review how to dispense of expired meds. Local pharmacies and police stations often have drop-off boxes for that specific purpose.

(Send your questions to askthedoctors@mednet.ucla.edu. Owing to the volume of mail, personal replies cannot be provided.)

Hello again, dear readers, and welcome back to our monthly letters column. You’ve kept our inbox lively this month, so we’ll dive right into your questions and comments.

-- A reader in Oregon, where ongoing wildfires have created dangerous air quality, wondered about masks. “Will our masks that we wear for COVID help us with the wildfire smoke here?” they asked. The answer depends on the type of mask you’re using. The cloth masks we’re using to slow the spread of the novel coronavirus don’t offer much protection from wildfire smoke. Although cloth masks can block the respiratory droplets that the virus travels on, they’re not an efficient barrier against the infinitely smaller particulates in wildfire smoke. That requires the close weave of N95 masks, which remain in short supply. Without an appropriate mask, it’s best to stay indoors with windows and doors closed, and run an air purifier if you have one.

-- The wildfire smoke question actually contains the answer to another reader’s mask question. “How is it possible for a mask to be effective against the virus?” they asked. “The virus is so small that it must be able to fit through a mask.” You’re correct that the virus itself is microscopically small enough to fit through a cloth mask. However, a virus can’t move on its own. The novel coronavirus travels via the respiratory droplets from an infected person’s cough, sneeze or breath. Due to their size, those respiratory droplets can be blocked by a multi-layer cloth mask. When used along with social distancing to stay out of range of another person’s droplet emissions, a mask can indeed reduce the risk of spreading and encountering the virus.

-- A reader from Oklahoma had a question in response to a column about alpha gal syndrome. This is when someone who was bitten by the Lone Star tick develops an allergy to red meat. “Why doesn’t anyone ever mention that gelatin can cause a reaction when you have alpha gal?” they wrote. “I’ve had the allergy for 10 years, and my one and only (allergic reaction) came from consuming gelatin capsules.” Thank you for your reminder that some people with alpha gal syndrome do become sensitized to gelatin, which is a protein obtained from animal byproducts. And, as you mention, gelatin can be present in capsules and is used in some medications as a stabilizer. As with all allergies, people living with alpha gal syndrome need to be alert to all potential triggers.

-- In response to a column that mentioned asymptomatic transmission of the coronavirus, a reader wondered if the terminology should be adjusted. “Doesn’t the term ‘pre-symptomatic’ better describe what is happening?” Actually, both terms are accurate. Some people infected with the novel coronavirus never develop symptoms. If they pass along the virus, it’s asymptomatic transmission. Pre-symptomatic transmission occurs when someone passes along the virus while in good health and then later develops symptoms.

Thank you to everyone for your letters and kind thoughts -- they mean a lot to us. We hope you and your loved ones stay safe and well.

(Send your questions to askthedoctors@mednet.ucla.edu. Owing to the volume of mail, personal replies cannot be provided.)