DEAR DR. ROACH: You’ve argued against veterinary ivermectin. It’s the same ivermectin that’s safely used for adults. Work out dose per kilo weight of patient. Why pretend that it’s not safe, when it’s a drug safely used for 70 years? It is better than remdesivir and other drugs that are dangerous and not effective but used only because so much money is made off them. What’s going on in the world now? — N.S.

ANSWER: What’s going on in the world now? People without expertise are making untrue claims, and they are believed. You believe that ivermectin is safe and effective for treating COVID, but there is strong evidence that ivermectin is ineffective and should not be used. A drug has to be both safe and effective at the same dose, and there is no dose for ivermectin that is both safe and effective. Ivermectin is certainly safe for treatment of parasites, but there is no effectively safe dose for COVID.

Veterinary ivermectin is particularly dangerous, because many people who have bought it to use on themselves have not used a safe dose, leading to dramatic increases in calls to poison control centers and hospitalizations for people who took improper dosages.

Paxlovid (used in patients healthy enough to be treated at home) and remdesivir (used mostly in hospitalized patients) are drugs that have been proven to be effective in the same kinds of trials ivermectin was subjected to when it was shown not to be effective.

Some people spread misinformation for greed, some from ignorance. Some physicians charged to prescribe a medication known to be ineffective to people who mistakenly believed that it was effective. Not only did they take an ineffective drug with (mostly mild) toxicity, but they avoided effective drugs, which might have made a difference to their health. I don’t personally know anyone who died because they took ivermectin instead of effective treatment, but I know that it happened. Fortunately, some of the physicians who have done this have been stripped of their licenses. The greed some demonstrated is a vile betrayal of the oaths we took and the obligations we have to protect our patients.

With ivermectin, you don’t just have to believe me. Read a report from the international group Cochrane, who continually updates their independent evaluations of ivermectin at tinyurl.com/Cochraneivermectin.

DEAR DR. ROACH: I have pain in my breast in one spot for the past three days. I didn’t have any mass I could feel. The doctor ordered a sonogram and a mammogram, but I am concerned I have breast cancer. Do I need to worry? — H.C.

ANSWER: Breast pain is a common symptom in women, and it is only rarely due to breast cancer. Women who have pain in one particular spot should get an evaluation to make sure there is no mass. One cause is a simple breast cyst most common in younger women. Cysts can cause pain, especially if they grow quickly.

If you are one of the 97% to 99.5% of women with breast pain who do not have breast cancer, treatment can include a custom-fitted bra, or over-the-counter pain medication if needed. A simple cyst causing pain can be drained for symptom relief, but most women do not need treatment beyond reassurance.

Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.