Repurposing Drugs for use in Oncology

Cimetidine to help fight cancer

Cimetidine to help fight cancer

A new research paper has looked at commonly used drugs that can be repurposed to help fight cancer. One example is the common used indigestion medicine cimetidine, which can help treat colorectal cancer.

Medical professionals already know cimetidine is safe, from various trials and many years of use. Therefore, it can be easily combined with other cancer treatments. Cimetidine reduces digestion by blocking histamine receptors in the gut, which reduces the production of gastric acid. It turns out that the drug can also block histamine receptors in cancer cells, which helps the immune system defend against them.

Cimetidine may have a beneficial effect in treating colorectal cancer, renal cancer and melanoma.

The researchers found that:

Based on the evidence presented, it is proposed that cimetidine would synergise with a range of other drugs, including existing chemotherapeutics, and that further exploration of the potential of cimetidine as an anti-cancer therapeutic is warranted. Furthermore, there is compelling evidence that cimetidine administration during the peri-operative period may provide a survival benefit in some cancers. A number of possible combinations with other drugs are discussed in the supplementary material accompanying this paper.

Reducing Cancer Risk

One of the most common drugs that can be repurposed to help avoid cancer may be aspirin. There is a growing body of research that aspirin can reduce pancreatic cancer risk and improve colorectal cancer prognosis.

Repurposing Drugs in Oncology (ReDO)

ReDO is a project that has been looking at ways common drugs may be used to help improve cancer treatments.

It’s primary pbjectives are:

– Identify the most promising drugs for further clinical investigation
– Review and bring to the attention of clinical investigators the data for these drugs
– Document on how these drugs can be combined with existing therapies, or with other repurposed drugs
– Develop clinical trials to provide positive or negative evidence of efficacy
– Where necessary, suggest areas where further pre-clinical work is necessary

By finding commonly used drugs that have a beneficial effect in the fight against cancer, the research group also helps provide low cost treatments and preventatives against cancer.

Link Between Cancer and Obesity Examined

Obesity and Cancer

Obesity and Cancer

A new study has reaffirmed the link between obesity and cancer.

The study, published in the Lancet Journal, reaffirms that a high body-mass index of 25 kg/m2 or greater is associated with increased risk of cancer. Researchers believe that in 2012 nearly 500,000 cases of cancer were attributable to high BMI around the world. The vast majority of these obesity related cancers occur in the United States and Europe, because of the higher levels of obesity found in those locations.

Women were more likely to be affected by cancer relating to obesity, particularly breast cancer. The most common forms of cancer caused by obesity were corpus uteri, postmenopausal breast, and colon cancers. These forms accounted for 63·6% of cancers and are attributable to high BMI.

The research looked at cancer rates in over 184 countries and found that obesity was associated with 5.4 percent of cancer in women and 1.9 percent in men during 2012. Those percentages are higher in developed countries with excess weight causing 8 percent of cancers in women and 3 percent in men.

The cancer rates were lowest in parts of Africa, due to lower calorie intake.

According to the researchers:

These findings emphasise the need for a global effort to abate the increasing numbers of people with high BMI. Assuming that the association between high BMI and cancer is causal, the continuation of current patterns of population weight gain will lead to continuing increases in the future burden of cancer.

FDA Warning About Device Capable of Spreading Cancer

FDA Warns of Laparoscopic power morcellator

FDA Warns of Laparoscopic power morcellator

The U.S. Food and Drug Administration has taken action to stop the use of a gynecological device that can spread pre-existing cancer in women.  Laparoscopic power morcellators are used in the removal of the uterus, or to remove fibroids.

The device is used to destroy fibroids, which are then removed by key hole surgery.  There is no way to know if the fibroids contain cancer cells. If they do, the destruction process may released some of those cells, allowing cancer to spread to other organs.

This can lead to more dangerous forms of cancer developing, which cannot be treated as easily.

In a press release,William Maisel, M.D., M.P.H., deputy director for science and chief scientist at the FDA’s Center for Devices and Radiological Health said: “Updating the device label with a boxed warning and contraindications will provide clinicians and patients with critical information about the risk of spreading cancerous tissue when these procedures are performed.”

The FDA was made aware of the flaw with this device by surgeon Hooman Noorchashm.  Dr Noorchashm’s wife, Amy Reed, had the procedure as a part of her hysterectomy and was diagnosed with stage 4 cancer.  The use of the device had spread cancer cells throughout her body.  Thankfully Amy is currently in full remission.

Whilst Dr Noorchashm was arguing for a complete ban on the device, the FDA was chosen to add a compulsory warning to the device.  The warning indicates that the device may spread cancer cells throughout the body.

The FDA chose to only use a warning because younger women may still safely use the device in their procedures.  That is due to the fact younger women are much less likely to have cancer cells in regions that can be spread.  If the device is not used, fertility can be affected.

Some hospitals have already stopped using the device, well aware of the risk before the FDA decision.  One of the companies that manufacture the device has also pulled it off the market, a sure sign that the risk of the procedure is well known.

So while this device might still play a role in certain surgeries, for older women with a higher chance of cancer, it is too risky.

The Angelina Jolie Effect – Women Screening for BRCA Mutation Increases

Angelina Jolie BRCA Mutation

Angelina Jolie BRCA Mutation

Angelina Jolie became famous thanks to a string of successful films and her amazing beauty. In recent years she has turned her focus to humanitarian and health issues. One of the health issues she has helped highlight is breast cancer and the BRCA gene mutation that can lead to breast cancer.

Jolie had a double mastectomy because she was found to be carrying the gene mutation that greatly increases the chances of cancer. Her high publicity case has seen an increase in the number of women who have come forward for screening for the gene mutation. For women who have a history of breast cancer in their family, it is an essential test. For women have the gene mutation, a double mastectomy is the most extreme option they can pursue but it may guarantee they will not have breast cancer in the future.

There is one caveat though — the double mastectomy solution may be best only when breast cancer is not already present. Recent studies have indicated that for women who already have breast cancer, a lumpectomy followed by radiation may be more effective than a double mastectomy.

Andrea Eisen, head of the Familial Cancer Program in Toronto recently presented some research on the “Angelina Jolie Effect”, which highlighted the increase in breast cancer screenings. Women with a family history are flocking to the doctor for screenings that test for BRCA mutations.

In recent years the number of mastectomies has greatly increased, largely because of increasing awareness about BRCA mutations and breast cancer. Additionally, most health insurance companies cover the cost of both the mastectomy and breast reconstruction surgery now. Women can now have their breasts removed and in the same procedure have implants added.

Angelina Jolie made a very public statement about her mastectomy by writing an opinion piece for the New York Times in 2013. The media jumped onto the story and thousands of women applauded Jolie for her bravery. In Jolie’s case she had more than an 80% chance of getting breast cancer.

The study found that the number of women who opted for genetic screening doubled after the Jolie story was published, the vast majority of which were in the high risk group for breast cancer. Of those women, 61 were found to have the BRCA mutation.

Reduction of Prostate Cancer Risk

Prostate Cancer Prevention

Prostate Cancer Prevention

Recent research has indicated that lifestyle factors play a significant role in the reduction of risk for aggressive prostate cancer. In new research at the Jonsson Comprehensive Cancer Center, they looked at people adhering to the eight lifestyle recommendations from the World Cancer Research Fund (WCRF) and how it plays out with agressive forms of prostate

The eight recommendations include:

  • Staying within acceptable ranges of body mass index
  • Staying physically fit
  • Eating foods with lower caloric density (so avoiding chocolates and fatty foods)
  • Eating fruits and non-starchy vegetables
  • Watching salt intake
  • Eating Legumes
  • Eating unrefined grains, so things like brown bread, brown rice
  • Moderating red meat consumption

The researchers looked at adherence to those eight recommendations and the risk of highly aggressive prostate cancer in subjects enrolled in the North Carolina-Louisiana Prostate Cancer Project. The research was led by Lenore Arab PhD, JCCC member and professor in the departments of medicine and biological chemistry. The results of the study have been published online ahead of print in the medical journal “Nutrition and Cancer”.

That group included 2212 men aged between 40 and 70 with newly diagnosed prostate cancer. Whilst the eight recommendations are for general avoidance of cancer, researchers wanted to narrow it down to look at these aggressive prostate cancers in particular.

For individuals who adhere to less than four of the eight recommendations, the risk of aggressive prostate cancer increased by 38% compared to those who adhered to four or more of the recommendations. The results were similar between racial groups, so men of different races all benefit from adherence to the recommendations.

Researchers found that the most two important recommendations were eating less than 500 grams of red meat per week, and avoiding foods with high caloric density. Those two recommendations really stood out as being important to avoiding the more aggressive prostate cancers.

For each point of adherence from the 8 recommendations, researchers estimated about a 13% reduction in risk of the most aggressive cancers but the people most in danger of aggressive prostate cancers were those who adhered to four or less recommendations.

The lead research, Dr Arab said: “Most men are at risk of prostate cancer, but it is the level of aggressiveness of disease that is most clinically relevant. These findings suggest that even men with prostate cancer can take control of their disease and moderate its aggressiveness through diet and lifestyle choices.”

Researchers determined the level of aggressiveness of the prostate cancer by a number of metrics: TNM malignant tumor classification, Gleason grading system scores, and blood levels of prostate-specific antigen.

Partical adherence to WCRF recommendations was also considered, so point scores and odds ratios were estimated. The research does make the assumption that adherence to the eight guidelines was regular throughout most of the patients adult life.

Very clear evidence here that the eight recommendations may not just help prevent cancer in general, but reduce risk of the more aggressive variants of some cancers.

Skin Cancer on the rise in the UK

Basal Cell Carcinoma

Basal Cell Carcinoma

New research has indicated there are some worrying trends for the numbers of cases of skin cancer every year. The research show there are over 200’000 basal cell skin cancers treated with surgery every year. That could even be lower than the real figure with some doctors suggesting the official figures do not account for some skin cancer patients.

With the increase in skin cancer incidents, the cost has also risen dramatically. The UK based study showed that the number of basal cell carcinomas in the UK is as much as twice the figure indicated by government statistics. General practitioners at the Norfolk and Norwich hospitals carried out the study which found the alarming results. Cancer registries, which the government uses to assess the number of yearly cases of cancer, are inaccurate when it comes to basal cell carcinoma (BCC), according to the study. BCC is one of the most common forms of cancer, so the real number is many thousands off previous estimates.

The fact that the official statistics are far from the reality of the disease means that politicians, the public and the media don’t pay enough attention to it. The lower public awareness leads to increased incidents of the disease and the lack of political awareness means insufficient funding to match the true extent of BCC.

Cancer Research UK says that because the official figures were off, the impact on the national health system is not truly realised with costs threatening to explode if the incidents of the disease continue to rise.

Basal cell carcinoma is typically one of the most common cancers but also one of the most easily treated, providing it is diagnosed early. It is rarely fatal but it still claims some lives every year, which could be avoided if the public was more attentive to the signs of this particular skin cancer. It is estimated that 75% of all skin cancers are BCC with the less common melanoma being responsible for the vast majority of skin cancer deaths.

Despite under estimating the current cases of basal cell carcinoma, the government already realizes that incidences are on the rise. A Department of Health strategy paper suggests that medical advisers are expecting a significant increase in cases: “If current trends continue, it is anticipated that there will be around 15,500 cases of melanoma diagnosed per year within the next 15 years”.

The risk factors pushing the increase in BCC include the aging baby boomer population and an increase in ultra-violet light exposure due to behavioural changes in the population. Simply put, in recent years more people have been spending more time in the sun.

The research paper suggests that the government has to become better at registering cases of BCC. That is a fact also previously identified by the government with a 2010 paper indicating that work was needed to improve the cataloging of BCC cases. The research paper states that in the 10 years covered, the incidences of BCC that required surgery increased by a dramatic 81%. On top of that there would most likely be increases in BCC that were treated by other methods including cryotherapy, radiotherapy and chemotherapy.

The easiest way to avoid BCC is to avoid long exposure to the sun and wear an appropriate sunscreen if spending more time in the sun.

Ovarian Cancer Symptoms

Ovarian Cancer

Ovarian Cancer

Ovarian Cancer is the 8th most common cancer in the United States. As the name implies, it is a form of cancer that affects women’s ovaries and it affects mostly older women. Women have 2 ovaries – small organs which make eggs and secrete hormones.

Symptoms and Risk Factors
It is a form of cancer that is very subtle in it’s early stages with the symptoms often continuing unnoticed. The common symptoms include pelvic pain, problems eating, bloating and frequent urination. Those symptoms are frequently found in conjunction with other illnesses so it is often difficult to diagnose early on.

Most ovarian cancers arise from the surface of the ovary, but research has suggested that the fallopian tubes may be responsible for some instances of ovarian cancer.

If you find yourself with the symptoms of ovarian cancer more than 10 times a month, then it is time to have yourself examined for ovarian cancer. So for example if you suddenly experience pelvic soreness on 5 days, have difficulty eating on 3 days, experience bloating on 4 days and are older than 50 you should seek diagnosis immediately.

Less common symptoms can include back pain, general tiredness, involuntary weight loss and an abdominal mass. The bloating and pelvic pain are usually caused by a buildup of fluid in the abdominal cavity. The pressure on the stomach from this fluid buildup is usually what causes changes to apetite also.

If you have a family member who has experienced ovarian cancer, your chances of experiencing the illness are twice as high. Unfortunately there are hereditary forms of ovarian cancer caused by gene mutations. So if you have a mother or grandmother who experienced ovarian cancer, you should consult a doctor early on if you experience symptoms, and get screened regularly when you are over 50.

Infertile women also have a higher risk of experiencing ovarian cancer as are women with endometriosis and women who have had estrogen replacement therapy.

Research has found that oral contraceptive pills are a protective factor against ovarian cancer. Long term studies have shown that women who used oral contraception for 10 years have a 50%+ reduction in their chance of contracting ovarian cancer.

Women who also had their first pregnancy at a young age also have a lower risk of contracting ovarian cancer, and women who have had their fallopian tubes blocked surgically also have lower risk.

Because the ovaries produce the estrogen and progesterone hormones that some cancers require to grow, ovary removal can halt or slow cancers that occur specifically in women (such as breast cancer).

In terms of genetic risk factors, carriers of some BRCA mutations have an increased risk of ovarian cancer. BRCA2 and BRCA1 gene mutations make up about 5% to 13% of ovarian cancers. Modern medicine allows women to understand their genetic risk factors more comprehensively so discuss this with your doctor.

Initially your doctor will do a physical examination to determine if there are any masses or fluid buildup in the abdominal cavity. A blood test for ovarian cancer markers will also be conducted, that specifically looks for CA-125. An ultrasound may also be carried out.

For the diagnosis to be confirmed, surgery must be undertaken to take biopsies and inspect the abdominal cavity. Cancer cells will most likely be found in the abdominal fluid if a patient has ovarian cancer. The symptoms aren’t very useful in early stages of ovarian cancer because they can point to many other illnesses. Only at the later stages of ovarian cancer do the symptoms easily confirm ovarian cancer.

Tubal ligation will drastically reduce the risk of ovarian cancer and some women who have a long family history of ovarian cancer may take this option. The use of oral contraceptives will halve the risk of ovarian cancer.

Regular screening and being attentive to the symptoms of ovarian cancer is one of the best ways to prevent the disease taking hold.

Surgical treatment is an option for malignant tumors that are confined to the ovary. If the tumors are aggressive, surgery may be used in conjunction with chemotherapy.

Chemotherapy is often used after surgery to treat any tumors that are not easily removed during surgery and to stop any cancer cells spreading.

Radiation may be effective in the early stages of the illness, but due to the location of the ovaries it is not safe to use a high dose.

Unfortunately because of the difficulty in spotting the symptoms of ovarian cancer early on, prognosis is generally not good for ovarian cancer. More than 50% of women presenting with ovarian cancer are already stage III or stage IV (stage I and II being early development). By stage III and stage IV the cancer has already spread from the ovaries into other parts of the body.

Early diagnosis of ovarian cancer has a survival rate of over 80-95%, stage II has a range of 60-70%, stage III 30-45% and stage IV <20%.All up the survival rate for ovarian cancer at all stages is 47%. If caught before spreading the survival rate is 92%. The key with ovarian cancer, like many other forms of cancer, is to look at your family history, look for symptoms and get tested early!

Colon Cancer Warning Signs

Colon Cancer Symptoms

Colon Cancer Symptoms

Colon cancer has unfortunately become more common in recent years, with many cancer researchers believing poor diet being the leading cause. It is one of the types of cancer where early detection greatly improves your chances of survival. So to spot colon cancer you should be looking out for the warning signs. There are a number of warning signs but this article will go over the most common warning signs that indicate you may have developed colon cancer.

Colon cancer usually manifests as a slow growing tumor in the colon or rectum. Because they are slow growing, the symptoms build gradually and can sometimes to hard to notice. Unfortunately this often means that the tumor is not diagnosed until a late stage, when it is more difficult to treat – the earlier you catch it the better.

The first warning sign you should be aware of is persistent fatigue. If you were previously an alert, energetic person who has begun to feel weak or tired regardless of how much rest you have, that is a sign of possible colon cancer or some other form of cancer. Unfortunately, quite often it is the only sign of colon cancer that people experience.

The fatigue is caused by bleeding inside your colon and can only be detected with a scan. The best way to spot fatigue is to stay fit and healthy. If you are healthy, then gradual feeling of fatigue is much more noticeable than if you were unfit and constantly tired already.

If you suddenly experience diarrhea or constipation and it goes on for a long period you should be screened for colon cancer. In fact, if you have any unusual changes in your bowel habits, when you go to the toilet and what comes out, you should see your doctor immediately. Another unusual change would be if you hadn’t changed your diet but went from 1 bowel movement a day to 4 bowel movements a day. If you went from 1 bowel movement a day to 1 every 4 days and that change was persistent, that would also be considered a very unusual change and you should see a doctor immediately.

The constipation could be a result of tumor growth in your rectum which is causing some kind of obstruction and preventing your stool from easily exiting the rectum. If you start to experience difficultly during bowel movements and it persists (lasts a number of weeks), you should see the doctor. Persistent diarrhea can be caused by tumor growth in the left colon which interferes with the stool.

You should also look at the color of your stool. If you notice unusual changes that are persistent or blood with your stool you should also see a doctor. Colon cancer can be a tricky one to catch, but if you are aware of the symptoms you stand a much greater chance of survival.