Tuesday, August 25, 2015

Propranolol and cancer survival

I do have a few roses though the Japanese beetles are tough on them

Weird seed pods of love-in-the-mist
Garden: things are too close together and I have too many sunflowers
2 days of tomatoes plus one squash
new necklace plus candy pink nails
Yesterday I was reading in the WSJ of a study in which patients undergoing chemo for ovarian cancer were divided into 2 groups: some were given the beta blocker propranolol and the other ones were not.
Median survival to death for the control:42 months
Median survival for the propranolol group: 93 months
This is significant though the death rate remained the same, the beta blocker group survived more than 4 years longer. What is propranolol? Not a cancer drug though if any new cancer drug improved survival so much, it would be approved in a heartbeat. Propranolol is a very old drug. It is mainly prescribed to treat heartbeat irregularities, mainly tachycardia but it has many other uses, prevention of migraines, lowering of blood pressure, treatment of excess sweating inhibition of certain anxieties(stage fright in particular), treatment of essential tremor and treatment of post traumatic syndrome. It even has limited use as an antimalarial. My favorite use (aside from extending the lives of cancer patients) is that it reduces racism. People who took it in one study had less negative stereotypes than those that didn't take it.

Why would it increase survival in ovarian cancer? As it turns out, stress hormones, norepinephrine in particular, act as growth factors for tumors. Propranolol, among its many actions, reduces this hormone so the tumors do not grow as fast. Is this specific for ovarian cancer? No as it turns out. Numerous studies have been done in breast cancer with very promising results (see Komen Page). Some of these studies are 9 years old meaning I should have noticed this before. I would have insisted on taking it while doing chemo. Is there a downside to propranolol? Well it lowers blood pressure significantly, maybe too much and it slows the heart rate considerably. Also it can cause swelling of extremities. I did take it for a few months to lower my heartrate when I had thyroid storm due to Graves Disease. It also interferes with the metabolism of the thyroid hormone which may be a problem . But the side effects seem slight versus some of the drugs given with much less results.

Will this drug be approved for this indication? Probably not as it is off patent and no company will put the work into having it approved with no payback. However doctors are free to prescribe it for any indication they believe is medically helpful.

My friend waiting for her bone marrow transplant got some good news: her brother is a match (only 25% of siblings are matches). Survival is much higher for related donors than non-related donors so that is good news.

1 comment:

Elephant's Child said...

How fascinating. It sounds as if Propranolot has a myriad of positive uses.
And yay for your friend and her brother on the match front.


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