Could an Older Diabetes Medicine Help Treat Cancer?

Hey there Guys,

The medical blogsphere has been alive with recent research that Metformin, an early diabetes medicine, may have a role in preventing some cancers – in particular bowel, breast and prostate cancer. As noted at First Coast News:

Metformin, a diabetes drug, was approved by the Food and Drug Administration in 1995, and since then tens of millions of Americans with diabetes have taken it daily to control their blood sugar.

The first hint that metformin might also have anticancer properties came a decade later, when two research teams separately reported that diabetes patients were less likely to develop cancer, and less likely to die from the disease, if they were taking the drug.

This news wasn’t entirely surprising: Metformin treats diabetes in part by lowering insulin levels, and several types of cancer — such as those of the breast, colon, and prostate — have been linked to high levels of that hormone.

But then, in 2006, researchers in Canada working with breast-cancer cells found that Metformin increased the activity of an enzyme involved in tumor suppression, suggesting that the drug might fight cancer by working directly on cancer cells.

Research into prostate cancer has shown that Metformin may help reduce some of the growth factors associated with the growth of prostate cancer: Dr Joshua discusses at Medscape News:

Metformin reduces insulin, which may promote tumor growth, he noted during a press briefing. “It may also have both direct and indirect effects on the mTOR [mammalian target of rapamycin] pathway, which contributes to cancer growth.”

On the basis of the significant preclinical and epidemiologic studies that suggest a role for Metformin in chemoprevention, Dr. Joshua and colleagues evaluated its use in the treatment of prostate cancer.

In his study:

All patients received Metformin, 500 mg 3 times per day, a dosage lower than that prescribed to patients with diabetes, he pointed out. The median duration of drug treatment was 41 days (range, 18 – 81 days), and all patients underwent prostatectomy with no adverse effect related to Metformin use.

“So the ‘crunch’ of the study was that if we compared the biopsied tumor tissue to the prostates that were surgically removed, it did seem to slow the rate of the cancer,” said Dr. Joshua. “But it did not stop the cancer from growing.”

Dr Joshua later reports that while not curative Metformin may have a role as an additional medication to augment other treatments.

Outside of cancer Metformin has shown promise for other treatments including weight loss and even longevity.

As noted by Dr Mirkin:

You may be overweight because your body makes too much insulin, especially if your store your fat primarily in your belly. When you eat, your blood sugar level rises. The higher it rises, the more insulin your pancreas releases. Insulin makes you fat by acting on your brain to make you hungry, your liver to manufacture fat, and the fat cells in your belly to fill with fat. So the treatment for this type of obesity is to avoid foods that cause the highest rise in blood sugar and to take medications that prevent your blood sugar levels from rising too high. Avoid bakery products, pastas and all foods made from flour, fruit juices and everything with added sugar. Eat fruits and root vegetables such as potatoes only with meals.

After you eat, sugar goes from your intestines into your bloodstream, and then immediately into your liver. Then your liver releases sugar back into your bloodstream to cause your blood sugar level to rise. To keep blood sugar levels from rising too high, your pancreas release insulin into your bloodstream. Insulin makes you hungry all the time and causes your liver to convert extra calories to fat and it constricts arteries to cause heart attacks. You need insulin to keep blood sugar levels from rising too high to cause diabetes, nerve damage, heart attacks, strokes and kidney damage. Glucophage (Metformin) reduces sugar release from your liver to prevent blood sugar levels from rising too high, so your body doesn’t need to produce as much insulin that makes you hungry and causes your liver to make fat.

By reducing insulin resistance, Metformin can limit the production of fat in the body and help increase the burning of sugars in the muscles. (NEJM)

While there is some evidence that Metformin has been associated with longer life in rats, the association has more to do with it decreasing hunger and the rats eating less. Less obesity leads to a longer life.

With Metformin now out of patent it’s an interesting time to see if we discover more uses of this drug beyond it’s treatment with diabetes. Keep an eye on the medical horizon.

Yours in good health.

Dr George


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