After primary colon cancer tumors were surgically removed from 34 patients, 16 of them were given a short, simple two-drug treatment devised at Tel Aviv University that proved to drastically reduce their risk of the cancer spreading (metastasizing).
Usually, the risk of metastases after tumor removal is about 35 percent among colon cancer patients.
However, only two patients (12.5%) of the 16 patients receiving the drug regimen experienced metastasis five years after surgery, compared to 50% in the control group of 18 patients.
Lowering stress is key
Study co-leader Prof. Shamgar Ben-Eliyahu of TAU’s schools of neuroscience and psychological sciences said the researchers “deliberately sought the safest and cheapest drugs capable of lowering the body’s stress-inflammatory response to surgery” — propranolol (Darlin) to lower blood pressure and reduce anxiety, and etodolac (Etopan) to prevent pain and inflammation.
The 16 randomly chosen patients took these medications for 20 days, from five days before to two weeks after tumor-removal surgery at Sheba. The other 18 patients received placebo drugs.
The findings corroborate what any cancer patient knows: that the anxiety surrounding cancer treatment takes a physical toll.
“The stress during the waiting period for surgery, the stress and inflammation reactions that the body produces during the surgery itself and the physical recovery period, and finally the following anxiety of cancer recurring — all have an adverse effect on the body’s ability to fight metastatic processes,” said Ben-Eliyahu.
“These mental and physiological conditions create stress-inflammatory responses, which cause ample release of hormones from the prostaglandin and catecholamine families. These hormones suppress anti-metastatic immune activity, and thus encourage the development of metastases,” he explained.
“In addition, these hormones directly help the cancer cells that remain in the body even after surgery. Due to exposure to these hormones, the cancerous tissue becomes more aggressive and metastatic.”
Clear statistical significance
Ben-Eliyahu and Prof. Oded Zamora of TAU’s Sackler Faculty of Medicine purposely sought out “a short, cheap drug treatment with no significant side effects” for treating stress and inflammation.
“Due to the small number of subjects in both studies, it is impossible to accurately estimate the magnitude of the beneficial effect, but the effects are statistically significant, meaning that they are not accidental,” said Ben-Eliyahu.
Ironically, using low-cost drugs could lead to difficulties in securing financing for larger clinical studies that must be done to verify the results from the small trial at Sheba Medical Center.
“One should bear in mind that the pharmaceutical companies have no financial incentive to support such studies,” admitted Ben-Eliyahu.
“Our medicines are not patented; they are safe, cheap, and administered in a short treatment lasting just a few days. The drug companies look for patents on expensive drugs and prefer that the patient be dependent on the drug for the rest of their life.”
He expressed his hope that funding will be found for a large-scale clinical study, “because without such research we will not be able to convince the medical establishment of the treatment’s effectiveness.”
The finding of the study, published in the European Journal of Surgical Oncology, “sounds too good to be true,” added Ben-Eliyahu, “but similar results in breast cancer tissue were obtained in a study we conducted in 2017.”
An overview of the theory and principles underlying the research was published in Nature Review Cancer.