You Finished Treatment, Now What? *Part Six: Off Label Use of Pharmaceuticals
As a licensed naturopathic doctor who relies on natural medicine approaches to the prevention and treatment of illness, I am also a strong advocate for the appropriate use prescription medication. Though licensed NDs work to use gentle natural therapies first, we are trained to precribe pharmaceutical agents according to the standard of care. And, there is increasing evidence that off-label use of certain medications may offer help in prevention and treatment of cancer and the prevention of recurrence.
The concept of drug repurposing is not new . Beyond the evidence of efficacy are economic reasons to consider drug repositioning. In one analysis, the number of new medications approved per one billion US dollars spent on research and development, has been cut in half every nine years since 1950. Statistics show that from 2006–2015, about 12 percent of drugs go from Phase 1 Trial to FDA approval, and for oncology drugs the number is only about 5%.
And, the incidence of cancer and difficult to treat cancers are outpacing the rate at which new drugs are approved. As the occurence of cancer across the globe increases, access to expensive cancer drugs remains an ongoing challenge. Researchers are working to articulate characteristics sought in the selection of drugs to study and to figure out which medications show most promise in the world of oncology.
In general, ideal drugs would be readily available, affordable, carry low side effect profiles and have the clincher attribute: the capacity to slow the growth or prevent cancer. Many of these repurposed drugs are also studied to be used simultaneously during conventional cancer care, to make cancer cells more radio- or chemo-sensitive. Whether an off label use of a non-cancer drugs is relevant during or after cancer care is a topic to discuss with your medical provider.
Some of the drugs considered and studied came to light because of statistical analysis. The best example here is Metformin. Studies show that cancer patients with diabetes who take Metformin have a considerably better outcomes. Metformin, used by many diabetic patients to keep blood sugar in the normal range, is derived from the plant Galega officinalis and has been utilized for over 50 years. Because of this long history, we know it’s generally safe. There are many clinical trials under way looking into the role Metformin may play in both the prevention and treatment of cancer.
By reducing the overall quantity of sugar feeding cancer cells, we reduce cancer growth. There are several ways that Metformin lowers blood sugar including: decreasing the amount of sugar absorbed from the digestive tract, reducing the overall amount of sugar made by the liver, and by raising insulin sensitivity. We know that Metformin inhibits other biochemical pathways which in turn helps slow tumor growth. Research also shows that Metformin helps address cancer stems cells and seems to stop precancerous cells from changing to cancerous ones. The hardest part of taking Metformin may well be convincing your provider to prescribe it for you if you are not prediabetic or diabetic.
There are 100s of research studies showing efficacy of specific non-cancer drugs, depending on cancer type, patient history and more. The list includes many drugs you have heard of from chloroquine to beta blockers, from lithium to simvistatin. If you are someone who has completed cancer care, you might consider having a conversation with your oncologist about other known medications that might be of use in your care.
Additional pieces in this series:
- *You Finished Treatment, Now What? Part One: Exercise
- *You Finished Treatment, Now What? Part Two: Nutrition and Eating
- *You Finished Treatment, Now What? Part Three: Intermittent Fasting
- *You Finished Treatment, Now What? Part Four: The Head Game
- *You Finished Treatment, Now What? *Part Five: Botanical Medicine
- *You Finished Treatment, Now What? Part Six: Off Label Use of Pharmaceuticals
- *You Finished Treatment, Now What? Part Seven: Nutritional Supplements