pubmed.org cancer + aspirin
argument: combine metformin and aspirin as you see fit Dr Reed,
Hooman Noorchashm, MD, PhD | Jefferson University ...
hospitals.jefferson.edu/find-a-doctor/n/noorchashm-hooman/
Hooman Noorchashm, MD, PhD is a specialist in Surgery who can be reached at 1-800-JEFF-NOW (800-533-3669) and whose practice locations include: ...
Open Biol. 2013 Jan 8;3(1):120144. doi: 10.1098/rsob.120144.
Oxidants, antioxidants and the current incurability of metastatic cancers.
Watson J1.
Abstract
The vast majority of all agents used to directly kill cancer
cells (ionizing radiation, most chemotherapeutic agents and some
targeted therapies) work through either directly or indirectly
generating reactive oxygen species that block key steps in the cell
cycle. As mesenchymal cancers evolve from their epithelial cell
progenitors, they almost inevitably possess much-heightened amounts of
antioxidants that effectively block otherwise highly effective oxidant
therapies. Also key to better understanding is why and how the
anti-diabetic drug metformin
(the world's most prescribed pharmaceutical product) preferentially
kills oxidant-deficient mesenchymal p53(- -) cells. A much faster
timetable should be adopted towards developing more new drugs effective
against p53(- -) cancers.
The Wall Street Journal
U.S. News
Doctor Who Pushed to Curb Hysterectomy Procedure Says Cancer Has Returned
Amy Reed’s battle with uterine cancer after morcellation procedure helped curtail common surgical tool
Amy Reed embraces a supporter after testifying at an FDA hearing on power morcellation in July. ENLARGE
Amy Reed embraces a supporter after testifying at an FDA hearing on power morcellation in July. Photo: Jennifer Levitz/The Wall Street Journal
By
Jennifer Levitz
March 4, 2015 2:52 p.m. ET
12 COMMENTS
A doctor whose personal battle with uterine cancer helped sharply curtail a common surgical tool that can spread malignancy said Wednesday that her own aggressive cancer has returned.
Amy Reed, a 41-year-old mother of six, lived for more than a year after her 2013 diagnosis and treatment with no sign of cancer. But a new tumor that was recently discovered and removed was found to be cancerous, she learned last week.
Dr. Reed said she had been preparing herself for the prospect of metastatic cancer and felt somewhat fortunate that the new tumor was removed completely. She will now undergo radiation. She said she and her husband, cardiothoracic surgeon Hooman Noorchashm, also plan to begin working in the lab to see how she might live with the disease as a chronic illness. Both have doctorate degrees in immunology.
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“If you look at the [survival] numbers, it’s very scary and very easy to get sucked up into that. But I’m hoping our aggressive approach will buy us some time,” Dr. Reed said.
Dr. Reed was a practicing anesthesiologist in Boston when she had a minimally invasive hysterectomy in October 2013 to treat what her doctors presumed were benign growths called fibroids. Instead, she had a dangerous form of uterine cancer called leiomyosarcoma, which can’t be reliably detected before surgery. The tool used during her operation, the power morcellator, spread her disease and worsened her prognosis, the hospital where she had the procedure acknowledged.
The story of a common surgery for women and the cancer it leaves behind. ENLARGE
The story of a common surgery for women and the cancer it leaves behind.
Her case, detailed in The Wall Street Journal in December 2013, upended the gynecological field, drew the eye of the U.S. Food and Drug Administration and brought many similar cases to light.
For more than a decade, many doctors believed uterine sarcoma was very rare, occurring in as few as 1 in 10,000 women. But after Dr. Reed and other cases became public, the FDA analyzed data and estimated the risk was significantly higher: 1 in 350 women undergoing surgery for fibroids could have a hidden cancer. A new University of Michigan study made a similar estimate.
Related
5 Questions About the FDA Warning
Cancer-Risk Debate Didn’t Halt Surgeries
A Medical Device Is Sidelined, but Too Late for One Woman (11/21/14)
How Surgical Robots Spurred Morcellator Use
What to Know — The Short Answer
Answers for Women With Fibroids
Gynecologists Resist FDA Over Popular Surgical Tool (9/21/14)
Johnson & Johnson Pulls Hysterectomy Device From Hospitals (7/29/14)
Doctor Quits Uterine-Device Safety Panel Over Conflict (7/10/14)
Women’s Cancer Risk Raises Doubts About FDA Oversight (7/8/14)
FDA Advises Against Morcellator Use in Hysterectomies (4/17/14)
How Morcellators Simplified the Hysterectomy but Posed a Hidden Cancer Risk (4/11/14)
In November, the FDA warned that morcellation shouldn’t be used on the vast majority of women. The agency called on device companies to put its strongest caution, a “black-box” warning, on product packaging. Many hospitals and some insurers banned the procedure. Johnson & Johnson, once the largest manufacturer, left the market last year.
Drs. Reed and Noorchashm have expanded their vocal criticism of the device to the way medical devices make it to the market. The FDA cleared power morcellators for sale in the 1990s through an expedited process that allows devices similar to ones already on the market to be approved without clinical trials to show safety and effectiveness.
The cancer recurrence adds a new challenge for Dr. Reed’s family. Experts say that once spread, the malignancy usually isn’t curable. Dr. Reed, whose children are ages 2 to 13, said she is hoping that the early aggressive treatment she had after her initial diagnosis will pay off. “We will absolutely stay the course,” she said.
Dr. Reed and her husband moved their family to the Philadelphia area last summer to be near their large network of extended family, and the support has helped immensely, she said. She recently returned to work as an anesthesiologist at the Hospital of the University of Pennsylvania.
“It’s a very vicious disease, and it takes some people out very quickly,” she said. “I am hoping I don’t go that route. I don’t know how much of that is under my control, but I will do all the right things. My hope is that I’ll be dealing with a problem maybe once a year or so, take care of it and move on.”
—Jon Kamp contributed to this article.
Write to Jennifer Levitz at jennifer.levitz@wsj.com
ScientificWorldJournal. 2015;2015:341362. Epub 2015 Feb 3.
Drug Repositioning for Gynecologic Tumors: A New Therapeutic Strategy for Cancer.
Abstract
The
goals of drug repositioning are to find a new pharmacological effect of
a drug for which human safety and pharmacokinetics are established and
to expand the therapeutic range of the drug to another disease. Such
drug discovery can be performed at low cost and in the short term based
on the results of previous clinical trials. New drugs for gynecologic
tumors may be found by drug repositioning. For example, PPAR ligands may
be effective against ovarian cancer, since PPAR activation eliminates COX-2 expression, arrests the cell cycle, and induces apoptosis. Metformin, an antidiabetic drug, is effective for endometrial cancer through inhibition of the PI3K-Akt-mTOR pathway by activating LKB1-AMPK and reduction of insulin and insulin-like growth factor-1 due to AMPK activation. COX-2 inhibitors for cervical cancer
may also be examples of drug repositioning. PGE2 is induced in the
arachidonate cascade by COX-2. PGE2 maintains high expression of COX-2
and induces angiogenic factors including VEGF and bFGF, causing
carcinogenesis. COX-2 inhibitors suppress these actions and inhibit
carcinogenesis. Combination therapy using drugs found by drug
repositioning and current anticancer drugs may increase efficacy and
reduce adverse drug reactions. Thus, drug repositioning may become a key
approach for gynecologic cancer in drug discovery.
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