Metformin for ovarian cancer

Could A Diabetes Medication Prevent Ovarian Cancer?

A laboratory study published in Clinical Cancer Research offers a new hypothesis about how ovarian cancer forms and suggests how an insulin resistance/diabetes medicine may prevent it.

Ovarian Cancer Facts.

  • Ovarian cancer is the fifth most common cancer in women, and
  • Ovarian cancer is a leading cause of cancer death in women
  • The five-year survival rate for ovarian cancer is 45 percent.
  • Women who have a family history of ovarian cancer or a mutation of the BRCA gene are at greatest risk of the disease.
  • There is no reliable screening test to catch this cancer early
  • The only options for prevention are birth control pills, which reduce the risk of ovarian cancer by half, or removing the ovaries and fallopian tubes.
  • Common symptoms are bloating, abdominal pain, gastrointestinal upset and weight loss/gain.

For more information on Ovarian Cancer please click the link to my article Let’s Talk About Ovarian Cancer

The New Research.

The study is the first to show that the natural stiffening of the ovaries called “fibrosis” occurs with age. It also suggests that the diabetes drug metformin may be able to halt this process.

This is an interesting hypothesis, which then begs many questions. It also then leads to looking at other supplements and medications that help with insulin resistance and regulation.

So, should we just be looking at the medications, or looking at the underlying cause of the issue, which seems to be insulin resistance?

After all, insulin resistance is a big driver on inflammation and disease processes in the body. But let’s look at Fibrosis first.

What is Fibrosis?

Fibrosis happens when body tissues are repeatedly injured and inflamed, leaving behind hard collagen fibres that pile up over time, like a scar on the skin. Research has shown that cancer cells tend to like growing in these fibrotic tissues. Fibrosis is also a normal part of aging and usually appears around the menopausal stage of life.

The Findings of The Study

The first part of the investigation was for the team to find out what was causing the fibrosis of the ovaries. They thought the answer might lie in ovulation. Every time an ovary releases an egg it becomes inflamed, creating a monthly cycle of wound and repair.

During the study the research was surprised to find an ovary from a 69-year-old woman that had no fibrosis. The woman’s medical records showed she had been taking metformin, a drug for Type 2 diabetes. What was interesting is that a Taiwanese study had previously noted an 82% reduction of ovarian cancer rates among Type 2 diabetes patients taking metformin.

The research team performed a series of experiments to investigate the links between ovarian fibrosis, aging and metformin.

The first part of the research, the team used mice studies and used a drug to prevent mice from ovulating. They noticed that the treated mice did not develop fibrosis with age, which then suggested that ovulation might be linked to the development of fibrosis. The team also noted that more detailed studies are needed to confirm these findings.

The second part of the research was to examine the ovaries that had been removed from women of all ages. What they found was that the ovaries of most of the postmenopausal women had fibrosis. But, they also notices the when the ovaries of postmenopausal women where were taking metformin were examined, none of these showed any evidence of fibrosis.

With these new finding the team set about looking at the rationale of targeting ovarian fibrosis as new option to reduce the risk of ovarian cancer. They also added in the rationale for the use of metformin to prevent ovarian cancer, based on these findings as well. The team are currently doing more research into learning how fibrosis develops in the ovaries and how metformin may be stopping this from happening.

These findings will need to be confirmed with more studies before clinical trails can take place. But, this could lead to a non-invasive test to measure fibrosis and help with early detection of ovarian cancer.

The team are hoping that metformin may prove to be an effective preventative treatment for younger women who are at high risk of ovarian cancer, but who can’t remove their ovaries because they still want to have children.

Added thoughts

While any research into ovarian cancer is welcomed, as mentioned previously, if metformin is helping with prevention of fibrosis, then surely we need to be looking insulin resistance as being a major cause of this?

It also begs the question, do other natural insulin regulators such as inositol do the same thing and would be better to use because Metformin does have a high side effect profile?

Insulin Resistance and Disease

We do know that insulin is a big driver of inflammation and disease states in the body. Insulin resistance is the name given to when cells of the body don’t respond properly to the hormone insulin.

Insulin resistance is the driving factor that leads to many disease states and health conditions such as:

  • Obesity and being overweight
  • Metabolic Syndrome
  • Type 2 diabetes,
  • Gestational diabetes
  • Pre-diabetes.
  • Stroke
  • Cardiovascular disease
  • Stroke
  • PCOS
  • Reproductive conditions
  • Infertility

Insulin Resistance is linked to certain cancers

Meanwhile, insulin resistance and metabolic syndrome are also linked with higher risk for cancers of the bladder, breast, colon, cervix, pancreas, prostate and uterus. 

The connection: High insulin levels early in insulin resistance seem to fuel the growth of tumours and to suppress the body’s ability to protect itself by killing off malignant cells.

Insulin resistance is closely associated with obesity; however, it is possible to be insulin resistant without being overweight or obese. We see this in women who have PCOS and who are not overweight, or obese.

Modern research has shown that insulin resistance can be combatted by treatment methods that reduce how much insulin the body is producing. Reducing insulin resistance can be achieved by following a grain free, low refined food diet.

Final note

If found to metformin to helping with fibrosis and this then leads to ovarian cancer, surely we need to look at what the root cause it. As mentioned above, one could assume it would have to be insulin resistance and we already know that insulin resistance is a driver of certain cancers and tumours.

Surely then, it would make sense to educate women, especially those with family history of ovarian cancer, about the importance of low GI diets and maintaining optimum health and optimum weight etc, in the prevention of not only ovarian cancer, but other disease states that affect women as well.

There are also valid alternatives to using Metformin, which has a very high side effect profile and has some long-term health consequences. There are valid alternatives such as using inositol, which has lots of research behind it and has been compared to Metformin in several research studies. Something to think about and I always like to give people something to think about important issues such as this. Just remember that you heard it here first.

 

Journal References:

  1. Curtis W. McCloskey, David P. Cook, Brendan S. Kelly, Feryel Azzi, Christian H. Allen, Amanda Forsyth6, Jeremy Upham, Katey J. Rayner, Douglas A. Gray, Robert W. Boyd, Sangeeta Murugkar, Bryan Lo, Dominique Trudel, Mary K. Senterman, Barbara C. Vanderhyden. Metformin abrogates age-associated ovarian fibrosisClinical Cancer Research, Oct 9, 2019
  2. Mehri Jamilian; Pegah Farhat; Fatemeh Foroozanfard; Faraneh Afshar Ebrahimi; Esmat Aghadavod; Fereshteh Bahmani; Bita Badehnoosh; Hamidreza Jamilian; Zatollah Asemi. Comparison of Myo-inositol and Metformin on Clinical, Metabolic and Genetic Parameters in Polycystic Ovary Syndrome. A Randomized Controlled Clinical TrialClin Endocrinol. 2017;87(2):194-200.
  3. Fruzzetti F, Perini D, Russo M, et al. Comparison of two insulin sensitizers, metformin and myo-inositol, in women with polycystic ovary syndrome (PCOS). Gynecol Endocrinol. 2017;33:39–42.
  4. Chiu TT, Rogers MS, Law EL, et al. Follicular fluid and serum concentrations of myo-inositol in patients undergoing IVF: relationship with oocyte quality. Hum Reprod. 2002;17:1591–1596.
  5. Artini PG, Di Berardino OM, Papini F, et al. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study. Gynecol Endocrinol. 2013;29:375–379.
  6. Zacche MM, Caputo L, Filippis S, et al. Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. Gynecol Endocrinol. 2009;25:508–513.
  7. Costantino D, Minozzi G, Minozzi E, et al. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial. Eur Rev Med Pharmacol Sci. 2009;13:105–110.
  8. Orgel: The Links Between Insulin Resistance, Diabetes, and Cancer. Curr Diab Rep. 2013 Apr; 13(2): 213–222. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3595327/
  9. Dijiogue S: Insulin resistance and cancer: the role of insulin and IGFs. Endocr Relat Cancer February 1, 2013 20 R1-R17. http://erc.endocrinology-journals.org/content/20/1/R1.full
  10. Orgel: The Links Between Insulin Resistance, Diabetes, and Cancer. Curr Diab Rep. 2013 Apr; 13(2): 213–222. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3595327/

 

IBS

Managing Irritable Bowel Syndrome & Inflammatory Bowel Disease

Irritable Bowel Syndrome, or IBS, is a problem that affects a staggering 3million people, or more, in Australia and about 20% of people world-wide. It is a condition that has baffled doctors for years. There is no single cause, no specific treatment and, as yet, no cure.

But first let’s look at some general information on IBS.

IBS is more common in women than in men and occurs more often in younger people. IBS is usually ongoing, and there are some times when symptoms are worse than other times. Having IBS does not mean you are more likely to develop colon cancer later in life.

Symptoms of IBS

Some people with IBS mainly have constipation, others have diarrhoea. Many people with IBS alternate between periods of constipation and diarrhoea.

Symptoms include:

  • Cramps and bloating in your lower abdomen, which usually get better after having a bowel motion or passing wind
  • Pain that can be a sharp or dull feeling
  • Constipation: feeling that you have not managed to empty your bowels completely, having bowel motions less often, straining to pass a motion or passing small, hard stools
  • Diarrhoea: having bowel motions too often and passing loose stools
  • Flatulence, or wind, and/or rumbling noises from your abdomen
  • Needing to rush to the toilet
  • Headaches
  • Mucus in your stools

Some of these symptoms can also be from other inflammatory bowel diseases such as Crohns disease and Ulcerative Colitis, which sometimes get categories as IBS.

But some of the symptoms above can also be part of having endometriosis and many women who are diagnosis with IBS, in fact have endometriosis. They then have all the testing for IBS, Crohn’s, ulcerative colitis etc (colonoscopy etc) as these don’t find anything and then these women are often told by doctors they are at a loss to what is happening. This is why endometriosis often takes up to 12 years for definitive diagnosis, which is terrible.

IBS triggers

The cause of IBS is not known, but certain things can trigger its symptoms, including:

  • Stress
  • Depressed mood
  • Food poisoning
  • Tummy bug
  • Virus
  • Certain foods and drinks
  • Some medication
  • Some people find avoiding alcohol, caffeine and nicotine can reduce their IBS symptoms

As said before some women suffer more acutely from symptoms of IBS just before, or during, their menstrual cycle. IBS symptoms can also mean that they have a condition called Endometriosis. Many times these conditions can be overlooked and they can be present at the same time, along with bladder issues as well.

Lactose and wheat intolerance and wheat may be a cause and needs to be assessed before permanent changes to diet are made. Wheat grains are inflammatory to the bowel anyway and they should be removed if anyone does have inflammatory bowel issues.

Treatments

There are a few medical treatments available but results can be varying. Many people with severe IBS end up on steroids to settle inflammation in the bowel. There are also other medications to slow bowel motility and reduce inflammation as well.

Dietary and lifestyle changes are a must for the treatment of IBS. See my post on what real nutrition should be food what a good diet should be like.

There is, however complementary therapies that can bring great results.

The complementary medicine unit and the University of Western Sydney ran a randomised, double blind, placebo controlled trial to determine whether Chinese Herbal medicine was of any benefit in the treatment of IBS. Chinese medicine has been used for thousands of years to treat many disease states, including inflammatory bowel conditions.

The results were stunning. More than 70% of patients taking the Chinese herbs improved. The results were published in the Journal of the American Medicine Association.

There are also other complementary therapies and treatments that can be used and combined with medical interventions, or other interventions mentioned above.

Studies have shown that strain specific probiotic bacteria have induced remission in inflammatory bowel conditions such as ulcerative colitis and IBS. But, this needs consultation with a qualified healthcare professional to treat disease properly. Self-prescribing is not an option for this disease that affects over 3 million people here in Australia alone.

With any disease state such as IBS, there needs to be an individualised approach, not a one treatment fix all approach, because everyone is uniquely difference in their symptoms they experience and what their triggers are. There also needs to be a multimodality approach because many times IBS overlaps with conditions such as endometriosis for women, and other inflammatory conditions in men.

If you have IBS or inflammatory bowel disease and need help and assistance in managing your disease better, please give my friendly staff a call and they will explain how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

References

  1. Treatment of IBs with chinese herbal medicine -Alan Bensoussan, MSc; Nick J. Talley, MD; Michael Hing, MBBS, FRACP; Robert Menzies, PhD; Anna Guo, PhD; Meng Ngu, PhD http://jama.jamanetwork.com/article.aspx?articleid=188145
  2. VSL#3 Probiotic-Mixture Induces Remission in Patients with Active Ulcerative Colitis- (American Journal of Gastroenterology 2005;100:1-8)
  3. Investigations and treatment of Endometriosis- Royal College of Obstetricians and Gynaecologists 2008
  4. Bensoussan A, Myers SP. Towards a Safer Choice: The Practice of Traditional Chinese Medicine in Australia . Sydney, Australia: University of Western Sydney Macarthur; 1996.
  1. Yu ZX, Wang K, Li FP. Clinical trial of Chinese herbal capsule for 157 cases of irritable bowel syndrome. Chin J Integrated Tradit West Med.1991;11:170-171.
  1. Liu ZK. Chinese herbal medicine treatment for 120 cases of irritable bowel syndrome. Chin J Integrated Tradit West Med.1990;10:615.
  1. Shi ZQ. Combination treatment of Chinese and Western medicine for 30 cases of irritable bowel syndrome. Chin J Integrated Tradit West Med.1989;9:241.
  2. Chen DZ. Tong Xie Yao Fang with additions in treating 106 cases of irritable bowel syndrome. Nanjing Med University J.1995;15:924.
  3. Xu RL. Clinical realisations during the diagnosis and treatment of 55 cases of irritable bowel syndrome. Shanxi J Tradit Chin Med.1995;11:10-11.
bread 821503 1920

Give us this day our daily…..Bloating

Many people do not realise that the cause of their daily bloating may in fact start with their daily consumption of bread.

I always used to comment that when I was in travelling through Asia and eating all the great fresh foods over there, that I was feeling really good. I never got that bloated feeling that most people often get each day.

On arriving back home, I would always suddenly start to get stomach cramps and bloating for no reason. I find this quite ironic as most people have a perception that you are going to get food poisoning etc if you go overseas. I have never ever been sick in all the years of travelling there. Actually it is always the opposite, I always feel better when I eat the foods there.

Having ruled out bugs and parasites etc, I was starting to go a bit crazy as to what was going on. Then one day I didn’t get the bloating anymore.

What did I do that day?

Was it a virus just getting out of my system, or was it a food that I missed that day?

Then it all dawned on me that I had not eaten bread that day. I’m not a big bread eater anyway, but the next day I tried out my theory and ate some bread. Bingo!

I had bloating and pains all day again. So much for supposedly being a healthy staple food. While travelling in Asia, I didn’t have bread or many refined foods at all and that is probably why I always feel better when I go there.

Many people suffer bloating caused by bread

Actually many people suffer from bloating each day, caused by bread, and some suffer it quite severely. Some to the point that they actually look pregnant with it. Many people’s bloating and weight issues are caused from over consumption of bread and other refined flour foods. Many people lose weight just by giving up bread alone. The sad fact is many people continue to eat bread even when they know it is causing them bloating and pain etc.

When you look at the average Australian diet, we live on the stuff. Toast in the morning, sandwiches at lunch and sometimes we have bread with our dinner too. In this day and age, there is no reason to eat as much bread as we do. There are so many more healthy food alternatives available to us today, but we all go for the gut filler and bloater every chance we get. It’s quick and it makes you feel full, temporarily anyway.

Bread is just a filler to help you fill full

Actually if you look at the history of bread, it was born through poverty. It was born out of necessity when there was no other foods around and it gave the perception of being full. The trouble is the first breads were semi good for you as they were very dense and full of whole grains. Not this refined rubbish, full of chemicals and additives, that make it last for weeks. These days, weevils won’t even live in it and some kids can even get hyper on it because it can be laced with that many preservatives.

Gluten, yeast and other additives

Besides all the additives in bread today, there are two main ingredients that make many people have digestive issues. One is gluten and the other is yeast. Yeast is a rising agent and it can surely make the stomach bubble and rise too. Then the refined grains containing gluten also causes inflammation in the system. The other disturbing thought about bread it that it is really just flour and water. Flour and water makes glue and that’s why it clogs so many people’s bowels up each day. The gluten can also cause loose bowels for some people too.

Many people also have a misconception about the different types of bread too. Many people choose brown bread over white thinking it is a healthier option. Wrong!

Brown bread is just white bread with a tiny bit of wheat germ added and a splash of colouring to make it brown. Even when you do find a semi decent option, with the many breads out there, it still really isn’t a really healthy option. Again it is just a filler and there are many more foods out there with much more nutrition, and again it won’t make you bloated. We also now know how bad refined grains are for you.

Gluten free does not mean healthier

Don’t think for a moment that Gluten free is a healthier option, because it isn’t. It is still refined grains, minus the gluten. It is still inflammatory due to lectins and leptins and other things in the grains. Many gluten free products also contain a lot more sugars and emulsifiers too. It is best to go grain free than go gluten free.

Eating other foods instead of bread

I must admit that there is nothing quite like the smell of freshly baked bread, but that doesn’t make it good for you. The other hard thing about it is it is really hard not to give it to our kids, especially if they are going to school.

But I also know that with cooler packs now, there are many other options that we can give our children to take to school. Moderation is the key here. Have a look at some of the health snack options you can use instead of bread and refined flour products.

All of us need to cut back on the stomach glue (bread) and start eating some healthier foods such as salads, lean proteins, nuts, seeds, veggies and fruit. It isn’t all that hard.

Instead of eating that meat and salad sandwich tomorrow, how about just having the meat & salad. It is a much healthier option and it won’t bloat you either. Some nice sliced ham off the bone, or tuna, or chicken, and a lovely Greek salad and hey presto, we have a great healthy lunch option.

Other foods that may cause bloating

There are other may other things in our diet that cause bloating such as alcohol, oats, sugars, chocolate, fermented bean paste (miso) etc that people also need to be aware of. Overindulgence in all of these things can all lead the stomach to overload and cause bloating and pain.

One more thing, “no”, you just can’t take medicines and supplements to make the bloating go away and still eat the foods that cause bloating.  It doesn’t work that way. You have to remove the cause, otherwise the problem will continue no matter what you do.

So next time you look like you have added two clothe sizes,  with a stomach full of wind, remember that it may just be from the bread that you have just eaten beforehand. If you are getting bloating each day, it is a good idea to talk to your healthcare provider about this and look into the cause of your issues. There are simple testings for food allergens and your healthcare provider is trained to know what to test for and look for in your diet as well. There may also be an underlying disease state being missed as well.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate