In yet another breakthrough in the treatment of cancer to come out of Israel, Scientists from Tel Aviv University (TAU) in Israel determined that medication used to prevent anxiety, stress and inflammation markedly reduced the risk of developing metastases after the operation to remove the tumor. What they described as a “short, simple and safe drug treatment” was found according to the first clinical study of its kind conducted among 34 colon cancer patients operated on at Sheba Tel Hashomer Medical Center.
Israel has always been at the forefront of medical research and the development of new techniques. Some of its startup firms like Nectin Therapeutics do so in the private sector. And in November alone there were a number of breakthroughs made in the treatment of cancer by Israeli researchers.
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Also at Tel Aviv University, research conducted by Israeli scientists found that a combination of ultrasound and nanobubbles could destroy cancer tumors, eliminating the need for invasive treatments. And another study from TAU found that aerobic exercise can reduce the risk of metastatic cancer by 72%. According to the researchers, intense aerobic exercise increases the glucose (sugar) consumption of internal organs, thereby reducing the availability of energy to the tumor. The third achievement from TAU in November was the development of a new cancer treatment that scientists say may significantly enhance the efficacy of chemotherapy in breast cancer patients, reducing the risk for lung metastasis following chemo from 52% to only 6%.
This new study included 34 patients treated at Tel Hashomer Hospital. The findings show that 5 years after surgery, only 12.5% of the surgical patients who received the drugs developed cancer metastases, compared to 50% in the control group.
The scientists said the treatment included two safe drugs available in every pharmacy: a drug to lower blood pressure and reduce anxiety, and a drug used to prevent pain and inflammation. The treatment starts 5 days before surgery and last for only 20 days, with minimal-to-no adverse effects.
The research was led by Prof. Shamgar Ben-Eliyahu of TAU’s Sagol School of Neuroscience and School of Psychological Sciences and Prof. Oded Zamora of TAU’s Sackler Faculty of Medicine, and its results were published in the European Journal of Surgical Oncology. At the same time, an overview of the theory and principles underlying the research was published in Nature Review Cancer.
Although surgery to remove primary tumors is the mainstay of all cancer treatments, the risk of metastases after tumor removal is estimated at 35% among colon cancer patients, with higher risk in patients with more advance stages of the disease.
Prof. Ben-Eliyahu explains: “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. 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. 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. The good news is that we know how to treat both stress and inflammation using off-the-shelf medications.”
The researchers from Tel Aviv University gave 34 colon cancer patients two safe drugs that are available in every pharmacy: propranolol (Darlin), used to lower blood pressure and reduce anxiety, and etodolac (Etopan), used to prevent pain and inflammation. Sixteen randomly chosen patients took the medication for 20 days – from five days before to two weeks after surgery at the Sheba Medical Center. The other 18 patients received placebo drugs (control group). Five years later, nine of the 18 patients who received the placebo (50%) developed cancer metastases, compared to two of the 16 patients who took Darlin and Etofen (12.5%).
According to Prof. Ben-Eliyahu, part of the medical establishment distrusts the effects of stress-inflammatory reactions, particularly those resulting from psychological factors such as waiting for surgery or fear of the disease spreading. Another problem concerns the financing of clinical studies.
“One should bear in mind that the pharmaceutical companies have no financial incentive to support such studies. 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. Unfortunately, the major science foundations in Israel do not fund clinical research on drugs, assuming that the drug companies will fund them. We seek to save lives without financial gain, and we have received financial support from several Israeli and international sources, but these are insufficient for large clinical studies. I hope that funding will be found for a large-scale clinical study that we have now embarked on, with the intention of recruiting hundreds of colon and rectal cancer patients in Israel, because without such research – we will not be able to convince the medical establishment of the treatment’s effectiveness.”