WEDNESDAY, June 1 (HealthDay News) -- Beta blockers -- safe,
inexpensive drugs that have been used for decades by millions of
people -- may eventually have a role in fighting breast cancer,
according to two new studies.
One study suggests that women who are already taking beta
blockers to lower blood pressure tend to be diagnosed with breast
cancer at an earlier stage of the disease and to have better
survival odds.
The second study finds that women who took a beta blocker while
undergoing chemotherapy for breast cancer had a lower risk of
recurrence.
Both studies, whose authors declared no conflicts of interest,
were released online May 31 in advance of publication in an
upcoming print issue of the
Journal of Clinical Oncology.
While the idea of dispensing a cheap drug with a good safety
profile to women to combat breast cancer is enticing, these
findings are hardly enough to recommend prescribing beta blockers
such as propranolol (Inderal) for breast cancer, said an
expert.
"These studies are hypothesis generating. I don't think they are definitive by any means in terms of what physicians and patients should go out and do tomorrow," said Dr. Lori Goldstein, director of the Breast Evaluation Center at Fox Chase Cancer Center in Philadelphia.
On the other hand, women with breast cancer who are already
taking this class of drugs need not worry that "it's going to
jeopardize the care of their cancer," said Dr. Amal
Melhem-Bertrandt, lead author of the second study.
Beta blockers basically work by damping down the effects of
epinephrine and norepinephrine, both stress hormones.
These stress pathways may also be involved in the spread of
breast cancer.
"There's a lot of literature out there that people under a lot of stress may have a higher incidence of their breast cancer recurring, meaning that the cancer may come back when they're under stress," said Melhem-Bertrandt, who is an assistant professor of breast medical oncology at the University of Texas M.D. Anderson Cancer Center in Houston. "We wanted to figure out if something [was] done pharmacologically to reduce epinephrine and norepinephrine, whether that would reduce the incidence of the cancer coming back."
The first study connected 2001-2006 data from a large national
cancer registry in Ireland with additional information from a
pharmaceutical database. The researchers, from Ireland and the
United States, identified 70 women who were taking the beta blocker
propranolol and another 525 taking a different beta blocker called
atenolol (Tenormin) in the year before they were diagnosed with
breast cancer; they were matched with a control group of more than
4,700 women with breast cancer who had not taken beta blockers. All
of the women were 40 or older.
Women taking the beta blocker propranolol were significantly
less likely to be diagnosed with advanced cancer or to die from
breast cancer. The longer the woman used propranolol, the better
her outlook.
There was no similar association with the beta blocker atenolol,
the study authors noted.
But the results could have been skewed by the fact that women
who end up in these databases are actually visiting their doctor
and being prescribed medicine, said Dr. Stephanie Bernik, chief of
surgical oncology at Lenox Hill Hospital in New York City. "They're
more inclined to follow through with therapies and screening" and
that might help explain their better prognosis, she said.
The researchers also cautioned that the propranolol group was so
small that the results could have been due to chance, and that they
needed to be confirmed in larger studies.
The authors of the second study went back to records on 1,413
women who had received chemotherapy for breast cancer and compared
those who had been taking beta blockers to those who had not.
Overall, taking a beta blocker was associated with a 50 percent
decrease in the cancer coming back but not overall survival, they
found.
The benefit really seemed to be restricted to women with
triple-negative breast cancer who had a 70 percent lower risk and
who tend to have fewer options when it comes to treatments, said
Melhem-Bertrandt.
Possible good news for all women, pointed out an accompanying
editorial, is that these stress pathways can also be modified
through lifestyle factors, such as weight management as well as
curbing tobacco use.
More information
The U.S. National Cancer Institute has more on
breast cancer.