Metformin exhibits anti-cancer effects
There are many studies about metformin and cancer. It is confusing. Some studies are conflicting, and some show benefits in specific patient groups only.
But there is a growing feeling among many practitioners that high blood sugar is bad. They feel it may be the root cause of many disease processes- not just cancer. Heart disease? Autoimmune? Inflammation? Maybe to all.
So what is the thought process?
People think that metformin is anti cancer from indirect and direct ways. I will continue to blog on this subject, as I think it is important. But for this blog we will focus on cancer.
Indirectly
- it changes blood glucose and insulin levels This is thought to influence the survival of cancer cells.
- Insulin and the insulin growth factor promotes tumor growth by stimulating epithelial cells
- Decreasing insulin levels may prevent tumor growth
- It can affect inflammation, which is thought to play a role in tumor progression
- Blocking of transcription factor nuclear factor -KB (which is mediated by metformin), results in reduced secretion of inflammatory cytokines
- Metformin has been reported to activate immune response to cancer cells. (One study showed metformin improved experimental anti cancer vaccines)
Direct anti cancer effects
- Some are connected with AMP-K mechanisms. This starts to get super bench-science level, and hard to understand. But the gist is it stops signaling in the cell which encourages cell growth. It inhibits folates, which helps stop cancer cell proliferation. It interacts with oncogenes and tumor suppressor genes. They have looked at experiments in breast cancer cell lines, and metformin down regulates key factors for those cells.
- Other methods are that metformin inhibits cell DNA damage
- It upregulates autophagy in esophageal squamous cell cancer which led to reduction of tumor growth. (This was mediated by a signal transducer and pathway which is understandable to the bench researchers way smarter than I.)
- Metformin reduced glucose uptake in lung and breast cancer cells. This kept them from getting an energy source, which led to mitochondrial issues and cell death.
My thoughts?
Metformin is cheap. It is an old medication (around for over 40 years). Some people feel yucky or nausea or have GI issues, so it isn’t without issues.
I do not think it likely helps everyone. You need to know YOU. What is your baseline fasting glucose? Is your HbA1C elevated? These are knowable things. You can test your fasting glucose. You can test your HbA1C., and insulin levels, and insulin insensitivity. You can get a wearable which will show you how your blood sugar changes during the day and with what you eat.
For those who know me, in my older and wiser state, I have become much more focused on how to age better. The buzzwords “healthspan” and “lifespan” are important to me.
I think the future of medicine is going to be a lot more tailored to each person, as we have unique issues and genetics and can respond very differently to the same input. My hope is that medicine is much less reactionary- wait til something is bad- and much more proactive.