Metformin study

jojo68

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3324825/

Anyone here taking Metformin?  How much daily?

Momine

I am not, because my onc wasn't into the idea. Instead I lowered my fasting sugar with diet and exercise.

jojo68

Hi Momine...I don't think it's just about lowering blood sugar...I think there is some other mechanism going on that it kills the stem cells?

Momine

ETA: saw it.

JAN69

Yes, I take it. PCP was very happy to prescribe it. I take 500 mg. 2x daily.

BrooksideVT

My understanding is that sugar in the bloodstream prompts the pancreas to send out insulin.  Circulating insulin is thought to be a growth factor for breast cancer.  Managing blood sugar levels reduces circulating insulin and everybody is happy, except, of course, those hungry little buggers.  I have no idea where the stem cells fit into the equation.

Momine

OK, I looked through the study. It sounds very promising, but is still preliminary. They would have to do quite a lot of work still to show that it does the same thing in human cancers in human bodies etc. Also, diabetics taking metformin may get fewer cancers, statistically, but they still get cancer.

Anyway, I think there are some trials going, so if you can get in one, why not.

SelenaWolf

I'm enrolled in the Canadian leg of the Metformin clinical trial.  Been taking the trial meds (either metformin or placebo) for the last year-and-a-half.  The trial lasts five years, so I'll be in it until 2017.  I haven't heard any interim results, so I have no idea what the status is.

Anonymous

I'm sure there are many variables with this that would need investigating. Dosage, length of treatment required to make a difference, types of cancers, etc. I've been on Metformin for nearly 5 years for PCOS. I take 500mg twice daily. I was diagnosed with very early IDC in September 2012.

It would be wonderful if this helps some people. I'll be interested to hear more results and studies.

Momine

Jojo, also, as noted by someone else, you may be able to get your GP to give you a script. How is your blood sugar and weight?

AlaskaAngel

Jojo68,

Google Dr. Lisanti for his studies about metformin.

I wasn't eligible to participate in any clinical trial for breast cancer and the use of metformin because I am considered "too far out from diagnosis", but I would encourage as many others as possible to get these trials completed by participating in them.

My PCP had no problem prescribing metformin for me at low dosage. But in addition I hope to get more of a connection built for breast cancer patients to deal with the metabolic basis for breast cancer, so I spent both $ and time getting an appointment in a major city (Seattle) with a reputable endocrinologist to have him go over my metabolic status as a patient with no chronic health condition other than breast cancer.

It was extremely difficult to get any endocrinologist to see me. They deal solely with diabetes, thyroid issues, pancreas issues, etc. and they do not consider breast cancer to be related to their practice -- but also, they are backed up with those other patients to begin with. So that is part of why breast cancer relationships to the endocrine system have been very slow to be made.

IMHO, if we want to identify better ways to deal with bc, we should start having our metabolic system followed with labs long before anyone gets cancer, to see if our diets and exercise need modifying in order to prevent cancer metabolically.

I exercise daily and as a HER2 positive stage 1 cancer patient 11 years out from treatment with just CAFx6, IMRT rads, and 1 3/4 yrs of tamoxifen (no AI, no taxane, and no trastuzumab), I take 250 mg of metformin with every meal. Until I got the Rx from the endocrinologist (along with his acknowledgement by lab testing results that my diet was as good as it could possibly be), I was having severe difficulty with weight management despite daily exercise. My weight has become easier to manage since starting low-dose metformin.

Thanks for the link. Good luck with your situation.

Heidihill

My onc just prescribed me 850 mg a day based on "two big studies." Anyone have side effects?

Anonymous

Hi again, Heidi.

I take 1000mg per day. Initially I had some stomach issues and a little D.

My dr at the time had me start with one 500mg a day for a couple of weeks and then increase to one in the morning and one in the evening. I had tried the time release and it bothered me more. Now I have no SE's unless I'm bad and eat too many carbs. Then my stomach gets pretty upset. I also make sure I always take them with a meal. My current dr said if I miss a meal I should skip that pill. 

Hope that helps!

Momine

Heidi, if you are able to get out of your onc which studies swayed him/her, that would be great, because mine is not inclined that way at all so far.

leggo

Heidihill, I take 2000mg/day. I've had stomach issues all along. I like Dulcigirl, started out slowly with 500mg/day and had the issues even at the lower dose.

Heidihill

Thanks for your responses, dulcigirl and leggo. I'll start tomorrow. I'm going to try to get ahold of a glucose measuring device to see what difference it makes taking it at different times of the day as I only have a tablet a day.

I will see if I can wrangle that info from my onc tomorrow, Momine. As others have said it's the insulin-lowering effect that seems to convince him too, because that's what he mentioned to me. But maybe he thinks my brain cells could stand some repairing.

http://www.sciencedaily.com/releases/2012/07/120705172044.htm

Maggs09

I'm also on METFORMIN (2x850) and this is a fairly recent info (from October /2013), about its effectiveness. 

My understanding is that it should work even better for non diabetics (lower glucose environment), am I correct?

http://www.coloradocancerblogs.org/study-metformin-breast-cancer-less-effective-higher-glucose-concentrations/?utm_source=rss&utm_medium=rss&utm_campaign=study-metformin-breast-cancer-less-effective-higher-glucose-concentrations

Rdrunner

i am very interested in this, I havent had the chance to do research yet though. My concerns are how it effects someones blood sugar that tends to be on the low side. I can get serious low if i dont eat every 2/3 hrs depending on activity levels.

sandcastle

I...Have been on Metformin for a number of years......long before BC.....I take 500 two times a day...you MUST and I say MUST eat with Metformin....for it does lower your blood sugar.....and low blood sugar is just as bad as High.....I happen to be  Diabetic so for me this is a must and since I have BC I am a Nut about my glucose readings......I go to a Endrocronologist and I also us Bydureon once a week which I inject.......I do find this strange that non-diabetics are using this drug.....but understand the key to BC.....Liz

leggo

Maggs. I'm just going to reiterate what my doctor said. Yes, you are correct, it works differently on non- diabetics. If I was diabetic, it would not be prescribed as a cancer treatment...it wouldn't work.  Also, if your not diabetic and your pancreas is doing it's job, it doesn't matter if you eat with it or not. Again, this is information from my doctor and for my particular situation, so I urge everyone to get the correct information regarding the cancer study from their doctor about dosage, how it affects your blood sugar if you're not diabetic, etc. It's a vastly different drug when used as cancer treatment as apposed to diabetic treatment.

flimsical

My onc let me go on it - 500 mg a day. I am wondering if I should up the dosage in a few weeks? Thoughts, anyone?

SelenaWolf

According to the clinical trial I am participating in, the dosage being tested is 850mg bid.  Check with your onc before you raise the dosage as there can be unpleasant GI side effects as your body adjusts to higher dosages.

journey61

I'm in the middle of trying to figure out the next step in my treatment-after being diagnosed with bc I met a doctor who went over my history and was sure I had adrenal exhaustion and the thinking was that it was leading to chronic diseases and cancer by the cortisol affecting other hormones.  I have been very conscious of this and do alot to try to help my body-however, some things have been antagonizing my system. After my last set of chemo from Jan-Apr 2012 my markers were down and my sternal met showed healing. My oncs decided not to have me go on Letrozole, but after 7 months and my CEA reaching 5 (0-5 normal) I went on it. I understand it can take awhile to become effective, though.

Each time I would have a scan with the oral contrast I would be "off" with bp problems, skin peeling off my hands, stomach upset for at least a month and then I would have another scan. I recently found information that the contrast dye can cause bp problems and thyroid problems. After my scan last May my hair had started falling out. I have flown to Van to see an endocrinologist who assured me I was fine and didn't order any tests. In the summer I would have lightheadedness and would sweat alot but I was drinking alot of water. In August I had a Pamidronate infusion and had a bad reaction-the infusion was 1 1/2 hrs (I had asked for longer because I have a hard time processing things) and the next day I couldn't catch my breath if I stood up, was nauseous, and felt dehydrated.

Around that same time I had been doing some things I don't normally do, such as eating sweets, drinking tea, flying in a plane, walking/running 8k in a fundraiser and would continue to have uncontrollable sweating. In September, two days after the run I had a scan (yes, I drank the contrast because the medical staff said it would help to see things) and two days after that I had shakiness and my eyes turned red. The scan showed some lungs spots and the mass on my adrenal gland had gotten bigger and was showing invasion into my kidney. What? I didn't even know I had a mass! I had consultations in Oct and they decided to continue treatment until my next scan which was last week. In the meantime I consulted with a nutritionist who put me on an adrenal boosting diet and recommended I put 1/4 tsp good quality seasalt by pinches in my food and drink all day. Within weeks my blood pressure started reading again when I would stand up after getting out of bed and my lower back pain that I had had for 1 1/2 years (started after my first post chemo scan) went away.

My scan last week (didn't drink the oral but had the IV) showed the invasion is stable, basically, no mention of anything on the lungs, but the adrenal gland has enlarged. I really believe we should be followed much more closely hormonally.  My CEA had reached a high of 25 last summer but has stayed pretty much the same. I feel so much better than last summer, my hair has stopped thinning and my bp is reading better for the most part. I think what happened is that my adrenal was being shocked by the contrast dye, I was dehydrated because of lack of salt balance and because I was dehydrated and had a Pamidronate treatment-which can be hard on the kidneys and you have to be well-hydrated- my kidney was shocked, my adrenal was shocked, and my thyroid was affected.. I asked my doctor yesterday to have a blood test for my thyroid and he just ordered the TSH-I haven't had it checked for 10 months. I am from a small town and I can tell the doctors are being pressured from the medical services plan because I am now only allowed to have bloodwork every two months and TMs once a month. I was having TMs every three weeks because I am on Herceptin but I guess the two extra tests over the year aren't allowed. 

Anyway, last Oct I saw one of only a few board-certified naturopathic oncologists in the country who recommended things like Melatonin, Metformin, DCA, but also maybe Xeloda. The conventional doctors have said Xeloda/Tykerb, TDM1, Afinitor/Aromasin without Herceptin (not approved in Canada) and when I suggested changing from Letrozole to another anti-estrogen, was told it hasn't been proven in trials. 

I am trying to keep a level head and be methodical about the next step. I find it interesting, Leggo, about your paraneoplastic syndrome, which is what a physiotherapist told me I had. I also have Gilbert's Syndrome which is being hypothesized to be a new risk factor for breast cancer because of the liver's inability to process estrogens and I have had major problems metabolizing.

I am off any bisphosphonates and my sternum is stable. I had been on zopiclone but after reading about it being carcinogenic, I have discontinued it after 7 years. (that was the only pill I was on before cancer) My liver function tests are the lowest they have been in two years and I don't "feel" like I have cancer except for some pulling under my right shoulder blade that got worse after the Pamidronate, but why did the adrenal gland grow? Was it because I had a bad reaction to the last scan?

Any help would certainly be appreciated.

pipers_dream

If you guys are going to take metformin, be sure to get some B-12 along with:  Metformin linked to vitamin B-12 defiency The most absorbable form is methylcobalamin, not cyanocobalamin.  You sure don't want to survive BC only to end up with dementia a few years later.  I say this b/c I had a aunt who died recently and I'm convinced that her dementia was due to a B-12 deficiency and it was bad--as bad as any advanced alzheimer's patient.  With this you can live for years and years too, which she did--at least 20, unlike those with alz.   Well that was my scare for the day but a couple of my diabetic friends have been complaining of memory loss, though that could be due to blood sugar problems too.  

leggo

Hi journey. The paraneoplastic syndrome can be confirmed with a blood test. In Canada, where I'm from also, the test will be sent to the Mayo clinic so the results could take a while. What they will be looking for is something called the CV2 antibody. My onc thinks it may be a double-edged sword. On one hand, the antibody may slow the progression of the cancer, but on the other hand, can also be completely debilitating. As a matter of fact, one of his patients is completely paralyzed by it, but continues to show regression in the size of the tumors. Just a hypothesis on his part though.

Regarding the dye and drink for the ct scans, they are terribly hard on the kidneys. I wonder if maybe that's the source of your back pain. Maybe you could ask to have your kidneys checked before and a few days after the scan (even it will take some doing by your doc if he's under pressure by higher-ups).

About the herceptin...I'm not on it anymore but when I was, it was not combined with any other chemo. Even though it's not approved in Canada as a single agent treatment, being that we're palliative, your onc can ask for approval. It would very likely be approved for you as well, depending on whether or not your onc thinks it would be beneficial alone. 

Good luck to you in your future treatment decisions. I hope that whole adrenal thing turns out to be not as serious as it seems. 

leggo

Oh....and if you do end up going on the metformin, you will have to have a kidney function test a few days after receiving the dye for the ct. It's protocol. 

Never mind what I said about the herceptin. After re-reading your post I saw I misunderstood and see you were already getting it. Sorry about misunderstanding.

pipers_dream

I want to point to a supplement you guys might be interested in too.  It's Olive Leaf Extract and according to some it's a wonder drug but one thing it does is to improve glucose sensitivity.  Olive (Olea europaea L.) Leaf Polyphenols Improve Insulin Sensitivity in Middle-Aged Overweight Men Alright so it's men in the study but I'm sure it benefits women as well.  It says in the article that OLE is comparable to metformin in improving insulin sensitivity--metformin 17% and OLE about 15-20%.  

Also this from Sloan-Kettering:  "Derived from fresh or dried leaves of olive plant. Both the leaves and the extract have been used to treat infections, inflammation, diabetes, and hypertension. A major component of olive leaf, oleuropein, has antioxidant properties ⁽¹⁾. Because of its hypoglycemic effects, the leaf extract can induce insulin release and improve peripheral uptake of glucose ⁽²⁾. Further, the leaf extracts demonstrated antimicrobial properties ⁽³⁾, anti-HIV ⁽⁴⁾, and anticancer ^{(13)(14)(15)(18)(19)} properties. Animal studies showed anti-arrhythmic, spasmolytic, diuretic ⁽⁵⁾, antihypertensive ⁽⁶⁾, analgesic ^(20)(21), and cholesterol lowering⁽⁷⁾ effects."

My own experience with it began a few years ago when I began to have heart arrhythmia--my BP went wacky and my heart was racing or offbeating all over the place.  I got some OLE and had it settled down within a week.  It makes sense now b/c I do believe my arrhythmia started after a particularly bad sugar binge--in other words, right after Christmas.  It's supposed to have some anti-cancer effects too, though not proven.  Well in mice it is.    

Anyway, I hope I didn't highjack this thread too much, but metformin is not a supplement--it's a pretty potent drug and I'd be looking for alternatives to that too.  

abigail48

I've used olive leaf for a few years now, make the decoction myself & drinking a few tablesoonsfull a day.  Ive been in touch with a pharmaeceudical/chemical executive & he says the mice studies are iffy in at least 2 way, as gary says because what works in mice doesn't work in humans, also   ?(need to check back but later), if it works in mice it "might" work in humans.  seems to me in petri dishes even more iffy

pipers_dream

Right Abigail, but the study was about men, not mice.  I think women have more in common with men than mice or petri dishes, don't you think?  If you're talking about my earlier post, I did say the anti-cancer effects are unproven, but it does so many other good things, that I think it's worth taking.  Or, what's likely is that it does things like lower blood sugar, and that impacts cancer indirectly.     

I am not one of those holistic people who says things like "sugar causes cancer."  What I do believe is that sugar affects your body in a negative way and sets up conditions in your body so that cancer is more likely to happen.  It's not good for your liver for one thing, and when your liver isn't working at top capacity, neither is your health.  I have tried to limit sugar over the last few years but every time I got stressed out, which has been often, I'd hit the candy/cupcake/cookie jar and wouldn't know how to stop.  Now I've stopped.  

A wise oncologist once said that if you're going to go the natural route, you have to change your whole inner terrain--you can't just throw a bunch of natural remedies at it and expect them to work. 

pamela1204

I was thinking about asking my dr about this. Wondering if a  side effect of this drug is weight loss or gain? I have read that breast cancer is fueled by "obesity" and although I am not obese, I am putting on the pounds with this tamoxifen and I am worried that this weight gain will do more harm to me in the future. I also have thyroid disease so my metabolism, and hormones are already out of whack. Normal weight is 115-120, and height is just under 5'3.

sandcastle

My brother was on Metformin and Lost weight....his Doctor took him OFF....... I have been on Metformin before BC and it did not make me Loose weight....I also have the thyroid problem....and I do go to an Endrocrinologist.....Liz