Beta Blockers May Reduce BC Recurrence

Thanks Falls, for the link to the Israel study. I thought bringing the whole trial here was important. bbl

hi goats bbl on a mission

Solfeo. At this point, I agree with your doc. BUT don't close the door on the concept until we can get an idea if the door is truly closed.

You have done well to get your cortisol levels lower. I had been thinking about a post regarding stress. Elevated cortisol is a stress hormone how it plugs into what we are talking about. I don't think it does. BUT thinking is not knowing. So far none of the studies have included cortisol in any discussion. It could be researched though. Millions of studies out there. Do a quick google" Keywords. Cortisol, beta blocker,and cancer.' See if it pulls anything.

Not sure if you have seen me post about Healthy Lifestyles program of the many cancer organization. Some things like exercise are proven by science. Obesity is only associated by a retrospective relationship in epidemiology studies.. No causal scientific connection has been proven. Until the most recent research on the microbiome in mice. We may be getting closer to an answer.

What we are seeing here with these mouse studies is that there is a causal relationship to cancer cells activity increasing when exposed to a beta agonist(mimics beta stimulation) Isuprel from the 2001 study. When I read that it said to me elevated neural-hormones are connected to cancer. For me that was big. It's old news to the researchers, but I hadn't seen before. I was going to suggest discarding that study. Maybe not.

Back to your problem. I have a thought. Several. Call the nears College of Pharmacy. Tell them you are looking for a doc that specializes in cardiac drugs particularly the beta blockers. You may have to tell them your story a few times. Also, one of the docs is involved in the City of Hope study on the brain mets and TNBC is a usual contributor to the news in California. I was so hoping to have a reason to call him. Anywhoos, He seems very approachable and a teacher. He might be a real source. I would do both. Two conclusions we are used too.

I'll bring back his name and phone number.

WENCHI yoohoo. Why don't you and Solfeo chat. If you both feel uncomfortable calling Jandail. I'll call

It's been very nice to have contact with Dr. Retsky and Dr. Forget. In fact I was going to send them the Israel study. I was surprised NSAID Lodine was used along with the beta blocker propranolol. I was also surprised that the Israel study is muddying the waters by using two drugs. To date there is only retrospective studies on NSAIDS. But , alas, one may have been published since I last looked.

The reason I said muddying the waters. There hasn't been a prospective trial of the beta blockers. With evaluating outcomes how can they ascribe outcome to one or the other drug. Impossible. The ideal is each drug trialed independently and then trialed together. That would be perfect. Except not for us The Israeli study is 5 years in length and then likely another 2 years to publish.

We need something now. This search will go on for weeks(just like Toradol, ugh)........

FALLS HOOTIE HOO Would you check on Lodine please. It seems to me I have seen something, but............Actually you will find some studies it's under the generic name for Lodine..

Falls, Hugs you always come through. He's not a male model that's Dr. Jandial at City of Hope.

Solfeo and Wenchi. Haven't called Jandial. But thinking. See the reason beta blockers are contraindicated for you with low BP is there is no reversal agent. Once it in a body it's there till it wears off. That's always been a problem when a patient has an event and they are on blockers. Trying to maintain Bp is a nightmare or a very bad dream. It isn't always successful.

Soap box:

With the two of you, I suggest medic alert tags that say "SBP usually < 100. Nothing fancier. Clearly stated. Reason: if you are injured or have something where you are unconscious and medics respond and no other reason can be determinded for the low BP, you are going to be treated by fluid resuscitation i.e shock of undetermined origin. The body can usually handle a certain resus, but could be a problem in some situations i.e head problems. The safest route is to allow that info to be known when you can't say it. How it would play out is the medics would treat by protocol starting IV normal saline, they would run it wide open, then transmit situation and treatment with the the medic alert info in the radio report. The doc would consider it and either tell the medics to continue fluids at wide open or might have them back off some i.e maintain SBP at 100-110. In any event knowing all the variables allows better management. Off soap box. Hope I kept that simple. Tried.

(shaking my head)

Solfeo, Okay. I would still like to do a parallel tutorial on YouScript. We sign on under my UN & PW at the same time. There are nuances that aren't in there tutorial.

Licorice, is not a benign substance. Be very careful with it. It's been a very long time since I looked at. My saved memory bit is----------be careful, avoid if possible, can be scary. How's that for a memory bit

Did you consider chatting with the neurohormonal physiologist at a College of Pharmacy?

Adding this tidbit here about propranolol so I can properly formulate the question to ask them. In the research propranolol was the most commonly used drug in the mouse studies. In the one existing human trial ongoing now, propranolol 20 mg is being studied with an NSAID(Lodine).

I pondered as to why the choice of propranolol. These are my thoughts. It was the first BB in the class indentified and developed. The intensity of the research on a novel(new) drug class is different than the development of drugs after. The drugs developed after have to prove they work in the way that the original drug worked and doesn't have any untoward characteristics that are incompatible to life. The preponderance of the research is done with the novel drug. In this case propranolol. Not sure if that's the best way to describe things. Once getting into this BB stuff without knowing which drug and dose was being suggested, I predicted Metoporol which was the second drug in the class.

Propranolol changed the history of cardiac care when it came to market in the 1970's. Prior to propranolol the drug of choice was Digitalis(many other names). But propranolol did have many side effects.

Rebound was a problem. Rebound as it relates to drugs is per google " The rebound effect, or rebound phenomenon, is the emergence or re-emergence of symptoms that were either absent or controlled while taking a medication, but appear when that same medication is discontinued, or reduced in dosage.". The particular way it is applied to cardiovascular drugs is----- if a dose is late or missed the BP or heart rate bounds up to very high levels. Some BB's rebound worse than others. Metoporol rebounded less than propranolol. My simple explanation "it was a more forgiving drug if it were late" More BB's were developed since, but without taking a look metoporol is the most prescribed drug in the world. It may have been supplanted by another BB, but that's not the key point. Thinking in the respect of the original research needed to bring the novel drug to market .i.e. propranolol, it seems to explain why it has been studied in it's relationship to cancer. The first study being done around 2000. There may have been early studies and we/I just haven't identified them. The tendency in science is to stay with an original path if they're is positive outcomes. The research then is repeated and validated.

The dose of propranolol for standard usage is an initial adult dose of 40 mg. The dose for the cancer trial was determined to be 20mg. This is a small dose. With other drug classes the body impact of taking much smaller dose than the usual starting dose is minimal. BUT BUT this is a beta blocker. Remember no reversal agent.

Solfeo, you now know, you have an altered 2D6. All medications going through 2D6 have to be dosed differently. As you now know from your studies of the CYP450 enzyme paths, docs are not well versed on what to do with dosing. Hence my suggestion of going to a neurohormonal physiologist at a College of Pharmacy. The description of 2D6 as below reinforces why you really need to find someone that understands this stuff. BECAUSE you have the added problem of low blood pressure.

From DailyMed. The government repository for drug info " In vitro studies have indicated that the aromatic hydroxylation of propranolol is catalyzed mainly by polymorphic CYP2D6. Side-chain oxidation is mediated mainly by CYP1A2 and to some extent by CYP2D6. 4-hydroxy propranolol is a weak inhibitor of CYP2D6.

The direct question that needs to be answered once you get to the all knowing person is "With full understanding of my underlying normal blood pressure being below 100 systolic, my 2D6 being intermediate metabolizer, and my stated goal goal of reducing BC recurrence, is there any safe dose to take a beta blocker?"