Hi all,
sorry for being so silent during the past months and again a special and huge THANK YOU to @Johan for providing such a wealth of extremely valuable information in this forum! Everytime I scroll through this thread I am blown away by all your input! It is absolutely amazing!
Brief update on Bianca's situation:
We meassured her CTCs again and they went slightly up from zero (below limit of detection) to 50. Accoording to the lab it is nothing to worry about since it is within the "natural range" of CTCs in healthy individuals. She is still on the COC protocol + Apigenin, Luteolin, Quercetin, Bromelain, Vit D, K2 and Vit C (oral + IV during Doxy cycle).
She is going to have breast surgery in December to remove the healthy breast. Our doc from the Care Oncology Clinic recommends to use Celecoxib (NSAID) starting 10 days prior to surgery 2x100mg daily for 6 weeks. I was rather thinking about ketorolac, but thanks to a study (DOI 10.1007/s13277-015-3322-5) that johan shared somewhere in this thread, celecoxib might be even better in combination with luteolin. Anyway, do you have any opinion on which NSAIDs might be most promising in her situation?
When she had the mastectomy last year, she was given some opioids. I stumbled across studies that indicate that opioids could be promoting cancer metastasis. One study showed that ketorolac was able to compensate that effect ( https://pubmed.ncbi.nlm.nih.gov/32243929/ ) in mice. Whereas in humans there was a finding that "Higher intraoperative opioid dose was associated with improved recurrence free survival (hazard ratio [HR] 0.93, 95% CI 0.88-0.99, per 10 morphine milligram equivalent [MME] increase)" https://www.uptodate.com/contents/anesthesia-and-cancer-recurrence#:~:text=Clinical%20studies%20of%20the%20effects,associated%20with%20negative%20oncologic%20outcomes
Would you take opioids during the hospital stay or rather avoid them?
Hi Chris, good to hear from you! Recurrence-free survival doesn't always improve overall survival. Here's an interesting review:
Opioid medications: an emerging cancer risk factor?
I agree with the recommendation to use celecoxib prior to the surgery, and it seems like a good combination with Luteolin which Bianca is already taking. And with Vitamin D:
Combined Treatment of Breast Cancer Cell Lines with Vitamin D and COX-2 Inhibitors
Results: The proliferation of MCF-7 and MDA-MB-231 was inhibited by both calcitriol and the COX-2 inhibitor celecoxib and even stronger by their combination. Moreover, calcitriol inhibited the COX-2 protein expression in MDA-MB-231, as well as the COX-2 mRNA expression in both cell lines.
Conclusion: The combination of calcitriol and celecoxib demonstrated a cooperative growth-inhibiting effect in breast cancer cell lines.
Protective effect of lycopene on celecoxib-induced hepatotoxicity
GRP78 is overexpressed in TNBC
Aspirin potentiates celecoxib-induced growth inhibition and apoptosis in human non-small cell lung cancer by targeting GRP78 activity
"Aspirin induced an endoplasmic reticulum stress response by inhibiting GRP78 activity. Furthermore, combination therapy (with celecoxib) also exhibited a better inhibitory effect on tumor growth in vivo."
@chris48 be aware that taking metformin (part of COC protocol) with Celecoxib may increase the risk of a rare but serious and potentially life-threatening condition known as lactic acidosis.
Thank you, I was not aware of that. Since she has none of the risk factors and the doctor recommends this combination I guess she should still use it, but we will watch out for any early symptoms of lactic acidosis.
GRP78 is overexpressed in TNBC
Aspirin potentiates celecoxib-induced growth inhibition and apoptosis in human non-small cell lung cancer by targeting GRP78 activity
"Aspirin induced an endoplasmic reticulum stress response by inhibiting GRP78 activity. Furthermore, combination therapy (with celecoxib) also exhibited a better inhibitory effect on tumor growth in vivo."
and btw, aspirin isn't a good combo with metformin
