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New Prevention Weapon for Those at Risk for Colon Cancer

WebMD Health News

June 28, 2000 -- There's good news for people with a rare inherited colon disease, reports TheNew England Journal of Medicine. The disease, called familial adenomatous polyposis, causes polyps in the colon that lead to cancer in nearly 100% of all cases. The report shows that the arthritis drug Celebrex reduces these polyps by 30%.

And for those who the drug could benefit, no wait is required. Celebrex received FDA approval for this use in December 1999. It was first approved for arthritis about a year earlier.

Polyps are masses of tissue that bulge out from the walls of the intestines, and since people with this disease begin to form these polyps at around 10 years of age, use of Celebrex may allow them to delay surgery until they are through their teen years.

Right now, the only cure for the disease is removing the colon through surgery. Without surgery, these patients will almost certainly go on to develop colon cancer. Although polyps are often removed one by one, the sheer number of polyps in this disease makes singular removal nearly impossible.

The study looked at nearly 80 patients with the disease and gave them the study drug at either a 100-mg or 400-mg dose, or they received a placebo (dummy pill). Those who received the 400-mg dose twice a day had the 30% reduction of polyps.

"We now have something we can feel reasonably good about using as an agent that will delay surgery," Patrick M. Lynch, MD, tells WebMD. This could enable these younger patients to undertake surgery when they are more emotionally ready for its consequences. Lynch, one of the researchers, is an associate professor of medicine in the department of gastrointestinal medical oncology and digestive disease at MD Anderson Cancer Center in Houston. The study also was conducted at St. Marks Hospital in London.

This 30% reduction of polyps also was seen with another arthritis drug, Clinoril, Lynch says. Clinoril and other drugs in its class, nonsteroidal anti-inflammatories, act similarly to Celebrex. However, they have some serious side effects, such as bleeding in the stomach and intestines. Celebrex does not appear to have these same side effects.

It is hoped, Lynch tells WebMD, that perhaps the number of polyps might be diminished either through Celebrex alone or in a combination therapy, and then surgery may help manage the disease without resorting to complete colon removal.

However, removing the colon, Raymond N. DuBois, MD, PhD, tells WebMD, is "still the gold standard and suggested therapy" for this disease. DuBois is director of cancer prevention at the Vanderbilt-Ingram Cancer Center in Nashville, Tenn.

The success of Celebrex at warding off colon cancer isn't surprising to some. Gideon Steinbach, MD, another MD Anderson researcher, told WebMD in an interview last year that drugs that are effective in familial adenomatous polyposis could be very useful for preventing sporadic colon cancer.

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