Angiotensin Ⅱ Receptor Blockers - Advanced Prostate...

Advanced Prostate Cancer

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Angiotensin Ⅱ Receptor Blockers

pjoshea13 profile image
14 Replies

A new paper in the Japanese Journal of Cancer and Chemotherapy, below, [1].

"The use of anti-hypertensive drugs was reportedly associated with an increasing risk of Pca. However, as an effect of post diagnostic use of anti-hypertensive drugs, angiotensin Ⅱ receptor blockers(ARBs)was associated with improved overall survival and cause specific survival, which means the second chemoprevention potential for Pca.

{Note: ARBs are used to control hypertension. [2]}

"Our previous investigation demonstrated ARBs can suppress the expression of androgen receptor and affect the proliferative signal transduction system in Pca cells. Based on additional data of our experiment, we confirmed the anti-tumor effect of ARBs for Pca ..."

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/349...

Gan To Kagaku Ryoho

. 2021 Dec;48(12):1435-1439.

[Chemoprevention for Prostate Cancer-The Potential of Angiotensin Ⅱ Receptor Blocker]

[Article in Japanese]

Hiroji Uemura 1

Affiliations collapse

Affiliation

1 Dept. of Urology and Renal Transplantation, Yokohama City University Medical Center.

PMID: 34911906

Abstract

In Japan, the incidence of prostate cancer(Pca)has been increasing mainly due to the early detection system by PSA screening. Considering pharmacoepidemiology, the statins and metformin have been recognized to lower the risk of incidence of Pca. Excessive intake of calcium, multivitamin and vitamin E increased the Pca risk. The 5-alpha-reductase inhibitors( 5ARIs)are widely used in the treatment of benign prostatic hyperplasia(BPH)by biological function of inhibiting the conversion from testosterone to dihydrotestosterone. A systematic review and meta-analysis identified that 5ARIs had no impact on overall mortality and Pca-related mortality, nor on high-grade Pca diagnosis. The use of anti-hypertensive drugs was reportedly associated with an increasing risk of Pca. However, as an effect of post diagnostic use of anti-hypertensive drugs, angiotensin Ⅱ receptor blockers(ARBs)was associated with improved overall survival and cause specific survival, which means the second chemoprevention potential for Pca. Our previous investigation demonstrated ARBs can suppress the expression of androgen receptor and affect the proliferative signal transduction system in Pca cells. Based on additional data of our experiment, we confirmed the anti-tumor effect of ARBs for Pca, and further clinical trials to make sure the chemoprevention for pre-diagnostic Pca is needed in future.

***

[2] en.wikipedia.org/wiki/Angio...

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MateoBeach profile image
MateoBeach

Good one! Thanks, Patrick. Have been on an ARB for 20+ years. Perhaps another factor keeping my PC indolent.

A couple of years ago my BP started increasing enough for me to see a cardiologist. He wanted me to start a BP med. I researched and decided on Losartan (an ARB) for PCa therapeutic effects in addition to BP. Since then my BP has dropped and is around 125/75 without Losartan. I decided to continue using it because of cancer. It also helps me sleep at night :)

I suspect that the reason why my BP increased was that I started 400 mg/wk cypionate injections. I didn't think it would drop back down but perhaps my body adapted?...

Schwah profile image
Schwah

Thx for the post. But for us dummies can you help clarify ? I think this means that most drugs for high blood pressure were associated with worse PC. But one type of blood pressure medicine (ARBS) was actually associated with better outcomes. Can you explain which specific Type BP meds are supposedly helpful and which are supposedly bad. I’m on a couple of BP meds so this is important to me. Thx so much.

Schwah

pjoshea13 profile image
pjoshea13 in reply to Schwah

Some older studies associated ARBs with increased PCa risk. However, a recent meta-analysis, using only high-quality data found no association with cancer.

ARBs seem to come into their own after diagnosis. The new paper makes this look plausible, because of their effect on the androgen receptor.

Seems to me that an ARB might be a useful add-on to AR-axis treatments (Abi, Enza, etc.)

-Patrick

Graham49 profile image
Graham49

Thanks Patrick. I am on Valsartan. Do you know which ARBs were used in the Japanese study?

pjoshea13 profile image
pjoshea13 in reply to Graham49

I don't, but in an older (animal) study, he used "telmisartan or candesartan", with similar results.

en.wikipedia.org/wiki/Telmi...

en.wikipedia.org/wiki/Cande...

-Patrick

Graham49 profile image
Graham49 in reply to pjoshea13

Thanks Patrick

Canoehead profile image
Canoehead

Thanks, Patrick. Your stuff is always super informative. I don’t remember where I read it, but my recollection is that beta blockers are the blood pressure meds which have some positive benefits for PCa patients? Should I be looking at a different class of meds for my mild hypertension?

pjoshea13 profile image
pjoshea13 in reply to Canoehead

Seems that ARBs are the way to go.

In an old Canadian study, beta blockers had no effect on survival for any type of cancer.

More recently:

"... ITB {immortal time bias} led to spurious beneficial associations of beta-blocker use among cancer patients."

pubmed.ncbi.nlm.nih.gov/288...

-Patrick

Teufelshunde profile image
Teufelshunde in reply to Canoehead

I just googled "Beta blockers and prostate cancer" (I always use xxx and prostate cancer as my search) and most that comes up indicates a reduced risk of cancer specific death among users of beta blockers. This recent study is the only one that may indicate different, although it is hard for me to interpret this. I use a beta blocker and my heart doc wants to add an ACE inhibitor to really drive my BP down. Think it is time to get my Onc involved in this. journals.plos.org/plosone/a...

j-o-h-n profile image
j-o-h-n in reply to Teufelshunde

To RSP - greetings.

Please tell us your bio. Age? Location? When diagnosed? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?

All info is voluntary, but it helps us help you and helps us too. When you respond, copy and paste it in your home page for your use and for other members’ reference.

THANK YOU AND KEEP POSTING!!!

(From a Blue state prisoner released 23 times - bail never required)...

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 12/17/2021 10:12 PM EST

Teufelshunde profile image
Teufelshunde in reply to j-o-h-n

Will do. Thanks for the tip.

Teufelshunde profile image
Teufelshunde in reply to j-o-h-n

Took a while but here is info. I also posted it to my profile.

Diagnosed via biopsy 11/17. Original PSA was 5. Robotic RP at U of Chicago, Dr Zagaja, 3/18. Pathology results - Gleason score 3+4=7/10 (Grade group 2 – which is now a candidate for active surveillance); 11 lymph nodes all negative; Tumor volume (10%); Margins (all negative); seminal vesicles (negative for tumor).

PSA after surgery was <0.01 and stayed for one year, at which time I was given ok to start on T gel (3/19). History of low T -brain fog/lethargy/ etc. First PSA 6 months after start of T was 0.10 (9/19). Stopped T gel. Then 0.16 (12/19), 0.19 (03/20) which is when I talked to RO at U Chicago, Dr. Liauw, but due to Covid and upcoming hip revision due to infected prior hip replacement that had to be done first, we had to wait. PSA hit 0.21 (05/20), hip spacer (05/20), final hip (7/20). PSA 0.36 (09/20). Obviously doing nothing does not help, so I decided to do something. I ran across Joe Tippens story and I started on the FenBen, supplements, and pulsed in Artemisinin. PSA dropped to 0.30 (10/20) and has basically stayed there. I test every month. Dropped to 0.29 (4/21). Did one month of Bicalutamide 50mg before start of SRT and PSA dropped to 0.07 (late 4/21). Came off it once SRT started. Had also switched to a 90% plant-based diet about a month before SRT.

Concluded SRT mid-May 2021. No real issues from SRT other than does not get along with plant based high fiber diet so had to go bland diet while doing SRT. PSA one month after finishing SRT was 0.15 (7/21) and at six-month point was 0.06 (12/21). I have my follow up appointment with RO mid-January.

Goal is to keep PSA low. Using supplements that have clinical trials to back them up such as sulforaphane, MCP, flax hull legumes, pom juice, etc. If data on humans show slows PSA rise or reverses it, I am taking it as prophylaxis.

That is it. Thanks.

j-o-h-n profile image
j-o-h-n in reply to Teufelshunde

Thank you sir....... very thorough and good to add to your home page. This will help when other members ask you for info you can direct them to your home page. You look like you're on top of the situation so keep it up....Happy New Year to you!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 01/03/2022 5:03 PM EST

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