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[Prevention of carcinogenesis in familial tumors]

Hideki Ishikawa1

  • 1Dept. of Molecular-Targeting Cancer Prevention, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Osaka, Japan.

Gan to Kagaku Ryoho. Cancer & Chemotherapy
|July 28, 2005
PubMed

Insights

Preventing familial colorectal cancer (CRC) is challenging. While non-steroidal anti-inflammatory drugs (NSAIDs) like sulindac show polyp reduction, side effects limit use. Newer COX-2 inhibitors and dietary components are under investigation for safer, effective familial CRC prevention.

Area of Science:

  • Oncology
  • Gastroenterology
  • Pharmacology

Context:

  • Familial colorectal cancer (CRC) encompasses hereditary conditions like familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC).
  • Effective cancer prevention strategies for hereditary CRC syndromes are crucial due to increased cancer risk.
  • Current prevention research focuses on pharmacological and dietary interventions.

Purpose:

  • To review the current state of the art in cancer prevention for familial colorectal cancer.
  • To evaluate the efficacy and safety of interventions, including non-steroidal anti-inflammatory drugs (NSAIDs) and dietary components.
  • To identify promising future directions in familial CRC prevention.

Summary:

  • Sulindac, a non-steroidal anti-inflammatory drug (NSAID), has been extensively studied for familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC), demonstrating a reduction in polyp size and number.
  • Despite efficacy, sulindac's clinical use is restricted by significant gastrointestinal side effects and instances of aggressive tumor development.
  • Selective COX-2 inhibitors show promise for reduced gastrointestinal toxicity.
  • Vitamins and dietary components have been explored, exhibiting minimal side effects but insufficient efficacy, necessitating further research.

Impact:

  • Identifies limitations of current NSAID-based strategies for familial colorectal cancer prevention.
  • Highlights the potential of selective COX-2 inhibitors as a safer alternative.
  • Underscores the need for continued research into dietary interventions for improved efficacy and safety in hereditary cancer syndromes.

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