As a person who has an arthritic condition I can tell you that when the cox-2 inhibitors first came on the market I thought they were a magical gift. Instead of always being in some level of discomfort or pain I found that most of the time I was pain free. The acute episodes that I experienced three to four times a year all but disappeared.
Then came the news that the cox-2 drugs caused coronary issues and doctors were warned to use them with great caution. At my last visit with my rheumatologist directed me to cut back by half my consumption of cox-2 inhibitors. With great trepidation I followed his directions and now I must deal with low levels of constant discomfort. It is manageable, but not pleasant.
However, the vale of the cox-2 inhibitors seem to be ever increasing. According to a recent online article published October 30, 207 in the British Journal of cancer, there might be a new use for the cox-2 inhibitors, in the treatment of cancer.
As prostate cancer patients we move into end stage disease there is often severe pain. Morphine and its related opioids are used as the main therapy for the treatment of pain.
However, chronic morphine treatment stimulates angiogenesis and tumor growth in mice. It also increased the morbidity rate in the mice. When coupled with cox-2 inhibitors the morphine not only provided better analgesic effects (better pain control), but also decreased the morbidity rate as welll as decreasing tumor growth rate.
Of course this study was confined to mice and we might not see similar result in humans. One would go on to suggest that this information warrants additional study including clinical trials. In reality, I don’t see the drug companies investing in this, so again we will need to fly by the seat of our pants.
Personally, I will ask my doctor to add cox-2 inhibitors to my drug regime to control pain and hopefully decrease tumor load. It will also help my arthritis. At that time I am not going to worry about my heart, what will be will be.
Joel T Nowak MA, MSW
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