Non-steroidal anti-inflammatory drugs (NSAIDs) (COX-2 Inhibitors) have been available for many years and are primarily used for the treatment of arthritic conditions. They have for many arthritis suffers been an absolute gift from G-d. They provide their anti-inflammatory effect by inhibiting COX enzymes. There is accumulating evidence from animal models, epidemiologic studies and clinical trials, that suggests that NSAIDs may be useful in prevention or treatment of a variety of tumors including prostate cancer, colorectal, breast, lung, gastric, oesophageal, liver and head and neck.
A search of the literature to identify reports on the use of NSAIDs in the treatment of urological malignancies, including prostate tumors, will yield a number of studies. Analysis of prostate cancer tumor cells often show, an over expression of the COX-2 enzyme. The COX-2 enzyme clearly is a potential treatment target for prostate cancer.
In addition there have been a limited number of studies that demonstrate a significant decrease in PSA progression when a man takes a COX-2 Inhibitor. However, the impact of this PSA reduction on survival is yet unknown.
The use of COX-2 inhibitors for the treatment of advance prostate cancer shows promise. Additional research into the efficacy of this type of treatment needs to be done.
When I participated in the last Department of Defense Congressional Directed Research Program I was aware that there were proposals that intend to evaluate the use of COX-2 inhibitors in prostate cancer. Perhaps these drugs will eventually provide us with a new potential treatment modality.
Joel T Nowak MA, MSW