Metformin all on one page

1. Why you are taking it?  Chemo caused my A1c to go to 8.5.  Even though I have been diagnosed with T2 diabetes for over 10 years because when I get up in the morning after fasting for a long period of time, my BG (blood glucose) is over 130, my A1c prior to chemo had never been over 6.

2. Strength of dosage?  1000 mg per day of extented release.

3. How many times a day?  One time per day in the morning with food.

4. Results of taking it?  A1c returned to normal but that could be because I quit chemo.  

5. Any additional info you can help me with?  I have no side effects.  I have IBS and I'm sure it doesn't help with that but I haven't noticed the IBS is any worse with taking it.  I think Metformin has very few side effects overall.  I am going to ask my GP to up my dosage to 1500 mg per day when I see her in November.  I don't think it can hurt and everything I read about it, says it looks promising in controlling the uterine cancer from finding itself a new home someplace else in my body.  She told me I can take up to 2000 mg per day to control my BG.  If that doesn't control it, then they usually start insulin.

Love,

Eldri

Jerri,
Based on what you are dealing with, I would recommend you read my story at "NED from Stage IV
Endometrial Cancer" posted Jan 10, 2016. Metformin saved my life.

1) Why are you taking it?  Diagnosed with Stage3B, Grade 3 endometriod adenocarcinoma Nov 2014.
Two months later, before treatment, progressed to Stage IV with mets to my liver, spleen, outer rectum,
nodules on my lungs, kidneys, spleen and outer rectum. Entered a trial at Sloan Kettering that added
metformin or placebo to the Taxol/Carbo. After 2 chemo infusions, met with my integrative oncologist
who put me on the real drug because I was insulin resistant (pre-diabetic). Removed myself from the trial.
Couldn't risk not getting this drug. Trial ends in 2019 (and they predicted I had 4-6 mos to live).

6 months later, I was in complete remission - 34cm of tumors vanished. Have been NED since Aug 2015.No
new cancer since the day I started metformin.

 2) Dosage- 1000mg/day initially. Extended Release version. Changed to 1500mg/day when I finished 6 chemos, since
I still had 2cm of tumors left. No radiation.

3) Take 750mg in AM/750mg in PM - have been on this dosage since June 2015.

The dosage in the trial I was in was 1700mg/day- 850mg in AM & PM
I think you need at least 1000mg/ day to be effective if you have mets.

4) Have never suffered side effects.  Doctors are denying patients a drug that is well known for its
many anti-cancer effects, and is particularly effective for endometrial cancer.  When you have
advanced or metastatic cancer, they have no right to deny you a potentially life saving treatment.
It is well known that there is no effective treatment for metastatic endometrial cancer with current
cancer treatments.  You have to treat the root causes of your cancer. If you are pre-diabetic or
diabetic, you definitely should be on this drug.

I will send you a document that I put together that lists all the processes that metformin addresses
that are involved in the creation and metastasis of cancer.  You can bring that to your doctor.  My
own doctor hands this list out to all his patients.

Don't worry about the fact that metformin is prescribed off-label for cancer.  Almost every chemotherapy
drug is prescribed off-label, which most people are not aware of. Yet they have no problems prescribing
chemotherapy which can kill you but talk about the side effects of metformin, which they are minor compared
to the chemo, and the drug has been around for over 50 years. Over 150million people in the world take this drug.
The highest my blood sugar has even been is 118- it has remained around 90 since I have been on metformin.

Takingcontrol58

Shcolwell said:

Metformin for uterine cancer

Hello!  I am looking for the document that you put together that lists the processes that metformin addresses with cancer--am looking to add it to a chemo regimen to slow progresseion of recurrent uterine cancer, and need to provide information for my doctor--anything you can help with would be wonderful!  Thank you--Karen Carr

Karen, I'm up to 2000 mg per day - 1000 in the morning; 1000 in the evening.  I have shown no evidence of disease since my hysterectomy on 9-30-15.  I was only able to tolerate three chemos (Carboplatin and Taxotere).  I have bery little side effects from the Metformin, if any.  I see my oncologist's PA on the 28th of this month and hopefully will remain NED.

Good luck!!!

Love,

Eldri

My mom just recently finished with her cancer treatment. Her BS levels are normal and she is not diabetic. How would I convince her doctor to give her a prescription of metformin at this point?

Thanks,
Rebecca

Try just asking politely. To my surprise, it worked!

I didn't think I could get it, either, but after my PCP warned me of potential side effects (such as gatrointestinal upsets), she agreed to the beginner's dose (500 mg), once a day. We both agreed that would be sufficient until I get my tumor analzyed. Metformin may not the the ticket in my case, though it works well for many women with UC (I haven't even HAD my hysterectomy yet). I had some borderline issues with A1C in the past (pre-diabetic), though I hadn't at the time I got the Metformin (it was at least a year ago), so my PCP could use that as a reason to prescribe it (albeit a little iffy). I didn't have much trouble getting it, as long as I stuck to 500 mg for now. Better that than nothing.

Other than Metformin causing me to reduce my laxatives (I don't take those at all now, except before a chemo treatment, and I probably will before surgery) and stool softeners during chemo (BOY, did that combo hit me!), I see no ill effects. I eat normally, though I have cut down on sugar and am eating more healthily. Eating better is a good idea anyway, cancer or no. Like others wrote, I take the Metformin on a full stomach.

I just let my endo know about it. (I have thyroid issues.) If it turns out that she is opposed to it, or that Metformin will not work with my mutations, I will not take it anymore. This dose is the "training wheels" dose. I just started a couple of weeks ago. If it turns out that upping it is a better idea, that is what I will do.

Shcolwell said:

Metformin list

Hi there--am so sorry it has been months--but its been a bit of a rollercoaster with various hospital stays, etc--but I am back pushing for metformin to be added to Karen's carbo/taxol treated recurrence--this is her 8th protocol, and can't get her local onc to try something without fda approval.  Anyway--my email is 2minnies@sbcglobal.net and I thank you very much!!!  Suzanne

Shcolwell,

I would make the following suggestions:

1) Like Evolo says, you can ask your oncologist nicely, but it sounds like he/she won't budge
on prescribing metformin.

2)It is a well known fact that most FDA approved drugs are prescribed off-label.  As long as 
a drug is FDA approved, it can be prescribed for any reason that a doctor feels necessary.
Metformin was FDA approved in 1995. Look at Viagra. It was originally developed for heart
disease, but we all known that it is prescribed today for something totally different. Just because
oncologists won't acknowledge metformin has been proven to work on many cancers doesn't
mean that is doesn't.  There are over 100 trials on metformin and different cancers.

2) You can remind your doctor that most chemo drugs are not FDA for most types of cancer.
The chemo we receive for endometrial cancer was originally FDA approved for ovarian and
breast cancer.  Plus the FDA does not FDA approve combinations of all chemos- yet oncologists
have no problem prescribing different chemotherapies when Taxol/Carbo don't work.  
Many women on this site are taking Avastin- it is not FDA approved for endometrial cancer and
was pulled off the market in 2010 for breast cancer patients.  Yet the oncologists have no
problem prescribing it "off-label." Yet it has some verry serious side effects. It is hypocritical
to prescribe Avastin yet refuse to prescribe metformin.  I'm surprised Avastin hasn't been
prescribed for Karen.

3) You might want to ask your primary care physician or an endocrinologist (if you see one).  Or
you could meet with a naturopath or integrative oncologist.  I get my metformin from my 
gynecological oncologist/surgeon. You could also speak with your gynecologist.

4)  I was never diabetic when I was put on metformin- I was pre-diabetic (glucose between 100-125).
You could do the following blood tests: serum insulin, insulin growth factor-1, glucose, A1C- if any
of these markers are raised, metformin will help regulate them.  I was high on all fronts. Plus being
on metformin can help prevent you from becoming diabetic, which has some serious problems associated
with it. If you are considered insulin resistant or have metabolic syndrome, you also qualify for the drug.
The reason the drug is approved for PCOS is  tied to what causes PCOS- insulin resistance. And insulin
resistance is a key driver of endometrial cancer. This is why I was put on the drug.

5) Did you ever have genomic testing done on Karen's tumor?  Many women  on this site have mutations that
metformin is known to target. If she has some of those mutations, metformin could be of great benefit.

6) You might also tell the doctor that Karen will sign a document removing the doctor from any liability if
he prescribes the metformin.  I don't think a doctor can refuse to prescribe an FDA approved drug like
metformin for Karen when the chemo is not working.It is so sad that a doctor will refuse to prescribe a
well tolerated drug when a person now has had a recurrence- which means the chemo did not work-
and getting more chemo may not work if Karen is now chemo resistant, which is what typically happens.
And the chemo will continue to destroy her immune system which she needs to fight her cancer.

7) Last suggestion is to find another oncologist who will prescribe the drug. Many of them do.
Don't take no for an answer.  It is her life and she has the right to get this drug. Metformin
is considered one of the most 100 essential drugs in the world- because it is safe, it works and
it is low cost. Over 120million people use this drug.  Why would it be refused to a cancer 
patient who is having a recurrence. There is no logical explanation unless she has liver or 
kidney issues, which might prevent her from using the drug. But to simply refuse it is unacceptable.
There is no harm in trying the drug.

Doctors precribe opioids everyday when they are unnecessary for most people- it is why we have
an epidemic in this country.  Yet Karen't doctor is refusing to prescribe a drug that might help her.
A drug that has proven benefits in cancer treatment.

Takingcontrol58

I was on metfomin years ago when I was first diagnosed with diabetes. I started with 500mg 3x a day, then my doctor doubled it. At that point, I got explosive diarrhea so I refused to take it anymore. (I have been on insulin almost since then as no oral meds worked) I swore never again, but I understand those who would put up with the side effects if it is keeping your cancer at bay.