Metformin

I've seen Metformin mentioned here as an important tool to strengthening our bodies' fight against cancer. I looked up the studies, and the research is so promising, I'm surprised we haven't heard more about it!

I am on the verge of getting lung biopsies for what appears to be metastasis of serous endometrial cancer. I completed 6 rounds of carbo/taxil and 25 rounds of radiation in October, 2023. Since then, I've had Herceptin/trastuzumab infusions every 3 weeks. Once they analyze the nodules in my lungs, it is expected my next step would be to repeat chemo. (Ugh.)

I wrote to my oncologist and said I'd read studies about Metformin's effectiveness in cancers like mine. I'm not diabetic, but I would be glad to try Metformin. The answer was basically, 'Sure there's research but Metformin is not approved for cancer, and since you're not diabetic we'd have to worry about your blood sugar. Sorry.'

It seems to me it's easier to treat low blood sugar and regulate Metformin dosage, than to go through chemo again, no?

What if I WANT to try Metformin before going back to chemo, get the next set of CT-Scans, and THEN re-evaluate? Do I have that right?

Thanks for any advice.

Comments

  • oldbeauty
    oldbeauty Member Posts: 381 Member

    Hi MDale,

    Longtime survivor here, but with a more conventional diagnosis (multiple recurrences of dx Grade 2 endometrioid type). I have great respect for Takingcontrol58, her journey and her knowledge. She joins several women here who have made it a life mission to develop an expertise in Tx options for this disease. After my 2d recurrence, I, too, wanted to get on Metformin despite no Dx of diabetes. My former onc declined my request. You may have to "shop areound," as I did before finding a sympathetic ear/open mind. One of my docdocs referred me to a colleague who studied my case, and decided they could, in good faith, dx me with a "metabolic disorder." That opened the door to a Rx for Metformin. I stayed on a daily dose of 2,000 mg from 2018 to 2023. I gave it up reluctantly. I do believe, and my current onc does not disagree, that it contributed to prolonging my time between recurrences. It did not "cure" me as it seems to have done for TC (plus she is far more rigorous in her health regimen), but I wanted to continue on it. I stopped only after my Dx and Tx for colon cancer after which1 I titrated the dosage down and then back up again to confirm it was the Metformin (and not the CRC) that gave me the daily explosive diarrhea. After my successful CRC treatment, my DH was Dx'd with a progressive neuromuscular disease. We now live on a faster timetable, and the diarrhea was a definite lifestyle downer, so I elected to give it up. Perhaps a naturopath can assist you, or press your PCP if you have a good relationship. I agree with you. If it's unlikely to hurt you, and it may help you, why should you not have it if you want it? I had an endocrinologist once who was from Eastern Europe and they said, fascetiously, that it was a wonder drug and should be in the water supply!

    Good luck and best wishes, Oldbeauty

  • Forherself
    Forherself Member Posts: 1,034 Member

    I have taken Metformin 1000mg per day since I was diagnosed with serous endometrial intraepithelial carcinoma. That was almost 7 years ago, will be in July. I was started on it for elevated Blood sugar. I got my blood sugar down and my family doctor said I could go off it if I wanted to. I did get bad diarrhea from it when I first started it. I discovered that if I only drank two cups of coffee a day it went away. I loved my coffee. So, I told my doctor that I had read studies showing recurrence was less in people who were on Metformin so I would like to stay on it. The next time I saw her she said thank you, she had read the studies too, and was glad to keep me on Metformin. The purpose of my story is to encourage you to ask your family doctor for an RX. If you are overweight it helps lose weight. They often prescribe it for women who have polycystic ovaries and it doesn't upset their blood sugar. Cancer loves sugar and it lowers the sugar available to cancer cells. Good luck. And prayers to stop any more cancer!

  • takingcontrol58
    takingcontrol58 Member Posts: 279 Member

    MDale,

    Yes, you have the right to try metformin before getting any more chemo. You do not have to get more chemo- You’ve already had chemo, radiation and Herceptin. You may already be chemo resistant. Wait until you get the CT scan results. If the nodules are tiny, it may not make sense to take “an anvil to an ant.” I refused Avastin and Everolimus and tried metformin instead (since it targeted what these drugs target) and it shut down my cancer in 30 days. I learned about what the drug does through my own research. I stopped chemo with 2cm of tumors remaining and they were gone about 2 ½ months later. I always recommend trying a less dangerous treatment first. You can always get the cancer drugs if you choose.

    If your oncologist thinks metformin only treats diabetes, he/she doesn’t read the medical journals. Or maybe they are worried about being sued. You could write a document that says your oncologist will not be responsible for any effects you might have on the drug (and sign it). That is an option. They can poison you will too many cancer drugs and you can’t sue them but if they recommend a non-cancer drug, they are worried about being sued. I thought they are doctors and know what is OK for their patients. The best option would be to see a good internist who will work with you to address all your health issues. Oncologists won’t do that- they are trained to dispense cancer drugs.

    If they do a biopsy of your lung nodules, I would suggest you ask the oncologist to send a specimen to Foundation Medicine for comprehensive genomic testing -they are one of the best. Genes control cellular processes in the body and once you know the genes that are mutated, you can identify the cellular pathways in your body that are malfunctioning. Then you can identify the proper treatment for your situation.

    I started posting in Jan 2016, and I posted many summaries of metformin and cancer. That drug stopped my cancer in its tracks because it was a targeted treatment for me. A targeted treatment doesn’t have to be a cancer drug. But you have to know what to target. Metformin doesn’t treat cancer, it treats many of the underlying risks that can cause cancer to develop. Cancer is a symptom of all the toxins in your body- they can be biological, chemical, emotional. Viruses, metals, vitamin and mineral deficiencies are also big drivers of cancer.

    If you want to learn about metformin and cancer, go to www.pubmed.gov (the website of the National Institute of Health) and search metformin and cancer. There are 8000 articles posted. They absolutely know all that metformin does- the researchers themselves take the drug. It is also known to have anti-aging benefits so you see many of the elites who are trying to extend their life take the drug. It is referred to as a magical drug in the medical journals.

    Below is a summary of a few of the key benefits of metformin. Metformin controls metabolism and metabolism is the engine that runs our body- if the engine is malfunctioning, you have issues.

    1Lowers glucose

    2)Lowers serum insulin (hormone that is a key driver of cancer -works with glucose- get your insulin tested)

    3)Lowers Insulin Growth Factor Hormone – 1 (IGF-1) a growth hormone that drives cancer- get this tested

    4)If you are pre-diabetic (glucose between 100-125 or A1c 5.7-6.4), it can prevent you from becoming diabetic (doctors wait until you turn diabetic) – what is your A1c

    5)Treats insulin resistance—your body doesn’t utilize insulin properly

    6)Treats PCOS -Poly cystic ovary disease (which is caused by insulin resistant)

    7)Inactivates the PI3K/Akt/Mtor (Pick) pathway) – this pathway controls our metabolism- when it is activated cells grow out of control- mutated in 90% of endometrial cancers

    8)Targets cancer stem cells- the cells that initiate cancer metastasis

    9)Targets angiogenesis – targets the growth of blood vessels that feed cancer cells so they turn into tumors (Avastin and Lenvima are used to target this process)

    10) Helps restore function of the TP53 gene- this gene is frequently mutated in serous endometrial cancer

    11)Lowers estrogen

    12)Metformin is known to help with Herceptin resistance, which is common

    13)Stops the cell cycle between the G1 and S phase (there are 4 phases), to trigger cell cycle arrest

    14)Targets the mitochondria, the powerhouse of our cells that make ATP, the energy that runs our bodies

    15)Lowers glucose production in the liver (liver is a key site of metastasis- IGF-1 is also stored in the liver)

    16)Targets the inflammation pathway (Nf-kb)- inflammation is a key driver of cancer

    17)Helps you lose weight- fat cells are hormone making factories

    18)Promotes autophagy of cancer cells (cellular housekeeping)- you have to clear out the old and damaged cells- it’s like a pac-man for cells

    19)If you take metformin, be sure to get the extended-release formula so you don’t suffer an upset stomach or diarrhea

    20)To take metformin, your eGFR (kidney function on the comprehensive metabolic panel) should be over 60- metformin is processed through the kidneys

    21)Metformin prevents the body from absorbing Vitamin B12- you would need to test your B12 levels on a regular basis and supplement to maintain adequate levels

    Here is a link to a more recent article that shows many of the health issues that metformin helps-it reviews some of the items I mentioned, but there are so many other things metformin does in the body I can’t list them all here.Metformin for Cardiovascular Protection, Inflammatory Bowel Disease, Osteoporosis, Periodontitis, Polycystic Ovarian Syndrome, Neurodegeneration, Cancer, Inflammation and Senescence: What Is Next? - PubMed (nih.gov)

    Many of the long termers on this site use metformin. That should tell you something. Some medical articles state that if you use metformin, you won’t die from cancer. It will not help everyone, but it is a tool in the tool box, and if you have any of the issues that metformin targets, it just might help save your life.

    Takingcontrol58

  • Mercorby
    Mercorby Member Posts: 131 Member

    Hi MDALE,

    I am on Metformin, Anastrozole, and Everolimus. Before Everolimus, I was on Ibrance, but Ibrance got toxic so I was off more than on. With Everolimus, I have caught all the winter bugs, so it's almost the same thing - off more than on. I strongly believe that Metformin with Anastrozole is holding back the cancer now and the last time. When I wasn't taking it, I got a recurrence.

    The retrospective of the studies have been inconclusive. However, I am going to the SGO/FWC conference in Seattle. At least one researcher is reporting on adding Metformin to a cdk 4/6 inhibitor and letrozole. I'll report back here about any studies that are presented that include Metformin.

    BTW, you can attend the conference virtually, if you can't come to Seattle. https://www.sgo.org/events/annual-meeting/

  • MDaleMaryland
    MDaleMaryland Member Posts: 16 Member

    Thank you so much, old beauty. I am on a steep learning curve! It is difficult for me to shop around for doctors, because I'm locked into an HMO and 'Medicare Part C. '

    Your words of wisdom have helped me very much! All my best to you and yours! ❤️

  • MDaleMaryland
    MDaleMaryland Member Posts: 16 Member

    Hi, Forherself! Thank you. Unfortunately, I am not overweight, and actually have a history of being underweight, which doesn't help in this circumstance. My husband has type-2 diabetes, and I wonder if I couldn't use his testing kit just to check out what's going on? I wish I understood what might have caused this cancer or what I could do - besides poisoning my entire body - to make it stop growing. Thanks again, and my best to you, too! ❤️

  • MDaleMaryland
    MDaleMaryland Member Posts: 16 Member

    Hello, takingcontrol58!!

    Thank you for all the information! I must confess that I don't understand all of it, but I can agree that underlying imbalances and weaknesses in our bodies give cancer cells opportunity to grow.

    I have always been on the opposite end of the glucose issue - hyPOglycemic. This definitely runs in my family. (My Mom, her brother, some of my sisters and I carry food in our purses and cars in case we get faint. We all tend toward the 'skinny' side.) I'm told hypoglycemia isn't treated in the U.S., but apparently my body grabs too fast at any easily-available, refined sugar and metabolizes it wrongly, sending out too much insulin -? Once I ate "Quaker oat squares" for breakfast and went to the grocery store, then ended up having to call my husband and daughter to come get me because I was blacking out. Like that.

    It's been better in the past 15 years, partly because I am cautious not to eat straight-up carbs at any point (I have to have protein and fat with it, and no overdose of caffeine!), and maybe because of menopause? I don't know. But yes, it is definitely something to do with insulin!!

    There was something in the initial analysis of my cancer about the P53 mutation, but since then doctors have dismissed that. "It's only the tumor, not your heredity in general," or something. (??)

    I really wish I understood all of this better!!

  • MDaleMaryland
    MDaleMaryland Member Posts: 16 Member

    Hi Mercorby! I don't even know what most of those are. How do you wise women learn all this, and which comes first: doctors who will prescribe, or your search for doctors who will prescribe?!? HMOs are by-the-book, and it's a short book.

    I am seriously WAY behind the rest of you, and I'm lost on the science, but I will take a look at the conference - at least virtually. (The last time I went to Seattle was decades ago, but I loved it!) ❤️

  • takingcontrol58
    takingcontrol58 Member Posts: 279 Member

    Mercorby,

    Metformin has also been shown to inhibit CDK4 and CDK6 on its own.

    Takingcontrol58

  • takingcontrol58
    takingcontrol58 Member Posts: 279 Member

    MDale,

    Based on what you posted, it appears you do have some type of metabolic dysfunction. It is the thyroid that controls metabolism, so you might want to see an endocrinologist who can run al the proper thyroid blood tests.

    Endocrinologists also prescribe metformin.

    Regarding your TP53 mutation, it is mutated in about 50% of all cancers. It is an extremely important tumor suppressor gene and is called the Guardian of the Genome. Your doctor probably blew you off because there are no cancer drugs that target this common mutation. But metformin does. It might help you restore your mutated gene back to its correct function. That alone could be the reason to try it.

    Takingcontrol58

  • MDaleMaryland
    MDaleMaryland Member Posts: 16 Member

    This makes perfect sense. With my HMO, I have to justify every request for every referral but I'll see what I can get! My '2nd opinion' oncologist will be back in a few days and this will give me a lot to go on.

    Thank you so much again!

  • MDaleMaryland
    MDaleMaryland Member Posts: 16 Member

    My oncologist said "No" to Metformin, again. I've been doing more research, ordered books, and do believe this is metabolic and has to do with insulin in the converse of diabetes. My problem has always seemed to be that my blood sugar would spike very high all at once — too much insulin — then crash, requiring more sugar. It's been a long struggle to keep it level.

    I've always eaten carbs and vegetables but have to force myself to eat protein (and I haven't eaten meat since I was 17). What I am reading is that I need to try a low-carb, moderate-protein, high-fat diet? That is so opposite what I'm used to! But I'll try it.

    The other thing I've read today is about Berberine, which lowers blood sugar as Metformin does. Does anyone here have experience with this or similar herbal/natural supplements? I ordered something from Amazon.

    Meanwhile, lung biopsy in 2.5 weeks for the metastasis.

  • Mercorby
    Mercorby Member Posts: 131 Member

    The problem was that I was off the cdk 4/6 inhibitor too long. Anastrozole let the cancer return. There will be a speaker about the combo at the conference. I'll report back afterwards. Anyway, not on a cdk 4/6 inhibitor anymore. Everolimus works with metformin and anastrozole.

  • MDaleMaryland
    MDaleMaryland Member Posts: 16 Member

    Mercorby, Please ask around (or maybe you already know!) about Berberine as a 'substitute' for Metformin?

    Meanwhile, I did yet a little more research about hypoglycemia and it is true — similar dysfunction as diabetes! The pancreas apparently doesn't gauge how much insulin to release. But in hypoglycemia, there was never an insulin test. Just, "No diabetes, so you're fine, honey."

  • takingcontrol58
    takingcontrol58 Member Posts: 279 Member

    MDale,

    Many people use Berberine instead of metformin. It is well known for lowering glucose. Some people take both.
    Below is a good article to read for some background- I don't know if berberine targets all the cancer causing processes that metformin targets, that I mentioned in my summary above-or targets the TP53 mutation that you have. Metformin has been studied for many decades- and the medical journals confirm all the things it does. It also targets many of the cellular processes involved in cancer formation like cancer stem cells, inflammation, angiogenesis, autophagy. I don't know if berberine also targets these processes. I've never used berberine, but have been on metformin now for ten years, and have remained cancer-free.

    This site is great for looking up supplements- Dr. Axe is a well know integrative doctor.
    Berberine Benefits, Supplement Dosage and Side Effects - Dr. Axe (draxe.com)

    Takingcontrol58

  • MDaleMaryland
    MDaleMaryland Member Posts: 16 Member

    Mercorby - I just looked at the link to the conference again! It looks fabulous and I envy you for being able to go. I hope you learn a lot and can share it all here.

    At the same time, I wish the Registration Options included "Patient, Unemployed, on Medicare and Social Security."

    And I wish there were sessions like:

    "Can You Hear Me Now? Rare cancers matter!" (An exploration of the cancers often underfunded, under researched, and overlooked in the scientific community.)

    "Why Do We Have DIY Cancer Care?" (An examination of patients' need to research their own illnesses, pertinent scientific studies, and potential means for survival.)

    "Impertinent Patients!" (A support-group among doctors about managing those patients who ask for alternate therapies - ones less poisonous than chemo and radiation, but outside of the protocols!)

    "We Don't Have That Here." (A theatrical recitation for staff who need to tell patients repeatedly that care - including needed surgery, radiation, massage therapy, chat therapy, and means of keeping their hair during chemo - are not available at their center. "Sorry!")

  • oldbeauty
    oldbeauty Member Posts: 381 Member

    MDale, my naturopathic doctor recommended that to me as an alternative. I am travelling for the next few weeks so I don't have the formulation handy. They had me take it with something else which escapes me right now. One or the other, or together, also gave me diarrhea (which they warned me about) and I stopped taking it while I was on a trip last October. I've been stressing since the election, and have not connected with them to sort through this but I intend to when I return home in April. Can you find a naturopath in your area and get a referral to satisfy your HMO plan to discuss? Best wishes.