Review
Familiar drugs may prevent cancer
R A Sharmaa, A J Gescherb, K J O'Byrnea, W P Stewarda
a Oncology
Department, University of Leicester, Leicester Royal Infirmary,
Leicester LE1 5WW, UK, b MRC Toxicology Unit,
University of Leicester
Correspondence to: Dr Sharma ras20{at}le.ac.uk
Submitted 10 October
2000;
Accepted 15 February 2001
Despite positive results in large scale chemoprevention trials,
many physicians are unaware of the potential cancer preventive properties of drugs in common usage. The antioestrogen tamoxifen and
the selective cyclo-oxygenase-2 inhibitor celecoxib have been licensed
in the USA for the chemoprevention of breast and colorectal cancers
respectively in selected high risk individuals. Similarly, folate and
retinol have been shown to decrease the incidence of colorectal cancer
and squamous cell carcinoma of the skin respectively in large scale
intervention trials. Other retinoids have proved efficacious in the
tertiary chemoprevention of cancers of the breast and head/neck.
Epidemiological evidence also exists in favour of aspirin,
non-steroidal anti-inflammatory drugs, and angiotensin converting
enzyme inhibitors preventing certain cancers. Phytochemicals may
represent less toxic alternatives to these agents. Although some of
these drugs are available without prescription and most are not yet
licensed for use in cancer chemoprevention, physicians and students of
medicine should be aware of this accumulating evidence base.
Practitioners should be amenable to patient referral to discuss complex
issues such as risk estimation or potential benefit from intervention.
Keywords: cancer chemoprevention; tamoxifen; folate; retinoids; cyclo-oxygenase
© 2001 by The Fellowship of Postgraduate Medicine
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