The FAP Gene Support Group

(Familial Adenomatous Polyposis)

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Omega-3 Fatty Acids and FAP

Development of treatments to prevent growth of polyps

The lining (mucosa) of the wall of the large bowel undergoes a continuous state of renewal, with new cells being formed and old cells removed in a balanced manner.

When the rate of formation of new cells exceeds the rate of removal of the old ones, small outgrowths or polyps can occur. Since, potentially, these can develop into cancer, it is important to remove them or prevent them from developing.

Efforts are being made to find ways of restoring the balance between the processes of cell formation and removal to help prevent: the development of polyps. It was found that some of the new, more selective types of aspirin-like drugs, the COX-2 inhibitors, have this effect. Clinical trials with the COX-2 inhibitor, Celebrex (celecoxib) showed that the number of polyps was reduced in FAP patients following treatment for six months. These results subsequently led to approval by regulatory authorities for the product to be marketed for this indication. Unfortunately, it was discovered that there was an increased incidence of heart problems in patients taking the product on a regular basis and so there are concerns over its long-term safety.

It has been known for some years that people who have a high proportion of fish (especially oily fish) in their diet are less likely to suffer from bowel cancer. This has been attributed to the presence of high concentrations of omega-3 fatty acids in fish. One of these fatty acids. eicosapentaenoic acid (EPA), is d particular interest in relation to bowel cancer.

In a study at St. George's Hospital, London, in patients with sporadic polyps (i.e. occasional. non-FAP), It was shown that taking a special, highly concentrated, pure form of EPA on a daily basis helped to restore the balance between cell formation and removal. This suggests that, like the COX-2 inhibitors, it has the potential to reduce the formation of polyps, but with minimal side effects.

A study is now in progress at St Mark's Hospital in Harrow to determine whether taking this special formulation of EPA for 6 months reduces the number and size of polyps in the rectum of FAP patients with ileo-rectal anastomosis. The study is being conducted by Dr Nick West in the Polyposis Registry at St Mark's.

Anyone interested in finding out about the study is welcome to contact Dr West or Specialist Nurse, Jo Rawlings" on 020 8235 4263 for more information.

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