Capsules St. George's Hospital Trial
Fatty Acids and FAP
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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