The Not So New Super Drug
Written by Jacob Gomez
Edited by Kelly Chau
May 2, 2021
Edited by Kelly Chau
May 2, 2021
Diabetes is a health disorder caused by an inability to maintain healthy blood sugar levels, and, according to the Centers for Disease Control and Prevention (CDC), 34.2 million Americans are diabetic, with an additional 88 million at high risk of developing diabetes (CDC, 2020). In order to help patients improve their lifestyles, doctors typically prescribe anti-diabetic medications like metformin. Metformin works by suppressing the release of sugars from the liver, resulting in a decrease in glucose levels in the body. However, as more studies have been conducted, it appears that metformin does have other beneficial functions such as preventing different cancers through a variety of possible mechanisms.
In one systematic review of 5 studies with 105,495 diabetic patients in total, those prescribed with metformin had a 62% reduction in developing liver cancer (Zhang et al., 2012). Similarly, the drug appears to have a correlation with reducing the risk of colon cancer as well. From data collected in a study spanning 15 years in Northern California, diabetic patients who took metformin for more than 5 years had a smaller likelihood of developing colon cancer (Bradley et al., 2018). Surprisingly enough, metformin also demonstrates potential anti-cancer effects for those at risk of breast cancer. During a study conducted with Taiwanese females, the incidence of breast cancer decreased by more than half in those prescribed with metformin. Results indicated that 535.88 new cases of breast cancer per 100,000 people per year occurred in the sample group not prescribed metformin, whereas only 201.8 new cases of breast cancer per 100,000 people per year occurred in the metformin group (Tseng, 2014).
In spite of some studies indicating that metformin does not have any significant effects on cancer development, the leading theory as to how metformin can decrease the process is that, as the drug reduces the release of sugar stored in the liver, it also limits a cancer cell’s ability to replicate. Rapid duplication of cells requires energy in the form of a molecule called adenosine triphosphate or ATP. In order to produce ATP molecules, cells undergo a process called oxidative phosphorylation, which requires sugar molecules. Because metformin lowers the body’s sugar levels, the drug also inhibits the division and activation of cancer cells (Li et al., 2019). Another theory states that metformin can suppress cancer growth by increasing cell death. To do so, metformin stops the activity of survivin, a protein responsible for keeping a cell alive. Without survivin present, cancer cells are more likely to die without replicating and attacking other cells (Hsieh et al., 2018).
Although popularly known as an anti-diabetic drug, metformin has shown remarkable capabilities as a possible preventative treatment against cancer. Given metformin’s widespread approval and availability, it fortunately has the most potential to be mass manufactured and prescribed. Before this can happen, further research needs to be done to validate the results of the studies conducted thus far; however, it is not unreasonable to believe that future experiments will generate similar results. If metformin eventually becomes approved as an anti-cancer medication, it would not be surprising to someday consider metformin an actual super drug.
Works Cited
Bradley, M. C., Ferrara , A., Achacoso, N., Ehrlich, S. F., Quesenberry , C. P., & Habel, L. A. (2018). A Cohort Study of Metformin and Colorectal Cancer Risk among Patients with Diabetes Mellitus. Cancer Epidemiology, Biomarkers, & Prevention, 27(5). https://doi.org/10.1158/1055-9965.EPI-17-0424
Centers for Disease Control and Prevention. (2020, February 11). National Diabetes Statistics Report, 2020. https://www.cdc.gov/diabetes/library/features/diabetes-stat-report.html#:~:te xt=New%20in%202020%2C%20the%20report,1%20in%203%E2%80%94have%20prediabetes.
Hsieh Li, S. M., Liu, S. T., Chang, Y. L., Ho, C. L., & Huang, S. M. (2018). Metformin causes cancer cell death through downregulation of p53-dependent differentiated embryo chondrocyte 1. Journal of Biomedical Science, 25(1), 81. https://doi.org/10.1186/s12929-018-0478-5
Li, W., Zhang, X., Sang, H., Zhou, Y., Shang, C., Wang, Y., & Zhu, H. (2019). Effects of hyperglycemia on the progression of tumor diseases. Journal of Experimental & Clinical cancer research : CR, 38(1), 327. https://doi.org/10.1186/s13046-019-1309-6
Tseng, C.-H. (2014). Metformin may reduce breast cancer risk in Taiwanese women with type 2 diabetes. Breast Cancer Res Treat, 145, 785–790. https://doi.org/https://doi.org/10.1007/s10549-014-2985-8
Zhang, Z.-J., Zheng, Z.-J., Shi, R., Su, Q., Jiang, Q., & Kip, K. E. (2012). Metformin for Liver Cancer Prevention in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. The Journal of Clinical Endocrinology & Metabolism, 97(7), 2347–2353. https://doi.org/https://doi.org/10.1210/jc.2012-1267