How Botox Could Save Your Life
The Botulinum toxin protein is produced by Clostridium botulinum bacterium, and it is the single most acutely lethal toxin known to man. The commercially available, Type A form of this is more commonly referred to as ‘Botox’. It’s known as a rejuvenating treatment that works by blocking synaptic acetylcholine transmission, paralysing the facial muscles and preventing the development of wrinkles. It is a non-invasive procedure growing in popularity in the UK; it was given 45,464 times in the UK in 2011, which is 26% higher than the previous year. Its interest is not exclusive to the UK however, as Botox was performed over 3 million times worldwide in the same year.
This cosmetic use of Botox is what it’s best known for, but it is also used medically, to reduce muscle activity in the management of a wide variety of medical conditions including strabismus, hyper-salivation and movement disorders. Recently it has been suggested that another medical use for Botox could be in the treatment of stomach cancer.
Stomach cancer is the fourth leading type of cancer and the second highest contributor to cancer mortality worldwide. With the raising rates of obesity and reflux disease increasing the occurrence of certain types of gastric cancer, this figure is only rising. The idea behind this suggestion is that if the Botox were targeted at the vagus nerve (leading from the brain to the digestive system) then it would disrupt nerve function, stopping the growth of the tumour and therefore making it easier to kill using chemotherapy. So it is being looked at to use in conjunction with current therapies, to make them more effective.
A supporting study by a research team from Columbia University Medical Center was published in Science Translational Medicine. They performed vagatomies (cut the vagal nerve) on different mouse models of cancer. The results showed slowed tumour growth and increased survival, supporting the idea that nerves could be critical in the progression of stomach cancer. This success was emulated when they blocked the transmission pharmacologically by injecting the mice with Botox.
Although these findings were promising, it doesn’t tell you about the effect in humans, whether the success would be replicated. To investigate this, the team conducted a study using 37 patients who still have reoccurring stomach cancer many years after surgery. Of these patients, 13 were given a vagotomy and 24 were not. The results showed that with a single exception all the patients who underwent a vagotomy didn’t develop tumours in the area of the digestive system that had been surgically denervated. In contrast all 24 of the control patients developed tumours in the same region of their stomach
A criticism of these studies has been that they have only been conducted on early stage and localised cancers. This is an issue as it doesn’t consider effectiveness with more advanced and invasive forms of cancer which may have separated from the main tumour mass. This is particularly relevant with gastric cancer as it’s a ‘silent cancer’ that is often not even noticeable until it is advanced.
Despite this the findings are still promising, particularly for patients who can no longer respond to chemotherapy, or have an inoperable form of cancer. This research has lead to the possibility of finding these growth connections with other tumours such as prostate cancer. The researchers behind the original study are now following up their work with phase 2 clinical trials with patients in Norway.
It is too early to say anything conclusive about this treatment, particularly as tumourshave the ability to out-evolve any single agent, but it is still a potentially viable target to look into for the future.
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