Potential link between EPO (procrit) and cancer

http://www.rndsystems.com/cb_detail_objectname_SP04_Erythropoietin.aspx

[mikesimon]

Since the patients were suffering from cancer it isn't as startling as it would be otherwise .I have seen articles about issues/side effects with Epo but they have always centered around cancer patients. Perhaps there is not enough history of Epo use in HCV treating patients but I don't recall seeing anything in that setting. If you have seen something I would appreciate a link.

Mike

[Andiamo1]

EPO is primarily given to cancer patients and people with kidney failure, so you won't see much about non cancer patients.  People on dialysis have a life expectancy of about two years on average; not long enough to see if cancer will develop.

I think that if it stimulates cancer growth,it is reasonable to think that it might stimulate a cancer that was not viable to grow enough to develop a blood supply.

The only way to test the theory is if a large body of non cancer patients take the drug and develop cancer at higher rates than the general population.  The only candidate group I can think of for this study is US!

[eureka254]

It was explained to me similarly a couple of years ago when I made inquiries into Epo use and associated cancer risks:  that limited data was indeed skewed by the population analyzed.  Since then, some interesting data has emerged via the other "large body of non-cancer patients" being administered epo: the chronic kidney disease population suffering with anemia.

“Incidence of symptomatic stroke and cancer in chronic kidney disease patients treated with epoetins”
Authors: Imai, E,  Yamamoto, R, Suzuki, H , Watanabe, T
CLINICAL AND EXPERIMENTAL NEPHROLOGY 14 (5): 445-452 OCT 2010
Abstract:
“Use of erythropoiesis-stimulating agents (ESA) has been reported to increase the incidence of cardiovascular diseases at target Hb levels by more than 12.0 g/dl. The recent TREAT study found an increased incidence of stroke and cancer when maintaining the Hb level at 12.5 g/dl in diabetic patients.
Surveillance of Epoetin-Adverse Events of Stroke and Cancer (SEASCAN) was a cross-sectional study conducted under urgent conditions by the Committee on CKD Initiatives of the Japanese Society of Nephrology. Patients who were at least 18 years old and had CKD stage 4 and 5, namely, eGFR < 30 ml/min/1.73 m(2), and who had visited the outpatient department of the participating facilities between December 2009 and January 2010 with at least 6 months of prior medical treatment in the participating facilities were eligible to participate in the study.
Of 7,415 patients with CKD stage 4 and 5, 3,653 (49.3%), 879 (11.9%) and 2,883 (38.9%) patients received no epoetin, epoetin for less than 6 months and epoetin for at least 6 months, respectively. In patients who did not use epoetin, use of epoetin for less than 6 months and use of epoetin for at least 6 months, the numbers of patients with stroke were 38 (1.0%), 8 (0.9%) and 27 (0.9%), respectively, and those with newly diagnosed or exacerbated malignancy were 88 (2.4%), 30 (3.4%) and 71 (2.5%), respectively, demonstrating insignificant associations between outcome and duration of treatment with epoetin (P for trend = 0.666 in stroke and 0.836 in malignancy).
No significant increase in the risk of developing symptomatic stroke and cancer was observed for the use of epoetin in current clinical practice in Japan.”

It's interesting to note that even adverse cardiovascular events were minimized when Epo administration was withheld at hgb 12g/dl.  ~eureka

[GSDgirl]

http://www.mdguidelines.com/renal-dialysis

Outcome with dialysis procedures is dependent on the underlying disease process and physical condition of the individual. Acute renal failure is often reversible while chronic renal failure is not. In general, those undergoing dialysis therapy have an average life expectancy of 4 years although many survive as long as 25 years on dialysis therapy.


Source: Medical Disability Advisor

[Andiamo1]

My source for the average of 2 years was the Hospice evaluation of my mother in law. Hospice will not admit you unless they conclude you have 6 months or less to live.  They admitted my mother in law after 18 months on dialysis and the admitting doctor told me that their statistics show an average life expectancy of 2 years. My mother in law made it to 22 months.

It really depends on your age.  If you start dialysis younger that 30, you have a much better chance of surviving.  If you start in your 80s, the probability of lasting 2 years is low.  The majority of dialysis patients are elderly.