prophylactic to prevent basaloid squamous cell carcinoma recurrence

Posted by ahimsa @ahimsa, Jun 27 12:47pm

I had a stage 4 base-of-the tongue throat cancer seven years ago. It started as a kind of sore throat that I'd never experienced before. Then I began to cough up little droplets of blood. The ENT doc said I had a "garden variety throat cancer". I googled that, and read that throat cancer is about the most painful and horrible cancer to die from. The ENT did a biopsy, for which I was briefly anesthetized. By good luck I received a copy of the biopsy report: it said I had a "basiloid squamous cell carcinoma". I'm not an expert but it sounded like a skin cancer in my throat. Back to google: I learned that these cancers are very common in Australia where the population is mostly from northern Europe and so is very fair-complected, yet the sun in Australia is especially strong due to some kind of defect in the ozone layer. I read that clinicians in Australia give niacinamide amide (aka nicotinamide), a form of vitamin B3, and a study was done that showed that 500mg of niacinamide twice a day reduced the recurrence of skin cancer significantly:

"The prevention of common skin cancers and precancers is possible by taking an inexpensive, widely
available, oral pill twice daily. The pill—the vitamin B3 supplement called nicotinamide—cut the rate of new
squamous-cell and basal-cell skin cancers by 23% compared with placebo after 1 year among patients at high risk for skin cancer. Nicotinamide also reduced the risk for developing actinic keratosis, a common precancer of the skin.
The results of the phase 3 ONTRAC skin cancer prevention study were presented at ASCO 2015.
These findings have the potential to lower healthcare costs. In the United States, skin cancer accounts for approximately $4.8 million annually.
The investigators emphasized that these results were achieved in individuals who previously had skin cancer and were thus at high risk for new skin cancers. The results do not apply to other patient populations.
In addition, the investigators emphasized that nicotinamide is the form of vitamin B3 that should be taken for
prevention—not other forms of vitamin B, such as niacin—and that continuous treatment is advised.“This form of prevention is safe and inexpensive, costing around $10 per month, and it is widely available. It is ready to go straight to the clinic for high-risk patients with a track record of skin cancer. This is a new opportunity for skin cancer prevention,” said lead investigator Diona Damian, MBBS, PhD, Professor of Dermatology, Dermatology University of Sydney, New South Wales, Australia. “The pill does not take the place of sunscreen use and regular skin checkups by dermatologists for people at high risk,” Dr Damian noted.
As the aging population continues to grow, basal- and squamous-cell carcinomas will become even more common than they currently are. The investigators are from Australia, which has extremely high rates of sun- induced skin cancers. A previous phase 2 study by this group showed that nicotinamide reduced the number of new actinic keratoses in Australian patients with sun-damaged skin.The present study included 386 patients aged 30 to 91 years who had ≥2 nonmelanoma skin cancers over the past 5 years, and were therefore deemed high-risk. The patients were randomized to oral nicotinamide 500 mg twice daily or to placebo for 12 months. Dr Damian said that the patient mix reflected those seen in a typical skin cancer clinic. The average age was 66 years, and 66% of the patients were men, many with ongoing chronic comorbidities.
“These patients were typical of the ‘warts-and-all’ type of patients we see in the clinic,” Dr Damian said.
The patients were checked by a dermatologist every 3 months and suspicious lesions were biopsied. Nicotinamide reduced the rates of new basal-cell cancer and squamous-cell cancer diagnoses by 23% compared with placebo (P = .02). Nicotinamide reduced the rates of actinic keratoses (precancers) by 11% at 3 months and by approximately 15% after 12 months of treatment compared with placebo.
“This preventive treatment has no side effects. Unlike niacin, another form of vitamin B3, nicotinamide does not cause headache or increased blood pressure,” Dr Damian said.
This “is welcome news. With this study, we have a remarkably simple and inexpensive way to help people avoid repeat diagnoses of some of the most common skin cancers. With just a [twice-]daily vitamin pill, along with sun protection and regular skin cancer screenings, people at high risk for these types of skin cancers have a good preventive plan to follow,” said ASCO President Peter Paul Yu, MD, Director of Cancer Research, Palo Alto Medical Foundation, CA."

The protocol for the throat cancer I had calls for a visual exam of the throat via an endoscope that goes into your nose and thence down into your throat, at least quarterly FOR FIVE YEARS. That shows this kind of cancer has a strong chance of coming back! So I started taking 500mg of niacinamide (the same thing as nicotinamide) twice a day, and I've had no recurrence after 7 years!! Now I only get checked once a year. Luckily Niacinamide 500mg capsules are readily available on Amazon and are very cheap! No Rx necessary.

The cancer that I did have required 3 large doses of cisplatin chemo, which I could only tolerate because I was young and healthy. I was left with considerable neuropathy in my legs and I can only walk a short distance, and I need a walker to do that. My balance is very poor and
I had sudden hearing loss in my left ear. But I am very much alive!

Interested in more discussions like this? Go to the Head & Neck Cancer Support Group.

Thanks for reminding me about that info. I was told 10 yrs ago and took the vitamin but stopped a few years ago.
I'll start up again after reading this. I'm currently on Libtayo for my SCC.

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I'm 19 years out from squamous cell carcinoma on the base of the tongue. As I understood it, recurrence was more likely with smokers and drinkers, neither of which I did. It's the recurring injury to the throat that puts us at risk. I also was told that I'd need annual checkups for the rest of my life after the quarterly ones ended in 5 years. Since then, I was told that any cancer would be considered new, thus the annual checkups ended. A UK study demonstrated there was no change in survival rate for those who received annual checkups vs those who did not after 5 years. I suppose it's whatever helps you sleep at night.

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