Highlights
- Propranolol is a beta blocker that’s often prescribed to manage heart conditions and as a second-line treatment for hypertension (high blood pressure).
- As retrospective patient data has become available to study, doctors have noticed a strong correlation between taking propranolol and survival rates for various forms of cancer.
- Other studies have found that propranolol can keep cancers from growing and spreading and can encourage the natural death of cancer cells, making cancer easier to manage.
- Major clinical trials for propranolol are needed before definitive conclusions can be made.
- If you have elevated cancer risk and are a good candidate for propranolol for its prescribed use, talk to your doctor about its risks and benefits.
One of the most commonly prescribed medications in the U.S., propranolol is used to treat conditions such as high blood pressure and headaches. Recently, researchers are finding it may have an even more important role — fighting cancer. Learn what propranolol is, why it may be able to help treat certain cancers, and the future of this promising medication.
What Is Propranolol?
Propranolol is a beta blocker that blocks the hormones adrenaline and norepinephrine. This action helps to prevent the various reactions of the body’s fight-or-flight response, like constricted blood vessels. It’s most commonly used to help people who’ve had a first heart attack manage the risks of a second one. It’s used to treat migraines, as well, and can also be used to treat high blood pressure.
Propranolol is the generic name of a medication that’s also available under the following brand names:
- Inderal
- Inderal LA
- Inderal XL
- InnoPran XL
- Propranolol Hydrochloride ER
- Hemangeol
Propranolol and Cancer Prevention: What We Know
Currently, there’s a wide range of research into the possible way propranolol can be used to treat various forms of cancers. This is a fast-moving area of research, but here are the most notable findings so far.
Propranolol and Liver Cancer
Propranolol has been used for liver cancer patients for years to help with both the side effects of treatments and some symptoms of the cancer. However, over time, doctors began to notice that patients who take it regularly seem more likely to have better outcomes than those who don’t.
So far, this theory has largely been borne out by research. For example, a 2019 study of patient data from the Taiwanese health system found a 22% reduction among propranolol users with liver cancer, while a 2012 study found positive results on patients with cirrhosis, or scarring of the liver.
Why this is the case is still being studied. Bench tests have found propranolol can inhibit the growth of liver cancer tumors and speed up their apoptosis, or self-destruction process, but it’s not yet clear if that ability translates to the human body.
Propranolol and Breast Cancer
With breast cancer, the evidence is just as promising, although still in early stages. One small phase II clinical trial found that propranolol helped keep breast cancer cells from metastasizing after surgery to remove tumors, while retrospective studies have shown evidence of reduced breast cancer mortality.
Much like with liver cancer, researchers are still figuring out why it works. In cell tests, it appears that propranolol keeps cancer cells from moving through the body, particularly if combined with other drugs, such as metformin.
Propranolol and Melanoma
Similar to the other two cancers, propranolol has shown promise for helping melanoma survivors. Melanomas that metastasize have a significantly lower survival rate than other forms of melanomas, so preventing that spread is key to better outcomes.
One study using propranolol off-label found it helped drive down the risk of melanoma coming back by up to 80%. Another small study that paired it with pembrolizumab, better known as Keytruda, also showed promise.
Propranolol and Future Cancer Treatment
Despite the promise of the research, there are three core challenges facing propranolol as a treatment for cancer.
Finding The Mechanism
The biggest challenge at the moment is launching the studies that will definitely show how propranolol works, or doesn’t work, for cancer one way or the other. While the research is promising, propranolol isn’t yet approved to treat any form of cancer. And there’s no guarantee that research will come back with positive results, or show enough of an effect for the Food and Drug Administration (FDA) to sign off on it.
Finding The Right Combination of Drugs
Another factor is that propranolol might need to be tested with other drugs, such as immunotherapy-based cancer treatments or other well-known medications, like metformin, to see if there’s a notable effect. This creates another layer of complexity in figuring out which medications should go forward as potential cancer fighters.
Which Cancers Propranolol Therapy Should Target
There’s also a question of which cancers propranolol can target. Analysis of propranolol historical data and other sources have found possible benefits for other forms of cancer including:
- Head and neck
- Prostate
- Esophagus
- Stomach
This creates multiple lines of research, each of which are going to need to be followed carefully. Finding which cancers propranolol is best suited to treat, and who will most benefit, will need to be worked out by researchers.
Who Will Benefit Most, and Who’s At Risk?
Even when that work is done, propranolol still won’t be available for everyone. For example, people with certain heart conditions or breathing problems like asthma shouldn’t take propranolol. Any drugs it’s paired with will have similar issues with contraindications.
Also, like any medication, propranolol does have side effects. Serious side effects are rare, however, so your provider may feel that the benefit to you outweighs the potential risk.
Right now, the best thing to do is talk to your doctor if you’re at risk for these cancers and are already a candidate for propranolol for its approved use. No matter what, only take propranolol when it’s prescribed to you, and follow any directions or warnings to the letter.
Conclusion
While recent research into propranolol’s cancer-fighting properties is encouraging, the research is still in its early stages. As of this writing, several major clinical trials are underway in the U.S. Their outcomes will likely guide future research into propranolol’s full potential as a cancer-fighting agent.
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