Word: sulindac
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...reading the medical literature and calling scientists. Eventually he talked to Dr. Randall Burt, now the chief of gastroenterology at the University of Utah. Coincidentally, Burt had just heard University of Colorado surgeon William Waddell tell a scientific meeting that he had seen an aspirin-like arthritis drug called sulindac (Merck) almost miraculously melt away colon polyps. The finding was anecdotal, observed in only a few patients, but it was just what Nichols wanted to hear...
Nichols began calling pharmaceutical houses in the U.S. and Europe, telling them that if they started making sulindac it would save thousands of lives. But it was about to come off patent, and as a generic drug it didn't offer much of a payoff because of the likelihood of competitive products and lower prices. Moreover, FAP--Nichols' cancer--is a so-called orphan disease, afflicting only 25,000 Americans, so there wasn't much of a market for it. Thanks, but no thanks, the drugmakers said...
Instead, he set out to "find the essence of the drug" and remove the side effects. When Pamukcu arranged for scientists at the University of Arizona to take on the research, Nichols moved to Tucson to help oversee their work. The scientists determined that the body breaks down sulindac into two components, but then got bogged down in a debate about which of these components to pursue. After listening to the pro and cons, Nichols decided for them--they would explore both chemical pathways. In the test tube, one compound quickly proved to be superior. "It was killing...
...uncontrolled growth. Nichols' scientists suspected instead that the problem was uncontrolled death. Cells lining the intestines usually live only 72 hours. But while cells are born at the usual rate in FAP patients, some fail to self-destruct, producing an excess. Johns Hopkins' Giardiello eventually showed that drugs like sulindac work by restoring the natural process of cell death in the colon. Precisely how it does that, however, remains unknown...
...acid, a precursor to aspirin that was derived from willow bark, but only in the past 15 years have they understood that it works by inhibiting the production of prostaglandins. Tylenol (the most common brand of acetaminophen) works much the same way, as do popular prescription analgesics like Clinoril (sulindac), Motrin (ibuprofen) and Dolobid (diflunisal), often used to relieve arthritis and severe menstrual cramps...
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