Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to reduce inflammation, with notable benefits in increasing survival and reducing risk of several types of cancer; however, expert consensus is that the risks of harm from using these drugs long-term are greater than the benefits for prevention against cancer for many people.

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This section does not replicate the other information on this topic but provides additional details or context most relevant to professionals.

Modes of action: microenvironment effects

Mechanisms by which celecoxib may act on cancer prevention and treatment include apoptosis induction, anti-angiogenic effect, microenvironment regulation, proliferation inhibition, resensitization of antitumor drugs, and immunoregulation.1Li J, Hao Q, Cao W, Vadgama JV, Wu Y. Celecoxib in breast cancer prevention and therapy. Cancer Management and Research. 2018 Oct 26;10:4653-4667. 

Celecoxib affected genes and pathways involved in inflammation and malignant transformation in tumors but not normal tissues.2Sagiv E, Sheffer M et al. Gene expression following exposure to celecoxib in humans: pathways of inflammation and carcinogenesis are activated in tumors but not normal tissues. Digestion. 2011;84(3):169-84.

Further evidence 

Notable preclinical evidencetesting a drug, a procedure, or another medical treatment in isolated cells or in animals; preclinical evidence is considered only an initial indication of possible effects in people; clinical evidence is summarized in How can non-aspirin NSAIDs help me? What the research says ›

Improving treatment outcomes: preclinical evidence

Synergistic effects with conventional and complementary therapies

Celecoxib (Celebrex)

Indomethacin

Noscapine

Optimizing your body terrain: preclinical evidence

Blood sugar and insulin resistance
  • Diclofenac down-regulated glucose metabolism in cell lines of leukemia, melanoma, and prostate cancer14Pantziarka P, Sukhatme V, Bouche G, Meheus L, Sukhatme VP. Repurposing Drugs in Oncology (ReDO)-diclofenac as an anti-cancer agent. Ecancermedicalscience. 2016;10:610.
Immune function
  • Celecoxib regulated the immune system and the tumor microenvironment in cell studies for breast cancer15Li J, Hao Q, Cao W, Vadgama JV, Wu Y. Celecoxib in breast cancer prevention and therapy. Cancer Management and Research. 2018 Oct 26;10:4653-4667.
  • Celecoxib decreased release of CXCL9 and CXCL10, chemokines associated with improved survival, in high-grade serous ovarian cancer cells16Bronger H, Singer J et al. CXCL9 and CXCL10 predict survival and are regulated by cyclooxygenase inhibition in advanced serous ovarian cancer. British Journal of Cancer. 2016 Aug 23;115(5):553-63.
  • Celecoxib reduced prostaglandin E2 and prevented the local and systemic expansion of all MDSC subtypes in animals17Veltman JD, Lambers ME et al. COX-2 inhibition improves immunotherapy and is associated with decreased numbers of myeloid-derived suppressor cells in mesothelioma. Celecoxib influences MDSC function. BMC Cancer. 2010 Aug 30;10:464.
Inflammation
  • Diclofenac modulated immune suppression in preclinical trials18Pantziarka P, Sukhatme V, Bouche G, Meheus L, Sukhatme VP. Repurposing Drugs in Oncology (ReDO)-diclofenac as an anti-cancer agent. Ecancermedicalscience. 2016;10:610.

Managing side effects and promoting wellness: preclinical evidence

Cachexia
  • Weight gain in late-stage cachetic mice with tumors of the colon or head and neck with celecoxib use in preclinical studies19Davis TW, Zweifel BS et al. Inhibition of cyclooxygenase-2 by celecoxib reverses tumor-induced wasting. Journal of Pharmacology and Experimental Therapeutics. 2004 Mar;308(3):929-34.

Keep reading about non-aspirin NSAIDs

Author

Nancy Hepp, MS

Lead Researcher and Program Manager
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher, program manager, and writer for CancerChoices. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher and Program Manager

Reviewers

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, RN, MSN, OCNS Senior Clinical Consultant

Barry D. Elson, MD

Integrative physician and CancerChoices advisor
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Barry D. Elson, MD, has been practicing and teaching integrative medicine for over 40 years. He has been the medical director of Northampton Wellness Associates, adjunct faculty for Touro University College of Medicine, medical director at Commonweal, and professor of medicine at the Pacific College of Naturopathic Medicine. He recently retired from clinical practice and has been providing freelance medical consulting. He is an avid biker, cross country skier, and sailor. He currently resides in the rolling hills of western Massachusetts.

Barry D. Elson, MD Integrative physician and CancerChoices advisor

Andrew Jackson, ND

Research Associate
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Andrew Jackson, ND, serves as a CancerChoices research associate. As a naturopathic physician practicing in Kirkland, Washington, he teaches critical evaluation of the medical literture at Bastyr University in Kenmore, Washington. His great appreciation of scientific inquiry and the scientific process has led him to view research with a critical eye.

Andrew Jackson, ND Research Associate

Last update: October 7, 2022

Last full literature review: September 2021

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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