Investigating the use of anticancer drugs to treat Endometriosis

Professor Andrew Horne

“We are absolutely delighted to be awarded this grant funding to enable us to work on identifying new treatments for the millions of women who suffer from endometriosis. This truly reflects the commitment of Wellbeing of Women to improving the health of women worldwide”.
Professor Andrew Horne, Edinburgh University

Investigating the use of anticancer drugs to treat Endometriosis
Endometriosis is a disease which causes tissue like that from the womb lining to grow outside the womb. It affects 1 in 10 women of reproductive age globally – that is around 2 million women in the UK alone – and is usually associated with debilitating pelvic pain. It can also have a significant impact on a woman’s fertility. It is as common as diabetes among women yet it is a chronically under-researched disease and available treatments are invasive, costly and often ineffective. The research project at Edinburgh University is led by Professor Andrew Horne, a world expert on endometriosis, and will investigate anticancer drugs already in use as a new, more effective and non-invasive treatment for endometriosis.

How are women’s lives affected by Endometriosis?
Often dismissed as ‘women’s troubles’, very little is known about endometriosis and as a result a shocking number of women are under treated or do not receive proper health care or advice. Often their doctors do not know what endometriosis is and the specialists to whom they are sent are ill informed.

It takes an average of 7.5 years from the onset of symptoms to get a correct diagnosis. Diagnosis requires invasive techniques, such as laparoscopy, and hospital admission. Once diagnosed, endometriosis is either managed surgically or medically. Many women with constant severe pain undergo repeated and risky surgery but even the removal of their ovaries and uterus may not remove all the diseased tissue. The diseased tissue can be difficult to access and remove as it becomes sticky and internal organs fuse together. In 3 out of 4 women the endometriosis comes back within two to three years of surgery. The current medical option is to treat milder cases of endometriosis with hormones which induce early menopause. The treatments, however, have life-changing side effects and both surgical and medical treatments can cause infertility.

The length of time it takes to diagnose endometriosis and the harsh treatments have a huge impact on the quality of life of women. To summarise:

• Many woman with severe endometriosis live with crippling pain.
• Women as young as their early 20s have hysterectomies to end the pain, believing it is the only treatment available, yet their disease may return.
• Many women experience depression and 25% of women with endometriosis have felt suicidal.
• Thousands of women fall out of the workplace because of the pain.
• The annual costs to the UK economy of treating endometriosis and the loss of productivity due to sickness are around £8.2 billion.
• Endometriosis is as common as diabetes yet 1 in 2 people have not heard of the disease
• There is therefore an urgent need for new treatments for women which will preserve their fertility and end their suffering and psychological distress.

How can this research help women?
Professor Horne is building on successful research previously funded by Wellbeing of Women, which discovered that endometriosis cells behave in a similar way to cancer cells. Professor Horne and his research team made a breakthrough when they discovered that cells from the pelvic cavity in women with endometriosis behave like cancer cells, increasing energy production (‘glycolis’) and producing excess lactate. Their hypothesis is that high levels of lactate in the pelvis supports the growth of endometrial lesions outside of the womb. The accumulation of lactate within tumour cells in cancer is associated with a poor prognosis for cancer patients. They believe that the drugs like dichloreate (DCA), used to treat lactic acidosis and certain cancers could reduce glycolysis and halt the production of lactate in cells in the lining of the pelvic cavity, thereby altering the environment in the pelvic cavity and halting the growth of endometriosis lesions in women.

The team will therefore be testing cancer drugs already in use which target lactate production, secretion or uptake, to determine whether they can be repurposed to treat endometriosis.

As a result of this breakthrough, the research team strongly believe that conventional anticancer drugs administered in small doses could be used effectively in treating endometriosis. We believe that this research will deliver the most significant new treatment for endometriosis in decades. The research team are on the brink of making a major breakthrough in treating the disease and, if successful, this research will transform the lives of women with endometriosis in the UK and worldwide.