Written by Marcia Egles, MD. After consuming folic acid, 28% of the patients had complete resolution of a precancerous throat ailment, 44% had partial resolution, and 28% had no response. No patients worsened or developed cancer.
A recent study published in Cancer, the journal of the American Cancer Society, has found benefit in the use of folic acid supplements in the treatment of laryngeal leucoplakia, a precancerous condition of the throat. (1) Folate, vitamin B-9, is a naturally occurring water-soluble vitamin found in fruits, grains and vegetables. Because folate is not stored well within the body, an ongoing adequate intake is needed for good health. The body needs folate to make and maintain DNA. Folate’s importance in the prevention of birth defects such as spina bifida has been well recognized. (2) Mounting evidence also suggests that low folate levels may be linked to increased risk for cancer and heart disease.(2-4)
Forty-three participants with untreated laryngeal leucoplakia found on endoscopic exam of the throat were enrolled in this preliminary study done at the Universita Cattolica del Sacro Cuore in Rome, Italy. The larynx, also known as the voice box, can be examined and biopsied by the use of an endoscope which is a lens-containing, fiber optic tube that can be passed down the throat. Leucoplakia, meaning “white plaque” is a surface abnormality that can be seen with an endoscope. Leucoplakia sometimes resolves spontaneously. If leucoplakia persists, it can progress into cancer. As the majority of spontaneous resolutions occur within a month of diagnosis, only patients with persistent leucoplakia were enrolled in this study. The average age of participants was 54 years. Most (88%) were smokers and 70% of the patients routinely consumed alcohol, although heavy drinkers (more than 4 glasses of wine/day) were excluded as heavy alcohol consumption can significantly interfere with folate metabolism.
All of the participants were prescribed a high dose regimen of 5 mg of folic acid* to be taken orally three times a day for six months. Every month the participants underwent laryngeal endoscopy with biopsies to monitor their leucoplakia. Over the six months, 28% of the patients had complete resolution of their leucoplakia, 44% had partial resolution, and 28% had no response as seen on microscopic examination of the biopsies. No patients worsened or developed cancer. Those at the start of the study who had the lowest erum folate levels showed the most response to folic acid supplementation.
This small, uncontrolled study is a preliminary or pilot study for an upcoming, wide randomized, double-blind, multi-center clinical trial to evaluate the effectiveness of long-term folic acid supplementation in the prevention of cancer after resection of laryngeal leucoplakia. The researchers showed that the early evidence of folic acid as a cancer prevention merits the major study that they have planned.
Source: Almadori, Giovanni, Francesco Bussu, Pierluigi Navarra, Jacopo Galli, Gaetano Paludetti, Bruno Giardina, and Maurizio Maurizi. “Pilot phase IIA study for evaluation of the efficacy of folic acid in the treatment of laryngeal leucoplakia.” Cancer 107, no. 2 (2006): 328-336.
© 2006 American Cancer Society
Posted July 24, 2008.
*5 mg per day is much higher than the normal daily usage.
References:
- Almdori,G, et al. Pilot phase IIA study for the evaluation of the efficacy of folic acid in the treatment of laryngeal leckoplakia. Cancer, Published Onloine: June 12, 2006.
- National Institute of Health’s Fact Sheets, posted on their website.
- Jennings E. Folic acid as a cancer preventing agent. Med Hypothesis 1995;45:297-303.
- Voutilainen S, Rissanen TH, Virtanen J, Lakka TA, Salonen JT. Low dietary folate intake is associated with an excess incidence of acute coronary events: The kuopio ischemic heart disease risk factor study. Circulation 2001;103:2674-80.
