With its uniquely bittersweet taste and toxin that causes numbness in the lips and tongue, blowfish or fugu a.k.a. puffer fish is a delicacy in Japan.
People pay hundreds of dollars to experience this fish, that is potentially deadly when not prepared properly, because it contains a lethal poison called tetrodotoxin.
That toxin, however, could also ease severe pain in cancer patients and help treat heroin-withdrawal symptoms.
Vancouver-based Wex Technologies started clinical trials across Canada to lend support to claims about the toxin’s potential healing powers.
Wex has licensed and patented the toxin and manufactures it under the names of Tetrodin and Tectin.
Presently on its second phase of testing, the medication is being administered to ten patients across Canada. One of them is at Grey Nun’s Hospital Palliative Care unit.
“It is something a little different. It’s quite exciting. It may be a break through in pain medication,” Dr. Doreen Oneschuk told the WCR.
“It’s been a long while since we’d had something that is new for the pain, so in fact if this proves to be safe and effective, it’s going to offer the public with cancer another alternative for pain management.”
Given the nature of the medication, thorough investigation is required, Oneschuk noted.
“You don’t want to prematurely put out a medication that is potentially not safe or isn’t effective.”
The criteria for a patient to be admitted into the research test are strict. A patient must have a poor response to more traditional pain treatment, and a lengthy list of other criteria may exclude a patient.
A patient must also have a suitable longevity, plus no other medication that could contribute to any significant complication that may overlap with the effects of this particular medication.
At this stage, researchers are looking not only at how effective it is, but also how safe it is.
“The most common side effect usually is numbness and tingling, either around the mouth or at the arms and legs. But other- wise it tends to be quite well tolerated,” Oneschuk said.
The toxin is a sodium channel-blocking compound, which acts to put brakes on electrochemical nerve-signal transmission and reduce pain.
What makes it different from other anesthetics and painkillers is that it appears the toxin does not yield side effects associated with other drugs including dependency and drowsiness.
If poor pain relief leads a patient to decide to have doctor-assisted suicide, with the availability of this drug such a scenario can be avoided.
“That’s possible in some circumstances because poor pain relief may contribute to a patients request to have euthanasia,” the palliative care doctor said.
The study will be open until the manufacturers and the study group has recruited 36 patients. It then enters the third phase which will focus on its effectiveness within the clinical population as manufacturers offer it to a wider spectrum of individuals.
But for now it is only administered to people who are responding poorly to pain medication.
“There is a chance that if this medication is approved it still may not be given to all patients. It still may be reserved as an agent,” Oneschuk said. “I think so far the research company is pleased. It seems to have a fifty per cent response and that might improve as the doses go higher. This is a multi-dose study.”
There is one safety concern. It is unlikely, but researchers have to watch that it doesn’t affect the respiratory muscles.
“This is what we are watching right now. It is not highly likely because you have to keep in mind this is a very minscule amount of the toxin that is being prepared.”
For more information on this medication, visit www.wextech.ca.