Can propranalol prevent hepatocellular carcinoma?

β-Adrenergic signaling is involved in many processes that may contribute to cancer progression. In this issue of the journal (beginning on page 1007), Nkontchou and colleagues report their retrospective observational finding that the β-blocker propranolol was associated with a highly statistically significant reduction in the incidence of hepatocellular carcinoma in patients with advanced cirrhosis and related esophageal varices. This surprising finding requires confirmation, but the result is biologically plausible. Epidemiologic studies have linked β-blockers with reduced rates of metastasis of other cancers and reduced cancer mortality. Laboratory studies suggest biologic mechanisms for anticancer effects of β-blockers.