Feasibility - Beta Adrenergic Blockade (BB) in Cervical Cancer (CX)

Study Therapy Administration:

If you are found to be eligible to take part in this study, you will take propranolol by
mouth 2 times a day.

While taking the drug, you should continue to check your blood pressure daily with your own
personal blood pressure machine, at your local pharmacy, or in the clinic. If you are
personally monitoring your blood pressure, you should contact the research nurse if the
systolic blood pressure (SBP - the higher number) is less than 110, or if the diastolic (DBP
- the lower number) is less than 50 (or your heart rate is 50-60 and you show symptoms at 2
different timepoints 24 hours apart). The study doctor may decide to lower or raise your dose
of study drug during the study based on your heart rate and/or blood pressure measurements.

You will fill out a pill diary to write down the doses of propranolol that you take each day.

For the relaxation and guided imagery sessions, you will be given an MP3 player with an audio
recording that you should listen to 2 times a week for up to 4 months (or longer if you
choose). The study staff will talk to you about how to complete the sessions. You will fill
out a relaxation diary to write down whether you were able to complete the sessions and
whether you had any difficulties with it, such as distractions.

You should bring both diaries to the clinic at each visit.

Study Visits:

At Month 1:

- Your vital signs will be measured.

- You will be asked about any side effects you may have had.

At Months 2 and 4:

- Your vital signs will be measured.

- You will be asked about any side effects you may have had. Blood (about 5-6 teaspoons)
will be drawn for routine tests and for testing on cytokines, RNA, and tumor markers.

- You will complete the same questionnaires as at screening.

- If the doctor thinks it is needed, you will have an EKG to check your heart function.

- If you are an MD Anderson participant, the test to find out how many calories you need
to have on a daily basis will be repeated.

- At Month 2 only, if the doctor thinks it is needed, you will have a CT scan of the
chest, abdomen, and pelvis to check the status of the disease.

- At Month 4 only, any updates to your medical history will be recorded. You will have a
physical exam.

Length of Treatment:

You may continue the study therapy for as long as the doctor thinks it is in your best
interest. You will no longer be able to take the study therapy if the disease gets worse, if
intolerable side effects occur, or if you are unable to follow study directions.

Your active participation on the study will be over after the last visit. The study staff
will continue checking your medical record from then on to see how you are doing.

This is an investigational study. Propranolol is FDA approved and commercially available to
treat certain heart and blood pressure problems, anxiety, migraines, and tremors. Its use in
this study is investigational.

Up to 20 participants will be enrolled in this multicenter study. Up to 5 will be enrolled at
the Harris Health System. Up to 10 will be enrolled at MD Anderson.

Inclusion Criteria:

1. Proven recurrent cervical cancer of any histology not eligible for curative
radiotherapy or surgery.

2. Failed chemotherapy for first recurrence (excluding chemotherapy with concurrent
irradiation) or refractory to first line systemic therapy.

3. Measurable or non-measurable disease

4. Unlimited prior therapies

Exclusion Criteria:

1. Patients whose disease may be cured by surgery or radiotherapy.

2. Contraindication to use of a beta-blocker.(uncontrolled DM, COPD-unstable, Bradycardia
<50 BPM)

3. Already receiving a beta-blocker.

4. Performance status >3. Must have had treatment for first line recurrence

5. Prior radiation therapy for localized cancer of the breast, head and neck, or skin is
permitted provided that it was completed more than 3 years prior to registration, and
the patient remains free of recurrent or metastatic disease.

6. With the exception of non-melanoma skin cancer and other specific malignancies as
noted above, patients with other invasive malignancies who had (or have) any evidence
of the other cancer present within the last five years or whose previous cancer
treatment contraindicates this protocol therapy are excluded.

7. Use of systemic glucocorticoids such as Prednisone or Decadron in the last month for
greater than one week

8. Inability to accurately answer questions (e.g. dementia, brain metastases) or speak
English or Spanish.

9. Cirrhosis of the liver

10. Patients under the age of 18

11. History of comorbid conditions: Addison's disease, autoimmune hepatitis, hepatitis B,
hepatitis C, AIDS or HIV, lupus erythematosus, mixed connective tissue disease,
rheumatoid arthritis.

12. Hypersensitivity to propranolol, or beta-blockers

13. Uncompensated congestive heart failure

14. Cardiogenic shock

15. Severe sinus bradycardia; heart block, second or third degree or sick sinus syndrome
(if no artificial pacemaker present)

16. Severe hyperactive airway disease (chronic obstructive pulmonary disease, asthma)

17. Any patients on Avastin or any other anti-angiogenic drugs.

18. Patients with brittle diabetes mellitus (DM). Brittle diabetes mellitus is a type of
diabetes when a person's blood glucose (sugar) level often swings quickly from high to
low and from low to high. Also called "unstable diabetes" or "labile diabetes."

19. Patients participating in or who plan to participate in other treatment trials during
the course of this study.

20. Patients actively using cocaine

21. Cannot be receiving any other active neoplastic treatment during 4 months of study.