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The mechanism of action isnt well understood, but its believed it doesnt affect the tendon tissue cells directly, but rather that either works by activating other repair cells that can help tendons or ligaments or making the human growth factor receptor on the repair cells more sensitive (3)

Yano K, Brown LF, Detmar M

To achieve comparable effects, oral doses must be 30-50 times higher, creating cost and side effect challenges

J Vasc Interv Radiol

"Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis" (PDF)

Cancer development typically occurs over years to decades