Antacids linked to better survival in patients with head and neck cancer

Patients with head and neck cancer who used antacid medicines to control acid reflux had better overall survival, according to a new study.

 Reflux can be a common side effect of chemotherapy or radiation treatment for head and neck cancer. Doctors at the University of Michigan Comprehensive Cancer Center in Ann Arbor frequently prescribe two types of antacids, proton pump inhibitors or histamine 2 blockers, to help treat this side effect.

The researchers reviewed 596 cases of head and neck cancer. More than two-thirds of the patients took one or both types of antacid medication after their diagnosis.

Patients who were taking antacids had significantly better overall survival than those who did not take them. Proton pump inhibitors, including drugs such as Prilosec, Nexium, and Prevacid, had the biggest effect: a 45% decreased risk of death compared with patients who did not take antacids. Patients taking histamine 2 blockers, such as Tagamet, Zantac, or Pepcid, saw a 33% decreased risk of death.

"We had suspicions that these medications somehow had a favorable impact on patient outcomes. This led us to review our large cohort of patients and screen them for common medications, focusing on antacids. In fact, our study did show that people taking antacids are doing better," said lead study author Silvana Papagerakis, MD, PhD, research assistant professor of otolaryngology–head and neck surgery at the University of Michigan (U-M) Medical School and an adjunct clinical assistant professor at the U-M School of Dentistry.

Results of the study were published in Cancer Prevention Research (2014; doi:10.1158/1940-6207.CAPR-14-0002).

The researchers are not clear why these medications affect the cancer, although they have begun additional work to understand the mechanisms involved.

"Currently, patients might be on and off of this medication according to their symptoms of acid reflux. We believe this medication can also be beneficial at stopping cancer progression. Perhaps longer duration of treatments may have significant effect in terms of outcome survival," Papagerakis said.

In addition, the researchers would like to understand if using antacids in people with reflux disease or people with precancerous lesions might reduce their risk of developing head and neck cancer.

Antacids are seen as relatively safe and typically have little or no adverse side effects. More importantly, Papagerakis noted, patients with head and neck cancer are already taking these medications.

"What this study makes clear is these medications may be more beneficial to the patients than just controlling side effects," she said.

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