study questions, do PPIs increase risk esophageal cancer, (please dont jump to conclusion

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mock turtle
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Date Joined Mar 2011
Total Posts : 467
   Posted 8/8/2011 11:27 AM (GMT -6)   
Jobe et al, Pittsburg university have a study out that suggests bile acids may have much to do with esophageal cancer rates, and PPIs may increase risk for developing cancer...the study is complex and please dont just read the headline and then throw away your medication

this article is grist for talk with our doctors and nurses , OK?

but certainly the study merits questioning the value of some (not all) of the drug solutions

i wonder if H2 acid blockers are implicated...they are not mentioned in the article

http://www.post-gazette.com/pg/11213/1164375-114-0.stm

heres a quote

"Heartburn meds tied to cancer
Popular drugs may mask risk for disease
Monday, August 01, 2011
By David Templeton, Pittsburgh Post-Gazette

"..... long-term use of these drugs, known as proton pump inhibitors, can have unexpected consequences, a new study shows.

Blair A. Jobe and his research team at the University of Pittsburgh School of Medicine say the severity of symptoms for GERD, or gastroesophageal reflux disease, has an inverse relationship with the presence of Barrett's esophagus, a precursor to a lethal form of esophageal cancer known as adenocarcinoma.

The concern is that good symptom control does not reduce cancer risk but actually increases it.

The study, published online by the journal Archives of Surgery, also raises questions whether proton pump inhibitors might cause the cancer, whose incidence per million has risen sixfold from 1975 to 2001, a time when PPIs came on the market with increasing use. It's the fastest growing cancer in the nation, outpacing melanoma, breast and prostate cancers."

if the link above doesnt work, thry the one below or search
jobe esophageal cancer PPI pittsburg
and it should be the top hit

Read more:
http://www.post-gazette.com/pg/11213/1164375-114-0.stm#ixzz1USI1Rgt4

Chuck T
Regular Member


Date Joined May 2011
Total Posts : 143
   Posted 8/8/2011 12:23 PM (GMT -6)   
Freaky stuff. I wouldnt be at all surprised if in a few years these medicines were banned. Its frustrating that there is still so little known about the best selling drug in America. Guess we are the lab rats.

mock turtle
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Date Joined Mar 2011
Total Posts : 467
   Posted 8/8/2011 5:56 PM (GMT -6)   
maybe we are lab rats ,indeed...but

if there is one thing i have learned form having gerd, its that cause and effect are very difficult to figure out

and heres the thing, who knows if these studies are able to tease out "self selection", that is the people who take the PPIs and take em longer and more often are the ones who "know"thaey are at greater risk

the study tries to look at people with identical symptom profiles etc, but this is hard o do

and then there is the idea that, ok, if PPIs add risk to cancer...what is the mechanism...the study seems to suggest that since PPIs dont stop reflux , just increase PH, then is the real source of damage and risk may be bile which is relatively unaffected by these medications, or pepsin, or others

when we are looking at studies trying to track what happens over a decade of medication use, how can we avoid serving as lab rats

because imagine the screaming and table pounding if FDA made americans wait 10 years during additional PPI testing after clinical trials phase two testing...or waiting an additional 10 years for torax linx, for an example

on one level or another we are all lab rats

Alcie
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Date Joined Oct 2009
Total Posts : 5028
   Posted 8/8/2011 6:53 PM (GMT -6)   
Wow! Important article! Jobe is part of a really top group in the 'burgh, great reputation for research. DeMeester, also in the article, is well known too. There should be a link to this in the forum information.
Alcie
 
 

jasmine8
Regular Member


Date Joined Jan 2011
Total Posts : 69
   Posted 8/10/2011 6:50 PM (GMT -6)   
Mock turtle are you serious? 10 years for the lynx?!!! That makes me want to cry. What are you going to do?

mock turtle
Regular Member


Date Joined Mar 2011
Total Posts : 467
   Posted 8/10/2011 7:47 PM (GMT -6)   
Jasmine...i was just saying, "what If"

i dont think it will take 10 years for fda to approve the linx...im hoping we will get a decision end of october

but, just sayin , if we dont want to ever be "lab rats" as the question was raised above...then fda approvals would take much much longer

btw...im not doing so good...been knocked of my :high horse" in terms of me "touting" around here what works for me

i think anxiety and many family visits...relatives passing thru...etc has done me in...put me back on meds etc,

im leaning toward the linx...but....fudoplication looking better and better to me as time goes by

jasmine8
Regular Member


Date Joined Jan 2011
Total Posts : 69
   Posted 8/11/2011 11:06 PM (GMT -6)   
I'm right there with you. I want to wait for the linx but I don't think I'll make it. In fact I'm talking to a surgeon on the sixth. Maybe the FDA will pull a miracle or I'll find money in my backyard to take a trip to London

jasmine8
Regular Member


Date Joined Jan 2011
Total Posts : 69
   Posted 8/11/2011 11:12 PM (GMT -6)   
Mock turtle sorry you had a bad week. I hope it will calm down for you. I think I've mentioned it before but I found something that I can drink without too much reflux. It's not a miracle but it helps me keep hydrated because I can't drink anything else: Capra mineral whey and coconut water. The whey works the best but just use 1-2tsp not a tablespoon or you'll bloat. The coconut is expensive but convenient. Cosco is the cheapest place for it. Lots of love and support to you and all us other gerd sufferers

sk55
Regular Member


Date Joined Jun 2011
Total Posts : 225
   Posted 8/12/2011 10:18 AM (GMT -6)   
hi mock turtle,

hang in there.

With this sickness you will have Good times and Bad times... The trick is too have more good times then bad times...

Perhaps you need to figure out a strategy to have when your family visits so you don't stray from your diet.

Me, i always have my own food with me.

Feel better.

Jesse

mock turtle
Regular Member


Date Joined Mar 2011
Total Posts : 467
   Posted 8/12/2011 10:48 AM (GMT -6)   
Jesse

Jasmine

thanks for the words of understanding an encouragement...i will try your suggestions

best wishes, mock turtle

theacidrefluxman
Veteran Member


Date Joined Oct 2009
Total Posts : 739
   Posted 8/12/2011 12:20 PM (GMT -6)   
thanks mock turtle for the link, its scary but good to know i guess

sunbeam48
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Date Joined Jun 2011
Total Posts : 795
   Posted 8/13/2011 7:31 AM (GMT -6)   
I just don't get this PPI business. I now have Barretts, yet the risk of esphsageal cancer is very small. I have stenosis, osteopenia, and lots of arthritis, yet two doctors including my GI, want me to keep taking a PPI which sigificantly increases my risk of bone fractures, which are very common and could greatly limit the quality of my life/mobility; the fracture I fear most is of a vertebra, and that increases 50% with PPI's. No now it looks possible that the PPI may INCREASE cancer risk? Hey, my life will end at some point anyway.

jasmine8
Regular Member


Date Joined Jan 2011
Total Posts : 69
   Posted 8/14/2011 12:15 PM (GMT -6)   
Sunbeam, it is so frustrating but we can make it. I'm actually allergic to ppis and have been dealing with the pain head on. I don't think you can win either way. But do what you feel is right for you and your body. I keep waiting for the linx but I think I'll end up with the Nissen in the next month or so. Good luck to all of us!

jasmine8
Regular Member


Date Joined Jan 2011
Total Posts : 69
   Posted 8/14/2011 1:10 PM (GMT -6)   
Mock turtle,
You seem to understand the FDA better than me. You said we might get a decision on the linx in October. Does that mean it would then be approved or does that take longer? I just don't know if I should wait. Oh, by the way, I looked up getting the linx in the uk, and they won't accept any Americans as patients.

You linx people, please keep us posted on your progress especially if your out a while. I want to know how bad the dysphasia is.

theacidrefluxman
Veteran Member


Date Joined Oct 2009
Total Posts : 739
   Posted 8/16/2011 5:26 PM (GMT -6)   
I read this and I don't understand how they are drawing the link between PPI's and cancer. They say that people without symptoms on PPI's have a higher chance of cancer than people with symptoms on PPI's. Both groups are on PPI's. At least that is what I remember reading. So that would not show in any way PPI's and cancer risk...its just saying you have a higher risk of cancer if PPI's take all your symptoms away as opposed to leaving some with you...right?

mudmagnetmum
Veteran Member


Date Joined Apr 2011
Total Posts : 1604
   Posted 8/17/2011 10:00 AM (GMT -6)   
I agree with Acidrefluxman. Surely it's just that those who get to live symptom free on the medication probably fall through the net follow up wise and don't get scoped at all, whereas those who continue to have some symptoms probably do get more intervention and care.

The fact remains that they still do not know what causes Barrett's to become malignant and the number of cases is small. In the same way that some smoker's just die of old age and not lung cancer, the reasons are not understood. And the answer will likely lie in the body's ability to detect and destroy abnormal cells rather than the mechanism of the original disease. That is to say, it may be more to do with your individual risk of cancer than how you control your GERD.

Too much is not known and may lie within genetics. If money were no object and the physicians were told to select those at high risk of transformation of their Barretts, so that they could be closely monitored, they would actually have no way of doing it. They just cannot reliably predict who is at high risk . . Not yet anyway. And there is no global agreement on how often people should be rescoped, whether they have symptoms or not.

The presence of symptoms keeps our antenae on our oesophagus, but the fact is we are probably more at risk of other more common cancers such as those of bowel, breast and prostate. I think constant symptoms, especially pain, perpetuates our fear of damage and cancer, when instead we need to focus on "living with" rather than "dying of" our various forms of GERD.

MMM
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma

theacidrefluxman
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Date Joined Oct 2009
Total Posts : 739
   Posted 8/17/2011 10:23 AM (GMT -6)   
MMM - your last paragraph made my day a little bit. It is what my wife tells me. I need to do that more.

I did read that even w/ Barrets, risk of E. cancer is lower for you than other more common cancers. Still, why take the risk? that is why I like to be on top of it...

mudmagnetmum
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Date Joined Apr 2011
Total Posts : 1604
   Posted 8/17/2011 10:40 AM (GMT -6)   
Tee hee - well yes. I was going to say "Live for Today" but for us GERD folk that would probably entail a fair amount of alcohol and chocolate today and a good deal of pain tomorrow......!

It's also possible that the well controlled GERD folk manage other lifestyle choices that we can't (different diet, alcohol consumption etc) and perhaps it's some other unmeasured factor that increases their cancer risk and is unrelated to ppis.

I've also recently managed to sort out my side effects and am now doing ok on Lansopraozle, after 6 months of stopping and starting ppis. Well, one month in, and doing OK. I know your side effect is this pain you get and I know it comes on only when you take ppis, but based on my recent experience, I just wanted to {gently} ask if you've tried other things to relieve the pain? My brain was stuck in "drugs = side effects = stop drugs" but the solution was in stopping the side effects. I'm just saying don't write off the ppis forever - keep trying for a workable solution. Food for thought!

TTFN
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma

theacidrefluxman
Veteran Member


Date Joined Oct 2009
Total Posts : 739
   Posted 8/17/2011 10:53 AM (GMT -6)   
thanks. I will.

Actually apple cider vinegar works just as well as PPI's for me, but ALSO gives me the right side pain. That made me at least think the right side pain isn't serious. It does become literally unbearable as it progresses though...

I have thought about starting ranitidine but at a super small dose and not every day. We'll see. Thing is, I also get 3-4+ weeks of literally no symptoms, which makes me always think a non-medication solution is always a close possibility.

Align seemed to help the right side pain (and the GERD), so I am taking it. I have figured I might be able to take Ranitidine and Align together and not get the right side pain. We'll see...

I am a couple weeks away from shifting back to school again and am kind of holding off til then, just trying to manage for now while I finish up a summer job. I did buy Aloe Vera to try, but left it with my wife and won't be able to give it a shot for a few weeks (it is an aloe vera that is supposed to help stomach acidity)...

I am glad you are doing better after those 6 months. Hopefully I'll join the club shortly. Sadly it seems GERD is a battle that is never definitively won...

mudmagnetmum
Veteran Member


Date Joined Apr 2011
Total Posts : 1604
   Posted 8/17/2011 12:40 PM (GMT -6)   
It sort of sounds gall bladder ish in nature, your pain? Though nil to find on your tests I think you said. I think people use ACV to flush the gall bladder in detox type methods (naturopathic methods). I wonder if lecithin would do anything for you? I mentioned it in a complex thread on phosphatidylcholine and the LES, but lecithin is also supposed to help fat digestion and support the gall bladder. Another line of tack would be to try the ACV or ppi (whichever you can most withstand!) in combination with a low fat diet?

Pre GERD, what was your tolerance to coffee like? (coffee also stimulates the gall bladder. . . )

Well that's all the brain scratching I have for today . . .

MMM
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma
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