Reviewed by Kate Anderton, B.Sc. (Editor) Jan 17 2020
Acid reflux drugs that are sometimes recommended to ease stomach problems during cancer treatment may have an unintended side effect: impairment of breast cancer survivors ' memory and concentration.
New Ohio State University research shows an association between breast cancer survivors' use of proton pump inhibitors (PPIs) and reports of problems with concentration and memory. On average, cognitive problems reported by PPI users were between 20 and 29 percent more severe than issues reported by non-PPI users. PPIs are sold under such brand names as Nexium, Prevacid and Prilosec.
The study, the first to look at PPI use in breast cancer survivors, used data from three previous Ohio State clinical trials examining fatigue, a yoga intervention and vaccine response in breast cancer patients and survivors. In each of those studies, participants had reported their use of prescribed and over-the-counter medications and rated any cognitive symptoms they had as part of routine data collection.
After controlling for a variety of factors that could affect cognition - such as depression or other illnesses, types of cancer treatment, age and education - the researchers found that PPI use predicted more severe concentration and memory symptoms as well as lower quality of life related to impaired cognition.
The severity of the cognitive problems reported by PPI users in this study was comparable to what patients undergoing chemotherapy had reported in a large observational study. PPI non-users also reported problems, but were definitely getting better. Based on what we're seeing, we don't know if PPI users might not be able to fully recover cognitively after chemotherapy. It's an area for further investigation. Annelise Madison, lead author of the study and a graduate student in clinical psychology at Ohio State
The study is published online in the Journal of Cancer Survivorship .
Madison pursued this study based on her knowledge of PPIs' known potential to bypass the blood-brain barrier and previous research suggesting that off-label use of PPIs in cancer patients may increase tumors' responsiveness to chemotherapy and protect the digestive system from the ravages of chemo drugs.
"I thought there could be a cognitive effect from taking PPIs, particularly in this population, because breast cancer survivors are already at risk for cognitive decline," she said. "PPIs are over the counter and generally considered safe so there haven't been many long-term trials, especially looking at cognitive outcomes, because nobody was really thinking that would be a downstream effect."
As part of her graduate program, Madison works in the lab of Janice Kiecolt-Glaser, professor of psychiatry and psychology and director of the Institute for Behavioral Medicine Research at Ohio State. For this work, Madison conducted secondary analyses of three of Kiecolt-Glaser's earlier studies examining inflammation's connection to breast cancer treatment and survivorship. Related Stories
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