The People's Perspective on Medicine

Heartburn Could Signal Cancer Risk

People who regularly suffer from reflux or heartburn seem to be at a higher risk for cancer of the larynx and pharynx. The research compared people with throat and vocal cord cancers to matched controls.

Those who reported frequent heartburn had a 78 percent higher risk of developing throat cancer. Using antacids to ease the discomfort, however, seemed to offer some protection. Neither prescription acid suppressors nor home remedies provided a protective effect.

Please reread that last sentence. Yes, you read correctly. The prescription medications that doctors normally prescribe for reflux apparently did not protect people from developing cancer. That comes as a huge surprise. The idea that lowly antacids actually seem protective comes as a bit of a shock. In recent years drugs such as Tums, Rolaids, Maalox or Mylanta have lost their appeal because proton pump inhibitors (PPIs) such as omeprazole (Prilosec) and lansoprazole (Prevacid) have been promoted heavily and are now available over the counter.

[Cancer Epidemiology, Biomarkers & Prevention, May 23, 2013]

You can learn a great deal more about treating reflux, including a new high-tech treatment for Barrett’s esophagus, from our recent interview with one of the country’s leading gastroenterologists. Here is a link to the one-hour interview with Dr. Nicholas Shaheen, Professor of Medicine at The University of North Carolina at Chapel Hill.

You can also learn more about heartburn and the pros and cons of a variety of treatments in our Guide to Digestive Disorders.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I’ve suffered severe heartburn and late at night occasional GERDS for the last several years, probably from eating too late at night or too much at one meal. Anyway, the burning was unbearable and nothing seemed to work at all. I tried about every over-the-counter product on the market and nothing helped.
But I’ve determined to stay away from doctors as much as possible, in view of the high number of close relatives and friends lately who have died under their care, several even from simple things like failure to properly diagnose a particular condition, and two close friends who died recently after failure of the doctors to correctly prescribe blood thinners after surgery, plus a next-door neighbor who suddenly died only a few months ago from a brain aneurism shortly after knee surgery, who was also on a blood thinner. So I’m unwilling to take a chance on doctor’s advice any longer.
And after trying many over-the-counter heartburn products and none working properly, one day at Walgreens Pharmacy I spoke with a pharmacy student working there and she insisted I try their brand product of “Ultra Strength Antacid – Soft Chews” assuring me it works really well. I did so, and she was right – for me it really works! Each antacid tab is 1177 mg of Calcium carbonate. After reading online about “calcium carbonate” it seems that up to seven (7) tabs a day is the maximum one should take. As soon as I first sense an oncoming attack, I chew one tab quickly and literally within seconds it goes completely away.
I’ve used their product for nearly a year now and it has been amazing how well it works. Nothing else I’ve ever tried has worked at all for any length of time. Perhaps my condition isn’t as severe as others, but for me this stuff really works, although I have to be careful to not exceed 6-7 chews per day.

With the news that taking Tums, Rolaids or the like is more cancer-protective than newer heartburn (GERD) treatments, such as Nexium, Prilosec and Aciphex, there is less reason to fear the occasional “breakthrough” heartburn.
My spouse has been on a proton-pump inhibitor daily since suffering a stricture over 10 years ago, caused by poorly controlled GERD. I, too, suffer from GERD but I break out in hives in response to proton-pump inhibitors, which forced me to adopt alternatives.
Uncomfortable with the fact that my spouse has been on an OTC proton-pump inhibitor on a long-term basis when these drugs, as I understand, were only studied (and approved) for short-term use, it occurred to me that if I was well controlled by Zantac perhaps my husband could use the same (plus it is cheaper). Our main concern is that these newer heartburn medications, unlike older drugs like Zantac and Tagamet, may increase risks of certain cancers. We also understand that regular proton-pump inhibitor users are more likely to acquire pneumonia and other communicable diseases as a consequence of decreased acid production in the stomach. All things considered, it was time for a change.
It took some effort, but my spouse recently switched to what has been working for me: prescription strength Zantac, 300mg every 12 hours.
In the past it has been impossible for my spouse to reduce the use of proton-pump inhibitors due to “rebound heartburn” so this is what we came up with: I suggested he do three days on the Prilosec, one day off (using the Zantac at prescription strength on his “off day”). When that became tolerable, after about two weeks, he went to two consecutive days of the OTC proton-pump inhibitor followed by one day of Zantac (and so forth). When that became tolerable, he moved to an alternating day schedule: Zantac one day, Prilosec the next. After adjusting to that, he began doing two consecutive days on Zantac and one day on the proton-pump inhibitor. Eventually, he was doing more days on the Zantac than off, suffering no ill effects.
I share our story because I believe one of the reasons so many Americans suffer such severe GERD is that proton-pump inhibitors, when used on a long-term basis, trigger the same problem that the likes of high-dose Tylenol does (rebound headaches) and does the daily use of Afrin nasal spray (rebound sinus congestion). When trying to go off these proton-pump inhibitors, one’s heartburn may become worse than ever and this forces people to remain essentially dependent on these drugs. Likewise, there was seemingly no answer for my husband’s severe case of rebound heartburn and seeming life-long dependence on Prilosec. Worse, my spouse had begun to experience adverse events tied to the long-term use of Prilosec (IBS-like bowel problems). Using my own prior experience in tapering off prednisone as a guide, I came up with a solution that his doctor approved of.
In my experience, missing a single dose of Zantac does *not* provoke a more serious case of heartburn than one may have had to begin with, unlike my spouse’s experience with Prilosec. Consequently, by moving my spouse to Zantac, we now have the option to seek out the lowest effective dose using the same step-down method. For instance, we now have the option to go from a 300MG twice-daily prescription-strength dose of Zantac, opting for a once daily 300MG dose of Zantac with an OTC 150MG dose 12 hours later. If and when that becomes tolerable, we can opt for 150MG 2x per day in pursuit of the lowest effective dose.

Since bacterial infection causes cancer and acid suppresses bacteria, it comes as no surprise to me. That’s why I stopped taking a PPI. I started taking enzymes and Betaine HCI occasionally and probiotics to help digest my food, and the reflux went away.
My doctor insisted I would get cancer if I didn’t take the medicine, but I decided he was TOTALLY wrong. He’s still handing out “eat more fiber” digest sheets if he finds diverticulosis after a colonoscopy. Having always eaten a lot of fiber, I know that is NONSENSE. More and more I find that “following doctor’s advice” is wrong. They get it wrong with Vitamins, diet advice, avoidance of the sun in midday, cholesterol, and so much else. I feel so sorry for the really fat people who spend hours exercising and eating low fat, and who keep getting fatter. No one WANTS to be fat, but our doctors and the “party line” are leading the whole country in that direction.

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