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cimetidine (Tagamet??)

dianetavegia's picture
dianetavegia
Posts: 1953
Joined: Mar 2009

Saw this discussion on the bottom of another thread. Can we bring that discussion here since it seems pretty important?

So, what did the Onc recommend?

I found some OLD studies (1998- 2002) which said 'we've known for 20 years...' I have not yet found anything current.

Lisa, the numbers were much larger. I saw 85% of Dukes C survived 10 years vs 50% without cimetidine.

All those in the tests took the cimetidine for 1 year following surgery. Does cimetidine do the same thing the aspirin does?

If studies have proven such great survival stats, why are we not all tested for the Lewis whatever and given cimetidine?

jscho
Posts: 62
Joined: Jun 2009

It is my understanding that cimetidine acts differently from aspirin. Aspirin apparently inhibits the activation of a transcription factor that leads to cellgrowth and inflammatory response (via cytokines IL-1 and IL-6). Cimetidine, on the other hand, supposedly prevents histamine binding and indirectly enhances local anti-tumor response via IL-18 signalling to the immune system's natural killer and T cells. It also seems to lower the levels of some molecular hooks in blood vessels that cancer cells use to anchor (using the Lewis things) and form metastases.

I think this work is too new to become part of mainstream treatment at the moment, and there are so many potential biological markers one could test. If the side-effects aren't too severe, it seems worthwhile to take it as a precautionary measure, particularly for stage III people who seem to benefit more, probably since they are more likely to overexpress sLx and sLa (Lewis things).

Cheers,
Jeremy

lisa42's picture
lisa42
Posts: 3663
Joined: Jul 2008

Hi,

Cimetidine showing help for cancer is not new, as the clinical study on it was a few years ago- I think one in 2002 and one in the 90's. WHY isn't it being prescribed and tried more for cancer? Interestingly, I really don't know. The one study, as Diane referred to, was on earlier stage colorectal cancer patients. Some were given cimetidine (generic version of Tagamet at a much higher dose than the over-the-counter)a week before their colon resection surgery and then continued to take it for a year following surgery. All had chemo after surgery. The group that had cimetidine in addition to the chemo had a much higher 5 year survival rate- over 30% better than the group that had just chemo alone. I guess it does something to help prevent metastasis. Since I'm stage IV and already have metastasis, I'm wondering if/what it can do for metastasized tumors already there. But, even if it prevents more metastasis, that could be worth a lot! I am planning on mentioning this to my oncologist at my appt next week Monday, along with also discussing several other things- like "what next!".

dianetavegia's picture
dianetavegia
Posts: 1953
Joined: Mar 2009

I did see a reference that said not to take cimetidine if you are on any blood thinners. I also saw mention that Japan found it works only on tumors prone to mets (is there any other sort?) ....

Makes me wonder if we all missed out.

One article said the drug company stopped all 'cancer trials' ....

lmliess's picture
lmliess
Posts: 331
Joined: Dec 2008

I emailed my dr about this today and he said the results are unclear, but given that there are very little side effects, if I choose to take it then go ahead.

In my opinion, if it isn't going to hurt me and there is a chance these studies are onto something, then I think I will.

I know you aren't supposed to mix with Avastin or any of the chemo drugs in the Folfox mix. I think the Tagamet does what Avastin does so they may rule each other out. However, I am not on Avastin anymore. If tagamet can work like that and stop any metasis, then that would be great!

So I think I am adding it to my daily 'supplement' routine.

PRN
Posts: 5
Joined: Aug 2010

If you have blood tests with relatively highly expressed CA19-9 or CA-242, sialylated isoforms that have available blood tests, then, yes, the published Science indicates a major missed chance in Stage III/IV colorectal cancer at initial treatment. Like maybe 95+% survival in 10 years (Matsumoto, 2002) along with one year of daily chemo.

Personally I think every potential Stage III/IV colorectal patient should be blood tested for CA19-9 (commonly available test) and if the value is over 2, they should strongly consider cimetidine (common population genetic variations 0-20, centered around 5, or 3, for young and healthy). If no blood test, and prospect is stage III/IV colorectal cancer, others say just do it.

If the serum CA19-9 is over 15, I would change doctors, surgeon, hospital, lab etc until I had support for cimetidine 7+ days before surgery, IN SURGERY too, and a pathology lab that stained for CA19-9 (sialyl lewis A) or CA-242 if not the best CD15s antigens for sialyl Lewis X. I would ask for a COX-2 stain also. I talked to a number of oncs about cimetidine after reading dozens of sialyl Lewis and cimetidine papers, their heads were full of Roche eggs, they knew nothing or had Roche stuff falling out on the floor.

Hearts and minds: $10,000-$25,000 per month from my interviews vs $2 per month treatments, and frankly I would not take the others for free (toxicity, lack of meaningful effectiveness).

HollyID's picture
HollyID
Posts: 940
Joined: Dec 2009

I'm asking my onc about this next Tuesday. For me, I don't see a reason not to take it. I read somewhere that it suggests you take 1000mg a day. OTC come in 800mg doses.

Lisa, thanks for bringing this up again. You too, Diane. I'm just flabbergasted that the overall 5 year survival rate is so much higher.

Let us know what your onc says. I'll be curious to hear what s/he has to say.

HollyID's picture
HollyID
Posts: 940
Joined: Dec 2009

I printed out this thread so I could go armed and let him know I wasn't pulling this out of thin air.

He looked at a few different sites. He teaches at the University of Utah which is highly recommended here in the west. His partner worked at the Huntsman clinic in Salt Lake City.

He really couldn't find anything that correlated recurrence and tagamet. Like he said though, it's not gonna hurt to take it, so do it.

Maybe it's a placebo effect, I don't know. If we think it's gonna work, it will? I have no idea. When my dad had cancer, I read of a woman who dreamt she had pacmans eating her cancer cells. She went into remission. I have no idea if there is any correlation with tagamet and hoping and wishing.

I'm gonna do it. Just add it to my VitD3s. It ain't gonna hurt, but it might help more than anyone knows.

JR's picture
JR
Posts: 140
Joined: May 2009

My onc is at the Huntsman Cancer Institute. I don't see her for a couple of weeks but intend on bringing this up with her. She is Dr. Kim Jones, great onc. Is she possibly your onc's partner ??

John

HollyID's picture
HollyID
Posts: 940
Joined: Dec 2009

I have two oncs I see. The one onc's name is Dane Dickson. He's the one that came from the Huntsman center. A wonderful, caring KNOWLEDGEABLE man. In fact, they refer a lot of cancer patients that live in Idaho to see him. My second onc is Jeffery Hancock. He's from the U of U. He's an adjunct professor there. Another caring, KNOWLEDGEABLE man who makes sure your questions are answered. I talked to Dr. Hancock yesterday about the tagemet.

I'm curious what your onc would have to say, JR. Please do ask her and see what she has to say.

I've heard such great things about the Huntsman center. They are truly top of the line. If Dr. Dickson and Dr. Hancock weren't so close, and so highly recommended, I'd be at Huntsman in a heartbeat!

dianetavegia's picture
dianetavegia
Posts: 1953
Joined: Mar 2009

So they've known this for nigh on 30 years and it's not given to everyone?

Back when they did the trials, all cc patients had a full year of chemo with 5 FU only. It was only given before surgery and for the 1 year following.

One of the pages I read said the drug company stopped the 'for cancer' trials when they cut back on production. I have to say it the results were really this promising, you'd think the drug company would have continued production and made huge profits off saving lives.

Something just doesn't add up.

feniks's picture
feniks
Posts: 33
Joined: Mar 2009

a lot and I want to buy it but here in Czech republic they don't sell cimetidine!?You can buy all around:Germany,Austria,Slovakia but not in Czech republic.From what i read it could be sucess but we can't buy it.And we probably start with artemisinin.We think he couldn't do serious damage,maybe increase AST and Alt but we monitoring that.I e-maild DR.Lai,who is one of the leader in research and work on Washington university,I dont know which,and he told me he received mail from someone who have regressed his colon cancer and mets to liver.I hope it's true because wife decide to try it.

CAcancergirl
Posts: 1
Joined: Jan 2014

I was looking up info for ocular herpes (that lies dormant after you have chicken pox and then can re-activate later in life).  I think I have it.  I googled ocular herpes and one of the threads mentioned that Tagamet reduces severity/duration of attacks.  It also said the drug industry was not going to be able to make money from the application of the product in this manner so there had not been more done to promote it's use for this.  Since I have recently been diagnosed with breast cancer, I thought I'd see if there was anything about Tagamet in the blogs pertaining to cancer.  I don't have an oncologist yet but I'm going to do as much research as I can prior to my first appointment and maybe print a page to bring with me.  I have not had much time to do research and my surgery is next Friday.  I wanted to get my eye squared away first but everything is happening all at once and I'm running out of time.

ron50's picture
ron50
Posts: 1322
Joined: Nov 2001

I had problems with naprosyn a nsaid. It caused severe gastritis and I was passing quite a lot of disgested blood. I was initially put on zantac then changed to tagamet which I took continuously before during and after cancer. I have since been put on somac a stronger drug for duodenal and peptic ulcers and to lessen the damage caused by prednisone and methotrexate.Ron

PRN
Posts: 5
Joined: Aug 2010

Cimetidine is a specific, sialyl Lewis responding agent for advanced epithelial cancers. The other, more recent proton pump, stomach acid inhibitors simply don't have the same dendritic cell action as cimetidine.

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

Just to send it to my Onc.

lisa42's picture
lisa42
Posts: 3663
Joined: Jul 2008

Pepebcn,

Just google cimetidine colorectal cancer study or something like that & I would think you'd find it on the net.
My onc said he didn't know what to think of the results, as the study was based on stage I and II patients taking it along with Xeloda for the year following their initial surgery to prevent any metastasis. The difference was pretty big, as Diane stated above, between the group taking Xeloda only for the year and the group taking Xeloda with cimetidine.

Since I am stage IV, my onc didn't know what it would do for me- it doesn't seem to make tumors go away, but seems to help prevent spreading or metastasis. My onc's thoughts for me in my case were that it couldn't hurt, so why not take it- it is really pretty harmless to take. His thoughts were maybe taking it would keep the cancer from spreading any further. I have had it in liver and lungs & so far it hasn't spread beyond that point. I do get the results back of my PET/CT scan later this afternoon & hopefully it will show that I still have not had any further spreading of disease.

I'd take the cimetidine if I were you- pose it to your onc that if it's not harmful to take, why NOT try it?!

Good luck,
Lisa

Livingbyfaith's picture
Livingbyfaith
Posts: 56
Joined: Sep 2007

Has anyone been taking this before and after colon with liver mets surgery and have you had success? Thank you. Husband due for liver resection surgery Thursday and his doctor said he could take it.

GaryinUK
Posts: 63
Joined: Feb 2011

Good idea to bring this thread up, I remember reading something about it somewhere before.

So, for those that said they were going to take it or any that have, what happened next?

Love to hear

Gary

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

hi gary.

It sounds good to me.

Cheers.
Pete

Marianne313
Posts: 125
Joined: Mar 2011

interesting.

chikinkan
Posts: 1
Joined: Sep 2011

Hi,

I am colorectal cancer stage IV with mets for over 3 years. Just found out about Cimetidine's properties in fighting cancer mets. I really would like to hear from anyone out there who has been taking this drug to fight the disease. Would love to hear from you, especially Lisa42. Let us carry on the discussion with this thread.

annalexandria's picture
annalexandria
Posts: 2322
Joined: Oct 2011

tomorrow (800 mg a day) and will be taking it until my surgery on the 1st, and then at least two days IV after surgery. From the studies I've seen, it may reduce the possibility of cell migration during surgery. My surgeon didn't know anything about it but was willing to let me try it. May continue after I leave the hospital as well, if I don't have any problems taking it. I've seen some people on the forums who take it on a regular basis. Ann

tanstaafl's picture
tanstaafl
Posts: 1014
Joined: Oct 2010

Most of the cimetidine studies were for longer times, several weeks to a year or so for stage III. I've seen cimetidine used over seven years for other advanced cancers. Personally I view the initial decision, perioperative use for 1-4 weeks separate from the longer term use decision, based on biomarkers. I am biased by previous good results, and lots of homework.

Ultimately, long term use should be driven by biomarkers, like CA19-9 antigen staining, and perhaps CSLEX1 or e-selectin antigen staining, of the fixed tumor tissue pathology slides. We started our biomarker testing with the CA19-9 blood test the night before surgery after a lot of insistence, four weeks after starting the cimetidine, and haven't ever stopped it.

laurettas
Posts: 372
Joined: May 2011

tanstaafl, I have read that cimetidine should not be taken with "some" blood thinners. Do you know if Lovenox is one of the blood thinners that is not good to use with cimetidine?

dezysmith's picture
dezysmith
Posts: 6
Joined: Nov 2011

I am just learning about this, I wish I would have known last year when I had my initial surgery. Now I've gone from CC Stage 2A to recurrent colon cancer and am having HIPEC surgery. Only problem is I won't be able to take it the 2 days after surgery because I will be ICU for a couple of days and will not be able to have anything to drink for a long time. Do you have to take it immediately after the surgery for it to work? I am so bummed about this, actually scared to death of all this, I really thought I had put this behind me. I felt so good! Cancer really sucks!

annalexandria's picture
annalexandria
Posts: 2322
Joined: Oct 2011

That's what I've requested for my upcoming hospital stay. Based on previous surgeries, I won't be up to swallowing pills those first few days post-surgery! Ann

tanstaafl's picture
tanstaafl
Posts: 1014
Joined: Oct 2010

lauretta: I no experience on blood thinners, have not seen anything on Lovenox.

I saw mention of warfarin - cimetidine (among many) in this UMassMed "Guidelines for Antithrombotic Therapy"pp 6-7) that essentially recommended to monitor INR and presumably titrate warfarin dose.

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

doing cimetidine, aspirin and tumeric now!
see my post on tumeric and aspirin for what i found about inr.

hugs,
pete

cvdayhoff
Posts: 2
Joined: Apr 2012

I am a big believer in the studies and reports I have read over the past year. My husband was diagnosed with stage iv colon cancer on Jan. 5 2011 .. told not operable not curable and we settled in for dooms day. We did research and changed his diet to eliminate sugars beef and processed cheese hoping it would help. He had 20 radiation treatments then started chemo mid-feb. After researching many things on the Internet he started self dosing with cimetidine in march 2011 .. 800 Mg a day. So happy to report that he responded so well to his program of chemo and cimetidine that he had surgery in August to remove his colon tumor and several of the mets in his liver and is doing remarkably well to date (04/29/12). His onc. Said would cause liver damage but it was already damaged with the cancer so we figured we didn't have anything to lose. I couldn't find anything negative in my research ... don't think it's out there. Also found that manufacturer didn't want to have to deal with FDA re cancer treatment stuff so that's why not regular treatment ... all about the money ... Good luck to all of you and hoping to see more success stories!

cvdayhoff
Posts: 2
Joined: Apr 2012

My apologies for such a late response - I have not been on this site for some time.  Please forgive!

Today is February 15, 2013, and my husband is still alive and doing very well, considering.  His stage IV colon cancer is still there, but it is "stable".  This means (in case you are not familiar) that he still has mets in his liver, but they are not growing and they have not spread anywhere else in his body.  He has been taking cimetidine (800 mg) every morning and it will be 2 years in March.  The regimen he has been on has been with lucavorin, 5FU (fluororacil), compazine, decatron, and Avastin.  However, the Avastin was stopped June 20, 2012, as it was deemed he no longer needed it. His white count has NEVER gone below normal and he has NEVER suffered from nausea, hair loss, or many of the other various side effects expected.  He was able to have surgery in 2011 to remove the tumor in his colon and some of the mets in his liver.  Unfortunately, a couple of the tumors in his liver are around or too near a main artery for surgery to be an option, and our Government will not grant him Medicare/Medicaid, so we cannot leave our area to try CyberKnife or any other option for their removal. [He is 53 years old (54 in April 2013), so because he is not over 65 or legally blind, he is deemed ineligible for Medicare/Medicaid programs. Go figure. A veteran of the USMC, too!] Anyway, he tried Erbitux and had a seriously bad acne-like rash as a side-effect and was taken off of it after two sessions.  He was covered front to back from navel to his backside, inside his ears and nose and has scars today to show for it.  It was horrible for him.  In my research regarding Cimetidine, most studies showed its use with 5FU and lucavorin in most cases, so I am hoping this is why he has been so successful with its use.  Please keep in mind that it IS NOT A CURE! It is more like another weapon in your arsenal in fighting cancer - it helps to keep the cancer cells from going elsewhere in your body or from building more tumors. I think it is a weapon that should be used for all cancer fighters as our results have been very positive. To date, I can report that he has had no side effects whatsoever from using Cimetidine.  As a side note, we purchase ours at WalMart - about $5 or $6 dollars and twice the amount of pills than what you get in the Tagamet package. I personally recommend it, and if I am ever diagnosed with cancer, I will start with 800 mg of cimetidine immediately! Hoping this information has been helpful and that you are having positive results in your fight against cancer! God bless!

tanstaafl's picture
tanstaafl
Posts: 1014
Joined: Oct 2010

Thank you so much for getting back to us.  Disciplined, long term cimetidine treatment for stage IV CRC is an important topic that there are too few examples posted.   Best wishes.  

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

i just talked about cimetidine and newbies, and the next time i look here and this old worthwhile post comes back.

its nice to see lisa smiling face.

the issues re lowered stomach acid, and possible protien malabsorption can be addressed by supplemental stomach acid and then digestive enzymes.

a good naturopath can advise your details, if your doing cimetidine for its immune benefits. i am.

read about the side effects, especially for men. i am still on it,  life or sex. i vote for life. 

hugs,

pete

Discoveracure
Posts: 1
Joined: Apr 2013

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0048306/

 

Cochrane Database of Systematic Reviews: Plain Language Summaries.

Histamine type 2 receptor antagonists as adjuvant treatment for resected colorectal cancer

First published: August 15, 2012; This version published: 2012; Review content assessed as up-to-date: December 16, 2011.

Plain language summary

Colorectal cancer (bowel cancer) is the third most commonly diagnosed cancer in the world. Surgery is the primary curative treatment for those with early stage disease. However, a number of patients relapse after primary surgery, presumably due to cancer cells that have spread undetected to other parts of the body. In general, once colorectal cancer has spread it is no longer curable. Hence, adjuvant treatments are given around the time of surgery to eliminate any remnant cells to improve a patient's chance of cure.

Histamine type 2 receptor antagonist drugs (H2RAs) were originally developed as a treatment for peptic ulcers. However, anecdotal reports surfaced of tumour shrinkage with the use of these drugs. This launched a number of trials to see if these medications could be used to improve a patient's chance of cure following surgery for colorectal cancer.

This Cochrane review found six studies that adopted this strategy. There was wide variability amongst the trials in respect to a) the dose used, b) the timing in relation to surgery and c) for how long the H2RA drug was used for. When the results of the trial were analysed together it appeared that there was no survival benefit with the use of these medications. When the studies using cimetidine (a particular H2RA which has a theoretical additional mechanism of action in preventing tumour spread) were analysed, there appeared to be a survival benefit for patients receiving cimetidine.

Given the variability amongst the trials the results can only be considered as speculative, as opposed to strong evidence for this approach. Furthermore, these trials were conducted in a time where the approach to staging and treatment would be considered sub optimal by today's standards. Hence, further trials in the future are warranted.

Abstract

Background: Anecdotal reports of tumour regression with histamine type 2 receptor antagonists (H2RAs) have lead to a series of trials with this class of drug as adjuvant therapy to try and improve outcomes in patients with resected colorectal cancers. There was a plausible scientific rationale suggesting merit in this strategy. This included improved immune surveillance (by way of increasing tumour infiltrating lymphocytes), inhibiting the direct proliferative effect of histamine as a growth factor for colorectal cancer and, in the case of cimetidine, inhibiting endothelial expression of Eselectin (a cell adhesion molecule thought to be critical for metastatic spread).

Objectives: To determine if H2RAs improve overall survival when used as pre and/or postoperative therapy in colorectal cancer patients who have had surgical resection with curative intent. We also stratified the results to see if there was an improvement in overall survival in terms of the specific H2RA used.

Search methods: Randomised controlled trials were identified using a sensitive search strategy in the following databases: MEDLINE (1964 to present), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2009), EMBASE (1980 to present) and Cancerlit (1983 to present).

Selection criteria: Criteria for study selection included:

patients with colorectal cancer surgically resected with curative intent;

H2RAs used i) at any dose, ii) for any length of time, iii) with any other treatment modality and iv) in the pre, peri or postoperative period. The results were stratified for the H2RA used.

Data collection and analysis: The literature search retrieved 142 articles. There were six studies included in the final analysis, published from 1995 to 2007, including a total of 1229 patients. All patients were analysed by intention to treat according to their initial allocation. Log hazard ratios and standard errors of treatment effects (on overall survival) were calculated using the Cochrane statistical package RevMan Version 5. Hazard ratios and standard errors were recorded from trial publications or, if not provided, were estimated from published actuarial survival curves using a spreadsheet designed for this purpose (http://www.biomedcentral.com/content/supplementary/17456215816S1.xls).

Main results: Of the six identified trials, five used cimetidine as the experimental H2RA, whereas one used ranitidine. There was a trend towards improved survival when H2RAs were utilised as adjuvant therapy in patients having curativeintent surgery for colorectal cancer (HR 0.70; 95% CI 0.481.03, P = 0.07). Analysis of the five cimetidine trials (n = 421) revealed a statistically significant improvement in overall survival (HR 0.53; 95% CI 0.32 to 0.87).

Authors' conclusions: Of the H2RAs evaluated cimetidine appears to confer a survival benefit when given as an adjunct to curative surgical resection of colorectal cancers. The trial designs were heterogeneous and adjuvant therapy has evolved since these trials were performed. Further prospective randomised studies are warranted.

 

Editorial Group: Cochrane Colorectal Cancer Group.

 

Publication status: New.

Citation: Deva S, Jameson M. Histamine type 2 receptor antagonists as adjuvant treatment for resected colorectal cancer. Cochrane Database of Systematic Reviews 2012, Issue 8. Art. No.: CD007814. DOI: 10.1002/14651858.CD007814.pub2. Link to Cochrane Library. [PubMed]

 

Copyright © 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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