cimetidine (Tagamet??)

annalexandria said:

I'm starting Tagamet...
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

about "some of the people"
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 said:

Blood thinners
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?

Tagament
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!

laurettas said:

Blood thinners
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?

no se'
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.

amazing stuff cimetidine!
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 said:

Cimetidine & Stage IV colon cancer - update

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!

thanks

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 said:

what a coincidence

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

2012 published article on cimetidine and colon cancer

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 E‐selectin (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 post‐operative 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/1745‐6215‐8‐16‐S1.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 curative‐intent surgery for colorectal cancer (HR 0.70; 95% CI 0.48‐1.03, 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.