H2 blockers, used to treat gastrointestinal ulcers and/or reduce stomach acid, may improve survival among people with cancer, especially after colorectal cancer resection.

How can H2 blockers help you? What the research says

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

To see more details, click the plus sign to the right of any section.

Improving treatment outcomes

Are cimetidine and other H2 blockers linked to improved survival? Are they linked to less cancer growth or metastasis? Do they enhance the anticancer action of other treatments or therapies? We present the evidence.

Advanced cancer

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of longer survival and a large rise in performance status among people with advanced cancer treated with a daily combination of subcutaneous histamine and oral H2-antihistaminics

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of a clinical response among people with advanced renal cell carcinoma treated with cimetidine

Insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on tumor response or survival among people with metastatic malignant melanoma treated with cimetidine, sometimes in addition to conventional treatments

Preliminary evidence of better prognosis and overall survival after primary surgery among people with advanced serous ovarian carcinoma treated with platinum-based systemic chemotherapy and cimetidine

Breast cancer

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on tumor cell proliferation among people with breast cancer treated with cimetidine before surgery in a small study

Colorectal cancer

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better survival after surgical resection among people with colorectal cancer treated with cimetidine before, during, or after surgery

Gastrointestinal cancer

Colorectal cancer is listed separately.

Insufficient (conflicting) evidence of an effect on survival among people with stomach (gastric) cancer treated with cimetidine

H2 blockers combined with other therapies

Weak evidence of a better tumor response than expected among people with advanced renal cell carcinoma treated with lymphoblastoid interferon–α and oral cimetidine

Weak evidence of tumor response among people with metastatic renal cell carcinoma treated with coumarin and cimetidine

No evidence of tumor regression among people with hormone-refractory carcinoma of the prostate and bone metastases treated with oral coumarin and cimetidine

Weak evidence of progression-free survivalthe time during and after treatment of a disease that a patient lives without disease progression (worsening) for 16 months or longer in a man with pancreatic cancer treated with standard chemotherapy and TL-118

Preliminary evidence of better survival than expected after recurrence among people with glioblastoma with radiological disease progression treated with CLOVA cocktail in addition to temozolomide

Weak evidence of favorable responses and prognostic categories among people with advanced renal cell carcinoma treated with natural interferon-α, cimetidine, meloxicam, and candesartan or perindopril

Weak evidence of partial remission of metastases among people with metastatic renal cell carcinoma treated with cimetidine, cyclooxygenase-2 inhibitor, and renin-angiotensin system inhibitor

Optimizing your body terrain

Do cimetidine and other H2 blockers promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.

See Optimizing Your Body Terrain ›

Find medical professionals who specialize in managing body terrain factors: Finding Integrative Oncologists and Other Practitioners ›

Immune function

Increased immune system activation is not always beneficial, so your oncology team needs to determine whether immune activation would be favorable in your situation.

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of higher markers of immune activation among people with cancer treated with cimetidine

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better protection against Haemophilus influenzae type-B after vaccination among people with B cell chronic lymphocytic leukemia treated with ranitidine

H2 blockers combined with other therapies

Cimetidine and coumarin: no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on immunologic parameters among people with locally advanced or metastatic renal cell carcinoma treated with oral coumarin and cimetidine in a small study

Managing side effects and promoting wellness

Are cimetidine and other H2 blockers linked to fewer or less severe side effects or symptoms? Are they linked to less toxicity from cancer treatment? Do they support your quality of life or promote general well-being? We present the evidence.

Both type 1 and 2 histamine receptor antagonists are used to treat hypersensitivity reactions to antineoplastic agents.36Syrigou E, Syrigos K, Saif MW. Hypersensitivity reactions to oxaliplatin and other antineoplastic agents. Current Allergy and Asthma Reports. 2008 Mar;8(1):56-62; Saif MW. Hypersensitivity reactions associated with oxaliplatin. Expert Opinion on Drug Safety. 2006 Sep;5(5):687-94; Bookman MA, Kloth DD, Kover PE, Smolinski S, Ozols RF. Short-course intravenous prophylaxis for paclitaxel-related hypersensitivity reactions. Annals of Oncology. 1997 Jun;8(6):611-4. 

Gastrointestinal symptoms

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less liver dysfunction but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on diarrhea after treatment with gefitinib among people with non-small cell lung cancer treated with histamine type 2 receptor antagonists in a small study

Skin and tissue symptoms

No evidence of an effect on skin toxicity after treatment with gefitinib among people with non-small cell lung cancer treated with histamine type 2 receptor antagonists in a small study

H2 blockers combined with other therapies

Coumarin and cimetidine: weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of less bone pain and analgesic use among a subset of people with hormone-refractory carcinoma of the prostate and bone metastases treated with oral coumarin and cimetidine

Reducing cancer risk

Are cimetidine and other H2 blockers linked to lower risks of developing cancer or of recurrence? We present the evidence.

Colorectal cancer

Insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on recurrence of colorectal cancer treated with cimetidine around the time of surgery

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on adenoma risk or multiple adenoma formation after removal of adenoma(s) among people using either H1 or H2 blockers in a combined analysis of studies

Lung cancer

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately lower risk of lung cancer, especially lung adenocarcinoma, among people with type 2 diabetes using histamine-2 receptor blockers

Keep reading about H2 blockers

Author

Nancy Hepp, MS

Lead Researcher
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Reviewer

Susan Yaguda, MSN, RN

Manager at Atrium Health’s Levine Cancer Institute and CancerChoices Clinical Consultant
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Susan Yaguda, MSN, RN, has been a nurse for nearly 40 years, working in a variety of healthcare settings. She currently works in Charlotte, North Carolina, at Atrium Health’s Levine Cancer Institute as the manager for Integrative Oncology and Cancer Survivorship. She works with a multidisciplinary team to deliver holistic, evidence-based support and education for patients and care partners at any point along the trajectory of cancer care. She completed the Integrative Oncology Scholars Program through the University of Michigan in 2020, is certified as an Integrative Health Coach through Duke Integrative Medicine and has a post-graduate certificate in Nursing Education from the University of North Carolina, Charlotte. Susan also was awarded the Planetree International Scholar’s Award in 2018 and was recognized by the Daisy Foundation for Nurse Leadership in 2021. Susan has a particular interest in empowering patients and care partners with knowledge to help drive informed decision making and educating nurses on the benefits of integrative care for patients and self-care. She has presented nationally and internationally on integrative oncology and nursing education.

She and her husband, Mark, have two adult children and a very spoiled foxhound. She enjoys hiking, knitting, cooking, and pickleball.

“As a frequent consumer of Beyond Conventional Cancer Therapies, and now CancerChoices, for both professional education and patient support, it is an honor to have the opportunity to engage with the dedicated team at CancerChoices to serve those impacted by this disease.”  

 

Susan Yaguda, MSN, RN Manager at Atrium Health’s Levine Cancer Institute and CancerChoices Clinical Consultant

Last update: December 8, 2023

Last full literature review: May 2023

CancerChoices provides information about integrativein cancer care, a patient-centered approach combining the best of conventional care, self care, and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocialtherapy, and acupuncture therapies and self carelifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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