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Cognitive problems of breast cancer survivors on proton pump inhibitors

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Abstract

Purpose

Proton pump inhibitors (PPIs) are used in cancer patients to manage treatment-related gastrointestinal symptoms and to prevent damage to the gastric mucosal lining during treatment. However, PPI use may contribute to cognitive problems. To compare PPI-users and non-users, breast cancer survivors reported cognitive problems in three studies.

Methods

In Study 1, breast cancer survivors (N = 209; n = 173 non-users, n = 36 PPI-users; stages 0-IIIC) rated their cognitive function on the Kohli scale prior to cancer treatment, as well as one and two years later. In Study 2, women (N = 200; n = 169 non-users, n = 31 PPI-users, stages 0-IIIa, M = 11 months post-treatment) rated their cognitive function on the Kohli scale and BCPT checklist at three visits over a six-month period. In Study 3, participants (N = 142; n = 121 non-users, n = 21 PPI-users; stages I-IIIa, M = 4 years post-treatment) rated their cognitive function on the Kohli scale, BCPT checklist, and Functional Assessment of Cancer Therapy cognitive scale (FACT-cog).

Results

In Study 1, PPI-users reported more severe concentration problems (p = 0.039) but not memory problems (p = 0.17) than non-users. In Study 2, PPI-users reported more severe concentration problems (p = 0.022) than non-users, but not memory problems or symptoms on the BCPT (ps = 0.11). Study 3’s PPI-users reported more severe memory problems (p = 0.002), poorer overall cognitive function (p = 0.006), lower quality of life related to cognitive problems (p = 0.005), greater perceived cognitive impairment (p = 0.013), and poorer cognitive abilities (p = 0.046), but not more severe concentration problems (p = 0.16), compared to non-users.

Conclusions/implications

PPI use may impair breast cancer survivors’ memory, concentration, and quality of life.

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Abbreviations

PPI:

Proton Pump Inhibitor

BCPT:

Breast Cancer Prevention Trial

FACT-cog:

Functional Assessment of Cancer Therapy cognitive scale

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Funding

This study was supported in part by NIH grants: R01 CA186251, R01 CA126857, R01 CA131029, R01 CA186720, K05 CA172296, UL1RR025755, and T32 DE014320.

Author information

Authors and Affiliations

  1. Institute for Behavioral Medicine Research, The Ohio State University, 460 Medical Center Drive, Columbus, OH, 43210, USA

    Annelise A. Madison, Alex Woody, Brittney Bailey, William B. Malarkey & Janice K. Kiecolt-Glaser

  2. Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA

    Annelise A. Madison

  3. The Ohio State University Comprehensive Cancer Center, 4460 West 10th Avenue, Columbus, OH, 43210, USA

    Maryam B. Lustberg, Bhuvaneswari Ramaswamy, Robert Wesolowski, Nicole Williams, Raquel Reinbolt, Jeffrey B. VanDeusen & Sagar Sardesai

  4. Department of Internal Medicine, The Ohio State University, 395 West 12th Avenue, Columbus, OH, 43210, USA

    William B. Malarkey

  5. Department of Psychiatry and Behavioral Health, The Ohio State University, 1670 Upham Drive, Columbus, OH, 43210, USA

    Janice K. Kiecolt-Glaser

Authors
  1. Annelise A. Madison
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  2. Alex Woody
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Correspondence to Janice K. Kiecolt-Glaser.

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Madison, A.A., Woody, A., Bailey, B. et al. Cognitive problems of breast cancer survivors on proton pump inhibitors. J Cancer Surviv 14, 226–234 (2020). https://doi.org/10.1007/s11764-019-00815-4

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