Pancreatic cancer and blood pressure meds – a connection?

Researchers find possible link through anecdotal evidence
Kathryn E. Vinson, MS, CCRC

Pancreatic cancer – those two words are enough to strike fear in the more stoic of individuals, and for good reason.  The American Cancer Society projects that in 2018 alone, more than 55,000 people in the US will be diagnosed with this disease, and over 44,000 will succumb.  This disease accounts for 3% of cancer diagnoses in the US, but for about 7% of cancer deaths.  So why the disparity in those percentages?  Well, a big part of it is that pancreatic cancer is rarely caught early due to its lack of symptoms and lack of a reliable screening test for the disease.  While there are blood markers that are sometimes elevated in patients with pancreatic cancer, they aren’t always elevated; sometimes they can be elevated in people with no disease. It is not usually caught until it has spread to and affected other organs that symptoms begin to appear. Symptoms also vary by the type of cancer and the location of the tumor within the pancreas, further muddying the waters for an early diagnosis.  Take a look at University of Glasgow discovers 4 subtypes of pancreatic cancer for some detailed information on these differentiations.

So, with those frightening statistics, is there anything that we can do?  There are several risk factors for these cancers that are also common to other conditions including age, weight, and smoking.  Men are at a slightly higher risk of developing pancreatic cancer, as well as those of African-American decent. Other conditions such as diabetes, metabolic syndrome, chronic pancreatitis, and cirrhosis of the liver also increase the risk.  Some of these risk factors we can attempt to control via diet and lifestyle, but there are also some familial/genetic risk factors, as discussed in Tracking Down One of Cancer’s Deadliest Culprits.  If you have a family history of pancreatic cancer, we urge you to discuss this with a qualified genetic counselor or oncologist.

Just this April, researchers at Baylor College of Medicine published their findings that may link certain medications used to treat high blood pressure to an increased risk of pancreatic cancer in women.  Using data from the Women’s Health Initiative – a long term study looking at the health of women over the course of 20 years, these researchers identified an almost two-fold risk in the development of pancreatic cancer in ladies that take calcium channel blockers (CCBs) for high blood pressure. These scientists have hypothesized that “The blockage of the calcium channel by [the] use of CCBs may potentially reduce sRAGE release… and thus further decrease the levels of anti-inflammatory sRAGE.”  Okay – so what does that all mean?

In previous studies, these same researchers found that a receptor called sRAGE is involved in helping the body control inflammation.  Chronic inflammation is a major risk factor in the development of pancreatic and other cancers; thus, a reduction in sRAGE levels puts these ladies at a higher risk of developing this type of cancer. The evidence revealed that “women who had ever taken short-acting CCBs were 66 percent more likely to develop pancreatic cancer; women who had taken CCBs for 3 or more years were more than twice as likely to have pancreatic cancer than women who had taken other blood pressure drugs.”  It is important to note that other classes of blood pressure medications, such as ACE inhibitors and beta blockers, were also studied and were not found to have the same effects upon serum levels of sRAGE as CCBs.

With this information, many women may wonder if they should stop their blood pressure meds.  Let me answer that with a resounding “NO!”.  This study is based upon anecdotal evidence.  What this means is that it is obtained by looking backwards and seeing what has been reported, and it provides amazing information for the design of clinical trials, etc. Is there validity to the study?  Absolutely; but, as an old psychology professor said to me years ago – you cannot define causation by correlation.  Plainly put – could these CCBs be a factor in the development of pancreatic cancer, yes; did they cause the pancreatic cancer – that cannot be answered. Also, keep in mind two important pieces of information: 1) No other classes of hypertension medications were implicated in this link, and 2) Stopping blood pressure medicine can cause what is known as “rebound hypertension” – or extremely high blood pressure as a result of an abrupt cessation of medications.

If you are on a CCB and are concerned about an increased risk for pancreatic cancer, please discuss this with your physician. Do not change your medication schedule without discussing this with the prescribing doctor.  He or she can help you weigh the benefits and risks of any of your medications.

Sources:
https://www.cancer.org/cancer/pancreatic-cancer/about.html
https://www.medicalnewstoday.com/articles/321555.php