Beta-blockers
Also called: propranolol, atenolol.
Last reviewed 2026-09-16. How this works.
Treating cancer Grade C
Human evidence exists and does not settle it.
Overall these blood pressure drugs made no difference, though one breast cancer type may be an exception.
Null overall, with a replicated signal in one breast cancer subtype.
The claim
The claim is that beta-blockers, ordinary blood pressure drugs, slow cancer by blunting the effect of stress hormones on tumours.
What it does
Stress hormone signalling does influence tumour biology, and the idea is a reasonable one. This entry is in the book for a different reason: it is the best demonstration in it of a specific statistical trap.
The evidence
The observational evidence is not favourable, which is not the same as being absent. Among 30,060 women with breast cancer in Norway, beta-blocker use was not associated with breast-cancer-specific survival overall, hazard ratio 1.07. Among 3,340 people with lung cancer in the Netherlands, pre-diagnostic use gave a hazard ratio of 1.00.12
Pooling 11 cohort studies and 20,274 women with ovarian cancer gave no significant association with total mortality, hazard ratio 1.08.3
Here is the part worth the space. In the ovarian analysis, the subgroup of studies that had corrected for immortal time bias gave a hazard ratio of 1.28. The signal did not merely vanish when the bias was removed. It reversed.3
One finding survives and it is specific. In breast cancer the association appeared only in triple-negative disease, hazard ratio 0.66, and the accompanying meta-analysis confirmed an association with recurrence-free survival in triple-negative patients only.1
The studies this rests on
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Norwegian population cohort of beta-blockers and breast cancer survival1
An observational study, measured survival, 30060 participants.
no association overall; an association in triple-negative disease only.
hazard ratio 1.07, interval 0.97 to 1.19. overall; triple-negative 0.66, interval 0.47 to 0.91
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Pooled cohort studies of beta-blockers and ovarian cancer prognosis3
A meta-analysis, summarising observational studies, measured survival, 20274 participants.
no significant association overall; in studies without immortal time bias the association ran the other way.
hazard ratio 1.08, interval 0.92 to 1.27. total mortality; studies without immortal time bias 1.28, interval 1.10 to 1.49
What is absent
No randomised trial of a beta-blocker as a cancer treatment is recorded here. Everything on this page is observational, including the one surviving signal.
Scope: any tumour type, any endpoint.
Established by trial scope, checked 2026-09-16. Result: every study in this record is a cohort study or a pooled analysis of cohort studies.123
What to ask
Is there any reason to change the beta-blocker I already take because of my cancer?
The dish-to-person gap
The register holds no human pharmacokinetic measurement for beta-blockers against a laboratory concentration.
When to call your team — no warning signs are recorded
Whatever you are taking or thinking of taking, the people treating you can only weigh it if they know about it. That is true when nothing has been written down here, and it is most true then.
The register records no warning signs for beta-blockers. That is not a statement that nothing can go wrong, and anyone taking a prescription drug outside its licence should tell their oncology team.
Interactions
The register holds no measured interaction between beta-blockers and a cancer treatment class.
Nobody having looked is not the same as nothing being there. That is what this line says and all it says.
The whole interaction list, and how to turn it into a pharmacy review request.
Find a trial instead
The triple-negative breast cancer signal is the one thing here a trial could usefully settle.
Search ClinicalTrials.gov for recruiting studies of propranolol OR beta blocker
A trial is the same decision with monitoring, a known preparation and a doctor who knows what else you are taking.
References
Beta-blockers and breast cancer survival by molecular subtypes: a population-based cohort study and meta-analysis.
No persistent identifier recorded.
How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 14 note 10.
Pre- and post-diagnostic beta-blocker use and lung cancer survival: a population-based cohort study.
No persistent identifier recorded.
How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 14 note 11.
Post-diagnostic beta blocker use and prognosis of ovarian cancer: a systematic review and meta-analysis of 11 cohort studies with 20,274 patients.
doi:10.3389/fonc.2021.665617 · PubMed 34221981
How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 14 note 12.