Cancer deaths cut by Aspirin

Dave!

Hey folks,

Saw this on the front page of the Daily Mail, so I assumed it was some bullsh*t distortion of what the research actually demonstrated, but I fired it into Google and seemingly there's some truth to it.

Aspirin 'could help breast cancer'

A leading cancer charity has called for large scale clinical trials after a study claimed aspirin can increase the chances of survival in breast cancer patients.

According to research published in the Journal of Clinical Oncology, women with breast cancer could double their chances of survival if they take aspirin twice a week.

Ed Yong, head of health information at Cancer Research UK, said: "We need large clinical trials to see if it can really save lives from breast cancer, and, if so, to work out what doses to use and how long to use the drugs for."

The study was conducted by the Harvard Medical School, which analysed 4,164 women diagnosed with breast cancer between 1976 and 2002.

Researchers found women who took aspirin two to five days a week showed the greatest reaction to the drug against the disease.

They had a 60% reduced risk of their cancer spreading and a 71% lower risk of breast cancer death.

Those who took six to seven aspirins a week lowered the risk of spread by 43% and the risk of death from the disease by 64%.

Ed Yong added: "Several studies have found that taking aspirin and other related drugs is associated with a lower risk of breast cancer, and this new study suggests that they might also help to stop cancer from spreading and improve a woman's chances of survival."

All the women were nurses from the Nurses' Health Study. They were observed until they died, or until June 2006, whichever came first.

There were 341 deaths from the disease over the course of the study. Mr Yong also stressed the dangers of taking large quantities of the drug. He said: "Aspirin has risks as well as benefits, such as causing bleeding from the gut at high doses."

So what do we make of it? Anyone got a link to the full article (for free) ?

seamus

Sounds interesting. Possible link with blood thinning - stunting the growth and/or spread of tumours?

Breast tissue is very well supplied with blood vessels, but if it's blood-related, there's no reason why similar results can't be shown with other cancers.

Halving the risk of death is a huge deal.

DrIndy

Aspirin is a "dirty drug" and not used as a painkiller really for which it was originally intended - this is because it has many other effects on the inflammation system and affects thromboxane and other inflammatory mediators.

This is why it is effective in tiny doses for blood thinning. Undoubtedly it would also affect other markers too and it is the act of refining that aspect which is interesting - look at NSAIDs which were developed from aspirin and are more effective with less side effects.

Its interesting alright - not bad for a drug which was previously made from boiled willow bark for hundreds of years!

Kevster

...Aspirin continuing to make headlines...? :rolleyes: I just started a PhD in the area ofd genetics and breast cancer, but haven't heard anything of this study yet. I'm stll on my steep learning curve though, trying to get up to speed with the rest of the research group.

Doesn't Aspirin's effects remain in the body for days after taking the drug?

DrIndy

It will knock out platelets for the duration of their time in circulation so in general is still working for 3 days post ingestion - but this does depend on the dose. One 300mg tablet is needed for complete knock out. Aspirin is such a pest - people take it for headaches at full painkiller doses (which is up to 900mg a day) and then get very difficult to stop nosebleeds. Why not paracetamol I always ask!

The effect on other inflammatory markers would depend on how fast they regenerate. I don't know the answer to that one.

Dave!

Interesting that you say Aspirin works by knocking out the platelets. I didn't know that !

Does that mean that if you cut yourself after having taken Aspirin, that the wound won't stop bleeding either (much like the nosebleed) ?

Perhaps off-topic

Sitric

You will stop bleeding but your bleeding time will be prolonged. Ibuprofen will cause the same problem but this is reversible (lasts 48hrs) and aspirin is irreversible. That's why usually it's not a good idea to take both ibuprofen and aspirin together but paracetamol and ibuprofen is ok.

I don't know the mechanism for aspirin and breast cancer but the same study (Nurses' Health) has shown a reduction in the rate of colon cancers in women taking daily aspirin. This is possibly due to COX inhibition( Aspirin is a non selective inhibitor of the enzymes cyclooxygenase 1 and 2) and COX-2 is over expressed in 90% of colorectal carcinomas. I don't know if this is over expressed in certain types of breast cancer but may be the answer.


http://content.nejm.org/cgi/content/abstract/333/10/609

SomeDose

Dave! wrote:

Interesting that you say Aspirin works by knocking out the platelets. I didn't know that !

Well strictly speaking it doesn't "knock them out" (platelet count is unaffected), it just irreversibly inhibits one of their essential functions in clot formation i.e. platelet aggregation.

DrIndy wrote: »

One 300mg tablet is needed for complete knock out.

Has this actually been quantitatively proven though? My understanding was that the 300mg loading doses used peri-MI / pre-PCI are necessary purely to reduce the time to achieve inhibition of platelet aggregation. Regular low-dose aspirin (75-150mg) will achieve the same level of inhibition, albeit over several days. Having said that, prolonged treatment with unlicensed 300mg post-CABG is used by many cardiac surgery units (mine included) on the basis that it improves graft patency. I'm not sure how strong the evidence for this is though, which is probably reflected by the fact that there's no firm consensus amongst surgeons about it.

With regard to its anti-cancer activity, this has been bandied about for years now, and there's no shortage of studies showing positive associations such as the one highlighted by the OP. As Sitric mentioned, current theories point toward it's effect on COX-2 activity as being beneficial in/against certain malignancies. In fairness, the same benefits may actually be seen with other NSAIDs (or indeed COX-2 selective inhibitors) but the long-term safety of low-dose aspirin probably makes it a better candidate.

Sharmon1

If you pubmed aspirin & cancer you will see thousands of articles linking positive outcomes of longterm (over 10yrs) aspirin treatment with cancer prevention, having said that there are lots of theories as to how this is achieved. However the fact that aspirin can cause stomach ulceration as well as bleeding problems mean that aspirin at present is not recommended for prevention of certain types of cancer. There are several prodrug forms of aspirin under investigation, a prodrug form of aspirin should avoid the problematic side effect of stomach ulceration, so hopefully there could some day be a simple tablet one could take which does not cause stomach ulceration but still retains the beneficial effects such as COX I inhibition & possibly could also be used as a preventative measure against certain types of cancer.

DrIndy

We have a lot more here to understand about this.

Aspirin may have an appreciable effect on cancer - but that does not advocate the use of aspirin for the treatment of cancer.

What it does say is there is a hell of a lot more to understand here and appreciating why aspirin has this effect and which receptors it is acting on means that in the future - drugs can be designed to generate this with 1000 times the potency of the original and no side effects.

The you have a new cancer treatment.

Love the way aspirin keeps popping up again and again as having these effects. So much more we need to know about inflammation and signalling.