It might be hard to believe that the little white pill you’ve probably taken primarily for headache relief could be powerful enough to stave off a disease as dangerous as cancer, but two new studies confirm aspirin’s anti- inflammatory effect — one factor that could lead to reduced cancer risk.
The studies, which were presented at the American Association for Cancer Research meeting in New Orleans Monday morning, show that low-dose aspirin — taken just a few times a week — helps suppress inflammatory pathways that feed prostate cancer cell formation.
“I think the take-home point is that there may be some benefits to aspirin or nonsteroidal medications that are complicated to demonstrate but may be real to reducing the risk of a man developing prostate cancer,” says David Chen, a urologist at the Fox Chase Cancer Center in Philadelphia. “I don’t think [these studies] will greatly change practice. But they do suggest that it is safe [to take aspirin] and is not harmful.”
“It’s not strong enough data to say if you are told by a physician not to take aspirin, that you would counter that recommendation,” Chen continues, adding that the studies lend enough beneficial evidence for you to at least broach the subject of taking aspirin with your health provider.
“Aspirins are great medications, but to adopt them or not is not something we can advise because people should confirm with their doctors,” says Adriana Vidal, an author of one of the studies and a surgery professor at Duke University School of Medicine in Durham, North Carolina. Aspirin can cause gastrointestinal bleeding in some people, Vidal adds.
[Read: Calling on Cancer’s A- Team.]
Targeting Risk Reduction
The novelty of Vidal’s study, she explains, is that it targeted a population of men that has often been missed in other studies: Men who don’t necessarily have an elevated prostate-specific antigen level leading to a biopsy. In other words, the study looked at men who had received prostate biopsies independent of PSA screenings.
“In general, studies on prostate cancer have a detection bias because men who end up having a biopsy often have a higher PSA level,” which is often indicative of prostate cancer risk, but not always. Instead, Vidal’s study looked at the men who’d had surveillance biopsies. The observational study — meaning that it analyzed data from a previous study — looked at 6,390 men who were part of the REDUCE study, an international study testing the effect of a medication called dutasteride in lowering prostate cancer risk. Half of the men were not aspirin users and 21 percent used aspirin, with 18 percent using other nonsteroidal anti-inflammatory drugs.
Vidal found that aspirin and other NSAIDs lowered overall prostate cancer risk by 14 percent, and 17 percent for aggressive cancer. Both results were statistically significant, she says, adding that the results are “mainly confirmatory. Several studies have reported comparable associations, and actually the range [of risk reduction] is similar.”
“The most solid evidence of prevention is in colorectal cancer,” Vidal says, referring to previous studies. There is also some prior evidence of prevention for breast cancer. Aspirin works by inhibiting the enzymes in inflammatory pathways that lead to cancer, but what the role of those pathways is for each cancer type is unknown, says Randall Harris, a professor of medicine at Ohio State University who was not involved with the two recent studies but authored a study showing the benefits of aspirin in breast cancer prevention .
Harris explains that aspirin interferes with platelet activity in the bloodstream — and platelets help cancer cells travel the body.
[Read: Cancer: Men Are From Mars, Women Are From Venus.]
Identifying Aspirin’s Beneficiaries
Another great unknown is who exactly aspirin might benefit: people at low risk for developing cancer, those at high risk or those who already have cancer and want to prevent its spread.
“On a general population level, the incidence of prostate cancer is very high,” Chen says. “It’s unknown if it’s protective in a general sense.” Chen adds that for someone at average risk of developing cancer, aspirin is probably not worth recommending. But it might be for high-risk patients: those with a family history of prostate cancer or African-American men, who on average are at higher risk for prostate cancer than their Caucasian counterparts.
The second study presented Monday, which was sponsored by the National Institutes of Health, found that aspirin might not just prevent cancer from starting, but could slow metastatic spread and mortality, too. The researchers discovered that aspirin suppresses an inflammatory pathway called COX-2 in actual tumor cells (not just platelets). And suppressing COX-2 reduces the levels of a pro-metastatic molecule called prostaglandin.
“Our findings may explain how even a very low dose of aspirin taken daily can produce such a substantial reduction in cancer deaths and metastasis,” says Pierre Massion, a professor of medicine at the Vanderbilt University School of Medicine and lead author of the second study.
But for some experts, that may be a premature conclusion to draw. Chen says neither study addresses “what impact continuing these agents has on the course of cancer.” That’s because inflammation is just one factor in cancer’s causal web — and “seeing an effect based on the treatment of inflammation may not be easily measured,” he says.
Calling both studies “provocative,” Chen adds that what is now needed is more patient data, which he predicts will emerge with the dawn of widespread medical records with that data at providers’ fingertips. “You just need larger samples before you start to see the signal from the noise,” he says.
[Read: When Cancer Is In Your Genes.]
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Can Aspirin Cut Your Risk of Cancer? originally appeared on usnews.com
