Continued use of
low-dose aspirin may lower pancreatic cancer risk
The
longer a person took low-dose aspirin, the lower his or her risk for developing
pancreatic cancer, according to a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the
American Association for Cancer Research.
"We
found that the use of low-dose aspirin was associated with cutting the risk of
pancreatic cancer in half, with some evidence that the longer low-dose aspirin
was used, the lower the risk," said Harvey A. Risch, MD, PhD, professor of
epidemiology in the Department of Chronic Disease Epidemiology at the Yale
School of Public Health in New Haven, Connecticut. "Because about one in
60 adults will get pancreatic cancer and the five-year survival rate is less
than 5 percent, it is crucial to find ways to prevent this disease."
Men
and women who took low-dose aspirin regularly had 48 percent reduction in their
risk for developing pancreatic cancer. Protection against pancreatic cancer
ranged from 39 percent reduction in risk for those who took low-dose aspirin
for six years or less, to 60 percent reduction in risk for those who took
low-dose aspirin for more than 10 years.
"Older
studies of aspirin use have been clouded by the use of [regular- or high-dose]
aspirin for pain relief from conditions that themselves might be related to the
risk for pancreatic cancer. Only recently have people been using low-dose
aspirin for long enough times [to prevent cardiovascular disease] that the use
might bear on risk of pancreatic cancer development," explained Risch.
"There
seems to be enough evidence that people who are considering aspirin use to
reduce the risk for cardiovascular disease can feel positive that their use
might also lower their risk for pancreatic cancer, and quite certainly wouldn't
raise it," Risch added.
Study
subjects were recruited from the 30 general hospitals in Connecticut between
2005 and 2009. There were 362 pancreatic cancer cases and 690 controls.
Study
subjects were interviewed in person to determine when they started using
aspirin, the number of years they used aspirin, the type of aspirin they used
(low versus regular dose), and when they stopped using aspirin, among other
things. Confounding factors, including body mass index, smoking history, and
history of diabetes, were taken into account.
Of
the study participants, 57 percent were men, about 92 percent were non-Hispanic
white, about 49 percent were former or current smokers, and 19 percent had been
diagnosed with diabetes within the three years prior to this study.
A
dose of 75 to 325 mg of aspirin per day was considered as low-dose aspirin
(usually taken for heart-disease prevention), and a dose higher than that,
generally taken every four to six hours, was considered as regular-dose aspirin
taken for pain or anti-inflammation purposes.
Of
the participants, 96 percent of low-dose aspirin users and 92 percent of
regular-dose aspirin users reported daily aspirin use.
The
earlier a person started regularly taking low-dose aspirin, the greater the
pancreatic cancer risk reduction, ranging from 48 percent reduction in those
who started three years before the study, to 60 percent in those who started
taking it 20 years before the study.
On
the other hand, discontinuation of aspirin use within two years prior to the
study was associated with a threefold increased risk for pancreatic cancer
compared with continuing use.
"People
who are developing pancreatic cancer have various physiologic changes,
including taste disorders, starting to occur two to three years before
pancreatic cancer is diagnosed. Such individuals are more likely to quit using
aspirin. So it may be tricky to separate the various aspects of patterns of
aspirin use and risk of pancreatic cancer," noted Risch.
"Aspirin
use has potential risks of its own, and thus the risks and benefits for each
person have to be evaluated based on personal characteristics and
considerations," added Risch.
"For
the small subset of individuals with strong family histories of pancreatic
cancer or who otherwise have been evaluated to be at substantially increased
risk of pancreatic cancer, aspirin use could be part of a regimen designed to
reduce their risk."
Aspirin may lower the risk of pancreatic cancer
The
use of aspirin at least once per month is associated with a significant
decrease in pancreatic cancer risk, according to results of a large
case-control study presented at the AACR 102nd Annual Meeting 2011.
Xiang-Lin
Tan, Ph.D., M.D., a research fellow at Mayo Clinic in Rochester, Minn., said
the findings from this large collaborative study are preliminary and do not
encourage widespread use of aspirin for this purpose.
"The
results are not meant to suggest everyone should start taking aspirin once
monthly to reduce their risk of pancreatic cancer," said Tan.
"Individuals should discuss use of aspirin with their physicians because
the drug carries some side effects."
For
the current study, Tan and colleagues enrolled 904 patients who had documented
pancreatic cancer and compared them with 1,224 healthy patients. All patients
were at least 55 years old and reported their use of aspirin, NSAIDs and
acetaminophen by questionnaire.
Results
showed that people who took aspirin at least one day during a month had a 26
percent decreased risk of pancreatic cancer compared to those who did not take
aspirin regularly.
The
effect was also found for those who took low-dose aspirin for heart disease
prevention at 35 percent lower risk, according to Tan.
The
researchers did not see a benefit from non-aspirin NSAIDs or acetaminophen.
"This provides additional evidence that aspirin may have chemoprevention
activity against pancreatic cancer," said Tan. He added that more data
must be gathered before we can prove a real benefit.
Aspirin reduces
the risk of cancer recurrence in prostate cancer patients
Some
studies have shown that blood-thinning medications, such as aspirin, can reduce
biochemical failure––cancer recurrence that is detected by a rising
prostate-specific antigen (PSA) level––the risk of metastasis and even death in
localized prostate cancer. These studies, although very telling, have all
emphasized the need for more data. Now, with researchers at Fox Chase Cancer
Center having concluded the largest study on this topic, and there is
substantial data suggesting that aspirin improves outcomes in prostate cancer
patients who have received radiotherapy.
A
team led by Mark Buyyounouski, M.D., M.S., a radiation oncologist at Fox Chase,
examined a database of over 2000 prostate cancer patients who underwent
radiotherapy at Fox Chase between 1989 and 2006 and found that aspirin use
lowers the risk of cancer recurrence. The scientists presented their findings
on Sunday, May 1, 2011 at the 93rd Annual Meeting of the American Radium
Society.
The
team found that the 761 men who took aspirin at or after the time of
radiotherapy were less likely to experience biochemical failure––as indicated
by the levels of PSA––than were the 1380 men who didn't take the drug.
After
10-years from completion of treatment, 31% of the men who took aspirin developed
recurrence compared with 39% of non-aspirin users (p=0.0005). There was also a
2% improvement in 10-year prostate cancer related survival associated with
aspirin use with a trend toward statistical significance (p=0.07). "We
know that prostate cancer has a long natural history and 15 years or more may
be necessary to detect significant difference in survival," Dr.
Buyyounouski explains. "Longer follow-up is needed, but these results
warrant further study."
The
readily available drug could be a promising supplement to radiotherapy in
prostate cancer patients, and its beneficial effects may generalize to other
types of cancer, Buyyounouski says. Still, he cautions that "it's a little
premature to say that men need to start taking aspirin if they have a history
of prostate cancer."
The
optimal dose, timing, and duration of aspirin therapy, as well as potential
side effects are not well understood, Buyyounouski explains. It's not clear how
exactly the aspirin is helping and more research is needed to investigate this.
"Its possible aspirin therapy is making the radiation more effective or
preventing the cancer from spreading".
"Hopefully,
these clinical results will provide feedback to laboratory researchers to try
to explain the underlying mechanism so that we can better study the clinical
effects in targeted populations," Buyyounouski says.
Aspirin use and the risk of prostate cancer mortality
Experimental
evidence suggests that anticoagulants (ACs) may inhibit cancer growth and
metastasis, but clinical data have been limited. A study investigated whether
use of ACs was associated with the risk of death from prostate cancer.
The
study, published online Aug. 27, 2012 in the Journal of Clinical Oncology., comprised 5,955 men in the Cancer of
the Prostate Strategic Urologic Research Endeavor database with localized
adenocarcinoma of the prostate treated with radical prostatectomy (RP) or
radiotherapy (RT). Of them, 2,175 (37%) were receiving ACs (warfarin,
clopidogrel, enoxaparin, and/or aspirin).
The
risk of prostate cancer-specific mortality (PCSM) was compared between the AC
and non-AC groups.
AC
therapy, particularly aspirin, was associated with a reduced risk of PCSM in
men treated with RT or RP for prostate cancer. The association was most
prominent in patients with high-risk disease.
Aspirin May Guard Against Skin Cancer
Aspirin
and other commonly used painkillers may help guard against skin cancer,
according to a new study about to be published online in the journal CANCER, that was led by researchers from
Aarhus University Hospital in Denmark.
Previous
studies have already suggested that NSAIDs (nonsteroidal anti-inflammatory
drugs) such as aspirin, ibuprofen, and naproxen, and other prescription and
over the counter drugs, can reduce people's risk of developing some cancers.
For
example, earlier this year, three studies in The Lancet bolstered the evidence that a daily low dose of aspirin
may protect people in middle age against cancer, particularly those at higher
risk.
And
in another recent study in the British
Journal of Cancer, researchers from Leiden University Medical Centre in the
Netherlands reported that colon cancer patients who take aspirin regularly
shortly after diagnosis tend to live for longer.
In
this latest study, Sigrún Alba Jóhannesdóttir and colleagues looked at the
effect of these drugs on three major types of skin cancer: basal cell
carcinoma, squamous cell carcinoma, and malignant melanoma.
From
medical records covering 1991 to 2009 of people living in northern Denmark,
they found diagnoses of 1,974 cases of squamous cell carcinoma, 13,316 of basal
cell carcinoma, and 3,242 of malignant melanoma.
The
records also had information about prescription drugs, enabling the researchers
to compare their use in the people with skin cancer to that of 178,655 people
without a skin cancer diagnosis.
The
results showed that:
*
People with more than 2 prescriptions for NSAIDs has a 15% lower risk for
squamous cell carcinoma and a 13% lower risk for malignant melanoma than those
with fewer than 2 prescriptions.
*
The link was even stronger when the drugs appeared to have been taken for 7
years or more, at a high intensity.
*
Taking NSAIDs did not appear to be linked to a lower risk of developing basal
cell carcinoma overall.
*
But, taking NSAIDs was linked to a lower risk of developing this type of skin
cancer in less exposed parts of the body (ie not the head or neck),
particularly on a long term (15% reduced risk) or high intensity (21% reduced
risk) basis.
Basal
cell carcinoma is a type of nonmelanoma skin cancer that grows slowly and
painlessly and rarely spreads. It is the most common form of cancer in the US.
According to the American Cancer Society, 75% of all skin cancers are basal
cell carcinomas.
Squamous
cell carcinoma is also a nonmelanoma type and grows a bit faster than basal
cell carcinoma. Both of these types of nonmelanoma skin cancer are treatable.
Melanoma
is the most dangerous type of skin cancer and can spread to other parts of the
body very quickly. Some cases can be cured if caught very early. Melanoma is
the leading cause of death from skin disease.
Aspirin May Lower Melanoma Risk
A
new study has found that women who take aspirin have a reduced risk of
developing melanoma -- and that the longer they take it, the lower the risk.
The findings suggest that aspirin's anti-inflammatory effects may help protect
against this type of skin cancer. The study was published in Cancer, a peer-reviewed journal of the
American Cancer Society.
In
the Women's Health Initiative, researchers observed US women aged 50 to 79
years for an average of 12 years and noted which individuals developed cancer.
At the beginning of the study, the women were asked which medications they
took, what they ate, and what activities they performed.
When
Jean Tang MD, PhD, of Stanford University School of Medicine in Palo Alto, and
her colleagues analyzed available data from 59,806 Caucasian women in the
study, they found that women who took more aspirin were less likely to develop melanoma
skin cancer during the 12 years of follow up. Overall, women who used aspirin
had a 21 percent lower risk of melanoma relative to non-users.
Each
incremental increase in duration of aspirin use (less than one year of use, one
to four years of use, and five or more years of use) was associated with an 11
percent lower risk of melanoma. Thus, women who used aspirin for five or more
years had a 30 percent lower melanoma risk than women who did not use aspirin.
The researchers controlled for differences in pigmentation, tanning practices,
sunscreen use, and other factors that may affect skin cancer risk.
"Aspirin
works by reducing inflammation and this may be why using aspirin may lower your
risk of developing melanoma," said Dr. Tang. Other pain medications, such
as acetaminophen, did not lower women's melanoma risk. Dr. Tang noted that the
findings support the design of a clinical trial to directly test whether
aspirin can be taken to prevent melanoma.
Statin and Aspirin Use
Linked to Improved Survival in Women with Endometrial Cancer
Endometrial
cancer patients who took statins and aspirin reduced their chance of death by a
highly significant 84 percent, according to a new study by researchers at
Montefiore Einstein Center for Cancer Care. Additionally, women who used only
statins saw their risk of dying decline by 45 percent. The study was presented
at the June, 2013 annual meeting of the American Society of Clinical Oncology
in Chicago.
Endometrial
cancer is the most common cancer of the female reproductive organs and includes
several types of malignancies that appear in the lining of the uterus. The
American Cancer Society estimates nearly 50,000 new cases of endometrial cancer
will be diagnosed in the United States this year, and more than 8,100 women
will die from it. More than half of women diagnosed with endometrial cancer are
in the 50-69 age group.
“These
data are important as we explore the use of statins in patients with conditions
beyond cardiovascular disease,” said lead author Nicole Nevadunsky, M.D.,
gynecologic oncologist, MECCC and Assistant Professor, Department of Obstetrics
& Gynecology and Women's Health, Albert Einstein College of Medicine of
Yeshiva University. “We were pleased by these results and are continuing our
efforts to understand the unexpected positive effects of these medications in
endometrial cancer.”
The
retrospective study analyzed medical records of 554 patients diagnosed with
endometrial cancer between January 2005 and December 2009. Among them, 165
patients were on statin therapy and 68 women were taking both statins and
aspirin. All patients were treated at Montefiore Medical Center.
“It
is not uncommon for women in their 50s and 60s to take statins and aspirin to
treat cardiovascular conditions like high cholesterol or hypertension. Given
the clear association we saw between statin and aspirin use and improved cancer
survival, further evaluation is warranted to help us better understand how
these medications may improve survival in endometrial and other cancers,” Dr.
Nevadunsky said.
Aspirin reduces risk of Barrett's esophagus & cancer
Aspirin
use appears to reduce the risk of Barrett's esophagus (BE), the largest known
risk factor for esophageal cancer, according to a new study (July, 2012) in Clinical Gastroenterology and Hepatology,
the official clinical practice journal of the American Gastroenterological
Association.
"The
protective effect of aspirin use appears robust because the analyses suggests a
dose-response relationship in which high-dose aspirin was significantly
associated with decreased Barrett's esophagus risk," said Chin Hur, MD,
MPH, of the Massachusetts General Hospital Institute for Technology Assessment
and lead author of this study. "It would not be advisable at this time for
patients to start taking aspirin, particularly at higher doses, if preventing
Barrett's esophagus is the only goal. However, if additional data confirms our
findings and an individual at high risk for development of Barrett's esophagus
and esophageal cancer also could derive additional benefits, most notably
cardiovascular, aspirin could be a consideration."
Dr.
Hur and his team of researchers analyzed characteristics of 434 BE patients for
factors that might be used in screening and management. In addition to finding
that those taking aspirin were 44 percent less likely to have BE, they also
found that men were more than three times more likely to develop BE than women.
The
incidence of esophageal cancer has been increasing at an alarming rate during
the past few decades; current attempts at targeted screening for this type of
cancer focus on identifying BE. Nonsteroidal anti-inflammatory drugs (NSAIDs),
particularly aspirin, have been associated with reduced esophageal cancer
incidence. Although there have been many studies analyzing NSAID and aspirin
chemoprevention for esophageal cancer or BE progression to this cancer, few
have explored NSAIDs for BE prevention.
Low dose of aspirin wards off bowel cancer
Even
the lowest possible dose of aspirin (75 mg) can ward off bowel cancer, if taken
regularly, finds research published online in the journal Gut.
This
protective effect is apparent after just one year and in the general
population, not just those considered to be at risk of developing the disease,
which is the second most common cause of cancer death in the world, killing
almost half a million people every year.
Although
previous research has shown that aspirin protects against bowel cancer, it is
not known what the most effective dose is and how long it needs to be taken
for.
The
research team investigated just under 2,800 people with bowel cancer and just
under 3,000 healthy people, matched for age, sex, and residential locality.
All
participants completed food frequency and lifestyle questionnaires to assess
their usual diet and lifestyle choices, which are known to influence bowel
cancer risk.
NSAID
(non-steroidal anti inflammatory drug) intake was categorised as taking more
than four tablets a month of low dose aspirin (75 mg), other NSAIDs, or a mix.
The
likelihood of surviving bowel cancer once diagnosed or developing the disease
anew was then tracked over five years.
In
all, 354 (15.5%) of those with bowel cancer were taking low dose aspirin
compared with 526 (18%) of their healthy peers.
Taking
any NSAID regularly, curbed the chances of developing bowel cancer compared
with those who didn't take these painkillers.
This
finding held true, irrespective of lifestyle choices, age, diet, weight, and
level of deprivation.
After
a year, taking daily low dose aspirin was associated with a 22% reduced risk of
developing bowel cancer, and the magnitude of the reduction in risk was
cumulative, rising to 30% after five years.
Some
1,170 people died out of a total of 3,417 people diagnosed with bowel cancer
(including those who were healthy at the start of the study) during the
monitoring period. Most of these deaths (1,023) were attributable to the
disease.
Information
on NSAID intake was available for 676 of these 1,023 deaths, and it showed that
taking NSAIDs of any kind did not influence the risk of death from any cause
nor did it increase bowel cancer survival.
But,
crucially, the findings show that high doses of aspirin, taken for a long time,
are not needed to help ward off bowel cancer, say the authors.
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