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Another possible health benefit to taking Aspirin?

November 20th, 2013

By Brittany Santee, PharmD Student, Cedarville University

Aspirin is one of the most used drug worldwide, and this usage has been going on for centuries. It is most known for treating pain, inflammation, and cardiovascular disease.1 Aspirin has been used by many because of it’s ability to reduce the chance of having a heart attack due to it’s anti-platelet activity.2 The American College of Chest Physicians recommends people who reach 50 years old or older who do not have cardiovascular disease should take a daily low dose aspirin.3 But this might not be the only way aspirin can save lives.

Recently Yahoo News posted an article about a study done in Sweden published by the British Journal of Cancer.4 The study looked at how low dose aspirin use affects cancer characteristics. Colorectal, lung, prostate, and breast cancer patients were studied and their cancer progression was recorded as well as if they regularly used aspirin. The patients’ tumor size and progression were then compaired based on regular aspirin use.5

There are some considerations to take when thinking about taking aspirin daily. First, it interacts with the absorption of many vitamins and food substances. Alcohol should not be taken with this medication. If any kind of heart medication is taken, a primary care physician should be consulted because many of these interact with aspirin both in how it is absorbed and how it works. Aspirin may cause stomach ulcers or stomach pain in 6 to 31% of patients.6

So now the question is whether the study done shows enough evidence to start taking a daily dose of aspirin. Looking at the data for metastasis in the lung cancer, it would take treating around 14 people with low dose aspirin to have no distant metastasis (M0) instead of presenting with cancer that has spread to other areas of the body(metastasis-M1). Overall there was around a 20-30% reduction in the odds of metastasis among aspirin users across lung cancer.  The data from the colorectal cancer is very similar.5 The evidence is less clear with hormone based cancers such as prostate and breast cancer, in these patients the study actually shows that tumor progression and tumor size were greater in the patients who were on a low dose of aspirin.  This finding was not statistically significant and compounded by low sample size in the aspirin users group.5 Overall the evidence presented is not something to panic about, further studies are needed to determine if low dose aspirin effects tumor progression and metastasis.

Studies have consistently found aspirin to be beneficial in many different health conditions, but the problem with aspirin is that there are can be serious side effects if it is not used carefully under medical supervision. This limits the studies done because aspirin can’t be given to certain groups in the population. In general the scientific community is aware of the wide range of health benefits that come from regularly taking aspirin. Because the lack of evidence from this study, I would not recommend taking a daily dose of aspirin to lower the risk of tumor progression.

 

References

 

1. Fuster V, Sweeny J. Aspirin: A Historical and Contemorary Therapeutic Overview. 2011. 123(7): 768-778. Avaliable from: http://circ.ahajournals.org/content/123/7/768.full.pdf+html. Accessed October 27, 2013.

2. Centre for Reviews and D. Collaborative meta‐analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients (Structured abstract). Bmj [serial online]. 2002;324:71-86. Available from: Database of Abstracts of Reviews of Effects, Ipswich, MA. Accessed November 18, 2013.

3. Guyatt GH, Akl EA, Crowther M, et al, “Executive Summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines,” Chest, 2012, 141(2 Suppl):7-47.

4. Aspirin tied to smaller lung and colon cancer tumours. Yahoo News[serial online]. August 21, 2013:Available from: http://news.yahoo.com/aspirin-tied-smaller-lung-colon-cancer-tumors-130628628.html. Accessed October 27, 2013.

5. Jonsson F, Yin L, Lundholm C, Czene K, Pawitan Y, Smedby K. Low-dose aspirin use and cancer characteristics: A population-based cohort study. British Journal Of Cancer [serial online]. October 1, 2013;109(7):1921-1925. Available from: Scopus®, Ipswich, MA. Accessed October 27, 2013.

6. Lexi-Comp, Inc. (Lexi-DrugsTM). Lexi-Comp, Inc.; November 1, 2013.

7. Berardi RR, Kroon LA, McDermott JH et al. Handbook of nonprescription drugs, an interactive approach to self-care. APhA Publications; 2006.

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4 Responses to “Another possible health benefit to taking Aspirin?”

  1. Sarah Myers Says:

    This article is a great example of how the media can influence an individual’s beliefs about the indications and uses of common OTC products. Patients who are struggling with an array of disease states often seek complementary treatment options in addition to their physician-monitored therapy plan, thinking that additive measures can only benefit their therapy, especially if they are “safe” natural products or OTC medications. I like that you outlined some of the adverse effects associated with daily aspirin use to emphasize that commonly used OTCs are not safe for every patient. In addition, patients undergoing treatment for cancer and other complicated disease states are likely to be more susceptible to drug interactions and adverse effects of OTC products that are viewed as relatively safe by the general public. As pharmacists we can play a very influential role in helping customers better understand the evidence behind pharmacological recommendations from the media. Often times, patients seek any available therapy based upon emotional judgements. It is certainly important for us to provide support and compassionate care while steering patients away from making unsound decisions in their medical care. I agree with your recommendation, Brittney. I would not recommend that a patient take aspirin to lower their risk for tumor progression based upon this study. Aside from the lack of evidence that you mentioned, cancer patients should consult with the physician overseeing their treatment before any medication changes are made.

  2. Paul Bicknell Says:

    That’s a good point, I wouldn’t recommend aspirin as a stand-alone or adjunct treatment for cancer either. In order for a treatment to be recommendable, the benefits should outweigh the potential risks. There are too many risks associated with the interactions and potential for developing other conditions such as ulcerations from aspirin use, that I would need a lot of evidence that this is actually going to help before I would recommend it, evidence which this study doesn’t seem to provide. Like Sarah mentioned, patient support and encouragement would be needed in dealing with a patient who is desperate for a cure and willing to try something reckless.

  3. Laura Cummings Says:

    This is an interesting new suggested use for aspirin! The data from this study seems misleading because it suggests that 1/14 lung cancer patients can avoid tumor metastasis by simply taking aspirin daily. However, it’s important that you noted that these result have yet to be reproduced and, like Sarah and Paul mentioned, that all medicines and supplements used by cancer patients should be closely monitored by their oncologist, especially given its numerous potentially serious side effects. Did the study mention a proposed mechanism of action for aspirin preventing metastasis?

  4. Calvin Anderson Says:

    I found this to be an interesting take on Aspirin, because we all know it to be an analgesic. Who knew that it could potentially be used as a treatment option for lung cancer? Like everybody else seems to be mentioning, there is a lack of strong evidence supporting whether aspirin can be used, which leads me to believe that more research needs to be done in this field. This does not change my opinion of recommending aspirin more, as I still think we need to be cautious about our recommendations, especially when there are other available analgesics. A daily dose of aspirin to me seems a bit much, especially when it’s known to have many side effects and drug-drug interactions. Like Laura asked, I too am wondering if they know the science behind how aspirin may be able to have these properties.

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