Monday, July 4, 2016

ASPIRIN & CANCER


Every so often a product comes along that defies augury. And yet with each passing future it provides tiny visages of it’s abilities to predict what may lie ahead. Aspirin, the old Salicylic Acid, the most used and ofttimes reviled substance comes to the fore in cancer care.



But barely so, because the pockets of the high and mighty pharmaceuticals continue to whip up a storm of this and that in small incremental advances through complex machinations of the human cellular biology, while Aspirin continues along its merry way easing the burdens of diseases unbeknownst to its takers.

Aspirin and Colorectal Cancer:

Aspirin continues on its quest to impair the mechanism of inflammation; the hallmark of most diseases such as cardiovascular and rheumatological diseases and including cancer. We will leave the heart to the cardiologists, but for now let us delve into the wayward cancer cell.



Low dose Aspirin continues to be a constant nagging positive feature in cancer prevention, much to the delight of many. The most recently studied data disclosed suggest a significant reduction of risk and death from Colorectal cancer in those using a daily dose of lo-dose Aspirin. Looking at the mechanism, it becomes clear that COX-2 inhibition may be at play here. 


The implications stem from the reduced inflammatory effect and the production of polyp formation. Since most such polyp formations precede colon cancer and with the steady stream of sequential and sometime concurrent genetic mutation is at play in the polyps. Preventing the polyp formation itself becomes the “Strike three” (in baseball analogy) against the cancer. 



Aspirin and Esophageal and Stomach Cancer:

Continuing on the gastrointestinal tract issues, there is also abundance of proof that suggests that the same lowly lo-dose Aspirin taken over 5 years also may reduce the risk of Esophageal and Stomach cancers by 30% and death from these malignancies by 35-40% (1). A meta analysis of eight studies using individual patient data showed an overall lower deaths from common cancers in those patients consuming daily Lo-Dose Aspirin (3).

Aspirin and Colon, Breast and Prostate Cancers:

Another study highlighted benefits of risk and death reduction in bowel, breast and prostate cancer patients who took Lo-Dose Aspirin by 15-20% (2).

Given such accrued overwhelming data the USPSTF added Colorectal prevention with Lo-Dose Aspirin in their Preventative Recommendations in 2015 (4).

Liquid Aspirin:

A more interesting and provocative study from Britain shows that Liquid Aspirin in the form of IP1867B when given intravenously leads to cell kill in brain tumors (Glioblastoma Multiform or GBM). The nuance from this study has significant implications in overall cancer care in the future (5). Keep your eyes peeled on this development!

So with such a preponderance of information it behooves people over the age of 45 and beyond to take Lo-Dose Aspirin (as long as no allergy or sensitivity towards gastric bleeding exists) as a cheap form of prevention. This when added to exercise and a healthy 2000 calorie diet (fruits, vegetables, legumes etc.) will keep most in good health longer.



And just for the record, don’t forget Aspirin’s effect against Cardiovascular Diseases: heart attacks and strokes!

REFERENCES:

1. Jack Cuzick, Ph.D., head, Center for Cancer Prevention, Queen Mary, University of London, England; Leonard Lichtenfeld, M.D., deputy chief medical officer, American Cancer Society; Aug. 6, 2014, Annals of Oncology.

2. Peter C. Elwood, Gareth Morgan, Janet E. Pickering, Julieta Galante, Alison L. Weightman, Delyth Morris, Mark Kelson, Sunil Dolwani. Aspirin in the Treatment of Cancer: Reductions in Metastatic Spread and in Mortality: A Systematic Review and Meta-Analyses of Published Studies. PLOS ONE, 2016; 11 (4)

3. Rothwell PM1, Fowkes FG, Belch JF, Ogawa H, Warlow CP, Meade TW.Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet. 2011 Jan 1;377(9759):31-41. doi: 10.1016/S0140-6736(10)62110-1. Epub 2010 Dec 6. 
 
4. Chubak J, Kamineni A, Buist DS, et al. Aspirin Use for the Prevention of Colorectal Cancer: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force. Evidence Synthesis No. 133. AHRQ Publication No. 15-05228-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; 2015 

5. http://www.dailymail.co.uk/sciencetech/article-3663188/How-liquid-aspirin-help-fight-brain-cancer-Special-version-drug-ten-times-effective-killing-cancer-cells-chemotherapy.html

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