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14.08.2017


Aspirin is a cancer medicine

Just like people who have had a heart attack or stroke take a low dose of aspirin daily to prevent a recurrence, in the near future cancer patients will probably start taking 75-100 mg aspirin daily to increase their survival chances. This is suggested in a meta-analysis that researchers at Cardiff University in Wales published in PLoS One.

Aspirin and cancer
Aspirin is a cancer medicine
At the moment big trials are taking place worldwide in which people with cancer are put on a low dose of aspirin. One of the ideas behind the trials is that aspirin reduces the formation of blood clots. Cancer cells metastasise via the blood vessels, hitching a ride on blood clots. This makes it difficult for immune cells to spot them. A small dose of aspirin reduces the formation of blood clots and increases the chances of immune cells being able to clear them up. [Cell Mol Life Sci. 2017 May 9. doi: 10.1007/s00018-017-2536-7. [Epub ahead of print].]

Study
The researchers found 42 previously published epidemiological studies and trials on the effect of the use of aspirin on people with cancer. They put all the results together, rejected data from the outlying studies and analysed the data again.

Results
In general it appeared that a low daily dose of aspirin reduces the chance of tumours metastasising by 23 percent. The chance of dying decreased by 17 percent when a low dose of aspirin was taken daily.

Broken down according to the type of cancer, aspirin seems to be effective above all for bowel cancer, but also seems to be promising for prostate and breast cancer.


Aspirin is a cancer medicine


Aspirin is a cancer medicine


Aspirin is a cancer medicine


Aspirin is a cancer medicine


Aspirin is a cancer medicine


Conclusion
"It appears likely that low-dose aspirin has a beneficial role as an adjunct treatment of cancer," the researchers wrote. "Reductions in mortality are shown in colon cancer, probably in prostate cancer and possibly in breast and individual studies of several other cancers also suggest benefit."

"Aspirin benefit in colorectal cancers, and possible other cancers, may be restricted to patients with tumours expressing certain genetic mutations [in PIK3CA, COX2 - ed.]. However, other benefits of low-dose aspirin, including reductions in metastatic spread and in vascular events, including venous thromboembolism appear to be independent of these biomarkers, and so information on aspirin should be given to patients whatever the state of the possible biomarkers."


Aspirin is a cancer medicine


"The heterogeneity within the currently available studies both between different cancers, and within the different studies of each cancer, together with evidence suggesting some publication bias, are such that further evidence from a number of adequately powered randomised, placebo controlled trials is urgently required, including trials of less common cancers."

"Evidence on the possible role of aspirin in uncommon cancers, and the possible enhancement of its effect if mutation and other markers of increased sensitivity to the actions of aspirin, are also urgently needed. Much of this evidence could come from further observational studies."

"Nevertheless, despite the need for randomised trials, we believe the evidence of benefit from aspirin is sufficiently persuasive that physicians should engage with patients in a presentation and discussion of aspirin as an additional treatment."

"Furthermore, we hold that patients should be given this evidence within the context of a healthy lifestyle, they should be allowed to make their own decision about aspirin therapy, and should then be supported in whatever decision they make."

Source:
PLoS One. 2016 Apr 20;11(4):e0152402.

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