Saturday, November 5, 2011

May Aspirin Lower Pancreatic Cancer Risk?


Aspirin is the pain killer of choice of many Americans and is also recommended by a number of health care providers to reduce the risk of heart disease. Results of a new study reveal that tablet may also play a role in pancreatic cancer prevention in addition to having heart health benefits and providing pain relief.

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Aspirin belongs to a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs). Aspirin, like other NSAIDs, blocks a key enzyme that leads to inflammation in our bodies. This enzyme, cyclooxygenase, is also known to play an important role in the development of several types of cancer, and so aspirin, and other NSAIDs, have been extensively studied as potential cancer prevention drugs.

A recent study conducted by researchers from the Mayo Clinic College in Minnesota compared the use of pain relievers in more than 2000 adults age 55 and over. Researchers were able to conclude from the information gathered that subjects who took aspirin regularly were at a reduced risk of developing pancreatic cancer.

People who took aspirin at least once a month were 29% less likely to develop pancreatic cancer than those who used other types of pain relievers or nothing at all. Researchers also found people who regularly take low-dose aspirin to reduce their risk of heart disease had a 35% lower risk of pancreatic cancer. These very impressive results were evident even after researchers factored in other risks for pancreatic cancer, such as body mass index (BMI) and smoking status.

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 Xiang-Lin Tan, Ph.D., M.D., a research fellow at Mayo Clinic in Rochester, Minn. He added that more data must be gathered.

Why Aspirin?

"This study just looked at an association," Dr. Jennifer Ashton said. "So it did not provide cause-and-effect or the mechanism. But there is a theory that the way that aspirin and drugs like Motrin or Advil work to reduce other types of cancer risk is by cutting the risk of inflammation. Now, interestingly in this study, they also found a slight reduction in risk amongst those healthy people who took ibuprofen, but it just wasn't statistically significant. So again, the thinking is that it cuts down on inflammation."

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So should you start taking aspirin as a precaution?

Dr. Ashton warned that people need to understand the risks -- just like with any other drug. "Some doctors say that, if aspirin went up for (Food and Drug Administration) approval as an over-the-counter medication today, it may not get approved so readily," she said.

Ashton warned aspirin can increase the risk of gastrointestinal bleeding, as well as stomach irritation, and can worsen asthma. Aspirin, most importantly, she said, can interact with other drugs, and especially blood thinners.  "It definitely has risks, and people should talk to their doctor about whether those are worth it," Ashton said.

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Other Studies

While a randomized, placebo-controlled, prospective clinical research trial will be necessary to confirm the encouraging findings of this latest clinical research study, the findings of this case control study are, nonetheless, very compelling. Moreover, the findings of this retrospective study are very similar to the findings of both retrospective and prospective clinical research studies that have previously identified a similar reduction in the risk of colorectal cancer with aspirin and other NSAIDs.

However, not all the researchers reported the similar results as outcomes of the previous studies.

 In this 2002 hospital-based case-control study, 194 patients with pancreatic cancer were compared to 582 age and sex-matched patients with non-neoplastic conditions to examine the association between aspirin use and risk of pancreatic cancer at the Roswell Park Cancer Institute in Buffalo, NY. It was reported that pancreatic cancer risk in aspirin users was not changed relative to non-users. No significant change in risk was found in relation to greater frequency or prolonged duration of use, in the total sample or in either gender. Therefore, the outcomes suggested that regular aspirin use may not be associated with lower risk of pancreatic cancer.

Even more unexpected results were received by so called Nurses Study. An analysis of data from the Nurses' Health Study, published in the Jan. 7, 2004 issue of the Journal of the National Cancer Institute, suggested that regular use of aspirin for 20 years or more is associated with an increased risk of pancreatic cancer.The study of 88,000 nurses found that those who took two or more aspirins a week for 20 years or more had significantly higher risk of pancreatic cancer.

In details, who had reported regular aspirin use for more than 20 years were more likely to develop the cancer than women who hadn’t taken aspirin.
  • 86% increased risk 14 or more tablets per week
  • 41% increased risk 6 to 13 tablets per week
  • 29% increased risk 4 to 6 tablets per week
  • 11% increased risk 1 to 3 tablets per week

"Apart from smoking, this is one of the few risk factors that have been identified for pancreatic cancer," Dr. Eva Schernhammer of Harvard Medical School and Brigham and Women's Hospital in Boston, who led the study, told a news conference.

"Initially we expected that aspirin would protect against pancreatic cancer, especially since its preventive role in colorectal cancer has been well documented. However, now it appears that we need to examine the relationship more thoroughly," Schernhammer added in a statement.

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Summary

Because these substantial differences from findings in different studies, I would suggest do not take a side on any of the conclusions yet, but wait and see more elaborated studies’ results. It is however obvious that there are no easy answers, and that the conflict should be an impetus to additional research. Also, by no mean you should not stop using aspirin, as there are still important proven benefits to the drug.

However, the solid answer to the question of the aspirin’s ability to prevent pancreatic cancer is yet to be provided by ongoing medical researchers.


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