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.
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."
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.
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.
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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