Posted on 08/11/2009 9:12:27 PM PDT by neverdem
Men and women who were diagnosed with colorectal cancer and began regular use of aspirin had a lower risk of overall and colorectal cancer death compared to patients not using aspirin, according to a study in the August 12 issue of JAMA.
Numerous prospective, observational studies demonstrate that regular aspirin use is associated with a lower risk of colorectal adenoma (a benign tumor) or cancer. Aspirin is likely, at least in part, to prevent colorectal neoplasia (tumor growth) through inhibition of cyclooxygenase-2 (COX-2; an enzyme), which promotes inflammation and cell proliferation, and is overexpressed in the majority of human colorectal cancers, according to background information in the article. However, the influence of aspirin on survival after diagnosis of colorectal cancer has been unknown.
Andrew T. Chan, M.D., M.P.H., of Massachusetts General Hospital and Harvard Medical School, Boston, and colleagues studied the association between aspirin use and survival among 1,279 men and women with nonmetastatic (stage I, II, and III) colorectal cancer who were participating in 2 large prospective cohort studies (Nurses’ Health Study [NHS] and the Health Professionals Follow-up Study [HPFS]) that were initiated (in 1980 and 1986, respectively) prior to cancer diagnosis and followed up through June 1, 2008.
“Within these cohorts, we previously have demonstrated that regular aspirin use was associated with a reduction in the subsequent risk of developing an initial primary colorectal cancer, particularly tumors with COX-2 overexpression. Because these participants have provided biennially updated data on aspirin use, we had a unique opportunity to extend these findings by examining the influence of prediagnosis and postdiagnosis aspirin use on the survival of patients with established colorectal cancer,” the authors write.
For participants who were alive through the end of follow-up, the median (midpoint) time of follow-up from date of diagnosis was 11.8 years. There were 193 total deaths (35 percent) and 81 colorectal cancer-specific deaths (15 percent) among 549 participants who regularly used aspirin after colorectal cancer diagnosis, compared with 287 (39 percent) total and 141 (19 percent) colorectal cancer-specific deaths among 730 participants who did not use aspirin. For the entire cohort, the overall 5-year survival was 88 percent for participants who used aspirin compared with 83 percent for those who did not. The corresponding 10-year survival rates were 74 percent and 69 percent.
Regular use of aspirin after diagnosis was associated with a significant reduction in risk of colorectal cancer-specific death and a reduction in overall mortality. Compared with nonusers, regular aspirin use after diagnosis was associated with a 29 percent lower risk for colorectal-specific mortality and a 21 percent lower risk for overall mortality. Because the prognosis among stage I participants is generally favorable, the researchers also examined the influence of aspirin use among those diagnosed with stage II or III disease and observed similar results.
Among the 719 participants who did not use aspirin before diagnosis, initiation of use postdiagnosis was associated with a 47 percent lower risk for colorectal cancer-specific mortality and a 32 percent lower risk of overall mortality. In contrast, among participants who were using aspirin before diagnosis, continuation of aspirin use postdiagnosis was not associated with a significant reduction in colorectal cancer-specific survival or overall survival.
Among participants with COX-2–positive tumors, regular aspirin use after diagnosis was associated with a 61 percent lower risk of colorectal cancer-specific death and 38 percent lower risk of overall mortality, whereas postdiagnosis aspirin use was not associated with lower risk of either colorectal cancer-specific or overall mortality for those with COX-2–negative tumors. “This supports the hypothesis that COX-2–positive tumors may be relatively sensitive to the anticancer effect of aspirin, whereas COX-2–negative tumors may be relatively aspirin-resistant. Moreover, it potentially explains the observation that the benefit of postdiagnosis aspirin use on patient survival was not apparent among patients who used aspirin prior to cancer diagnosis,” the researchers note.
“These results suggest that aspirin may influence the biology of established colorectal tumors in addition to preventing their occurrence. Our data also highlight the potential for using COX-2 or related markers to tailor aspirin use among patients with newly diagnosed colorectal cancer. Nonetheless, because our data are observational, routine use of aspirin or related agents as cancer therapy cannot be recommended, especially in light of concerns over their related toxicities, such as gastrointestinal bleeding. Further studies among patients with colorectal cancer, including placebo-controlled trials of aspirin or related agents as adjuncts to other routine therapies, are required.”
JAMA. 2009;302[6]:649-659.
http://jama.ama-assn.org/
You see Obama was right. The pain pill is the best response to health problems
Anyone know the dosage?
My wife with Stage IV (aged 44) is thinking about quitting chemo.
This is not a clinical trial where participants are assigned a specific dose. What they did here was to ask people in large longterm studies about their habits. For example, the women were from the Nurses Study. There are > 80K women in that trial. They identified about 1K who developed this cancer, then interviewed them about their pre-diagnosis and post-diagnosis aspirin use and looked at their outcomes.
I pulled up some of this team’s previous work for you and it looks like “regular” aspirin use has meant 1/2 to 1 1/2 tabs per week.
I hope this is helpful to you. My best wishes to your wife.
My father is "over the hill" in Montrose, and also is undergoing chemo for stage IV colorectal.
IIRC, my sister has stage 1B or 2A, the primary lesion and one out twelve positive lymph nodes. Complications with the chemoport and chemotoxicity with 5FU caused her to say enough after one or two treatments. She's taking 3000 - 4000 IU of vitamin D3 daily depending on the season and Goji Berry juice.
Beware of what you find on the internet. I prefer to use PubMed.
Enter Curcumin and colorectal cancer into PubMed's query box. Curcumin is supposed to be the active ingredient in the spice called tumeric.
Urban materials trigger air pollution
FReepmail me if you want on or off my health and science ping list. Anyone can post any unposted link as they see fit.
There was some very good stuff on here yesterday. http://www.freerepublic.com/focus/news/2313061/posts?page=94#94 Praying for your wife.
ping
re: Curcurmin
Thnx.
More and more about the amazing importance of the anti-inflammatories!
Ordinary capscaicin is also showing alot of positive results.
I’d talk to Dr. Paul Sugarbaker out of DC before giving up anything. He’s pretty good with the toughest cases and saved a fellow I know’s life.
Sugar Baker Oncology is the site.
Thanks for the link! Can you post the story? I’ll link it if you do.
Cimetidine: A Common Heartburn Remedy Complements Conventional Cancer Therapy
Thank you!
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.