New report on aspirin risk v. benefit

From the Guardian newspaper in UK today --

[www.guardian.co.uk]

"It's certainly time to add the prevention of cancer into the analysis of the balance of risk and benefits of aspirin. So far, all the guidelines have just been based on the prevention of strokes and heart attacks. This research really shows that the cancer benefit is as large as, if not greater than, the benefit in terms of preventing heart attacks and strokes. It does change the equation drastically."

Gill

Gill: Is this the same study to which you are referring? [www.nytimes.com]

This one says, among other things, that the risk of bleeding from aspirin goes down with time of taking it. The reduction in cancers looks pretty dramatic to me.

Gordon

It certainly sounds interesting as prevention but do remember Hans' report on Aspirin: Friend or Foe.
[www.afibbers.org]

I knew a woman who was plagued with arthritis pain (bad diet) and gobbled aspirin for at least the thirty years I knew her.
She developed bladder cancer and died. When I saw that news splash last night, I thought... well, it may be preventive in some some people,
but certainly not all.

Another arthritic woman I know (also bad diet) was around 50 with arthritic hip pain also gobbled aspirin and eventually had a hip replacement.
Not long after that, she was diagnosed with colon cancer and is doing well about ten years later... so all her aspirin didn't spare her either.

Obviously, there are many other factors involved, but the news makes it sound as if all one has to do is take aspirin and they are protected.
There may be some merit to the protective effects of aspirin but if you choose to take it regularly, know all sides of the good and bad features.
An aspirin a day without cleaning up unhealthy lifestyle habits isn't going to change much so once again, it's the whole body health issue that's in focus.

Jackie

Obviously, it would be very convenient if aspirin's loss of market in the primary prevention of cardiovascular disease could be replaced by a brand new market in cancer prevention.

As I pointed out in my article "Aspirin: Friend or Foe", aspirin is by no means innocuous and at least two large American studies have found it ineffective in preventing colon cancer in both men and women. In any case, if I were to recommend a universal cancer prevention agent it would be vitamin C. More than a dozen studies reported in peer-reviewed medical journals have concluded that vitamin C is effective in preventing cancers of the bladder, cervix, colon, rectum, esophagus, larynx, lung, mouth, prostate and stomach.

References
(1) Levine, Mark, et al. Vitamin C pharmacokinetics in healthy volunteers: Evidence for a recommended dietary allowance. Proceedings of the National Academy of Sciences USA, Vol. 93, No. 8, April 16, 1996, pp. 3704-09
(2) Cameron, E. and Pauling L. Cancer and Vitamin C. Camino Books Inc., Philadelphia, PA, 1993
(3) Goldberg, Burton. Alternative Medicine: The Definitive Guide. Future Medicine Publishing, Puyallup, WA, 1993
(4) Block, Gladys. The data support a role for antioxidants in reducing cancer risk. Nutrition Reviews, Vol. 50, No. 7, July 1992, pp. 207-13
(5) Frei, Balz. Reactive oxygen species and antioxidant vitamins: mechanisms of action. American Journal of Medicine, Vol. 97, Suppl. 3A, September 26, 1994, pp. 5S-13S
(6) Block, G. Epidemiologic evidence regarding vitamin C and cancer. American Journal of Clinical Nutrition, Vol. 54, December 1991, pp. 1310S-14S
(7) Uddin, Shahab and Ahmad, Sarfraz. Antioxidants protection against cancer and other human diseases. Comprehensive Therapy, Vol. 21, No. 1, 1995, pp. 41-45
(8) Block, Gladys. Micronutrients and cancer: Time for action? Journal of the National Cancer Institute, Vol. 85, No. 11, June 2, 1993, pp. 846-47
(9) Diplock, Anthony T. Antioxidant nutrients and disease prevention: An overview. American Journal of Clinical Nutrition, Vol. 53, 1991, pp. 189S-93S
(10) Ferraroni, M. et al. Selected micronutrient intake and the risk of colorectal cancer. British Journal of Cancer, Vol. 70, December 1994, pp. 1150-55
(11) Stahelin, H.B., et al. Plasma antioxidant vitamins and subsequent cancer mortality in the 12-year follow-up of the prospective Basel Study. American Journal of Epidemiology, Vol. 133, No. 8, April 15, 1991, pp. 766-75
(12) Blot, William J., et al. Nutrition intervention trials in Linxian, China: Supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. Journal of the National Cancer Institute, Vol. 85, No. 18, September 15, 1993, pp. 1483-91
(13) Blot, William J., et al. Lung cancer and vitamin supplementation. New England Journal of Medicine, Vol. 331, No. 9, September 1, 1994, p. 614
(14) Han, Jui. Highlights of the cancer chemoprevention studies in China. Preventive Medicine, Vol. 22, September 1993, pp. 712-22
(15) Jacobs, Maryce M. Diet, nutrition, and cancer research: An overview, Nutrition Today, May/June 1993, pp. 19-23
(16) Bruemmer, Barbara, et al. Nutrient intake in relation to bladder cancer among middle-aged men and women. American Journal of Epidemiology, Vol. 144, No. 5, September 1, 1996, pp. 485-95
(17) Malins, Donald C., et al. Progression of human breast cancers to the metastatic state is linked to hydroxyl radical-induced DNA damage. Proceedings of the National Academy of Sciences USA, Vol. 93, No. 6, March 19, 1996, pp. 2557-63
(18) DeCosse, Jerome J., et al. Surgical and medical measures in prevention of large bowel cancer. Cancer, Vol. 40, November 1977, pp. 2549-52
(19) Niedzwiecki, A, et al. Micronutrient synergy - a new tool in effective control of metastasis and other key mechanisms of cancer. Cancer Metastasis Review, Vol. 29, 2010, pp. 529-42

So, in conclusion, it is highly unlikely that I shall be promoting the long-term use of aspirin as an effective and safe protocol for cancer prevention.

Hans

My former cardiologist wanted me to take aspirin every day, even though I made it clear that it caused severe inflammation in my lower GI tract. To heck with the knowledge of my body's reaction based on over a decade of aspirin use - aspirin is the cure-all! Bah.

Sure, we'd all like a "silver bullet" for our ills, and with aspirin already having nearly a folk-lore reputation...makes great media promo's. Sorry, I'll stick with proper diet and exercise, and skip the unnecessary daily drug.

Here is some background on one of the researchers if you are debating where to start in evaluating this latest research:

Peter M Rothwell MB ChB MD PhD FRCP FMedSci

Stroke Prevention Research Unit, Level 6 West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom


Professor Rothwell is a clinical neurologist with an interest in stroke. He was appointed as Clinical Lecturer in Oxford in 1996, was awarded an MRC Senior Clinical Fellowship in 2000, and was given the title of Professor of Clinical Neurology at the University of Oxford in 2004. He founded the Stroke Prevention Research Unit in 2000, which has since published over 250 scientific papers.

In addition to prevention of stroke, his research interests include hypertension, the risks and benefits of aspirin, and the more general theme of how best to apply the results of clinical trials and other forms of research to clinical decisions with individual patients in routine clinical practice.

Professor Rothwell’s responsibilities outside Oxford include editorial duties for several international scientific journals, membership of committees of several multicentre trials, and several national and international scientific and advisory committees.

Hi Hans,

The two major studies done in the US of low-dose aspirin for cancer prevention that you refer to, that did not find reductions in cancer with aspirin use, were excluded from analysis by the Oxford researchers because they involved use of aspirin every other day, rather than daily use, so not quite apples for apples.

[www.nytimes.com]

Kind regards,

Justine

Advice from Robert J. Rowen, MD from his free email news tips on health issues...
Second Opinion Health Alerts

March 23, 2012

When you should take an aspirin a day (Hint: It's not for your heart)
You may have heard about a study that came out not too long ago touting aspirin as a cancer preventive. The report came out in The Lancet and said that aspirin cuts hereditary cancer risk in half. That's pretty impressive. But you need to know the other side of the story.

First, the report was on Lynch syndrome, a genetic problem in which your DNA can't properly repair itself. Most experts believe that 10% of colon and uterine cancers are the result of genetic factors like this. The study followed almost 1,000 people with Lynch syndrome over 10 years.

While 15% of the people using aspirin regularly reported developing cancer, 30% of non-users got cancer. Interestingly, both groups got the same number of colon polyps, considered precursors of colon cancer. So, the researchers believed that aspirin could be destroying precancerous cells before they become malignant.

It's true that there might be a place for aspirin in cancer prevention for a hereditary disorder. But it won't be without risk of stomach bleeding and gastritis. I would turn to diet first. Here's why:

Loma Linda researchers conducted a colon polyp study on 2,818 participants of the Adventist Health Study. This study followed patients for a whopping 26 years! They found that consuming legumes three or more times per week netted a 33% reduction in getting polyps. Brown rice just once per week lowered risk by 40%. And those who consumed cooked green veggies daily had a 24% lower risk, as compared to those eating them less than five times weekly.

The lead researcher was Yessenia M. Tantamango. She said all these, and including dried fruits, have large amounts of fiber, which will dilute potential carcinogens. Cruciferous veggies, famed for cancer prevention, also contain detoxifying compounds.

There is colon cancer in my family. But I'm not taking aspirin. I'd rather more than halve my risk with a combination of foods mentioned above (except I don't cook the bulk of my veggies, so I think they have greater risk reduction).

I know you may not be able to increase these protective foods for one reason or another. If there is a genetic history, then you might consider an aspirin a day. Please consult your integrative physician before starting on aspirin.

Yours for better health and medical freedom,

Robert J. Rowen, MD

Ref: The Lancet 11-1-11; Nutrition and Cancer. May, 2011.


If someone forwarded you this email, and you'd like to receive your own Second Opinion Health Alert, please sign up on our website: www.SecondOpinionNewsletter.com

Jackie,

Thank you for posting this. I have not had a chance to carefully study the articles involved in this new promotion of aspirin, but expect to do this shortly. In any case, when it comes to preventing colon cancer it is unlikely that anything including aspirin and other pharmaceuticals can beat an apple a day which reduces the risk of developing colon cancer by about 50%.

An apple a day may hold colorectal cancer at bay [ncbi.nlm.nih.gov]

Case-control study on beneficial effect of regular consumption of apples on colorectal cancer risk in a population with relatively low intake of fruits and vegetables [ncbi.nlm.nih.gov]

This may also be of interest Aspirin - Treat with care! [www.yourhealthbase.com]

Hans



Edited 1 time(s). Last edit at 03/23/2012 05:02PM by Hans Larsen.

Justine,

The Oxford researchers speculate that it is the ability of aspirin to prevent platelet aggregation that is behind its purported cancer-preventing effects. If this is indeed so then there is no justification for excluding the two very large American studies which found no effect of the daily aspirin on colon cancer risk. Here is how it works:

One 300-mg dose of aspirin irreversibly destroys the ability of platelets to form the aggregates that are involved in thrombotic, ischemic stroke. The platelets recover their ability to aggregate at a rate of about 10% a day. Thus, a prophylactic regimen of a one-time, 325-mg dose (standard dosage) followed by a daily dose of 81 mg (baby aspirin) or even half a baby aspirin would provide the full beneficial effect of aspirin as far as prevention of secondary cardiovascular events is concerned. Limited data suggest that 100 mg of aspirin every other day is also effective in suppressing platelet aggregation.

Hans

Thanks Jackie and Hans for your latest thoughts. I am watching the debate with interest, grateful for what I can learn from both sides.

Kind Regards,

Justine

Want to prevent colon cancer?
Get your regular scheduled colonoscopy starting at age 50 and earlier for those at risk.
Didn't I just read something about long term aspirin use and detached retinas?

Mchale,

Do you have a link?

Thanks.

lisa
__________________________

So much of medicine is looking solely down the wrong end of the gun barrel, and that is really a pity for all of us---Shannon

Hans - On the Apple a Day comment... there are two recent studies indicating fiber decreases colorectal cancer risk.
It was found that for every 10 grams of total fiber intake, colorectal cancer risk fell by 10%.

That's typically about transit time. More fiber (25 grams+ daily as a recommendation) equals faster transit time and thus reduces the exposure time that toxins lie in the GI tract and cause problems.


Dietary fiber, whole grains and risk of colorectal cancer: systemic review and dose-dependent meta-analysis of prospective studies. BMJ. 2011:343:d6617

World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Interim Report Summary. Food Nutritiion, Physical Activity and the Prevention of Colorectal Cancer. 2011

Jackie

Jackie, you brought up the lower transit time of increased fiber, and it made me think. What about those of us walking the thin line between watery and soft stools due to our Mg consumption? Following that same logic, would we also have a decreased risk? Has anyone done any studies based on transit time alone (no matter the reason for it)?

lisa
__________________________

So much of medicine is looking solely down the wrong end of the gun barrel, and that is really a pity for all of us---Shannon

Lisa - there probably are.. but the fiber theory is not only the fiber's bulking capacity because it holds water, but because of the "scouring" effect as it passes through... cleaning the GI lining of residues. Remember that the inside of the GI tract it packed with nooks and crannies, folds and crevices. The quick transit time from magnesium would have the 'rapid transit' time benefit but lacks the scouring benefit. Either way, those dealing with GI health say two soft bowel movements a day is ideal so whatever one has to do to achieve that can be beneficial. If there is a too loose/watery consistency, then adding fiber would be an ideal adjunct. Fiber... as long as it is not the artificially sweetened junk sold as Benefiber or some of the others... there are various natural fibers that are just plain.

Taking an aspirin doesn't do anything for motility.

Jackie

Lisa,
This is the best I could dig up but I if I recall I just heard this all over the news

[www.emaxhealth.com]

Jackie,

It appears there is more to the benefit of the daily apple than just fiber content. There is growing evidence that the polyphenols found in apples are the key to their ability to prevent colon cancer (by as much as 50%). The polyphenol Phloridzin - mainly found in the skin of the apple - is particularly important and in addition to helping prevent colon cancer also is effective against glycation, one of the most common, preventable, and reversible causes of aging. I am not aware of any information as to whether organically grown apples are a better source of polyphenols, but suspect they probably are as many fruits adapt to spraying with pesticides by reducing their own natural defenses (including polyphenols) against pests.

[www.fattylipoma.com]

Hans