Could the humble aspirin prevent breast cancer survivors from suffering a second bout of the disease or even dying from it? A provocative study from Boston researchers suggests it's a strategy worth further consideration.
Scientists from several Harvard-affiliated institutions, including Brigham and Women's Hospital, reported today that women who took aspirin after finishing breast cancer treatment were half as likely to die from the disease as women who didn't regularly use aspirin. Taking the centuries-old remedy also appeared to significantly reduce prospects that breast cancer would return, according to the study published in the Journal of Clinical Oncology.
The study's authors, along with cancer specialists not involved in the research, cautioned that while the findings are promising, they are not definitive and should not be used to advise breast cancer survivors to start taking aspirin. The study's conclusions were based on registered nurses completing health surveys every two years, a form of research that can yield important hints about what works and what doesn't in medicine but can't provide absolute answers.
Still, the research adds to a growing mound of evidence that certain low-cost, tried-and-true medicines -- aspirin and diuretics, for example -- need to be regarded with more respect by doctors and patients who gravitate toward the newest drugs in the medicine cabinet. Some studies have suggested that long-term use of aspirin may reduce the likelihood of developing colon cancer.
"There's an increasing interest in aspirin as a cancer preventative," said Dr. Larry Norton, director of breast cancer services at Memorial Sloan-Kettering Cancer Center in New York. "But I wouldn't recommend based on [this study] that people go out and buy aspirin."
Researchers, led by Dr. Michelle Holmes of the Brigham and Harvard, used survey results from the Nurses' Health Study to examine the potential impact of aspirin on breast cancer recurrence and survival in 4,164 nurses diagnosed with the disease between 1976 and 2002. A total of 341 women in the study died from breast cancer.
After taking into account other factors that might explain why some women lived longer, the researchers, whose work was underwritten by the National Institutes of Health, concluded that aspirin may have figured prominently in the longer survival rates of nurses who took the medication. And there was a suggestion that women who took the drug more frequently had the best chance of beating breast cancer. The study was not able to determine the exact dose of aspirin women were taking.
Other studies have reached mixed conclusions about aspirin and whether it can reduce the chances of developing breast cancer. The sweeping Nurses' Health Study, in previous findings, has found that the top reason women take aspirin is to prevent heart disease, followed by relief of muscle or joint pain, headaches, and backaches.
Scientists can't say for sure why aspirin might forestall cancer's return, but research in laboratories and in animals has found that the ancient drug acts like water dousing the embers of a simmering fire, quieting inflammatory processes that contribute to cancer's spread.
"We don't know exactly the mechanism, but there are a lot of hints out there that aspirin has anticancer effects," Holmes said. "It is important to re-examine some of these old drugs and see if there can be additive effects on top of conventional treatments."
Usually, patients in the midst of chemotherapy, radiation, and other cancer treatments are discouraged from taking aspirin because of concerns about drugs interacting in potentially dangerous ways. And even when women start taking aspirin after treatment -- the group covered in today's study -- there are still risks associated with the medicine, including stomach bleeding and other gastrointestinal complications, specialists stressed.
Gold-standard trials that involve randomly assigning some patients to take a drug while others get a dummy pill are designed to assess risks and benefits rigorously, and, today, several specialists called for such a review of aspirin and breast cancer.
"Studies like today's generally shouldn't change clinical practice, they shouldn't lead to a change in women's health decisions," said Dr. Eric Winer, chief of women's cancer at Dana-Farber Cancer Institute. "What they do provide is good evidence to move forward with a study asking whether this finding is real and how it should be used in clinical care."
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|White Coat Notes covers the latest from the health care industry, hospitals, doctors offices, labs, insurers, and the corridors of government. Chelsea Conaboy previously covered health care for The Philadelphia Inquirer. Write her at email@example.com. Follow her on Twitter: @cconaboy.|
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