An Aspirin a Day Can Improve Non-Metastatic Colorectal Cancer Survival Rates by 30%

In January of 2009 Andrew T Chan, Shuji Ogino, and Charles S Fuchs published Aspirin Use and Survival After Diagnosis of Colorectal Cancer in JAMA (The Journal of the American Medical Association). (A. T. Chang, S. Ogino, C. S. Fuchs 2009. Aspirin Use and Survival After Diagnosis of Colorectal Cancer. JAMA 302:6 649-658)

The authors are associated with world class institutions including Harvard Medical School, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, and Massachusetts General Hospital. You will have to look very hard and for a very long time to find a better structured and thorough study.

You can get a copy of this article on its final form at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848289/pdf/nihms-185802.pdf

I’ve pasted excerpts from this paper below –

‘Conclusion Regular aspirin use after the diagnosis of coloractal cancer is associated with lower risk of coloractal cancer-specific and overall mortality, especially among individuals with tumors that overexpress COX-2.’

‘COX-2 promotes inflammation and cell proliferation, and is overexpressed in the majority of human colorectal cancers.’

‘Overexpression of COX-2 in tumor tissue has been associated with a poorer prognosis among colorectal cancer patients in some but not all studies.’

‘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.’

The bottom line on this article is that patients with diagnosed colorectal cancer had about a 30% increase in survival rate when they took one 325mg aspirin daily. Further analysis of the results indicates that the patients who were benefiting were the ones whose tumors overexpressed an enzyme called COX-2.

When you consider that the authors themselves say that overexpression of COX-2 probably leads to worse outcomes I would have to say that the results of this study are quite impressive.

But, because there is a chance these patients could get what is called a GI Bleed – which can be fatal – it’s better to let them die from their cancers?

Come on… what the heck is going on here…? With all due respect to these physicians, they’re talking like someone who has never sat in a physician’s office and heard the words ‘you have cancer’ or sat in a cancer infusion center’s waiting room while a loved one gets his/her chemotherapy administered.

It’s up to you… but I’d be talking very seriously to my Doc about the findings of this study if I had colorectal cancer – or cancer of the colon of any kind.

Me? I have researched the risks. I’m taking my aspirin.

As always…. I’m a pharmacist – not a doctor. I’m not recommending that you start taking an aspirin a day. I am recommending that you ask your Doc whether this would be worth a try.

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