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Aspirin May Protect Against Colon Cancer Recurrence,
Reduce Death Risk
Previous studies show aspirin also protects against
the disease
May 16, 2005 - Colon cancer patients who took
aspirin regularly fared better after surgery, reducing their risk of
disease recurrence and death by half compared to non-users, says new
research. While previous studies have shown that aspirin use provided a
preventative benefit by lowering the risk of developing colon cancer and
intestinal polyps, the new study is the largest to demonstrate that
aspirin had a potential treatment benefit in people who have been
diagnosed with colon cancer.
Charles Fuchs, MD, MPH, of the Dana-Farber Cancer
Institute in Boston, is lead author on the report by researchers from
the Cancer and Leukemia Group B, a national clinical research group. The
data will be presented tomorrow at the annual meeting of the American
Society of Clinical Oncology.
"Our data are intriguing because they showed that
aspirin use notably reduced the risk of recurrence in patients with
advanced colon cancer, but more research is needed before any treatment
recommendations can be made about the regular use of aspirin," says
Fuchs.
The findings emerged from a prospective study of
846 patients who were enrolled in a randomized trial of two chemotherapy
regimens following surgery for colon cancer. They all had stage III
disease that had spread to lymph nodes but not elsewhere in the body.
The researchers interviewed the patients about medication use and
lifestyle midway through their chemotherapy, and again six months after
therapy was completed.
Regular aspirin use was reported by 75 patients
(8.9 percent) in doses of 81 mg ("baby" aspirin) to 325 mg per day. A
total of 41 patients (4.7 percent) reported using COX-2 inhibitor
anti-inflammatory agents, Celebrex or Vioxx.
The researchers found, based on an average follow
up of 2.7 years after the second interview, that regular aspirin users
had a 55 percent lower risk of colon cancer recurrence and a 48 percent
lower risk of death compared to non-users. The benefit of aspirin was
independent of the dose, as long as the patient consistently took the
painkiller throughout the follow-up period. Those who took Celebrex or
Vioxx had a 53 percent reduction in recurrence risk.
The researchers also assessed the study
participants' use of acetaminophen – to determine whether the benefits
attributed to regular aspirin and COX-2 inhibitors had a non-specific
analgesic effect – and found no recurrence or survival benefit.
Fuchs, who is also an associate professor of
medicine at Harvard Medical School, says the next step is to conduct
more research to confirm these findings and to determine the mechanism
by which aspirin use produces treatment benefit. He adds that studies
currently are underway to examine the addition of COX-2 inhibitors to
chemotherapy in patients with advanced colon cancer.
Source notes:
In addition to Fuchs, the study's other authors are
Robert Mayer, MD, Jeffrey Meyerhardt, MD, MPH, and Denise Brady, BA,
Dana-Farber; Donna Niedzwiecki, PhD, and Donna Hollis, MS, CALGB
Statistical Center; Andrew Chan, MD, Massachusetts General Hospital;
Leonard Saltz, MD, Memorial Sloan-Kettering Cancer Center; and Richard
Schilsky, MD, University of Chicago.
Dana-Farber Cancer Institute is a principal
teaching affiliate of the Harvard Medical School and is among the
leading cancer research and care centers in the United States. It is a
founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), a
designated comprehensive cancer center by the National Cancer Institute.
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