Experts say there are health benefits for some people in taking aspirin daily.
- Regular use of low-dose aspirin could
potentially stop or slow the progression of colorectal cancer.
- Researchers
report that right-sided colorectal cancers had a more pronounced effect
from taking daily aspirin than tumors found on the left side of the colon.
- Experts
caution that daily aspirin use may cause gastrointestinal or brain
bleeding. They say the benefits and risks should be carefully considered
and discussed with your physician before beginning an aspirin regimen.
Taking low-dose
aspirin over a long period of time might slow or even prevent the
progression of colorectal
cancer, according to a study published by today in CANCER, a
peer-reviewed journal of the American Cancer Society.
Researchers conducted a study
of tissue samples from people with colorectal cancer who used aspirin and
others who didn’t in order to gain insight into how aspirin could slow the
progression of the cancer.
Scientists say they are
not sure why aspirin provides these benefits, but they speculate it might be
because the pain medication boosts certain aspects of the immune response against
cancer cells.
Details from
the study on aspirin and colorectal cancer
The researchers examined
tissue samples from 238 people who had had surgery for colorectal cancer. About
12% of the participants were aspirin users.
The researchers compared
those who used aspirin to those who did not. They say they discovered that in
people who regularly took aspirin, cancer spread to lymph nodes at
a lower rate. They added that aspirin users also had a higher infiltration of
immune cells into their tumors.
When the scientists
exposed cancer cells to aspirin in the lab, they noted an increase in the
protein CD80, enhancing cells’ ability to alert other immune cells to
tumor-associated proteins. People with colorectal cancer had higher levels of
CD80 in their healthy rectal tissue.
The researchers believe
these findings indicate a pro-immune surveillance effect of aspirin.
“Our study shows a
complementary mechanism of cancer prevention or therapy with aspirin besides
its classical drug mechanism involving inhibition of inflammation,” Dr.
Marco Scarpa, a surgeon at the University of Padova in Italy and a
principal investigator in the study, said in a press release. “Aspirin is
absorbed in the colon by passive diffusion to a significant degree. Its
absorption is linear and depends on concentration along the bowel, and in the
rectum, the concentration of orally administered aspirin can be much lower than
in the rest of the colon. Thus, if we want to take advantage of its effects
against colorectal cancer, we should think of how to guarantee that aspirin
reaches the colorectal tract in adequate doses to be effective.”
There were several
limitations of the study:
- It was a
retrospective and observational study, which are typically not as accurate
as direct studies.
- The
researchers did not know the dose or duration of preoperative aspirin use.
- Aspirin use
was self-reported.
- There was a
small sample size.
Nonetheless, one expert
said the findings are important.
“This is a fascinating
and important study,” said Dr. Anton Bilchik, a surgical oncologist, chief of
medicine, and director of the Gastrointestinal and Hepatobiliary Program at
Providence Saint John’s Cancer Institute in California.
“It provides more
information on the benefits of aspirin for colorectal cancer,” Bilchik, who
wasn’t involved in the study, told Medical
News Today. “Many previous studies
have looked at the risk
factors for colon cancer. This one looks at progression. The researchers
found that low-dose aspirin positively affected the immune system. Although,
there was a relatively small sample size.”
Colon
cancer: Right side vs. left side
The researchers said
there was a stronger effect from aspirin on right-sided
colon cancer than on left-sided cancers.
Right-sided and
left-sided colon cancers are considered distinct cancers. There are differences
in epidemiology, pathology, and prognosis. People with right-sided colon cancer
are more likely to be older, female, and have more advanced tumors at
diagnosis, according to a 2022
report in the journal Nature.
“Right-side cancer is completely
different than left-side cancer,” Bilchik said. “The different parts of the
colon behave differently, including during the onset and progression
of cancer. The scientists found less lymph node involvement in people
taking daily aspirin.”
Symptoms can
be different based on which side of the colon the cancer is.
Symptoms of right-sided
colon cancer include:
- Blood in
the stool
- Anemia
- Unexplained
weight loss
Symptoms of left-sided
colon cancer include:
- A change in
bowel habits
- Constipation
- Ribbon-shaped,
narrow stools
There is a poorer prognosis
for right-sided colon cancer than for cancers on the left, according to a 2023
study published in the journal Cureus.
Daily
aspirin use: Benefits, dangers
Medical experts have
touted the benefits
of low-dose aspirin for heart and stroke prevention. That’s partly
because aspirin acts as a blood thinner and therefore can decrease the risk
of blood clots.
A study completed in 2023 reported that over-the-counter
aspirin provided the same benefits as an injected blood thinner after
certain types of surgery.
Recent information has
questioned aspirin use based on potential side effects. Some researchers report
that daily aspirin use can potentially cause bleeding in the brain or gastrointestinal
tract. The risk increases with age.
The United States
Preventive Service Task Force (USPSTF) recommends against starting a daily aspirin regimen to
help prevent cardiovascular disease for people over 60 years of age.
According to the University of Maryland Medical System, people who should
not take daily aspirin include:
- Those who
are 60 or older and not at risk of heart attack or stroke
- Those at a
higher risk of gastrointestinal bleeding or hemorrhagic stroke
- Those who
drink alcohol on a regular basis
- Those with
an allergy to aspirin
- Those who
will have a medical or dental procedures in the near future
However, the
recommendations do suggest that low-dose aspirin can help in the secondary
prevention of people with atherosclerotic cardiovascular disease or who have
existing heart problems, such as a history of heart attack, stroke,
angioplasty, or other heart issues.
People who are likely to
benefit from daily aspirin, according to the University of Maryland Medical System include people
who:
- Have a
family history of cardiovascular disease or stroke
- Are
overweight or have obesity
- Have
conditions such as diabetes, chronic kidney
disease, and certain chronic inflammatory conditions
- Have high blood
pressure
- Have high cholesterol
- Have a
history of smoking
People 40 to 59 years of
age who have a 10% or greater 10-year cardiovascular risk may benefit from
aspirin use, but the USPSTF suggests the benefit is small. However, those who
do not have an increased risk of bleeding may benefit.
“Whether low-dose
aspirin should be taken or not is the million dollar question,” Bilchik said.
“The benefits and risks should be carefully weighed. The recommendation to take
or not to take is a judgment call by a physician who knows your health
history.”
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