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An Aspirin a Day Keeps the Cancer Away

 

Erica Williams

September 20, 2006

 

 

 

Aspirin is Prevention? What?

 

       Aspirin has long been used to treat headaches, muscle aches, and various other ailments.  A form of aspirin derived from willow barks and wintergreen can be traced back to the time of Hippocratic writings.  Aspirin as we know of it today is the collaborative product of the medical, laboratory, and pharmaceutical industry during the late nineteenth-century (Andermann 1996).  Recently, studies have examined the effects of aspirin in the prevention of breast cancer development.

But first…what exactly is Aspirin?

          The chemical ingredient found in the ground bark mentioned by Hippocrates contains the chemical salicin.  Salicin is converted to salicylic acid in the body after consumption.

Salicin

 

While the chemical salicin is successful in relieving pain, the side effects left many people literally sick to their stomachs as they suffered bleeding digestive tracks.

          In the late nineteenth century, Felix Hoffman converted the salicin into acetylsalicylic acid as an alternative to the harsh salicylic acid.  The drug was not officially marketed until years later (4).

Acetylsalicylic Acid

 

 


 

 

 

 

 

 

 

The drug, now with the given name of aspirin, competed with heroin as the top drug for pain relief for years.  After the addictive nature of heroin was discovered, aspirin became the leader of pain relief drugs.

For more information on the history of aspirin, visit

http:// www.med.mcgill.ca/mjm/issues/v02no2/aspirin.html

 

So what does this have to do with breast cancer?

Breast cancer is one of the top priorities in women’s health thanks to massive public support and awareness.  While breast cancer is not the leading cause of death for women (heart disease has that prize), it remains one of the greatest fears of women.  Around 2004, reports and studies surfaced that claimed aspirin, along with other non-steroidal anti-inflammatory drugs (NSAIDs), was an effective preventive measure against breast cancer.    As you can imagine, this was big news as various news outlets proclaimed “Aspirin Prevents Breast Cancer!!!” and women around the world rejoiced as they stocked up on aspirin. 

But is aspirin really a preventative measure?

          While the media was ready to proclaim the aspirin as the wonder drug to prevent cancer, the medical and science community was more hesitant to make such claims.  Conflicting studies surfaced that either supported the claim or concluded that aspirin had very little, if any, effect had reducing the risk of developing breast cancer.  However, the most recent research shows that aspirin does have a role in prevention, but only for a certain category of breast cancer.

The Research

A study done by researchers Mary Beth Terry and Dr. Alfred Neugut of Columbia University in 2004 found that there was a reduced risk found for breast tumors whose growth is fueled by the sex hormones of estrogen and progesterone.  The researchers discovered that women who used aspirin at least four times a week for at least three months were almost 30 percent less likely to develop hormone-fueled breast cancer than women who used no aspirin (CBS 2004) This lead the researchers to suspect that aspirin and other NSAIDS (nonsteroidal anti-inflammatory drugs) reduced the risk of breast cancer by interfering with the body’s production of estrogen (1).  Data from 1,442 breast cancer patients age 59 on average and a control group of 1,420 healthy women without breast cancer (1) was collected and analyzed.  During their interview, the participants of the study were asked about their use of the pain relievers aspirin, ibuprofen, and acetaminophen.  For older postmenopausal women, the link with aspirin was strongest when taken seven or more tablets a week.  The results provide evidence for the researchers’ suspicion of aspirin blocking estrogen production since hormone-fueled breast cancer in more common in older women.  Aspirin indirectly lowers levels of estrogen in the breast by producing an enzyme called prostaglandins which induces an enzyme crucial to estrogen production (1). However, as with the case of most of these earlier studies, researchers relied on people’s recollections of how often they took aspirin, which is not, methodologically, the best way to collect sound data.

Any more proof…

As mentioned in the previous study, post-menopausal women showed the strongest link between aspirin and breast cancer.  Post menopausal women account for eighty percent of all breast cancers and almost ninety percent of breast cancer deaths (2).  A study done by Rahme (2005) et al looked at this group of women and found similar conclusions to the Terry et al (2004) study.  The researchers looked at the inhibition of cyclooxygenase (COX)-2 inhibition along with NSAIDs as breast cancer preventive measures.  Cyclooxygenase was looked at because COX-2 enzymes are expressed more in breast cancer than in normal breast tissue (2). Researches obtained data from insurance companies for women 65 years or older who filled a prescription for COX-2 inhibitors, non-selective NSAIDs, aspirin, or acetaminophen between January 1998 and December 2002(2).  The patients were defined as women who had undergone a mammography between April 2001 and June 2002 and had a diagnosis of breast cancer within six months of the mammography (2). The controls were women had undergone mammography between April 2001 and June 2002 without a diagnosis of cancer during the following six months (2).  Exposure was defined as the refilling of one or more prescriptions for at least 90 days prior to a set date. With 1,090 cases and 44,990 controls and adjustment for confounding variables, the results showed that the use of NSAID and/or COX-2 lowered the risk (2) of developing breast cancer.  Aspirin usage that was at least a dosage of 100mg/day in the year prior to the mammography was also found to lower the risk (2).  Thus, according to this study and others, the use of aspirin ( at least 100mg/day) and other NAIDs is associated with a lowered risk for breast cancer.

Conclusion

As shown in the studies mentioned above, there is definitely an association between a lowered risk of breast cancer and aspirin.  The group that would probably benefit most from this discovery is older, post-menopausal women, who are at the greatest risk for hormone related cancer.  Further research is needed better understand the role aspirin plays in blocking estrogen and possible medications that could be derived from this research.  However, women should always remember that aspirin can cause bleeding in the stomach or intestine or strokes from bleeding in the brain (3).  Before making aspirin the miracle drug for prevention, women should always keep these risks in mind when considering taking aspirin regularly and talk to their physicians first.

References

CBS News.(2004). Aspirin may cut breast cancer risk. CBS News. September 17,

          2006, http:/www.cbsnews.com.

Rahme, et al. (2005) Association between frequent use of nonsteriodal anti-

          inflammatory drugs and breast cancer. BMC Cancer, 5,159-166.

Schwartz,L.M., Woloshin, S., & Welch,H.G..(2005) Overstating aspirin’s role in

          breast cancer prevention. Washington Post. September 18, 2006, from

          http://www.Washingtonpost.com

Andermann, A.A.J.(1996) Physicians, fads, and pharmaceuticals: the history of

          aspirin. MJM. September 19, 2006. http://

          www.med.mcgill.ca/mjm/issues/v02no2/aspirin.html

 

 

 

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