asprin reduces breast cancer

mawhinney

There was a report on the  2/16/10 evening news about a new study that has found that taking asprin 2-5x weekly reduces breast cancer reccurence 71%. You can read about the encouraging though preliminary study at  www.abcnews.go.com

 Please note -The reporter cautioned that those on chemo should not take asprin.

Anonymous

Did they say what specific type of cancer?

LRM216

On google's news (health page) they specifically site breast cancer and colon cancer - study was done on 1,400 nurses with breast cancer, hormone positive and negative cancers - and the stats were great for both.  What the heck are the onc's waiting for - it's aspirin, and while I know some people cannot take it and it's not without it's risks, we sure as hell have been given far more toxic drugs (chemo) with no guaranteed results.  I am calling my onc tomorrow to check this out.  My God, if something as simple as this can help us as greatly as the article and the study found, why aren't we already taking it?  It cannot be taken during any chemo or radiation study said.

Linda

Anonymous

Wow, I can't seem to find the link on abc. Is it a regular asprin or low dose?

Springtime

Apparently, it is a larger dosage than the little "baby aspirin" dosage of 81mg for heart health.

Has anybody figure out about how much we should take? Would 1 regular aspirin a day 5 days a week do it? 

They speculate it's the anti-inflammatory aspect of aspirin and I think they also said NSIDs that's doing it.  

Sugar77

I saw this on the news yesterday here in Canada but couldn't find anything on Google when I searched after the broadcast. Maybe it was just a bit too early to search.  I'd be interested to hear what your oncs have to say about it. I just finished chemo last week and will be going through radiation in a few weeks so I'll have to wait a bit. 

Anonymous

Wow, I can't seem to find the link on abc. Is it a regular asprin or low dose?

cd1234

After I was done with chemo my oncologist told me the only two things I should do everyday to reduce my chances of a recurring cancer is to take a low dose aspirin and get 30 minutes of exercise.

Anonymous

delete

mawhinney

I recall the report said that possibly imflamation may create a blood supply for cancer growth.  The asprin helps destroy the imflamation.

According to the news report asprin reduces the odds of death in breast cancer survivors. The study was done on 4164 participants in the Nurses' Health Study.  The article on the study appears in the latest issue of the Journal of Clinical Oncology.

I have not as yet seen a reference to amount of asprin used in the study. 

Ihopeg

They said baby aspirin. I am calling my onc tomorrow!!

jax65

Of course it only helps hormone positive breast cancers...when do we triple negatives catch a break

http://www.cancer.org/docroot/NWS/content/NWS_1_1x_More_Evidence_Aspirin_Protects_Against_Breast_Cancer.asp

karen_in_nj

jax- the link you posted was to a 2004 study that showed a benefit of aspirin for hormone positive cancers. But apparently the new study found a benefit for both hormone positive and hormone negative cancers -

http://www.msnbc.msn.com/id/35426947/ns/health-cancer/

somanywomen

Since entering this bc world, I have now a collection of bc health/anti-cancer books and have read more than once that aspirin could be helpful against bc ...Everyone should of course, consult thier docs, but at minimum if you are taking the low dose aspirin daily for heart protection, you could get a benefit for other health protections...I usually take a Enteric (safety coated) 81mg morn and evening....Walmart equate brand usually has 2 for 1 on these...

jax65

Karen thank you for pointing that out to me I didn't notice the date on the article. Makes me happy to see it gave hope for negative cancers as well.

KatRNagain92

I had been taking daily aspirin for years (cardiac prevention) and I still got breast cancer.   I guess I'm in that other 50%.   

Anonymous

I've been taking a baby aspirin (81 mg) daily to help prevent blood clots anyway (take Evista for  high risk from LCIS and family history of bc), so this is good news. If it helps against colon ca even better, at risk for that as well from family history.

Anne

otter

Here's a good news release about the new article.  It talks about the number of women in the study, the number of times per week that they took aspirin, and the fact that NSAIDS like ibuprofen and Aleve appeared to have a similar protective effect, but Tylenol did not (although the results were only statistically significant with aspirin):  http://www.medpagetoday.com/HematologyOncology/BreastCancer/18489

One interesting thing is that women who took aspirin "between two and five days a week" had a lower risk of recurrence than women who took aspirin "six to seven days" a week.  The numbers of recurrences and deaths among those groups seem awfully small to me; that's probably what accounts for the differences.

This was a prospective, "observational" study -- it was not a traditional, controlled clinical trial.  The researchers relied on the women's responses to written surveys that were sent out every 2 years. The standard, 2-year survey asked for frequency of aspirin use, not for the reason aspirin was being used or the dose being taken.  In 1999 (only), an extra survey was sent out that asked women to mark on a checklist the reason(s) they had been taking aspirin; and 35% of the respondents said it was for "heart disease prevention."  Other reasons included "muscle and joint pain" (16%), "headache" (13%), etc.  Since the researchers did not collect data on the dose of aspirin the women were taking, the comment about it most likely being low-dose  ("baby") aspirin for heart disease prevention is an assumption and might not be accurate. There really is no conclusive evidence that one dose is better than another.

The actual research paper is in the "early release" (not yet in print) section of Journal of Clinical Oncology. Here's the abstract:

++++++++++++ 

Aspirin Intake and Survival After Breast Cancer

Michelle D. Holmes, Wendy Y. Chen, Lisa Li, Ellen Hertzmark, Donna Spiegelman, and Susan E. Hankinson (Brigham and Women's Hospital and Harvard Medical School; Dana-Farber Cancer Institute; and Depts. of Epidemiology and Biostatistics at Harvard School of Public Health)

Purpose: Animal and in vitro studies suggest that aspirin may inhibit breast cancer metastasis. We studied whether aspirin use among women with breast cancer decreased their risk of death from breast cancer.

Methods: This was a prospective observational study based on responses from 4,164 female registered nurses in the Nurses' Health Study who were diagnosed with stages I, II, or III breast cancer between 1976 and 2002 and were observed until death or June 2006, whichever came first. The main outcome was breast cancer mortality risk according to number of days per week of aspirin use (0, 1, 2 to 5, or 6 to 7 days) first assessed at least 12 months after diagnosis and updated.

Results: There were 341 breast cancer deaths. Aspirin use was associated with a decreased risk of breast cancer death. The adjusted relative risks (RRs) for 1, 2 to 5, and 6 to 7 days of aspirin use per week compared with no use were 1.07 (95% CI, 0.70 t 1.63), 0.29 (95% CI, 0.16 to 0.52) and 0.36 (95% CI, 0.24 to 0.54), respectively (test for linear trend, P < .001). This association did not differ appreciably by stage, menopausal status, body mass index, or estrogen receptor status. Results were similar for distant recurrence. The adjusted RRs were 0.91 (95% CI, 0.62 to 1.33), 0.40 (95% CI, 0.24 to 0.65), and 0.57 (95% CI, 0.39 to 0.82; test for trend, P = .03) for 1, 2 to 5, and 6 to 7 days of aspirin use, respectively.

Conclusion: Among women living at least 1 year after a breast cancer diagnosis, aspirin use was associated with a decreased risk of distant recurrence and breast cancer death.

+++++++++++ 

I can't offer a link to the abstract in PubMed because it's not available yet. 

This really is an interesting study, but it leaves a lot of questions unanswered.  For example, the researchers note that their results show an association between aspirin intake and lower risk of BC metastasis, but other studies have shown that aspirin does not protect against getting BC in the first place.  The results of this study demonstrate a relationship between aspirin intake and BC recurrence (and death) that is statistically significant ... but the study does not show "cause-and-effect" (i.e., it does not show that aspirin actually prevents BC recurrence).  The researchers offer all sorts of hypotheses about the reason why aspirin might decrease BC recurrence, and the reasons all make sense; but some of them might not apply to us.  For instance, one possible reason they gave was that aspirin and other NSAIDs reduce estradiol levels.  If that's the reason for aspirin's benefit, those of us already on aromatase inhibitors might not need to toss another white tablet into the mix.

Very interesting...

otter

Claire_in_Seattle

I am not waiting around for them to do a double blind study, because we wouldn't know anything for another 10 years.  They have this data because they were interested in the heart protective aspects of aspirin. 

I'm in as soon as chemo is over.  No big deal as I am normally hurting anyway from all the sports activities.  So just a case of being more systematic about something I do anyway.

As for "didn't prevent", the barn door has long been open there anyway.  So focus needs to be on maximizing my long term health and survival.

Exercise is the other big one (not diet BTW).  Fortunately, aspirin helps me stay on track there as most of us do less when limping!

Claire_in_Seattle

As I mentioned, I am not waiting ten years for the results of this study!!!!  That is the minimimum time it will take to understand the LT benefit assuming it was ready to go by the end of the month and fully recruited.

I understand the esteemed Dr Winer's point of view as a clinician, but I am the one who needs all the protective benefits I can find.,,,,,NOW, not 10 years hence.

I view this as relatively little risk (in my case, as I tolerate aspirin extremely well) and major potential protective benefit.

otter

I haven't been watching the TV news reports about the aspirin paper.  I guess I'd rather read articles in ScienceDaily and MedPageToday, which take a more analytical approach.  My first choice is to go to the original paper in the medical journal and see what the researchers themselves said:  What did they do?  What were their results?  What did they conclude?  I think that's much more reliable than listening to a TV doctor's speculation about what the findings might mean. 

I don't mean to offend anyone here who thinks the 81-mg baby aspirin is the way to go; but that's not what the researchers found.  Here is what they said, in their own words (in the "Discussion" section of the paper):

"Limitations of our study include the following.  Information on aspirin intake, treatment, and distant recurrence was self-reported.  However, we believe our frequent updating improves accuracy.  We lack details on aspirin dose.  If there is a dose response, the effect size in the current study may be diminished because the frequent aspirin users may be more likely to be low-dose users attempting to prevent heart disease.  Confounding is always a limitation of observational studies.  We addressed this by adjusting for all relevant covariates and through marginal structural models.

"Our results may be generalizable only to longer term breast cancer survivors (i.e., only women who have lived long enough after diagnosis to report aspirin use after diagnosis, which is approximately 4 years).  Fortunately, almost 90% of women diagnosed with breast cancer live at least 5 years.  Thus, our findings have considerable clinical importance."

In other words (my words), their comment about "low-dose users" is an assumption that relates to their data analysis -- not to the dose that would be most beneficial.  They are assuming that the most likely reason why someone would be taking aspirin "frequently" is to prevent heard disease; and in that case, the person would probably be taking a low-dose aspirin.  The researchers have no data what dose(s) the women actually took, because they never asked that question in the study. 

What we're hearing from the news reports about low-dose aspirin is pure speculation at this point.  In fact, the authors speculated, in the paragraph I quoted, that their results might have missed a benefit of an even higher dose of aspirin.  That's because the women taking it 6 or 7 days a week were probably taking a low-dose aspirin, and getting less total aspirin per week, than the women taking it less often but for other reasons.  It would take 4 "baby aspirins" (4 x 81 = 324) to get the same total amount of drug as one standard-dose, 325-mg aspirin.

The issue of protection against mets versus protection against a first occurrence is relevant to the mechanism of action.  The authors pointed out the paradox of their findings.  The contradiction means the mechanism by which aspirin protects against mets probably isn't going to be something simple.  If it was simple, then aspirin ought to prevent the primary tumor from developing in the first place.

otter 

[Edited again, to delete my advice to Claire, who took it way too personally.]

Claire_in_Seattle

Don't worry Otter.  Won't yell again.

Have been spending way too much time here anyway.  Time to get back to my work and my life.

Thanks for making this major clear to me that I need to do this.

Kodapants

My sister called this morning and said she seen it on the TODAY show maybe they have a link.  I'll try it as soon as I'm done with reconstruction.

Koda

LRM216

I'm with you Claire - I don't have time to "wait".    We all took the toxic, poisonous chemos sent our way - and they had no guarantee but were a heck of lot more dangerous to our bodies and lives.  (Unless of course you are allergic to aspirin).  Checked with my PCP and she said go ahead as she has many female patients in their late 40s, 50s 60s and up on 81 mgs. per day to avoid heart issues - and I am on no meds that would counteract with aspirin.  At least, being triple neg, I feel as though I am doing SOMETHING towards avoiding a recurrence.  It will help my mind if nothing else!

Linda

Husband11

The way I see it on the dosage, is that 65% of the women taking aspirin were not taking it for prevention of heart disease.  What is the most typical dosage taken for headaches, backaches, muscle pain, etc?  325 mg.

LRM216

Here is the link that's posted over at TNBCfoundation.org:

http://www.msnbc.msn.com/id/35426947/ns/health-cancer/ and the Asco link

http://jco.ascopubs.org/cgi/content/abstract/JCO.2009.22.7918v1

leighannmarie

I was never told not to take aspirin or NSAIDs during chemo or rads.  I was told I could take it to help with the pain these treatments cause.  I don't know what the reasoning is there.  My onc told me about taking NSAIDS to prevent colon cancer but, said this is not safe for everyone and can cause kidney disease if taken too much.  I wouldn't go crazy and take it everyday.  I generally try to avoid pain meds but, maybe I shouldn't.

Springtime

Oh now today I am seeing a few articles that they don't know what dosage they took, but they assume it was 81mg (baby aspirin). Yesterday I saw an article saying it was more than this !! ahhhhhhck! 

http://www.webmd.com/breast-cancer/news/20080310/aspirin-may-lower-breast-cancer-risk 

• "The good news from the studies is that aspirin does seem to protect against breast cancer, study researcher Ian Fentiman, MD, of London's Guy's Hospital, tells WebMD.
• The bad news is that the protective effect was not seen with lower doses of the pain reliever, like those routinely given to protect against heart attacks and strokes, he says."

I don't get it. But I am going to start taking the 81mg baby aspirin!!! Can't hurt...

AmyD

I've done the low dose aspirin daily for close to 10 years (starting in my 30s) and I wish it would have helped prevent my breast cancer.   Sometimes it all seems like a crap-shoot.

mawhinney

Otter ~Thanks for providing the research references and for clarifying what is and is not known about asprin and breast cancer.

Anonymous

I saw my onc. today for my quarterly check up, and we discussed this.  She was clear that this is an observational study, and by no means a clinical study.  BUT, she also said that taking baby aspirin can't hurt - and is interested to see how this all pans out.

I started taking baby aspirin a couple of months ago for heart health.  My father has heart disease - and a bypass at the age of 35, so figured that I could use the aspirin (as far as my genetics - no cancer so I have been worried about heart disease - HA!).  

So, I will keep on taking the baby aspirin!  My onc. said that it also is preventative for strokes.

*edited to add - I agree - thank you Otter - I always love your posts!