does aspirin suppress the immune system?

I started taking a baby aspirin along w/ my tamoxifen because I'm at an elevated risk for clots. But...since it works as a slight blood thinner, I was wondering if it suppresses the immune system at all? Any info/experience?

Comments

  • Husband11
    Husband11 Member Posts: 2,264
    edited October 2011

    The blood thinning effect is its action on platelets.  I don't believe that would suppress the immune system.  There may be an added benefit to aspirin in reducing the risk of metastasis.  It is a suppressor of inflamation, and that may be the reason why in studies, women who took aspirin several times a week, had a much lower rate of recurrance of breast cancer.

  • peggy_j
    peggy_j Member Posts: 1,700
    edited October 2011

    Thanks Timothy. Do you know the implication of asprin suppressing inflamation? When I was googling around yesterday, some random blog suggested that inflamation is part of your body's natural immune response, so suppressing inflamation means at least part of the immune response is being dialed back. (?? I feel like I'm in speculation mode)

    Also, I read somewhere that "they" don't recommend asprin when you're doing chemo (I got to avoid chemo, so I have no experience). thanks.

  • Husband11
    Husband11 Member Posts: 2,264
    edited October 2011

    Did your Doctor recommend the baby aspirin for prevention of blood clots?

     No doubt aspirin has its risks, especially when taken daily.  The most common risk relate to bleeding related problems.  Ultimately, its a risk to benefit analysis in deciding what to take, as it all has some downside.

  • Anonymous
    Anonymous Member Posts: 1,376
    edited October 2011

    I'm reading the Anti-cancer Book right now (Dr. David Serbin-Schrieber) and just read that there is a strong link to cancer and inflammation (even if you don't suffer symptoms of inflam.). Asprin/aleve/advil, he claims, would have some benefit towards cancer protection but you have to be careful as too much can cause stomach problems and possibly ulcers.

    You can google the book and check it out. 

  • crazy4carrots
    crazy4carrots Member Posts: 5,324
    edited October 2011

    Peggy -- Inflammation is a signal to the immune response cells (B cells and T cells) to start "girding for war" and increase their numbers to fight the cause of the inflammation and thus reduce it.  Sort of the opposite of "dialing back"!

    Baby aspirin (81 mgs) seems to be the sufficient daily amount and enteric-coated aspirin is unlikely to cause tummy troubles. Advil is also an anti-inflammatory, (but I've never seen in in less than 200 mgs)  but tylenol is not.

  • peggy_j
    peggy_j Member Posts: 1,700
    edited October 2011

    Timothy, taking the asprin was my idea. When I asked my MO she said that it doesn't really help with the types of clots we're prone to have on tamoxifen. But she said the downside risks of taking aspirin are small and said that even if I'm taking it for clots I could skip a couple days and it's no big deal. (FWIW, I pestered her to be tested for the Factor V Leiden test and it turns out I have one copy of the gene--like 15% of the caucasian population--though they rarely test for it. This puts me at slightly elevated risk for clots.)

    lindasa, maybe I said it wrong but my thinking was that if aspirin reduces inflammation then it turns down the signal of the immune response.

    My understanding is that aspirin and ibuprofen and tylenol work differently. FWIW, I've also heard several dis-recommendations of taking ibuprofen daily.

    thanks clairinez for mentioning that book. I've heard a lot of good things about it.

  • starbeauty
    starbeauty Member Posts: 327
    edited October 2011

    It would seem a clot is a clot.  The same action would apply for Tamox clot issues as a stroke patient.  Asprin is a blood thinner... not sure what the MD is talking about pertaining to different types of clots.  I am taking it for the reasons Timothy noted.  It is having no impact on my WBCs or RBCs.  No effect on my ALT or AST.  Just my own observations.

  • Husband11
    Husband11 Member Posts: 2,264
    edited October 2011

    My wife Bev is taking 1/4 of an aspirin daily.  She is willing to take the chance of the bleeding risks, hoping for benefit of reduced risk of recurrance / spread.  She was diagnosed stage 3A , Er+, PR+ approx 3 years ago, and currently on tamoxifen.  While there is no proof it prevents metastasis, epidemiological evidence shows a strong corrolation between women who took aspirin regularly and whose breast cancer didn't spread.  Other data shows that men and women who took aspirin regularly, have about a 1/5 less rate of initial occurance of a number of different cancers.  If I recall correctly, for the reduction of the spread of breast cancer, it was an overwhelming difference, like around 80 percent less.  Was the aspirin the cause?  No one knows for sure, but there are reasonably theories that reduction of the enzyme cycloxygenase (COX) may interfere with the spread of cancer.  COX produces prostoglandins, which are chemicals causing inflammation.  The guess is that these inflammatory signals are necessary for cancer to grow and spread.

  • peggy_j
    peggy_j Member Posts: 1,700
    edited October 2011

    Thanks Timothy for the extra info.

    If I recall correctly, for the reduction of the spread of breast cancer, it was an overwhelming difference, like around 80 percent less. 

    Wow, That's huge. If you happen to come across that info again, could you share it? The reduction in the risk of recurrence due to tamoxifen is typically 40% (though it varies by how ER% a patient is).  I don't think I've seen any claim over 50%; even chemo and rads are generally lower.  Not sure if risk of spreading and risk of recurrence are measuring the same thing.

    starbeauty, my MO said there are diff. types of clots. (she's also a hematologist--or blood doc) I took notes in the meeting but don't have my notebook with me but this random website (below) explains some differences. I believe tamox increases the risk of venous clots (thrombosis) while aspirin more typically reduces the risk of arterial clots (again, I apologize that I don't have my notes handy)

    http://www.medicinenet.com/blood_clots/page3.htm

    thanks again for the info. this is helpful.

  • PLJ
    PLJ Member Posts: 373
    edited October 2011
  • starbeauty
    starbeauty Member Posts: 327
    edited October 2011

    Ok... Reviewed the link... But location of the clot does not change what it is... Blood thinners work for all clots And preventative thinners keep clots from ever forming. Now certainly 81mg of aspirin is not the big gun of thinners likecoumadin and heparin, but it is effective. I think there is legitimate evidence to support this low grade thinner and as previously stated perhaps additive benefits pertinent to our diagnosis. Additionally, the thought that the removal of inflammation might potentially be impacting the immune system appears to be similar in thought to saying the reduction in the sinus headache from a cold by advil cold medicine is suppressing the immune system. The real question is why are some of us generating inflammation to begin with.

  • Husband11
    Husband11 Member Posts: 2,264
    edited October 2011

    I hope this link provides some useful information on the subject.  Bear in mind they are talking about a correllation, and not a proven cause and effect.  71 percent was the figure they touted as the maximum reduction in breast cancer death from women who took aspirin several times a week.  Proving that aspirin was in fact the cause of the reduction in deaths would require a proper controlled study.

    Large Analysis Finds That Breast Cancer Patients Who Take Aspirin Reduce Their Risk of Breast Cancer Spread and Death by Nearly Half

    Posted online February 16, 2010, on http://www.jco.org/.

    An analysis of data from the Nurse's Health Study, a large, ongoing prospective observational study, shows for the first time that women who have completed treatment for early-stage breast cancer and who take aspirin have a nearly 50 percent reduced risk of breast cancer death and a similar reduction in the risk of metastasis. The findings were reported in the Journal of Clinical Oncology.

    Investigators report it is not yet clear how aspirin affects cancer cells, but they speculate it decreases the risk of cancer metastasis by reducing inflammation, which is closely associated with cancer development. Prior studies have also suggested that aspirin inhibits cancer spread: one study found that people with colon cancer who took aspirin lived longer than those who did not, and laboratory studies have also shown that aspirin inhibited the growth and invasiveness of breast cancer cells.

    In this analysis, researchers evaluated data from the Nurses' Health Study, which included 4,164 female nurses in the United States (ages 30 to 55 in 1976) who were diagnosed with stage I, II, or III breast cancer between 1976 and 2002 and were followed through June 2006. They examined patients' use of aspirin for one or more years after a breast cancer diagnosis (when patients would have completed treatment such as surgery, radiation therapy, and/or chemotherapy) and the frequency of metastasis and breast cancer death. (The authors emphasized that patients undergoing active treatment should not take aspirin due to potential interactions that can increase certain side effects.)

    A total of 400 women experienced metastasis, and 341 of these died of breast cancer. Women who took aspirin two to five days per week had a 60 percent reduced risk of metastasis and a 71 percent lower risk of breast cancer death. Those who took aspirin six or seven days a week had a 43 percent reduced risk of metastasis and a 64 percent lower risk of breast cancer death. The risk of breast cancer metastasis and death did not differ between women who did not take aspirin and those who took aspirin once a week.

    Researchers also found that women who took non-aspirin non-steroidal inflammatory drugs (NSAIDs), such as ibuprofen, six or seven days a week also had a reduced risk of breast cancer death (a 48 percent reduction), but women who took NSAIDS less frequently and those who used acetaminophen (Tylenol) did not experience such a benefit.

    While the investigators did not have data on aspirin dose, they noted that women who took aspirin regularly most likely took a low dose (81 mg/day), which is associated with heart disease prevention.

    What This Means for Patients

    This is the first study to find that aspirin can significantly reduce the risk of cancer spread and death for women who have been treated for early-stage breast cancer. If these findings are confirmed in other clinical trials, taking aspirin may become another simple, low-cost and relatively safe tool to help women with breast cancer live longer, healthier lives.

    However, it is important to note that aspirin is not for everyone because it can cause stomach bleeding. Do not begin taking aspirin every day without first speaking with your doctor.

    http://www.cancer.net/patient/Publications+and+Resources/Cancer+Advances/News+for+Patients+from+the+Journal+of+Clinical+Oncology/Large+Analysis+Finds+That+Breast+Cancer+Patients+Who+Take+Aspirin+Reduce+Their+Risk+of+Breast+Cancer+Spread+and+Death+by+Nearly+Half

  • Claire_in_Seattle
    Claire_in_Seattle Member Posts: 4,570
    edited October 2011

    I wasn't going to wait for the controlled study.  I tolerate aspirin well, and take one regular at bedtime.  Also helps with muscle/joint pain from the exercise I do.

    The three things I do beyond taking anastrazole at this point are:

    1. Exercise
    2. Aspirin therapy
    3. Maintaining a reasonable body weight (related to the first as I love to eat)

    Aspirin also appears to reduce recurrence in colon cancer.  Anyway, I thought a no brainer if you tolerate it well.  I know that from my years of sore shoulders, sprained feet etc.  (Hiking, skiing, cycling injuries.)

    I doubt that the controlled study will be done anyway.  No financial incentive to do this.  So this is the best we have.  The reason we have this information is because of aspirin's cardio-vascular benefits.  Nice to know. - Claire

  • Heidihill
    Heidihill Member Posts: 5,476
    edited October 2011

    http://atvb.ahajournals.org/content/3/4/383.abstract

    Just wanted to add that ibuprofen blocks the effect of aspirin on platelets.

    Also salicylates, of which aspirin is one, are found in fruits, vegetables and herbs so a baby aspirin dose can be covered by dietary means. Not sure though if anticancer effects are the same. But  no platelet suppression getting anti-inflammatories this way.

  • NatsFan
    NatsFan Member Posts: 3,745
    edited October 2011

    Claire - you and my onc are on the exact same page.  When I first started with her she showed me similar research that the three top things that correlated to a reduced risk of recurrence and death were:

    1. 30 minutes of exercise daily
    2. Maintaining a normal weight
    3. Aspirin therapy

    I was already doing the exercise part and trying to lose weight, so it was easy for me to incorporate a daily baby aspirin.  I have to admit - the weight is an issue for me - I gained 22 chemo pounds and am having trouble losing it on Femara, but with a lot of hard work, I have managed to lose 15 of it so far.  I keep complaining good-naturedly to my onc - they want us to keep a normal weight, but then they put us on drugs that can cause weight gain!!  Undecided

  • Husband11
    Husband11 Member Posts: 2,264
    edited October 2011

    On today's news, double blind placebo study in Britain shows aspirin reduces risk of colon cancer among those at high risk.

  • PLJ
    PLJ Member Posts: 373
    edited October 2011

    Hi all,

    I haven't started the aspirin yet but it is on my list! There are a few articles out there citing the benefits and it looks very promising.

    Question for those already taking it: are you on Tamox or an AI and do you take an 81 mg time-released  or regular tablet? Did your MO recommend one over the other?

    Thanks! Enjoy your day,

    PLJ

  • peggy_j
    peggy_j Member Posts: 1,700
    edited October 2011
    Thanks Timothy for the info. Here's a link to the original study including some tables (there's even a table showing link to rates of recurrences) They listed some of the biases/limitations of the study. (i.e. some patients with recurrence may be on chemo and needing to avoid aspirin, hence the numbers might be slightly skewed)
     
    I'm curious why the benefit is better for taking it 2-5 days vs. 6-7 days a week. (and if there's a sweet spot within the 2-5 days).  
     
    FWIW, even though my MO/hemotologist said that aspirin doesn't protect against thrombosis as much as other types of blood clots, she said the side effects of taking aspirin are mild. 
  • NatsFan
    NatsFan Member Posts: 3,745
    edited October 2011

    Pl - I'm on Femara.  My med onc said just to take the 81mg baby aspirin - I buy the generic stuff at the grocery store.

  • wallycat
    wallycat Member Posts: 3,227
    edited October 2011

    I started aspirin (I take 1 adult nightly) when I started tamoxifen because of the risk of clots with tamoxifen.

     I did read a new study that said those who are prone to retinal disease (macular degeneration) may be compounding the problem with aspirin.

  • Husband11
    Husband11 Member Posts: 2,264
    edited October 2011

    It's a very good question why the group taking it 2-5 days a week had different outcomes than the group taking it more frequently.  Since this is a retrospective study of habits reported, it is unknown and only speculative as to even the reasons why the women were taking aspirin.  A lot of guesswork involved about the circumstances surrounding a person and their health.  Usually those taking aspirin daily have some continuous issue or it is prescribed.  People taking it consistantly but not daily????  analgesic reasons?

     At the very least, the evidence mounts as to its effect on cancer.  The patients in the colon cancer risk study apparently took 2 whole aspirin per day.  Wow.

  • peggy_j
    peggy_j Member Posts: 1,700
    edited October 2011

    I was curious if there were other studies so I checked on PubMed. My query of "aspirin breast cancer" gave 158 hits including this recent meta-analysis (they analyzed 33 other studies, covering close to 2 million patients). I'm not able to read through this now (or honestly for a few days) but FYI in case anyone is curious.

     http://www.springerlink.com/content/q6h72311w82w5422/

    Abstract: Animal and in vitro studies suggest that the use of aspirin may be associated with reduced risk for breast cancer, but results from these studies of the association have been inconsistent. The objective of this meta-analysis was to quantitatively summarize the current evidence for such a relationship. We searched MEDLINE for studies of aspirin use and breast cancer risk that were published in any language, from January 1, 1966, to July 1, 2011. A total of 33 studies (19 cohort studies, 13 case-control studies, and 1 randomized controlled trial [RCT]) that included 1,916,448 subjects were identified. We pooled the relative risks from individual studies using a random-effects model, heterogeneity, and publication bias analyses. In a pooled analysis of all studies, aspirin use was associated with reduced risk for breast cancer (odds ratio [OR] = 0.86, 95% confidence interval [CI] = 0.81, 0.92). In the subgroup analysis by study design, results were similar except for RCT (OR = 0.98, 95% CI = 0.87, 1.09). In conclusion, this meta-analysis indicated that regular use of aspirin may be associated with reduced risk of breast cancer. More RCT were needed to confirm this association in the future. 

  • Heidihill
    Heidihill Member Posts: 5,476
    edited November 2011

    I tried to buy some baby aspirin some weeks ago but was told it was prescription only. Instead of trying to buy it in the US, I made an appointment with my onc to have him prescribe it for me. He was on board right away and is having me take 100 mg. 4-5 times a week. At least I know now it isn't contraindicated due to my blood counts or something else, and he'll be monitoring me.

  • Racy
    Racy Member Posts: 2,651
    edited November 2011

    Heidihill, that seems strange that you could not buy the baby aspirin without a prescription, as Dr Oz recommends it. I buy it in the supermarket in Australia. As you can see above, NatsFan also buys it at the grocery store in US.

  • Thatgirl
    Thatgirl Member Posts: 276
    edited November 2011

    My Onco put me on aspirin therapy as well. I take a baby aspirin at bedtime with warm water.

    Some of the post's indicate that people are asking too many Dr.'s about their treatment plan. If you do not trust your Onco, seek a second opinion from a second Onco not a heart, foot, or PC physician. Your PCP is not reading studies or case managements on carcinomas.  

    If you look at some of the conventional therapy and the alternative therapies they both have the same common denominator ....preventing inflammation in the body.

  • Thatgirl
    Thatgirl Member Posts: 276
    edited November 2011

    Peggy,

    I think our diets and external factors paly a part in flammation in the body. The Anti-inflammation diet gives you a lot of information on the subject. You can purchase it or find it at the library. After you read it come back and share your thoughts with us.

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