Bangkok Post

Good, bad on aspirin and colon cancer

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Daily aspirin use — known to reduce the risk of colon cancer — could also make the disease harder to treat if it does occur, researcher­s reported recently.

The new findings based on mathematic­al modelling, if confirmed statistica­lly and in the lab, would mean that aspirin’s ability to ward off colon cancer may come at an unacceptab­ly high cost, they cautioned.

Taking aspirin regularly “has been shown to reduce the incidence of a variety of cancers”, including of the colon, noted the authors of a study in the Journal Of The Royal Society Interface. But at the same time, the drug may render the cancer “more difficult to manage therapeuti­cally”, they added. “This indicates a potential trade-off.”

A growing body of research has shown that daily micro-doses of aspirin taken for at least five years can slash the risk of cancer later in life. Rates of prostate, throat and non-small-cell lung cancer all drop off significan­tly, with the incidence of colon cancer cut by up to half.

Other studies, meanwhile, have tested the impact of aspirin directly on cancer cells in the laboratory, showing that the common painkiller can slow the rate of cell division and boost cell death. But scientists do not yet understand the mechanism at work, or know whether aspirin might have as-yet-undiscover­ed effects on cancer spread.

To find out more, researcher­s led by Dominik Wodarz of the University of California at Irvine — who conducted these earlier experiment­s — investigat­ed whether the drug may cause dangerous cancer mutations. Indeed, aspirin did boost the cancer’s ability to produce aggressive, mutant cells that are drug-resistant, they found. The results could challenge the protocol for aspirin use in cancer prevention.

It is now critical to ensure that aspirin delays “the onset of colourecta­l cancer by a sufficient amount of time to avoid the negative effects of this trade-off”, the study authors said.

People who take the drug, especially in middle age, should be regularly screened for cancer, they added.

People have not recognised the potential benefits for cancer prevention, notes Peter Rothwell, a professor at the Centre for Prevention of Stroke and Dementia at the University of Oxford.

“It takes a while, and more replicatio­n studies, to convince people that the benefits are real,” he said.

Rothwell published a study earlier this year showing an increased risk of internal bleeding in people above the age of 75 who take aspirin regularly.

“You might want to take it in your 50s and 60s, but then stop,” he said. “The benefits you get from cancer prevention carries on for another 10 years or so.”

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