Aspirin and the treatment of cancer
A recent review of the medical literature shows that low-dose aspirin taken by patients with cancer (Bitter pill: is aspirin really a wonder drug?, G2, 24 January) is associated with a reduction in cancer deaths, and a reduction in cancer spread (metastases). Over 70 studies have been published, together including 120,000 cancer patients taking aspirin and over 400,000 cancer patients not taking aspirin. A meta-analysis shows a 24% reduction in cancer deaths and a 19% reduction in deaths from all causes in patients taking aspirin. That is: at any time after a diagnosis of cancer, about 19% more patients taking aspirin are alive, compared with patients not taking aspirin.
An author of each report was contacted and asked about bleeding in their patients: 31 replies were received and only one author reported an excess (11%) in the number of patients taking aspirin who had had a bleed, compared with patients not taking aspirin.
A summary of all this evidence is in Public Library of Science, an open medical journal (PLOS: Aspirin in the Treatment of Cancer).
Despite claims on the web and elsewhere of harm, including unsupported claims of deaths due to aspirin, a number of reviews of the published evidence have shown that within each thousand people taking aspirin, only one or two will have a bleed each year, and the bleeds associated with aspirin are less severe than the spontaneous stomach bleeds that occur across the community due to a stomach ulcer or infection. Relevant evidence on this is also available at PLOS (Aspirin and fatal bleeding).
While pharmacologists search for more effective anti-cancer agents, information on low-dose aspirin as an additional treatment of cancer – having a high probability of benefit and a low chance of harm – should be made widely available to patients, to enable informed discussions with their doctors.Professor Peter Elwood,
Ms Janet Pickering and Dr Gareth MorganDivision of population medicine, school of medicine, Cardiff University • J o i n t h e d e b a t e – emailguardian.letters@theguardian.co m
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