Results of a new study of nearly six thousand men with prostate cancer indicate those treated either with surgery or radiation could benefit from taking aspirin regularly. In a KERA Health Checkup, Sam Baker talks with Dr. Kevin Choe of U.T. Southwestern Medical Center about the study.
Dr. Choe: For many years, we’ve known that there exists an association between blood clotting system and cancer development. And recently, there are some evidence that came out that show that medications that interfere with blood clotting, like aspirin, may have a preventative effect on cancer formation. That is people who are taking aspirin were less likely to develop cancer than those who are not. The question we wanted to ask was, if aspirin can prevent cancer, can it also work as a cancer treatment in patients that are already diagnosed with cancer.
Baker: And the study has found what?
Dr. Choe: We specifically looked at prostate cancer, because prostate cancer is most commonly occurring in elderly patients who are most likely to be taking a medication like aspirin for other medical reasons, like to prevent heart attacks and strokes, and we thought it would be important to know whether aspirin has an additional benefit in those people.
Baker: Were you studying all people who had prostate cancer, or specific people who had the disease?
Dr. Choe: Two major treatments for prostate cancer are radiation and surgery. And those are the patients we looked at. Those patients who are diagnosed with prostate cancer who do not have any evidence of spread of the disease. We only looked at people with localized, curable prostate cancer.
Baker: Given the findings, are you or anyone on the team ready to recommend aspirin as treatment for prostate cancer, or is it more work that needs to be done?
Dr. Choe: I still think we need to better understand how to optimally use aspirin in prostate cancer, especially in conjunction with more standard treatments, like radiation and surgery. That is, we don’t have a good idea of exactly what dosage is necessary, what the duration of the treatment is, or even the timing of the treatment, whether it needs to start early on, in the middle of the treatment, or after the treatment. And until we have a good understanding of that, I don’t think it’s prudent to recommend aspirin to every patient who gets diagnosed with prostate cancer at this time.
What I recommend is to have a personal meeting with their physician, and discuss the potential risks and benefits of aspirin therapy and come up with an individualized decision. Because aspirin is a very well-tolerated, commonly used medication, but it is certainly not without any side effects.
The most common side effect of aspirin that we worry about is that it may increase risk of bleeding, mostly in the stomach or G-I tract. Or it can also cause hemorrhagic stroke. The risks of those are very low, nevertheless its not zero, so we have to consider them.
Baker: But this study offers some, how can we put it, hope?
Dr. Choe: It is certainly encouraging, and as I mention in the paper, that prostate cancer in the most common cancer in men in the United States outside of skin cancer. It’s also the second biggest cancer killer. So that they commonly use and relatively well-tolerated medication like aspirin can have an impact on cancer survival. It could potentially have a big effect on a large number of people.
Baker: Is there anything in the findings that suggests that it may be effective on other form of cancers at this point?
Dr. Choe: Not in our study. But there’s another study done similar to ours in breast cancer patients, and findings are similar as well.
Dr. Kevin Choe is an assistant professor of radiation oncology at U.T. Southwestern Medical Center and first author of the paper about the study.
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