Cancer study gives ‘final stamp’ to aspirin

A recent study carried in a reputable journal, which found that one aspirin a day may keep cancer at bay, has come as little surprise to local doctors who said the benefits of this drug had been known for a while.

“What Lancet has done is give the final stamp to it,” consultant surgeon Joe Debono told The Times.

His view was backed by gastroenterologist Pierre Ellul who pointed out that doctors prescribe aspirin for certain types of colonic cancer.

Aspirin, which is already known to be beneficial against heart attack and stroke, was found to reduce death rates for a range of common cancers by 34 per cent, with benefits appearing after as little as five years.

Moreover, death rates from stomach and bowel cancers fell by 54 per cent, according to the study reported in The Lancet on December 7. However, Mr Debono said non-steroidal anti-inflammatories – the category of drugs under which aspirin falls – have been used for some time to slow down and decrease the risk in forms of colonic cancer.

“This study has expanded onto other cancers. The advantages are there but they need to be balanced out with the disadvantages,” he cautioned, highlighting internal bleeding as a major risk.

As a surgeon working at Mater Dei Hospital, Mr Debono said he commonly saw people presenting themselves in hospital with bleeding from non-steroidal anti-inflammatories.

The decision has to be taken after the risks have been outweighed, he said. “The important thing is people will continue reporting symptoms even if they are on aspirin, that they still attend routine screening, especially if they fall under high-risk groups, and that the drug should always be started with a prescription,” he said. Potential complications should always kept under medical control, Mr Debono cautioned.

However, internal medicine consultant Charles Mallia Azzopardi argued that, although taking aspirin long term may be associated with side effects, such as peptic ulceration and gastrointestinal bleeding, the safety of aspirin had been proven in patients who have suffered from heart attacks or strokes and who then took aspirin for long years without major problems. The findings may have implications for guidelines on use of aspirin and for the understanding of cancer formation and its susceptibility to drug intervention, Dr Ellul pointed out.

“However, in my opinion this does not mean everyone should start taking aspirin automatically. I think we still have to wait for various international bodies to issue recommendations,” he said, adding that people should discuss taking the tablet with their GP.

“In the meantime, one can adopt a healthy lifestyle such as exercise, stopping smoking, and eating fruit and vegetables which have already been proven to improve our well-being,” he said.

Although this study is promising, one had to wait for further prospective studies to confirm or refute these findings and therefore be in a much better position to advise patients, Dr Mallia Azzopardi said.

The results of the study, carried out on an overwhelming 25,570 patients, are promising as they indicate that even a low dose of 75mg per day of the over-the-counter drug may reduce chances of dying from prostate, lung, oesophageal, brain and pancreatic cancers.

In spite of the known link between aspirin and an increased risk of internal bleeding, Prof. Peter Rothwell, who led the research, said those who were given aspirin had a 25 per cent lower risk of death from cancer during the trial period and a 10 per cent reduction in death from any cause compared to patients who were not given the drug.

The professor is reported to believe that taking the drug at about 40 to 50 years of age for some 25 years would be beneficial, if the risks are outweighed.