aspirin tablets, prevent a heart attack, benefits and risks of aspirin

Cancer remains our number two killer, just behind heart disease. Far too many people die each year from cancer of the breast, prostate, colon and lung. What can be done to prevent tumors or keep cancer from spreading?

What if an inexpensive aspirin tablet could not only prevent many cancers but also reduce the risk of metastases after treatment? A new study suggests that aspirin may indeed help keep cancer from spreading. A review of the world’s research suggests that aspirin lowers the likelihood that there will be metastatic spread and death from colorectal, breast and prostate cancer (PLOS ONE, April 20, 2016). Although data remain scanty, there is a hint that aspirin might also improve survival against lung and esophageal cancers as well as lymphatic leukemia.

The Greatest Challenge of Treatment Is to Keep Cancer from Spreading:

The greatest fear of cancer survivors is that one day their cancer will return. For reasons that remain mysterious, sometimes seemingly successful treatments can eventually fail. That is to say, breast, prostate and many other cancers can recur 10 or 15 years after surgery, radiation or chemotherapy.

The goal of most current cancer treatment is prolonged survival, turning a malignancy into a chronic condition after the acute emergency has been overcome. Can surgery, chemo or radiation keep cancer from spreading and/or produce long-lasting survival? Sometimes they do, but not always.

Even the latest immunotherapy agents can’t guarantee a cure. Some of the hottest new drugs offer median “progression free-survival” of only several months. Translating from medicalese, that means about half the patients getting the treatment live longer than three or four months. In some cases, that is significantly longer than they would live without treatment. But it also means that about half the patients get less than three or four months.

A TV commercial for Opdivo (nivolumab) promotes the idea that this immunotherapy drug will provide some lung cancer patients “A Chance to Live Longer.” The message is that by taking this very expensive medication patients “significantly increased the chance of living longer versus chemotherapy.” What the commercial does not say, though, is that the average improvement in lifespan on Opdivo was about three months more than with chemo alone. The cost: roughly $14,000 per month. Side effects can be severe.

How Long Have We Known that Aspirin Could Keep Cancer from Spreading?

Although the latest overview of aspirin research was published in PLOS ONE on April 20, 2016, researchers have long been suggesting that this old and inexpensive drug might have anti-cancer activity. In August, 1977, researchers writing in the Journal of the National Medical Association offered the following hypothesis that aspirin might keep cancer from spreading:

“Aspirin for Reducing Cancer Metastases?

“Distant metastases are the principal cause of death from cancer. Many animal experiments in the last 25 years have shown consistently that distant metastases can be significantly reduced by anticoagulants and fibrinolytic agents. Since aspirin inhibits platelet function and increases fibrinolytic activity in humans, it may be effective in preventing metastases in cancer patients. It is suggested that aspirin be offered as an option to cancer patients who are at risk for distant metastases.”

Oncologists are often quick to adopt the latest advances in cancer treatment. We understand their desire to extend the lives of their patients, even when the cost of the new drugs is prohibitive.

What we do not understand, however, is their reluctance to consider aspirin as a potential addition to traditional treatment. We find it intriguing that 39 years after researchers suggested “aspirin be offered as an option for cancer patients who are at risk for distant metastases,” a surprisingly similar message is offered by the authors of the April 20, 2016, PLOS ONE article in their conclusions:

“It appears likely that low-dose aspirin has a beneficial role as an adjunct treatment of cancer. Reductions in mortality are shown in colon cancer, probably in prostate cancer and possibly in breast and individual studies of several other cancers also suggest benefit.”

The researchers analyzed 42 observational studies and five randomized controlled trials and called for more research:

“Nevertheless, despite the need for randomised trials, we believe the evidence of benefit from aspirin is sufficiently persuasive that physicians should engage with patients in a presentation and discussion of aspirin as an additional treatment. Furthermore, we hold that patients should be given this evidence within the context of a healthy lifestyle, they should be allowed to make their own decision about aspirin therapy, and should then be supported in whatever decision they make.”

Preventing Cancer with Aspirin:

So far, we’ve been discussing the possibility that taking aspirin could keep cancer from spreading. What about preventing cancer in the first place? There is a substantial amount of evidence that regular aspirin use can help people from developing colorectal cancer in the first place. A review in JAMA Oncology (March 3, 2016) notes that people taking aspirin were 19 percent less likely to develop this kind of malignancy. The authors also note:

“Secondary analysis of randomized clinical trials (RCTs) of aspirin for the prevention of cardiovascular disease (CVD) supports a potential role of aspirin in reducing overall cancer incidence. In 6 trials of daily low-dose aspirin therapy (≥75 mg), aspirin use was associated with a relative risk (RR) of 0.76 (95% CI, 0.66-0.88) for overall cancer after 3 years, with the benefit increasing with longer duration.”

That means a 24 percent lower risk of cancer in general. To learn more about how aspirin might affect the risk of other cancers here is a link.

What About Aspirin Side Effects?

Whenever aspirin’s potential benefits are mentioned, there are some health professionals who downplay the good news and focus on the dangers. There is no doubt that aspirin can pose risks: stomach irritation, bleeding or perforated ulcers. The same risk holds for all NSAIDs, including diclofenac, ibuprofen and naproxen. Bleeding ulcers can be deadly.

The PLOS ONE authors offer intriguing insights about the harms:

“Shortly after aspirin taking commences the risk of a gastrointestinal (GI) bleed is high but the risk falls rapidly thereafter, and in short-term trials the additional risk of a bleed from low-dose aspirin amounts to perhaps one or perhaps two patients in every 1,000 on low-dose aspirin. After about three years of aspirin taking however, there appears to be no evidence of any excess GI bleeds attributable to the drug…

“The most serious bleeds are those that lead to death, and despite frequent references to fatal bleeds attributed to aspirin, there appears to be no valid evidence that deaths from GI bleeds are increased by low-dose aspirin…

“Cerebral bleeds attributable to aspirin are rare, about one or two per 10,000 patient-years. Hypertension is the major factor in such bleeds and in a randomised trial of aspirin based upon patients with hypertensive disease all of whom were adequately treated with anti-hypertensive drugs, there was the same number of cerebral bleeds in ten thousand patients on aspirin (19 patients) as in ten thousand on placebo (20 patients).”

Regardless of the risk, no one should ever start taking aspirin on a regular basis without medical supervision. Aspirin can interact with many other drugs and requires oversight.

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  1. Amy
    Reply

    I wonder about the essential oil wintergreen. I have read that it has aspirin-like effects but perhaps is safer than aspirin itself.

  2. Betsy
    Wisconsin
    Reply

    Daily Baby Aspirin is not for everyone. My husband was taking it for several years. In the last few years we noticed that he gets large bruise marks on his hands. He has cut down to a Baby Aspirin 2x/week. He still gets bruises on his hands, but less frequently.

  3. SGH
    Reply

    Wish I’d known this before losing my beloved sister to cancer three years ago. I don’t know if her oncologist told her to take aspirin or turmeric or not. She never mentioned anything but chemo & radiation for treatment/prevention. Had I known then, I be racing to her house with this article. Too late for her, but maybe not for someone else.

    Aspirin isn’t new to the 20th & 21st centuries. It’s an ancient fever reducer and pain reliever. Maybe the willow bark tea drinkers even knew it might help prevent heart attacks. Thanks, Dahlia and Art for your comments.

  4. Mary
    Milton, WA
    Reply

    What about those of us who are allergic to aspirin?
    Any other things to help deter cancer?

  5. Edna
    St. Louis, Mo.
    Reply

    I am a firm believer in taking a daily aspirin (81 mg.) I have had two “TIAs, and one of them happened because I went off the aspirin for 7 days because I was having surgery, and then I had a second TIA. I have had open heart surgery, and my Cardiologist kept me on my daily therapy of one 81 mg aspirin.

    I also have GERD, and I have not had any problems with my stomach bleeding. I was leery at first, but have been on the aspirin for several yrs. I am a redhead, and I have a tendency to bleed when I cut myself, etc. and the aspirin does make that worse. I can put up with that, and now health advocates are saying that aspirin can keep you from getting some kinds of cancer and it’s worth that even to me to keep taking them.

  6. Cindy M. Black
    Reply

    Well, I just read your article on “aspirin and AMD,” also the turmeric links. Just the risk of AMD alone would probably steer me clear of aspirin. I’m very glad I take turmeric, though, especially after reading the abstracts of those studies!

  7. Cindy M. B.
    Reply

    Thank you for this very informative article! Being a high-strung person, I’ve long assumed that when I leave this world, it’ll probably be heart-related. So, some years back I looked into taking a daily low-dose aspirin and found out that for me, an upper-60’s post menopausal female with no prior history of heart attacks (though I did have AFib now resolved), a daily aspirin would NOT be recommended.

    At some point I mentioned this in a PP comment, and you commented back that I was correct! I think it’s something about aspirin helping prevent a SECOND cardiac event, but not really helping prevent the first one — but now I can’t quite remember the details. Anyway, obviously a daily aspirin isn’t for everyone…

  8. Conrad
    Seattle, WA
    Reply

    “Many animal experiments in the last 25 years have shown consistently that distant metastases can be significantly reduced by anticoagulants and fibrinolytic agents.” Is there any evidence that using aspirin for reducing distant metastases is better than using other anticoagulants such as warfarin or dabigatran (Pradaxa)?

    • Terry Graedon
      Reply

      One study found that warfarin and aspirin (acetylsalicylic acid) were stronger at keeping breast cancer cells from adhering to other tissues than heparins. Here is the link: http://www.ncbi.nlm.nih.gov/pubmed/12740651 While aspirin can cause side effects, it is less likely to do so than warfarin.

      Another study found that aspirin and other anticoagulants increased natural killer cell activity against cancer cells. The link: http://www.ncbi.nlm.nih.gov/pubmed/15639720

      It does not appear that dabigatran has been tested to see if it discourages metastasis.

  9. Marilyn
    Indiana
    Reply

    Would you take low dose aspirin 81 mg and turmeric or one or the other?
    I wonder if turmeric would cover more as in cancer and arthritis or just arthritis?

  10. Brenda
    TEXAS
    Reply

    would taking white willow bark have the same effect without the potential side effects?

  11. bud
    Reply

    I can’t take aspirin or ibuprofen for more than 2 or 3 days or I get a bloody nose.No aspirin for me.

  12. Pat
    Florida
    Reply

    Turmeric is not only anti inflammatory and anti coagulant, it also is good for your stomach, whereas NSAIDS are damaging to it. If you damage your stomach and intestines, you may not get a bleed, but you can create additional inflammation all over your body.

  13. CC
    Tempe, AZ
    Reply

    My husband had a stroke. They prescribed a lot of drugs including Plavik and aspirin. It thinned his blood too much, and he died from bleeding on the brain.

    Recently my neighbor had a stroke. He is walking and talking so that is good. He said the doctor gave him a drug derived from animal urine that was produced in China. It got rid of the clots. He said the doctor increased his dosage of Plavik, and he was also taking aspirin. I told him what happened to my husband.

    He called his doctor and told him what happened to my husband. His doctor said, “Oh, we forgot to tell you to stop the aspirin—stop the aspirin immediately.” Neighbor was grateful that I told him it is important NOT to combine Plavik and aspirin. First time I ever took 2 low-dose aspirin for pain I ended up with black coming out both ends—bleeding ulcer. I was scoped with a contaminated scope, and my digestive tract has never been the same.

  14. Barbara
    Reply

    Who paid for this study? Makers of aspirin? My dr. says aspirin is too dangerous to take and if aspirin were new it could not get FDA approval because it is dangerous.
    Aspirin may be cheap, but if everyone took it, the huge, fancy Bayer buildings in Switzerland would be even bigger and fancier. Many of the fanciest buildings do have drug company names on them. Drugs are a multi-billion dollar a year business. So much money is involved, studies and the FDA are influenced .

    Barbara

  15. JE
    NC
    Reply

    Your information is useful and greatly appreciated.
    Question: Has any relationship been found between regular use of low-dose aspirin and the development of macular degeneration, retinal tears, or bleeding in the retina?

  16. Mary
    Reply

    For those of us with stomach issues, I would monitor closely taking aspirin in any dose. Maybe get feedback from your doctor?

  17. Dahlia
    Orange County, CA
    Reply

    Salicylic acid, the active ingredient of aspirin, comes from the bark of the willow tree. Instead of putting more money into BigPharma’s coffers, why not go to your local Chinese herbalist and pick up some white willow bark and make a nice soothing tea. Just saying ?

  18. Mary
    California
    Reply

    This article does not say specifically what aspirin dosage to take, nor frequency. Is it low dosage (“Baby”) aspirin, 1X daily? At bedtime? After a meal?

    • Terry Graedon
      Reply

      Different studies have used different doses and frequencies, so there is not yet a “right” answer. Ask your doctor if a low-dose (81 mg) aspirin per day would make sense in your situation. We think medical supervision is sensible.

  19. Anna
    Reply

    This is what the National Center for Complementary and Integrative Health wing of NIH says about turmeric as medicine:

    “What the Science Says: There is little reliable evidence to support the use of turmeric for any health condition because few clinical trials have been conducted.”

    There are some promising in vitro and animal studies but those can’t be automatically applied to human beings. More research will be needed, including clinical trials with humans, to make the big leap from petri dish or mice to using turmeric as a medicine in humans.

    https://nccih.nih.gov/health/turmeric/ataglance.htm

  20. Anne
    Reply

    I get increased ringing in my ears when I take aspirin or use any form of salicylate. I wish I could take aspirin preventively but hearing the sounds of nature clearly is too important to me.

  21. Dori
    Calif
    Reply

    I have some doubt about this….my husband has been taking low dose aspirin for about 30 years, and yet he developed prostate cancer and melanoma in situ. So, it would seem it’s not a guarantee.

  22. Olivia
    North Carolina
    Reply

    I have long intuited that as a participant in the NIH Sister Study (meaning my younger sister had bilateral breast cancer in Premenopause) that my use of aspirin for hip and knee arthritis had been protective. I am grateful, and will share this article.

  23. Skipper
    Northern Virginina
    Reply

    Around 20 years ago I was a regular blood doner. One problem was that it took 15 to 20 minutes to donate one unit of blood. I always had much more energy after the donation which lasted for several days. My Dr. suggested that I take a stress test to determine if I had any heart or vascular problems. Something went wrong with the equipment which gave impossible reactions and we stopped. He decided that I should take two aspirin tablets a day for a week and he would do some blood tests. He found that I had a very high red count which made very viscous blood even though wonderful low blood pressure and aspirin would thin the blood. I began taking a low dose enteric coated aspirin daily. I’m now 78 years old have a blood pressure of 110 or 115 over 55 or 60. It takes about 5 to 7 minutes to deliver a unit of blood. I do get a lot of sun these days in the summer and have several skin cancers a year sometimes a basil cell sometimes squamous cell.

  24. Diana
    Reply

    Sometimes I think it is a matter of choosing your poison. Aspirin would probably not be a good choice for those with GERD. Aspirin can cause loss of hearing and make asthma worse. A new study has also come out about over-the-counter pain relievers causing dementia. They can also cause liver toxicity.

  25. Barry
    Florida
    Reply

    Why do most medical oncologists (chemo doctors) not recommend aspirin to their patients? Simple: money. Chemo drugs are enormously expensive, while aspirin costs less than a penny a day. ASCO, the American Society of Clinical Oncology, is funded in part by BigPharma, which makes no profit from aspirin. Always follow the money!

    • Thai
      Reply

      Barry, six years ago my 93 year old father’s oncologist recommended after his surgery for a tumor completely blocking his transverse colon at the splenic junction that he take a low dose aspirin daily. After tests, they didn’t have him take chemo, and after a repeat colonoscopy finding a large area of flat polyps near his appendix, he opted for no more surgery. His 3 month, then 6 month, then yearly blood counts for cancer activity eventually showed no cancer activity. He lives in Silicon Valley. His surgeon and other doctors are top notch.

  26. Trevor
    Warrington, UK
    Reply

    I have taken a daily dose of 75mg of Aspirin for 3 years since I had a heart stent fitted. I have taken Omeprazole to protect my stomach, but find I still get discomfort in my stomach area when taking them. I have stopped occasionally and found my stomach was less sore, but usually return to taking them after a while as I realise the advantages the drug brings.
    However I have given up the daily statin, as I think the evidence is growing that is is not just the reduction in cholesterol score that prevents further heart problems, but more important is diet and lifestyle.

  27. Art
    New Jersey
    Reply

    What about TURMERIC. Hundreds of studies show effectiveness of it to prevent and kill cancer
    with almost no side effects.

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