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New study reports aspirin increases prostate cancer survival

Robin Wulffson MD's picture
aspirin, cancer treatment, prostate cance, anticoagulants, Coumadin, Plavix

A new study has reported that aspiring increases cancer survival; it focused on whether aspirin reduced the risk of death from prostate cancer. Prostate cancer is the most common cancer occurring among men and the second most common cause of cancer deaths in men.

The study was published on August 25 in The Journal of Clinical Oncology by researchers at the University of Texas Southwestern Medical Center (Dallas, Texas), University of California, San Francisco (San Francisco, California), Brigham and Women's Hospital and Dana-Farber Cancer Institute (Boston, Massachusetts), and University of Chicago (Chicago, Illinois).

The researchers noted that experimental evidence suggests that anticoagulants such as aspirin may inhibit cancer growth and metastases; however, clinical data is limited. Therefore, they designed a study to investigate whether use of anticoagulants were associated with the risk of death from prostate cancer.

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The study group was comprised of 5,955 men in the Cancer of the Prostate Strategic Urologic Research Endeavor database. They had localized adenocarcinoma of the prostate treated with radical prostatectomy or radiotherapy. Of the group, 2,175 (37%) were receiving anticoagulants (warfarin (Coumadin), clopidogrel (Plavix), enoxaparin (Lovenox), and/or aspirin). The risk of prostate cancer–specific mortality was compared between the anticoagulant and non-anticoagulant groups.

The patients were followed-up for an average of 70 months. The researchers found that the risk of prostate cancer–specific mortality was significantly lower in the anticoagulant group compared with the non-anticoagulant group (3% vs. 8% at 10 years). The risks of disease recurrence and bone metastases were also significantly lower. In a subgroup analysis by clinical risk category, the reduction in prostate cancer–specific mortality was greatest in patients with high-risk disease (4% vs. 19% at 10 years). The benefit from anticoagulants existed for both patients who received radiation therapy and radical prostatectomy. In addition, the greatest benefit was found with aspirin. Multivariable analysis indicated that aspirin use was independently associated with a lower risk of prostate cancer–specific mortality (risk reduction: 0.43).

The authors concluded that anticoagulant therapy, particularly aspirin, was associated with a reduced risk of prostate cancer–specific mortality in men treated with radiation therapy or radical prostatectomy for prostate cancer. Furthermore, the association was most prominent in patients with high-risk disease. It does reduce the risk of cardiovascular diseases such as a myocardial infarction or stroke; however, it is associated with an increased risk of gastrointestinal bleeding and hemorrhagic stroke. Thus, many physicians are likely to recommend it to healthy patients. However, when considering risks versus benefits in patients suffering from cancer, the benefit-risk ration is shifted to a situation in which benefits outweigh potential harms.

Reference: The Journal of Clinical Oncology