Weekly Health Update:
Aspirin & Breast Cancer Survival
“A critical weekly review of important new research findings for health-conscious readers…”
By, Robert A. Wascher, MD, FACS
Updated:  03/28/2010
The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.
Welcome to Weekly Health Update
“A critical weekly review of important new research findings for health-conscious readersâ€Â
ASPIRIN & BREAST CANCER SURVIVAL
Breast cancer tumors, like many other types of cancer, produce increased amounts of chemicals called prostaglandins. As with many other types of cancer, prostaglandins are thought to play an important role in the growth and spread of breast cancer.
Aspirin belongs to a class of drugs known as NSAIDs (non-steroidal anti-inflammatory drugs). Like other NSAIDs, aspirin is able to block the activity of the prostaglandin-producing enzyme cyclooxygenase (COX). Moreover, previous research has indicated that, in addition to decreasing prostaglandin production in the body, aspirin also reduces the levels of estrogen in the body (approximately 90 percent of breast cancers are stimulated to grow in the presence of estrogen).
Previous research on aspirin as a breast cancer prevention drug has resulted in contradictory findings (although aspirin and other NSAIDs have clearly been shown to reduce the incidence of colorectal polyps and colorectal cancer, and other cancers as well). However, a newly published study, in the Journal of Clinical Oncology, adds weight to prior evidence that the regular intake of aspirin may significantly decrease the risk of breast cancer recurrence, and the risk of death due to recurrent breast cancer.
The enormous Nurses’ Health Study is a prospective public health research study that began in 1976 with more than 120,000 female nurses in the United States. Every 2 years, this huge cohort of women completes detailed personal questionnaires regarding diet and lifestyle factors related to cardiovascular disease and cancer. Between 1976 and 2002, more than 4,000 nurses participating in this study were newly diagnosed with breast cancer. The researchers conducting this landmark study then analyzed the incidence of breast cancer recurrence, and the risk of death, among these 4,164 breast cancer patients as a function of their aspirin intake. (Other cancer-associated diet and lifestyle risk factors were also analyzed, as well.)
In this huge prospective public health trial, regular aspirin intake was found to significantly reduce the risk of death due to breast cancer. Taking aspirin 2 to 5 times per week was associated with a 71 percent reduction in the relative risk of death due to breast cancer, while 6 to 7 days of aspirin use per week was associated with a 64 percent reduction in the relative risk of cancer-associated death. Importantly, this apparent aspirin-associated reduction in the risk of death due to breast cancer recurrence was observed in women with both early-stage and more advanced breast cancers, in both premenopausal and postmenopausal women, in both obese and non-obese women, and in women with estrogen-sensitive and estrogen-resistant tumors.
While this study’s primary weakness is that (like most epidemiological studies) the collected data was primarily based upon patient questionnaires, the Nurses’ Health Study continues to be a carefully conducted prospective study with very stringent data quality controls in place.
To learn more about the potential role of NSAIDs in cancer risk reduction, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,†in the spring/summer of this year.
I and the staff of Weekly Health Update would again like to take this opportunity to thank the nearly 120,000 new and returning readers who visited our premier global health information website last month. As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can. http://www.youtube.com/watch?v=7-Tdv7XW0qg (Anticipated Publication Date: Summer of 2010)
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Robert A. Wascher, MD, FACS
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Dr. Wascher’s Archives:
3-21-2010:  Obesity, Alcohol & Liver Disease
3-14-2010:  Nuts, Diet & Obesity
3-7-2010:   Walnuts, Cholesterol, LDL & Triglycerides
2-28-2010:  Soy Isoflavones & Recurrent Prostate Cancer
2-21-2010:  Testosterone Supplements in Frail Elderly Men
2-14-2010:  Pancreatic Cancer Risk, Sodas & Juice
2-7-2010:    Vitamin D, Cardiovascular Disease & Death
1-31-2010:  Concord Grape Juice Improves Memory
1-24-2010:  Mozart, Music, Babies & Health
1-17-2010:  Breast Cancer, Physical Therapy & Lymphedema
1-10-2010:  Prevention of Surgical Site Infections (SSIs) after Surgery
1-3-2010:    Ginkgo Biloba, Memory & Cognitive Health
12-20-2009: CT Scans & Cancer Risk
12-13-2009: Soy Isoflavones Decrease Breast Cancer Recurrence Risk
12-6-2009:  Salt (Sodium) Intake, Stroke & Cardiovascular Disease
11-29-2009: Exercise & Prostate Cancer Risk
11-22-2009: Genistein (Soy Isoflavone) & Prostate Cancer
11-15-2009: Breast Cancer Treatment & Chronic Pain
1-8-2009:    Vitamin D & Breast Cancer Risk
11-1-2009:  Exercise & Prostate Cancer Risk
10-25-2009: HPV Virus & Risk of Breast Cancer
10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)
10-11-2009: Vitamin D & Falls in the Elderly
10-4-2009:   Surgery, NSQIP, Complications & Death
9-27-2009   Stress, Heart Disease, Exercise & Death
9-20-2009:   Vitamin D & Colorectal Cancer Survival
9-13-2009:   H1N1 Swine Flu Update
9-7-2009:     Green Tea, Aging & Lifespan
8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber
8-23-2009:  Update on Prostate Cancer and Cryotherapy
8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors
8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D
8-2-2009:   Honesty, Dishonesty & Brain Function
7-26-2009:   Coronary Artery CT Scans & Cancer Risk
7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer
7-12-2009:   Breast Cancer & Metformin (Glucophage)
7-5-2009:    Prostate Cancer & Green Tea
6-28-2009:   Air Pollution & the Risk of Deep Venous Thrombosis (DVT)
6-21-2009:   Red Yeast Rice, Statins & Cholesterol
6-14-2009:   Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)
6-7-2009:    Diet, Soy & Breast Cancer Risk
5-31-2009:   Diet and Prostate Cancer Risk
5-24-2009:   Diabetes, Glucose Control & Death
5-17-2009:   Drug Company Marketing & Physician Prescribing Bias
5-10-2009:   Hemorrhoids & Surgery
5-3-2009:     Statin Drugs & Blood Clots (Thromboembolism)
4-26-2009:   Are We Really Losing the War on Cancer?
4-19-2009:    Exercise in Middle Age & Risk of Death
4-12-2009:   Can Chronic Stress Harm Your Heart?
4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?
3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease
3-15-2009:   Depression, Stress, Anger & Heart Disease
3-8-2009:    Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children
3-1-2009:    Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children
2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer
2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones
2-8-2009:   Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum
2-1-2009:  Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence
1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up†Before Surgery?
1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors
1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure
1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood
12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps
12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection
12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome
12-7-2008:   Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival
11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk
11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk
11-9-2008:    Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level
11-2-2008:    Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk
10-26-2008:  Smoking & Quality of Life
10-19-2008:  Agent Orange & Prostate Cancer
10-12-2008:  Pomegranate Juice & Prostate Cancer
10-5-2008:   Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer
9-28-2008:   Publication & Citation Bias in Favor of Industry-Funded Research?
9-21-2008:   Does Tylenol® (Acetaminophen) Cause Asthma?
9-14-208:    Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke
8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles
8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration
8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients
7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer
7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer
7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins
6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer
6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer
6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut
3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children
3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer
2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis
2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps
2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for Down’s Syndrome?
2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer
1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly
1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer
1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer– Reasons for Poor Compliance with Screening Recommendations
12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?
12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease
To summarize the important findings of this study: Among women previously diagnosed with breast cancer, taking aspirin for 2 or more days per week was associated with a significant reduction in the risk of both breast cancer recurrence and death due to breast cancer. (As always, I recommend that you discuss the potential risks and benefits of regularly taking aspirin, or any other new medication, with your doctor before making such changes.)
