The Multiple Effects of Aspirin in Prostate Cancer Patients (2020, Review, Full Text)
[A British review]
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Highlights• Evidence from epidemiological and interventional studies suggests that regular aspirin use can reduce the risk of prostate cancer development and progression, and can reduce the risk of disease recurrence following anti-prostate cancer therapy
• Aspirin use in African-American men is associated with a reduced incidence of advanced prostate cancer, and reduced disease recurrence.
• The cyclooxygenase-2 enzyme inhibited by Aspirin, and which catalyses prostaglandin synthesis and mediates inflammation, is overexpressed in prostate cancer; inhibition of cyclooxygenase-2 may have direct, and indirect, therapeutic effects.
• Aspirin can modify prostate cancer biology and disease characteristics, and can modify prostate cancer risk.
• Adjuvant aspirin use may potentially be combined with other therapeutic approaches such as radical surgery and radiotherapy.
AbstractAspirin is a commonly used medication with anti-inflammatory and analgesic properties, and it is widely used to reduce the risk of ischaemic heart disease-related events and/or cerebrovascular accidents. However, there is also evidence from epidemiological and interventional studies to suggest that regular aspirin use can reduce the risk of prostate cancer development and progression, and can reduce the risk of disease recurrence following anti-prostate cancer therapy. Aspirin use in African-American men is associated with a reduced incidence of advanced PCa and reduced disease recurrence, and there is evidence from other studies of an association between regular aspirin use and decreased PCa-related mortality. The cyclooxygenase-2 enzyme inhibited by Aspirin and other NSAIDs, and which catalyses prostaglandin synthesis and mediates inflammation, is overexpressed in prostate cancer, therefore inhibition of cyclooxygenase-2 may have direct, and indirect, therapeutic effects.
This review explores the evidence suggesting that aspirin use can modify prostate cancer biology and disease characteristics, and explores the potential mechanisms underpinning the observed associations between aspirin use and modification of prostate cancer risk. It also summarises the potential for adjuvant aspirin use to combine with other therapeutic approaches such as radical surgery and radiotherapy....ConclusionsThere is epidemiological evidence that regular aspirin use is associated with protection against PCa development, progression, and recurrence following treatment, although the precise mechanisms underpinning each of these observations remain to be fully elucidated in pre-clinical studies using PCa models, or clinical studies including those where clinical samples are analysed. One intriguing concept is that aspirin use can prevent the establishment of distant metastases in patients who develop this malignancy, and this possibility warrants specific investigation in an RCT of patients with high-risk localised or locally advanced PCa. There is also evidence that aspirin can interact with several of the treatment options offered to PCa patients, including radical surgery and radical radiotherapy, and these potential beneficial interactions from aspirin use also require more detailed investigation in prospective clinical studies. Given that use of this NSAID is extremely common, particularly in order to reduce the risk of cardiovascular and/or cerebrovascular events in individuals with ischaemic heart and carotid artery disease, the potential for aspirin to modify PCa risk is extremely important, given the ubiquitous nature of this common malignancy in men with advancing age."
[Emphasis mine. See Full Text]
I had been taking 81 mg aspirin/day for many years, but my internist had me stop a few years ago, saying the risks outweigh the possible benefits for me (no heart disease). This review doesn't seem to cover the risks.
Djin