Acetylsalicylic acid hope for cancer treatment?

Acetylsalicylic acid as a hope in the fight against cancer

25/11/2013

At this year's largest European Cancer Congress in Amsterdam, organized by several cancer societies, there were medicines on board „ Acetylsalicsäure“ (ASS) in the center. They are currently being hailed as new hope bearers in cancer prevention, as reported by nutritionist Cornelia Ulrich, head of the Department of Preventive Oncology and member of the board of directors of the National Center for Tumor Diseases (NCT) in Heidelberg.

Most people in Germany, this drug is simply under the name “ aspirin“ It is mainly used as a painkiller or as an anticoagulant. People who have ever had a heart attack, must then take the drug regularly.

Studies have shown that when taken over a period of about five to ten years, an anticancer effect and, for example, reduces the incidence of colorectal cancer by about 40 percent. Apparently, with the use of ASA, fewer distant metastases are formed in tumor patients. For a long time, the experts disagreed whether even with a lower dose of this drug and a lesser intake, sets a colorectal cancer protection. Now the results of a study („Annals of Internal Medicine“ Bd.159 (2), p.77) confirmed these assumptions and it was found that a protective mechanism is also built up when taking smaller doses.

For many experts, however, a more thorough examination of these patients was the reason for better preventive care. This is because blood was often found in the stool when taking ASA medications, which is explained by a greater tendency to bleed, caused by acetylsalic acid. Especially with such findings is looked at more closely. In short, polyps or adenomas are detected earlier in ASD patients, but this does not necessarily mean that they also have an anti-carcinogenic effect.

However, this assumption could be refuted by studies with other blood coagulation agents, such as vitamin K. They showed no reduction in colorectal cancer, the study said.

But why ASD leads to a reduction, the scientists could not yet clarify clearly. For example, an effect on the circulating platelets could prevent the spread of the cancer cells and it is believed that ASA may influence the mutation rate of the cells. Maybe ASS influences the effect of other cancer medicines positively and reinforces them, says Ullrich.

Decisive are the gene variants
Further study results, among them not yet published from the Heidelberg research laboratories, showed that certain gene variants in individual patients influence the blood coagulation and also the tumor inhibition, according to the nutritionist. For the future, this could mean that certain groups of patients could benefit from the anti-cancer properties of ASA, without the unwanted side effect of the increased risk of bleeding, negatively impacting a beneficial treatment in any way. The University Hospital in Leisen also presented results of a working group that focused on the tissue typing of 999 colorectal cancer patients. On the basis of this can be seen whether ASD could prevent cancer.

All patients received a low dose of ASA, but not all of them were able to benefit from the anti-cancer effects, according to the investigator, Marlies Reimers. This result has led to a variety of studies on the anti-carcinogenic property of ASA.

High expectations for that „miracle drug“
But it is precisely the genetic differences and also some contradictory findings in other types of cancer that only allow a subdued euphoria, according to Cristina Bosetti, mathematician and epidemiologist at the Mario Negri Institute in Milan. Unfortunately, there are by no means uniform findings that show a clear prevention mechanism. In lung cancer, for example, there is a favorable course in the administration of ASA, but this can be seen only after the patients were medically observed for 20 years. Prostate cancer and breast cancer also have to wait a long time to see results. But those who now propose to treat themselves prophylactically because of the low price and the free availability of this drug, should bear in mind that there were also adverse observations in connection with cancer. In renal cell cancer, which appears to be more common with the use of ASA, contrary experience has been reported. However, this finding was doubted by some experts due to the study design.

Finally, the congress in Amsterdam reveals that without a detailed characterization of the patients, the efficacy of ASA can not be clearly established. There are still too many inconsistencies in clarifying why ASA helps in some patients with cancer therapy and not in some. Therefore, no one wanted to make a recommendation to use ASA specifically for the treatment of cancer. (Fr)

Picture: GG-Berlin