A new study has found that aspirin can prevent the recurrence of certain bowel cancers—reducing the risk by half in some patients.
Bowel cancer—which also includes rectal and colon cancer—is one of the most aggressive and hard to treat forms of the disease, with high rates of secondary incidents commonly diagnosed in other areas of the body, a phenomena known as metastasis.
Every year, nearly two million people worldwide are diagnosed with colorectal cancer, and of these cases, between 20 and 40 per cent develop metastases.
As part of the new clinical study, which was published in The New England Journal of Medicine, Swedish researchers from Karolinska Institutet and Karolinska University Hospital looked at how people with a specific genetic mutation reacted to the common painkiller—which can cost as little as 3p per tablet.
They were looking specifically at people with a mutation in their PIK3 signalling pathway—an inbuilt biological “instruction network” which tells cells how to react to certain stressors, and controls how cells grow and divide.
When this signalling pathway malfunctions or is faulty, it can cause cells to keep dividing, which can leading to uncontrolled cell reproduction and cancer development—particularly in the bowel.
They recruited more than 3,500 bowel cancer patients from 33 hospitals in Sweden, Norway, Denmark, and Finland—and testing revealed that around 40 per cent of them had the PIK3 mutation.
These patients were then randomised and for the three years following their cancer removal surgeries, were prescribed either 160 mg of aspirin daily or a placebo.
For patients with the genetic mutation in PIK3 who took aspirin, the risk of metastasis was reduced by 55 percent compared with the placebo group.
Study lead Anna Martling, professor at the Department of Molecular Medicine and Surgery, Karolinska Institutet, and senior consultant surgeon at Karolinska University Hospital said aspirin can be used to reduce both suffering AND the cost of cancer care.
She said: ‘Aspirin is a drug that is readily available globally and extremely inexpensive compared to many modern cancer drugs, which is very positive.
‘Aspirin is being tested here in a completely new context as a precision medicine treatment.
‘This is a clear example of how we can use genetic information to personalise treatment and at the same time save both resources and suffering.’
The new study came after previous observational studies suggested that aspirin may reduce the risk of certain cancers.
It had also been theorised that it could reduce the risk of post-surgical recurrence in bowel cancer patients with the PIK3 mutation.
This was the first randomised clinical trial which confirmed the association, and researchers believe that it is most likely to do with aspirin’s ability to ‘reduce inflammation and make the internal environment less favorable for cancer cells’.
Professor Martling added: ‘Although we do not yet fully understand all the molecular links, the findings strongly support the biological rationale and suggest that the treatment may be particularly effective in genetically defined subgroups of patients.’
Around 44,000 cases of bowel cancer are diagnosed every year in the UK, with about 130,000 in the US.
The disease kills almost 17,000 Britons each year, with the death toll rising to about 50,000 in America.
Overall, just over half of bowel cancer patients are expected to be alive 10 years after their diagnosis.
Aspirin is a medicine that contains acetylsalicylic acid, and is used to relieve pain, fever, and inflammation, with effects usually felt in 30 minutes.
It can also be used in low doses to prevent blood clots.
However, due to common side effects which include stomach problems, it is advised that people with stomach ulcers, bleeding disorders, or asthma should avoid the common over the counter pill.
