A PREEMPTIVE STRIKE AGAINST CANCER

The news that aspirin may cut risks gives a big boost to a slew of promising drugs

No one is ready to recommend that women start popping aspirin every day, in part because the drug can cause gastro­intestinal side effects.*  But the report, in the May 26 issue of The Journal of the American Medical Association, does raise the hope that women already taking aspirin to prevent heart disease may be getting another valuable benefit. “I think this is a very important paper,” says Dr. Waun Ki Hong, a pioneer in chemopre­vention at the M.D. Anderson Cancer Center in Houston.

Hong says a number of drugs have now been shown to suppress cancer, including aspirin and similar non­steroidal anti-inflammatory drugs (NSAID5) such as ibuprofin. In fact, aspirin has already been proven effective in preventing colon cancer.  A stream of studies over the last few yeas has also focused on aspirin’s potential against breast cancer, but with mixed results.  The JAMA study by researchers from Columbia University, is noteworthy because it shows which type of breast cancer would most likely be prevented—and why.

DOWNSIDE TO DAILY DOSES

THE RESEARCHERS studied 3,000 Long Island women, half with breast cancer and half without, and analyzed how often they took aspirin, ibuprofen (such as Advil), and acetaminophen (such as Tylenol). They found that 20.9% of the women with breast cancer had taken as­pirin regularly for six months or longer before they were diagnosed, compared with 24.3% of the women in the control group. That adds up to a 20% lower risk of breast cancer for aspirin users vs. nonusers. The drug was most effective against tumors that are dependent** on the hormones estrogen and progesterone, reducing the risk of these types of cancers by 26%. Hormone-dependent tumors ac­count for 60% to 70% of all breast cancer cases. Ibuprofen had a weaker effect, while acetaminophen, which is not an NSAID, offered no protection.

The Columbia scientists based their study on 10 years of lab research. They knew that aspirin blocks an enzyme in the blood called COX-2 that stimulates estro­gen production. Testing its effect in mice, Dr. Andrew J. Dannenberg of Weill-Cor­nell Medical College, a co-author of the JAMA report, found that aspirin reduced both estrogen and breast tumors.

Still, cancer experts say the Columbia study wasn’t flawless. It only followed the women for a year, and was retro­spective—the outcomes were based on participants’ reports of their own behav­ior and open to bias, a problem with many such studies. But more money is being poured into prospective trials, which give a drug to a large population over a number of years to see what hap­pens. The National Cancer Institute is conducting a seven-year trial with 22,000 women to see whether tamox­ifen, a breast cancer treatment, or Eli Lil­ly & Co.’s Evista, an osteoporosis drug, is better able to prevent breast cancer. Re­sults are due in 2006.

The NCI says there are more than 40 other drugs in chemoprevention tri­als, ranging from old standbys like aspirin to new targeted therapies such as AstraZeneca PLC’S Iressa, a lung cancer treatment approved in 2003. M.D. Anderson doctors are testing Iressa and Tarceva, a similar drug by Genentech and OS1 Phar­maceuticals, in heavy smokers in an attempt to prevent lung cancer.

There can be a downside to giv­ing a pill every day to prevent dis­ease. Merck & Co.’s anti-baldness drug, Proscar, was able in a large tri­al reported last year to reduce prostate cancer by 25%, but the men on Proscar who did develop cancer tended to get more deadly tumors, possibly because of the drug.  Still, cancer specialists are en­couraged. “Oncology is two decades behind cardiology when it comes to disease prevention, but we are be­ginning to get smarter about it,” says Dannenberg. The 212,000 women likely to be diagnosed with breast cancer in the U.S. this year can only hope so.

-By Catherine Arnst in New York

PAGE 48,  Business Week ; June7, 2004

*  Nearly all the studies which I have read comparing other NSAIDs to aspirin were flawed.  For example, the ibuprofen is coated while they aspirin is not, or they would not use equivalent doses.  Drug companies are like politicians, the ends justifies the means,

** THE CANCER IS NOT DEPENDENT ON ESTROGEN OR PROSTOGLANDINS, BUT RATHER HAS ON THE SURFACE OF THOSE CELLS RECEPTORS FOR ESTROGEN.  WHEN STIMULATED BY ESTRONGEN THEY DIVIDE MORE RAPIDLY.  THUS A LIFE THREATENING BREAST CANCER (link to explanation of how cancer becomes life threatening) WILL GROW AND SPREAD FASTER.  IN OTHER WORDS, THE CLOCK HAS BEEN PUSHED FORWARD FOR THOSE WITH THE RIGHT SET OF MUTATIONS.  A number of long-term studies of birth control pills have confirmed this assumption, because after several years of taking estrogen the rate of breast cancer approaches those who are not taking estrogen.--JK

Also on longevity is the article WHY WOMEN LIVE LONGER

Pancreatic cancer 53%

Lung cancer 33%

Diabetes caused blindness, coronary artery disease, strokes, and kidney failure reduced.

Dementia including Alzheimer’s disease reduced 42%.

Prostate cancer, significant delays in distant metastases, decreased rates of second cancers, and improvement in overall survival

First myocardial infraction reduced 32%

C-section 400%

Laboratory studies have suggested that by inhibiting the COX-1 and COX-2 enzymes, aspirin may enhanced programmed cell death (apoptosis) and inhibit the development of blood vessels (angiogensis) that feed a tumor