LOW DOSE ASPIRIN AND CANCER TREATMENT

A SUMMARY OF THE EVIDENCE ACROSS A WIDE RANGE OF CANCERS

Aspirin can help treat pain or fever and may be purchased without a prescription ‘over the counter’. In clinical use, many willow bark in 1828 patients with cardiovascular disease are prescribed a low dose of 75 mg per day to reduce risks of a heart attack or stroke caused by clots. In two blood cancers, myeloma and myeloproliferative neoplasms, low dose aspirin is also sometimes used to help reduce risk of clots.

A large review of over 100 observational studies in patients with 18 different types of cancer suggested that low dose aspirin could improve survival by 20%. The review, including about 250,000 cancer patients taking aspirin, also found evidence it helps reduce secondary or metastatic cancer spread. Whilst aspirin caused bleeds in some patients, overall the medicine had a good safety profile.

More definitive trials are ongoing for aspirin in cancer treatment and patients are encouraged to participate in these if they are invited to do so or to ask if they can be included. Yet the trials cover only a few cancers, which is a limitation. In addition, trials are unlikely to report for several years which raises a question about what happens during this interval whilst results are awaited.

The evidence on the efficacy and safety of low dose aspirin justifies it now being considered as a supplementary treatment in a wide range of cancers in adult patients.

Aspirin is not a possible alternative to any other treatment and cancer patients, or family member or carers on their behalf, could raise the topic of aspirin as an additional treatment with their healthcare team to discuss options..

This leaflet has several intentions:

• Firstly, general awareness raising about low dose aspirin and cancer treatment
• Secondly, it seeks to stimulate discussion between cancer patients and healthcare professionals
• Thirdly, to stimulate cancer patients being recruited into trials and new trials being set up
• Finally, to stimulate other research such as observational studies i from healthcare records

To fulfil the previous intentions, this leaflet reaches out to a broad audience including cancer patients, family members, carers, charities, researchers and healthcare professionals. The review paper is freely available in the public domain by typing in the title shown below into an internet search engine. More information on the benefits and risk of aspirin can be found on the NHS website.

The new study:

Elwood et al. Aspirin and cancer survival : a systematic review and meta-analysis of 118 observational studies of aspirin in 18 cancers. Ecancermedicalscience 2021;15:1258

Other resources:

https://www.cancerresearchuk.org/about-cancer/other-conditions/myeloproliferative-neoplasms

https://www.nhs.uk/medicines/low-dose-aspirin/ 

This leaflet has been prepared with the kind assistance of the team who undertook the above new study.

Photo of willow by Zhenya on Unsplash