'Repurposing a Safe, Inexpensive, and Globally Available Drug'
- A randomized study has produced some hopeful news for colorectal cancer survivors with an unlikely suspect: the commonly used over-the-counter aspirin.
- “Patients with treated, PI3K-mutated early [colorectal cancer] had a 50-60% lower risk of recurrence at 3 years if they received 160 mg of aspirin daily,” MedPage Today reported via Dr. Anna Martling of the Karolinksa Institute in Stockholm following the American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium.
- 160 mg is equivalent to around half of a regular-strength tablet of Bayer.
- A PI3K mutation, according to National Cancer Institute (NCI), has “been found in many types of cancer, including cancers of the breast, lung, ovary, stomach, brain, colon and rectum.”
“Patients with treated, PI3K-mutated early [colorectal cancer] had a 50-60% lower risk of recurrence at 3 years if they received 160 mg of aspirin daily,” MedPage Today reported via Dr. Anna Martling of the Karolinksa Institute in Stockholm following the American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium.
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“The benefit occurred in patients with PIK3CA exon 9/20 mutations,” a.k.a. “hot spot mutations, and in patients with other types of PI3K mutations,” said Martling, the “9” and “20” signifying the name of those specific gene variants.
“Aspirin 160 mg reduced recurrence by more than 50% in colorectal cancer patients with tumors harboring mutations in the PI3 kinase pathway,” she continued. “This is the first trial to show that mutations in this specific signaling pathway, beyond the PIK3CA mutations, predict aspirin response, expanding the targetable population to more than a third of patients.”
RELATED: Does Aspirin Help Prevent Cancer– Here is What We Know
“This is also an example of the repurposing of a safe, inexpensive, and globally available drug, and it stresses the importance of upfront genomic testing in colorectal cancer,” she noted.
“The results left little doubt about aspirin’s ability to prevent [colorectal cancer] recurrence in PI3K-mutations.”
Dr. Pamela Kunz of Yale Cancer Center and Smilow Cancer Hospital in New Haven, Connecticut, in a pre-briefing ahead of the symposium, said “it’s really clear that this is a practice-changing’ study.”
“It’s effective, it’s low risk, it’s inexpensive, and it’s easy to administer. What we’re seeing, in terms of over 50% lower risk of recurrence, is really important, and I anticipate that we’ll be seeing the adoption of this. I think aspirin is chemopreventative,” she added, “it has been around for awhile, but the uptake and the data to demonstrate its effectiveness have been lacking.”
“I think this really changes the paradigm.”
As Dr. Kunz shared, this is not new news, but just provided further proof of the benefits of aspirin in this scenario.
Aspirin and Colorectal Cancer
Back in 2019, it was determined that physicians should prescribe aspirin to anyone with advanced polyps, unless there is a reason not to, according to a significant new warning at the time.
RELATED: Colon Cancer Prevention: Major New Recommendation About the Value Of Aspirin
The task force that issued the recommendation, called the U.S. Preventive Services Task Force (USPSTF), is a group of experts in primary care and prevention that reviews evidence from different studies, and comes up with recommendations for preventative medical care. They concluded then that aspirin reduces the risk of colorectal cancer by 40 percent as well as recurrence of advanced polyps. According to their guidelines, without a specific “contraindication,” or reason not to, health care providers should routinely prescribe aspirin to all patients with advanced colorectal polyps.
Dr. Stephen Freedland, Urologist at Cedars-Sinai Medical Center in Los Angeles, told SurvivorNet at the time that patients should be aware that aspirin (which can also help prostate cancer patients) “can increase bleeding, increase certain types of strokes.”
Be sure to talk with your doctor about taking aspirin and, if they do recommend it, the proper dosage to take.
Understanding Colorectal Cancer
Colorectal cancer starts when abnormal lumps called polyps grow in the colon or rectum. If you don’t have these polyps removed, they can sometimes change into cancer. It takes up to 10 years for a colon polyp to become a full-blown cancer, according to SurvivorNet experts.
If you get the recommended screenings, your doctor will have time to remove any polyps that form, before they can cause problems.
Does alcohol increase, or lower your risk for colon cancer? SurvivorNet asked colorectal surgeon, Dr. Heather Yeo, to explain.
While experts don’t know exactly what causes colon cancer, they do point to certain risk factors, such as diet, smoking tobacco, and drinking alcohol. Having a family history of colorectal cancer can also increase the risk.
What Increases Your Risk for Colon Cancer?
Risk factors are things that make you more likely to get colon cancer. They don’t mean that you’ll definitely get this cancer — only that you’re slightly more likely to be diagnosed.
You may be at greater risk for colon cancer if you:
- Are older. About 90% of cases are in people age 50 or older, according to the U.S. Centers for Disease Control & Prevention (CDC). Yet it is possible to get this cancer earlier in life — and cases in younger adults have been becoming more common recently.
- Have inflammatory bowel disease. Crohn’s disease or ulcerative colitis can, over time, cause cells in your intestines to turn cancerous.
- Have a family history of this cancer. Just under one-third of people who get colon cancer have family members with the disease.
Getting Cleaned Out for a Colonoscopy
- Have a gene mutation. About 5% of colorectal cancers are caused by an inherited genetic mutation that causes syndromes such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (Lynch syndrome).
- Don’t exercise very often. Staying active can lower your risk.
- Eat a diet that’s high in meat. Regularly eating red meats like burgers and steaks, and processed meats such as hot dogs and bacon might put you at higher risk. Eating more fruits, vegetables, and whole grains instead might lower your risk.
- Are overweight or obese. Having too much weight increases your risk of both getting colon cancer, and of dying from it.
- Drink a lot of alcohol. Limiting alcohol to one drink a day for women and two drinks daily for men could help lower your risk.
- Use tobacco. Long-term smokers are more likely to get this cancer than are nonsmokers.
Risk factors such as smoking and obesity are important in the development of colon cancer before age 50.
Up to a third of people who develop cancer at a younger age have a genetic condition that puts them at high risk. Environmental factors may also contribute to younger people developing colon cancer.
For that reason, it is important for people of all ages to pay attention to changes in their body or bowel habits. Weight loss, blood in the stool, and changes in bowel movements that don’t go away are worth seeing your doctor about.
Colorectal Cancer Facts
Here is a more comprehensive list of symptoms of colon cancer to look out for:
- A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that last for more than a few days
- A feeling that you need to have a bowel movement that’s not relieved by having one
- Rectal bleeding with bright red blood
- Blood in the stool, which might make it look dark brown or black
- Cramping or abdominal pain
- Weakness and fatigue
- Losing weight without trying
Since these issues can also be common symptoms for other illnesses and aren’t always a cause for concern, it’s generally best to see a doctor to be on the safe side.
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