Clinical studies have indicated women taking regular low doses of aspirin were 16 percent less at risk for breast cancer. While inconclusive, some researchers believe aspirin has the ability to suppress cancer cell growth.
What is the research so far? What is the science behind this? And, most importantly, can a simple aspirin help prevent breast cancer?
We talked to the experts to find out.
Welcome to Giddy's series for Breast Cancer Awareness Month. Each week, we will take a deep dive into an aspect of the breast cancer experience. This week, we'll take a look at the exciting world of emerging research—specifically at whether an over-the-counter pain reliever can actually prevent breast cancer.
There have been several clinical trials looking at the connection between taking aspirin and reducing breast cancer risk.
Tara Scott, M.D., chief medical officer at the Revitalize Medical Group and medical director of Integrative Medicine at Summa Health Systems, broke down some of the research done to date:
So, there have been trials, but as of now, the research is still not conclusive. There is a lot more to understand.
Neil M. Iyengar, M.D., is a medical oncologist with clinical expertise in breast cancer and exercise oncology at the Memorial Sloan Kettering Cancer Center. "The main rationale for aspirin as an anti-cancer agent is that it has anti-inflammatory properties," Iyengar stated.
"Specifically, aspirin blocks the activity of cyclooxygenase (COX), a family of enzymes that promote inflammation. In fact, COX inhibitors, which are prescribed to treat arthritis, have been tested as a cancer treatment. The appeal of aspirin is that it is generally less toxic and has fewer side effects than COX-specific inhibitors."
Although Iyengar explained inflammation is one of the key drivers of cancer growth, especially breast cancer, he advised it doesn't act alone. There is usually a combination of causes, such as metabolic dysfunction or obesity, which work together to promote the growth of breast (and at least 13 other types) of cancer.
"Therefore, the most effective preventive or treatment strategy is likely one that reduces inflammation and also improves other parameters, such as metabolic health," Iyengar advised.
"In my opinion," he continued, "an equally—or potentially more effective—strategy with fewer side effects than aspirin is adherence to a healthy lifestyle, including regular exercise, a healthy diet, and maintaining a healthy weight. Of course, this is harder to do than taking a pill, so there is certainly an attraction to aspirin for this reason."
"Further trials are needed," Scott stated, "and are ongoing."
There are still several key questions scientists need to answer before aspirin can be recommended as a breast cancer risk reduction or treatment strategy.
"For example," Iyengar explained, "we need to know the optimal dose that is most effective with the least amount of side effects. There may also be specific groups of people that would benefit more so than others. Currently, the data is mixed and/or limited to less rigorous observational studies."
However, both Scott and Iyengar alluded to ongoing research in the United Kingdom. "There is currently an extensive trial (approximately 11,000 patients) going on in the U.K. that is testing whether aspirin (either low- or high-dose) can reduce the risk of recurrence for breast and several other cancers," Iyengar stated.
The Breast Cancer Now Catalyst Programme funds this large clinical trial. They aim to progress world-class breast cancer research through innovation and collaboration. The trial has been awarded Pfizer's independent medical research grant and given access to several of Pfizer's medicines.
This exciting study is one of many currently being run by the Catalyst Programme to develop better treatment options for people affected by breast cancer.
"There are risks to regular aspirin use," Iyengar warned, "such as increased gastrointestinal problems, including acid reflux or even ulcers, increased risk of bruising and bleeding, [and] worsening of asthma symptoms.
"Aspirin can also interact negatively with some cancer therapies and further increase the risk of these side effects," Iyengar added.
Higher doses of aspirin is associated with an increased risk of side effects.
The short answer to this question is no. "Right now, aspirin is not a routine recommendation for breast cancer prevention," Scott stated.
"The questions raised above need to be answered first by ongoing clinical trials before we can know whether aspirin is truly beneficial for cancer risk reduction," Iyengar explained.
"Currently, aspirin is not recommended for use with cancer therapy or as a precaution to reduce the risk of breast cancer recurrence. The existing data is mixed, with some studies showing the benefits, and a few studies showing an increased risk of dying from cancer when aspirin is taken in the older population (over age 65)," Iyengar said. "Ultimately, the risk versus benefit calculation varies from individual to individual and should be discussed with your doctor."
Scott added that because there are risks associated with daily aspirin use, the benefits of regular aspirin need to be proven before recommending it to patients.
"I think in general, we need to be more preventive about breast cancer," Scott continued. "Our approach right now is focused on early detection, and I think there is a lot more we could be doing for prevention."
