Can a daily aspirin prevent recurrence of early stage prostate cancer after first-line treatment?

According to media reports on the BBC’s web site and in The Guardian newspaper in the UK, a new clinical trial to be implemented by the National Health Service (NHS) will explore whether a simple aspirin regimen can be used to help to prevent the recurrence of certain types of early stage cancer following first-line treatment.

The original media release about the initiation of this trial — the Add Aspirin Phase III trial — can be found on the web site of the NHS’s National Institute for Health Research (NIHR). The trial has been designed to enroll about 11,000 patients from > 100 centers across the UK. It will attempt to answer the question whether taking aspirin daily for 5 years can stop or delay the return of cancers that have been caught and treated early, and it will enroll men and women who have just had or will still be receiving treatment for any one of five types of cancer: colorectal cancer, breast cancer, esophageal cancer, stomach cancer and prostate cancer.

Patients will be randomly assigned to one of three different treatment regimens:

  • Aspirin at a dose of 100 mg/day
  • Aspirin at a dose of 300 mg/day
  • Dummy (placebo) tablets

And don’t expect the results in a hurry. The investigators expect this trial to last for up to 12 years before they get the results. However, The “New” Prostate Cancer InfoLink would strongly encourage UK-based prostate cancer patients to consider enrolling in this trial.

According to Prof. Ruth Langley, the lead investigator for this new trial:

There’s been some interesting research suggesting that aspirin could delay or stop early stage cancers coming back but there’s been no randomized trial to give clear proof. … The trial aims to answer this question once and for all. If we find that aspirin does stop these cancers returning, it could change future treatment — providing a cheap and simple way to help stop cancer coming back and helping more people survive.

However, we do also need to be very clear about two other things:

  • Taking a daily aspirin to try to prevent recurrence of you own cancer unless you are a participant in this trial is absolutely not a good idea.
  • Taking aspirin every day is associated with risk for such serious side effects such as ulcers, bleeding from the stomach, and even bleeding in the brain (which can cause strokes).

Limited, additional information about this trial can also be found on the NIHR web site and greater detail on the trial’s own web site.

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