Can a regular aspirin regimen extend survival of men with prostate cancer?

Another intriguing paper to be presented this week at the Genitourinary Cancers Symposium suggests an association between regular aspirin intake and risk for lethal prostate cancer among men already diagnosed with prostate cancer. This paper has already been receiving attention in the media (see this article in The Wall Street Journal today.)

Earlier reports have suggested, for some time, that regular aspirin intake may have a preventive impact on the occurrence of progressive or advanced forms of prostate cancer (although this has yet to be shown in any type of prospective clinical trial). This new study by Allard et al. (abstract no. 306; “Regular aspirin use and the risk of lethal prostate cancer in the Physicians’ Health Study”) suggests a similar impact of regular aspirin use on the development of metastatic prostate cancer and prostate cancer-specific mortality (i.e., risk for “lethal” prostate cancer).

The study is based on data from 22,071 male physicians, all enrolled in the prospective Physicians’ Health Study and followed from 1982 to 2009. The goal of the study was to evaluate any relationship between regular aspirin use (> 3 aspirin tablets a week) and lethal prostate cancer. Data were also collected on a series of secondary outcomes.

Here are the core results of the study as reported to date by Allard et al.:

  • Total follow-up was 27 years (or 533,261 person-years).
  • During the follow-up period
    • 3,183/22,071 men (14.4 percent) were diagnosed with prostate cancer.
    • 402/3,183 men with prostate cancer (12.6 percent; or 1.8 percent of the entire cohort) developed lethal prostate cancer.
  • Among the 3,183 men diagnosed with prostate cancer,
    • Regular aspirin use after diagnosis was associated with decreased prostate cancer mortality (hazard ratio [HR] = 0.79).
    • Regular aspirin use prior to diagnosis was not associated with any measurable impact on prostate cancer mortality.
  • Regular aspirin use
    • Was not significantly associated with the incidence of total, high-grade, or advanced cancers.
    • Was associated with a decreased risk for the diagnosis of lethal prostate cancer (HR = 0.67).
    • Was protective when recent (i.e., within the prior 12 months), but the effects diminished with time since last regular use.

Allard et al. conclude that regular aspirin  use is

associated with a decreased risk of lethal prostate cancer in this cohort of American physicians. An inhibitory effect of regular aspirin use on prostate cancer progression is suggested.

One has to wonder whether this effect of aspirin correlates in some way with the effects shown by celecoxib + zoledronic acid in the STAMPEDE trial previously discussed. Both aspirin and celecoxib have well-known anti-inflammatory effects.

2 Responses

  1. I have been taking Celebrex for many years for arthritis, and Dr. Dattoli recommended I continue to take it for my prostate cancer. Since it’s an NSAID, like aspirin, can I assume that it might have the same beneficial effect on prostate cancer as aspirin?

  2. Bob:

    I suggest you see this commentary with respect to Celebrex.

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