
Aspirin May Prevent Cancer from Spreading, New Research Shows - azuajef
https://www.scientificamerican.com/article/aspirin-may-prevent-cancer-from-spreading-new-research-shows/
======
noam87
(on my phone right now)

Hasn't this been known for a while now? (with COX-2 NSAIDs specifically, like
Advil). Even the standard book "The Biology Of Cancer" (2014) mentions it in
passing in one of the later chapters.

I believe there's even been trials where NSAID is applied topically during
biopsy, reducing chance of mets.

If I recall correctly, suspected mechanism is some sort of correlation between
COX-2 inhibition and decreased expression of CTLA4/PD-1.

It's kind of sad, but it seems that too often vital lines of research sit on
university shelves for years before anything practical is done about it :/

(disclaimer: not an expert; just guy with cancer.)

~~~
dmichulke
> Even the standard book "The Biology Of Cancer" (2014) mentions it

Is this book ok for people with other backgrounds or does it require a good
foundation in medicine or biology?

And could a programmer (that knows how to learn) deal with it without spending
months on research?

Thanks and all the best wishes!

~~~
noam87
um some parts are more high-level than others, but a lot would be gibberish.
Familiarity with the contents of e.g "Molecular Biology Of The Cell" would
greatly increase your experience. -- That book is big and exhaustive (and
expensive), a focused intro to the same material is MIT "Introduction To
Biology" on EDx! It's an amazing course!

The book and MIT course also give a good enough conceptual intro to the
chemistry concepts you need too. Obviously the rabbit hole goes deeep tho...
people spend lifetimes scratching the surface.

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nonbel
There are some interesting theories about aspirin. For example that it was
Rasputin's secret healing trick to tell people to stop taking it:

"Gilliard,[32] the French historian Hélène Carrère d'Encausse[33] and Diarmuid
Jeffreys, a journalist, speculated Rasputin's healing practice included
halting the administration of aspirin, a pain-relieving analgesic available
since 1899.[34] Aspirin is an antiaggregant and has blood-thinning properties;
it prevents clotting, and promotes bleeding which could have caused the
hemarthrosis. The "wonder drug" would have worsened Alexei's joints' swelling
and pain.[35][36]"
[https://en.wikipedia.org/wiki/Alexei_Nikolaevich,_Tsarevich_...](https://en.wikipedia.org/wiki/Alexei_Nikolaevich,_Tsarevich_of_Russia)

It is also claimed to be the real cause of the "Spanish flu":

"The high case-fatality rate—especially among young adults—during the
1918–1919 influenza pandemic is incompletely understood. Although late deaths
showed bacterial pneumonia, early deaths exhibited extremely “wet,” sometimes
hemorrhagic lungs. The hypothesis presented herein is that aspirin contributed
to the incidence and severity of viral pathology, bacterial infection, and
death, because physicians of the day were unaware that the regimens (8.0–31.2
g per day) produce levels associated with hyperventilation and pulmonary edema
in 33% and 3% of recipients, respectively. Recently, pulmonary edema was found
at autopsy in 46% of 26 salicylate-intoxicated adults. Experimentally,
salicylates increase lung fluid and protein levels and impair mucociliary
clearance. In 1918, the US Surgeon General, the US Navy, and the Journal of
the American Medical Association recommended use of aspirin just before the
October death spike. If these recommendations were followed, and if pulmonary
edema occurred in 3% of persons, a significant proportion of the deaths may be
attributable to aspirin."
[https://academic.oup.com/cid/article/49/9/1405/301441/Salicy...](https://academic.oup.com/cid/article/49/9/1405/301441/Salicylates-
and-Pandemic-Influenza-Mortality-1918)

~~~
benji-york
> 8.0–31.2 g per day

That is surprising amount of aspirin.

~~~
salmonet
I would go out on a limb and say it's a LOT of Asprin. I usually use
"surprising" on HN because anything more specific gets criticized surprisingly
often, but that is a ton of asprin

~~~
oxide
it's a veritable fuck-ton. the usual modern dose is 325mg.

~~~
libdong
The maximum daily dose is usually around 4g. 325mg is probably the dose in one
tablet.

~~~
joshgel
Doctor here: very rarely does any prescribe anything more than 325mg daily.
Most people get 81mg daily. 325mg is considered high dose.

You are correct that it can be written for more, but the only indication you
would prescribe a higher dose is as a pain or fever reducer, and we have more
effective NSAIDs for that. Or tylenol (?NSAID).

I've personally never seen it given more than 325mg daily.

~~~
wahern
In the United States, 325mg is the amount in a single standard OTC pill.
People often take two pills because of the old doctor's adage, "take two
aspirin and call me in the morning".

81mg is marketed as low-dose (aka "baby aspirin"\--because of the size or
dose, not because it's intended for babies) and often prescribed as
prophylaxis. But that's not particularly relevant wrt the maximum safe short-
term dosage. The worst part of a flu usually only lasts a few days.

Here are the label directions from a bottle of generic aspirin as shown on
Amazon (GoodSense Aspirin Pain Reliever 325 mg Coated Tablets, 100 Count).

    
    
      Drink a full glass of water with each dose. Adults and
      children 12 years and over: take 1 or 2 tablets every 4
      hours or 3 tablets every 6 hours, not to exceed 12 tablets
      in 24 hours. Children under 12 years: consult a doctor.
    

That's approx. 4 grams/day for OTC usage.

~~~
gerdesj
So what we have learned here is that whilst many years ago 8-30+ g daily
dosage was either routine or at least proscribed in some cases, the routine
upper limit is now much reduced because the side effects of taking Salicylate
in such huge doses are worse than the symptoms or conditions that it was
prescribed for.

However, it may be possible that the stuff might (in huge doses) cure or at
least reduce something even worse than its own side effects. Then you are in
the realms of a simple risk assessment where the failure mode is pretty horrid
but that has to be weighed up against the alternatives if they even exist -
all of which ... well you get the idea.

(IANAD)

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aantix
As for the internal bleeding risks, I was wondering what the actual numbers
were. This is based on one low dose aspirin a day.

[http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2006....](http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2006.03077.x/full)

"These results translate into an absolute rate increase with aspirin above
placebo (the incidence of cases of major GI bleeding attributable to low-dose
aspirin) of 0.12% per year (95% CI: 0.070.19% per year).[20] Based on this
value, 833 patients (95% CI: 5261429 patients) would need to be treated with
low-dose aspirin instead of placebo to cause one major GI bleeding episode
during a 1-year period (i.e. the NNH is 833)"

~~~
mtgx
Does that mean the risks are very low? What about compared to aspirin
alternatives such as ibuprofen or acetaminophen (in terms of how much damage
they can each cause to the body, and which is safer)?

~~~
matt4077
Acetaminophen in particular is somewhat scary. Just 2.5x the recommended
maximal daily dose of 4g can lead to complete liver failure. With alcohol,
other medication, or existing damage, much less could be enough.

~~~
nostromo
A friend of mine swears that the reason acetaminophen is added to opioids
(like hydrocodone) is so that you cant abuse the opioid without being poisoned
by the acetaminophen.

If true, it's alarming that the way to "prevent abuse" is to poison the
patient.

~~~
jaggederest
That is completely correct. It also has synergistic effects as a pain
reliever, but it's mainly there to deter abuse.

Of course, addicts have found ways to extract the opiates from the
adulterants, so it's not even effective.

~~~
joshgel
Source?

Adding it for synergism makes sense and is what I was taught in medical
school. I doubt they add it to deter abusers, but I could be wrong...

~~~
jaggederest
Just look at the simple fact that they were schedule 3 instead of schedule 2
until 2014, even though the base hydrocodone was schedule 2 without
adulterants.

Here's an interesting discussion from 2010, before they were rescheduled

[https://painmedicine.oxfordjournals.org/content/11/3/379.ful...](https://painmedicine.oxfordjournals.org/content/11/3/379.full.pdf)

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erikpukinskis
Because it's anti-inflammatory?

Could be confirmation bias, but I keep getting the sense that cancer/immune
failure in general is connected to our modern 24/7 eating cycle, without any
down time for your body to not be inflamed and work on clearing out bad stuff.
Thus life extension from intermittent fasting.

~~~
iplaw
I abstain from food between 8PM and 12PM Monday - Friday, adjusting for
training schedules and such. It really helps me keep my GI tract clear,
reduces inflammation, resulted in weight loss, etc. without any effect on my
cycling fitness.

IF (or IMF as some people call it) is amazing.

~~~
tptacek
I've fasted from ~8P to ~3P every day for coming up on 2 years and apart from
making me more mindful of what I eat and drastically reducing my appetite I've
experienced basically no other health benefits. IF is increasingly well
studied and it is not especially amazing.

(I like it a lot. Just saying.)

~~~
agentgt
I do the same as well. It pretty much has changed my life.

The only thing I have noticed is that it seems not work well for females (my
wife is annoyed about that).

Also strangely my blood sugar has been above normal lately which is strange
because I don't eat a carb heavy diet and I have never had blood sugar
problems. Last time it was checked it was ~105 mg/dl or so (and I was fasted
of course).

I have had some theories about this but curious if anyone else seen this.

~~~
mrfusion
What's your theory about the blood sugar?

I have the same issue. Hovers around 100 when not eating. What's weird is it
drops to 85 within 20 minutes after eating a meal. I'm not sure what that
could mean.

~~~
joshgel
blood sugar is mostly regulated by hormones: glucagon and insulin. Not really
by what you just ate. Hence why you can go days without eating and still have
a normal blood sugar. Eating causes your pancreatic beta cells to release
insulin (in response to elevations in blood glucose). Diabetics have spikes in
their blood sugar right after they eat because they have impaired insulin
sensitivity and so their tissues (muscles mainly) don't take up the sugar in
the blood (a process mediated by insulin receptors).

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agumonkey
Talking about simply accessible products, anybody has knowledge about
cannabinoids (specifically cannabidiol, not THC) ?

I've dug as deep as I could from someone out of a lab and found tons of
evidence, but the issue is that doctors have each a different point of view on
it. So far I got:

    
    
      - it's innocuous but help opioids for pain
      - it's potentially antitumoral but human studies are lacking [0]
      - it's been studied and discarded because useless [1]
      - cannabis derivatives are toxic [2]
      - what's cannibidiol ? oh USA use that, Europe lags behind, I'll see
    

[0] mice model with human cancer lines showed regression, look for pierre yves
desprez or sean mcallister on pubmed, youtube has a talk where some patients
reported IRM visible regression on stage IV cancer

[1] renowned oncologist opinion, yet so many research on cannabidiol still
going ? odd

[2] so far I've yet to find more than one paper listing toxicity (except one
talking about accidental overdose on that one hypersensitive person that used
her daughter's provider)

I'll take any info just in case.

~~~
mohawk
Sorry haven't got much time at the moment, here's the paper that got me
interested

Anti-tumoral action of cannabinoids: Involvement of sustained ceramide
accumulation and extracellular signal-regulated kinase activation

[http://www.nature.com/nm/journal/v6/n3/abs/nm0300_313.html](http://www.nature.com/nm/journal/v6/n3/abs/nm0300_313.html)

Put that into Google Scholar (the paper title or just "guzman thc"), then
click on the Cited by xxx below in the search results to find newer papers.

GW Pharma is a company doing clinical trials, and i think Canadian licenced
producers of cannabis are doing trials as well (though i don't know how many
are about cancer/anti-tumoral activity).

Here's a long list of research papers on cannabinoids:

[http://www.cannabis-med.org/studies/study.php](http://www.cannabis-
med.org/studies/study.php)

~~~
agumonkey
Oh I know that, I mailed Cristina Sanchez about her research. I looked for the
GW trial (brain metastasis IIRC) in UK but so far couldn't find any results.

thanks for the other link, I never looked at that website before.

ps: and to add to the theories, Desprez cbd research hints at ID-1
transcription regulation; ID-1 appearing to be a embryogenic-time gene,
turning cells into highly mobile and differentiating regime => aggressive
tumor. If CBD does interfere with ID-1 expression, it's not implausible that
tumors grow much more slowly and locally, which is probably always good.

pps: one more thing, cbd and cannabinoids have a huge image problem; people
just dismiss it as hippie shit.

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joshgel
Probably more interesting is that the USPSTF recently added a recomendation
for aspirin use to prevent colorectal cancer in certain populations[1]. There
is increasing levels of evidence about this, though it is by no means
certain.[2]

[1]
[https://www.uspreventiveservicestaskforce.org/Page/Document/...](https://www.uspreventiveservicestaskforce.org/Page/Document/draft-
recommendation-statement/aspirin-to-prevent-cardiovascular-disease-and-cancer)
[2]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354696/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354696/)

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jszymborski
Anyone have a link to the paper? I'm usually the first to criticise popsci
treatments of cancer developments, but this actually seems to be an
interesting study/development.

~~~
carbocation
It seems the author is referring to a few papers, but the one most directly
related seems to be
[http://atvb.ahajournals.org/content/37/4/664.long](http://atvb.ahajournals.org/content/37/4/664.long)

I don't see a free, open-access form available.

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swah
Surely this would have been discovered by patients by accident, if it was
true?

~~~
ng12
How? Maybe you went into remission because you took an aspirin every morning.
Or maybe it's because drank a cup of coffee every day, or ate lots of greens,
or spent 10 minutes in the sun every day, etc. Your body is complicated and
more than likely lots of factors helped.

~~~
sp332
The effect in the article is just preventing metastasis, not going into
remission. There's basically no way a single patient would have noticed that
aspirin prevented that.

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omginternets
That effect size, though... :/

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vermooten
'may'

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jtwebman
So goes eating a whole plant based vegan diet.
[https://www.forksoverknives.com/science-says-about-diet-
and-...](https://www.forksoverknives.com/science-says-about-diet-and-cancer/)

