07- 13 JAN 2011

Aspirin continues to impress. A study published in The Lancet last year suggested that aspirin users have a 21 per cent less chance of dying from cancer. The meta-analysis, which was a pooled study of more than
25,000 people who either took aspirin or a placebo (sugar pill), indicated that there were greater benefits with longer aspirin therapy.

The study showed that the aspirin group had less chance of dying from cancer compared to the placebo cohort. Pancreatic, brain, lung, stomach and prostate cancer were some of the cancers that were prevented. The study's large sample size lends weight to the findings from Peter Rothwell and his colleagues at Oxford's John Radcliffe Hospital in the UK, but does this mean that we need to start popping 75mg of aspirin a day to avoid cancer?

Aspirin has long been regarded as a drug that prevents and helps treat strokes and heart attacks. In fact, the above findings about aspirin therapy were a by-product of an earlier study.

The original study was primarily designed to further define the role of aspirin in patients who suffered from strokes and heart attacks. Aspirin's capacity to protect patients from cancer was a serendipitous finding, common in biomedical research. Penicillin was also discovered serendipitously. (A note about the Sanskrit-derived word 'serendipity': Serendip was an old name for Sri Lanka. In an 18th century play by Horace Walpole entitled The Three Princes of Serendip, the travelling princes keep on making remarkable discoveries that they are not really looking for.)

At one point some doctors got so carried away by aspirin's perceived benefits they were prescribing the drug for older people who had not had a heart attack and were not at major risk either. But two years ago, definitive research revealed that the risks of aspirin, including bleeding ulcers in the stomach, outweighed the protection from heart attacks for this healthy cohort of people.

There has been a re-evaluation on the issue of 'primary' prevention of heart attacks with aspirin. Although popping inexpensive aspirin appears to be a highly cost-effective way to prevent cancer, especially in a resource-poor country like Nepal, it may be prudent to wait for proper international guidelines that take the recent Lancet publication into consideration.