In a nutshell
This review analyzed a number of studies which evaluated the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on cancers of the gastrointestinal system, such as colorectal cancer.
Some background
NSAIDs, such as aspirin and ibuprofen (Advil), are a class of drugs commonly used for pain relief and fever reduction. NSAIDs exert their anti-inflammatory effect effects through the inhibition of the cyclooxygenase-2 (COX-2) enzyme. COX-2 activity and inflammation appear to be related to the development and growth of gastrointestinal cancers. Recent studies have found that COX-2 is found in higher amounts in faster developing colorectal cancers. A mutation in the gene responsible for the production of COX-2, the PIK3CA gene, is also commonly found in some colorectal cancer cells. COX-2 also appears to be involved in the growth of new blood vessels, which are essential for cancer growth and spread. While several past studies have demonstrated that regular use of NSAIDs reduces the risk of developing colorectal cancer, the use of NSAIDs as part of treatment after cancer diagnosis is still being investigated.
Methods & findings
Three of the studies reviewed found that regular use of aspirin after diagnosis of colorectal cancer was associated with a lower risk of overall mortality (mortality from any cause, including cancer). One of the reviewed studies showed that in patients with tumors who express high levels of the COX-2 enzyme, the use of aspirin after diagnosis reduced both the risk of cancer-specific, and overall, mortality. A recent study indicates that colorectal cancer patients with a PIK3CA mutation who regularly use aspirin experience higher survival rates compared to colorectal cancer patients without the PIK3CA mutation.
The bottom line
This review concluded that regular use of NSAIDs, and specifically aspirin, may improve survival among colorectal cancer patients. Recent evidence suggests that aspirin should be seriously considered in the treatment of PIK3CA-mutated or high COX-2 expressing colorectal cancers.
The fine print
Further controlled studies are required to determine the long term effects and optimal dosage of NSAIDs as added colorectal cancer treatment. Since NSAID use has been shown to reduce the risk of developing colorectal cancer, it is assumed that NSAIDs may also reduce recurrence rates among cancer survivors, although this has yet to be investigated.
What’s next?
Consult with your physician regarding the risks and benefits of NSAIDs in the treatment of colorectal cancer.
Published By :
Cancer Letters
Date :
Sep 07, 2013
