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Tuesday, August 18, 2009

The Many Benefits of Aspirin

Anyone who's watched the excruciating process by which a new drug gains FDA approval knows that if garden variety aspirin, that mainstay of medicine cabinets everywhere, was up for review today, it would never make the cut. That's because aspirin is known to have a number of negative side effects, especially gastrointestinal bleeding. But now another study in JAMA is extolling the benefits of aspirin: Aspirin Use and Survival After Diagnosis of Colorectal Cancer.

The study followed over 1200 men and women with various stages of colorectal cancer and examined deaths and aspirin use. Those who used aspirin, also at varying dosages, experienced fewer recurrences and deaths related to colon cancer than those who did not. Tumor analysis revealed that aspirin responders had more of an enzyme in their tumors called cyclooxyenase 2, abbreviated COX-2. This is the same enzyme (which can be thought of as a helper to chemical reactions) that is the target of prescription drugs like Celebrex.

Once again we're hearing about how interfering with COX-2 can be beneficial, and aspirin is a cheap, effective way to do so. We already know that aspirin is recommended for many at risk of heart attacks, and it may have utility in other preventive settings as well. But the bottom line, as Rick points out, is that before embarking on regular aspirin use, you should consult your primary care physician. That's because aspirin in conjunction with other medications may be harmful, and you may have other medical conditions that preclude its use.

Another aspect to this study we've been hearing so much about is tumor analysis and personalized medicine. Checking to see whether colon tumors express COX-2 would predict who is likely to benefit and who is not.

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