Acetylsalicylic Acid: Hope in Cancer Treatment?

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Acetylsalicylic acid as hope in the fight against cancer

At the largest European Cancer Congress in Amsterdam to date, which was organized by several cancer societies, drugs with "acetylsalic acid" (ASS) were the focus this time. They are currently being hailed as new hope in cancer prevention, as reported, among others, by the nutrition scientist Cornelia Ulrich, head of the preventive oncology department and member of the board of directors of the National Center for Tumor Diseases (NCT) in Heidelberg.

Most people in Germany simply know this active ingredient under the name "Aspirin" and it is mainly used as a pain reliever or as an inhibitor of blood clotting. People who have suffered a heart attack must then take the active ingredient regularly.

Studies have shown that when taken over a period of about five to ten years, a cancer-inhibiting effect develops and, for example, the incidence of colorectal cancer is reduced by about 40 percent. Apparently, fewer distant metastases form in tumor patients when taking ASA. For a long time, the experts disagreed whether colon cancer protection could be achieved with a lower dose of this active ingredient and a lower intake. The results of a study ("Annals of Internal Medicine" Vol.159 (2), p.77) have now confirmed these assumptions and it has been shown that a protective mechanism is also established when taking lower doses.

For many experts, however, a more thorough examination of these patients was the reason for better preventive care. After taking ASA medication, blood often appeared in the stool, which is due to a greater tendency to bleed, caused by acetylsalic acid. It is precisely with such findings that a closer look is taken. In short, polyps or adenomas are detected earlier in ASA patients, but this does not necessarily mean that there is also an anti-carcinogenic effect.

However, this assumption could be refuted by tests with other blood coagulation agents, such as vitamin K. The study found that there was no reduction in the colorectal cancer rate.

However, the scientists have not yet been able to clearly clarify why ASA leads to a reduction. For example, an effect on circulating platelets could prevent cancer cells from spreading, and it is believed that ASA may influence the cell's mutation rate. However, ASA may also have a positive effect on and strengthen the effects of other cancer drugs, says Ullrich.

The gene variants are decisive. Further study results, including those that have not yet been published from the Heidelberg research laboratories, showed that certain gene variants in individual patients influence blood coagulation and also tumor inhibition, according to the nutritionist. In the future, this could mean that certain groups of patients could benefit from the cancer-inhibiting properties of ASA without the undesirable side effect of the increased risk of bleeding adversely affecting cheap treatment in any way. The University Clinic in Leisen also presented the results of a working group that focused on the tissue typing of 999 colon cancer patients. This can be used to determine whether ASA can prevent cancer.

All patients were given a low dose of ASA, but not all of them could benefit from the anti-cancer effects, according to the head of the study, Marlies Reimers. This result has led to a large number of studies on the anti-carcinogenic properties of ASA.

High expectations for the “miracle drug” But it is precisely the genetic differences in the effects and also some contradictory findings in other types of cancer that only allow subdued euphoria, according to Cristina Bosetti, mathematician and epidemiology at the Mario Negri Institute in Milan. Unfortunately, there are no uniform findings that show a clear prevention mechanism. In lung cancer, for example, ASA administration shows a favorable course, but this can only be recognized after the patients have been medically observed for 20 years. With prostate cancer and breast cancer, too, you have to wait a long time to see results. However, anyone who now intends to treat prophylactically due to the low price and free availability of this medication should bear in mind that adverse observations have also been made in connection with cancer. The opposite experience has been reported in renal cell cancer, which appears to be more common with ASA. This finding was questioned by some experts due to the study design.

Ultimately, the congress in Amsterdam revealed that without an exact characterization of the patients, the effectiveness of ASA cannot be clearly demonstrated. There are still too many inconsistencies in clarifying why ASA helps cancer patients in some patients and not in others. Nobody wanted to make a recommendation to use ASA specifically for cancer treatment. (fr)

Image: GG-Berlin /

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