Aspirin may help colon cancer patients live longer

Adding aspirin to the regular treatment of people whose tumour cells give off a specific antigen, or defence mechanism, may help them to live longer.

Recent research has raised the possibility that low-dose aspirin could add extra years to the lives of colon cancer patients. Now, a new study suggests that only certain patients may gain a survival benefit by taking aspirin after diagnosis.

The study of about 1,000 patients found that people whose tumour cells give off a specific antigen, or defence mechanism, gained most from adding aspirin to their regular treatment.

The findings, published online in JAMA Internal Medicine, aren't conclusive, and patients who develop colon cancer while already taking aspirin may not get any benefit. Also, aspirin, while inexpensive, comes with its own risks.

More research required
Experts asked if colon cancer patients should begin taking aspirin as a result of these findings were divided.

"Absolutely not," said study lead author Dr Marlies Reimers, a doctoral student at Leiden University Medical Centre in the Netherlands. She believes more research is necessary.

But the author of a commentary accompanying the study, Dr Alfred Neugut, said he now plans to recommend aspirin therapy for specific patients.

The study adds to growing evidence that aspirin is helpful for certain colon cancer patients, said Neugut, an oncologist and epidemiologist at Columbia University Medical Centre in New York City.

In his commentary, Neugut writes he himself would add aspirin to his chemotherapy treatment regimen if he had a stage III colon cancer tumour, and he's ready to recommend that patients do, too. Stage III means the cancer has spread to nearby lymph nodes, but has not yet spread to other parts of the body.

Bleeding in the digestive system
Together, this research and other recent studies "paint a very sound picture that warrants a change in standard of care – that aspirin can and should be recommended for use for stage III patients," he said in an interview.

But what about aspirin's well-known risks, especially the possibility of bleeding in the digestive system?

"Stage III patients have a 40 percent to 70 percent chance of dying. I don't think the possibility that 1 percent to 2 percent will have some significant bleeding should deter aspirin's use, given a potential 20 percent to 30 percent improvement in survival," Neugut said.

Aspirin is a "much easier and safer drug than chemotherapy, which we use without reservation," he added.

Neugut said, however, that he doesn't recommend aspirin as a way to prevent colon cancer.

Survival rates notably higher
The study examined tissue samples of 999 patients in the Netherlands who had surgery for colon cancer, mostly stage III or lower. Researchers then compared death rates for patients who were prescribed low-dose aspirin after diagnosis to those without the prescription, which is required in the Netherlands.

The death rate was 38 percent among those who took low (80-milligram) doses of aspirin after diagnosis compared to 49 percent among the non-aspirin users, the study found.

Survival rates were notably higher among aspirin-taking patients whose tumour cells gave off what's called HLA class I antigen – a type of substance that alerts the immune system to defend the body. About two-thirds of 963 patients whose tumours were analyzed fell into this category.

Aspirin had no apparent effect on the other patients who took it, the researchers said.

It's unclear why aspirin might help some colon cancer patients but not others. Reimers said researchers believe aspirin may affect a process involving tumour cells and the components of blood known as platelets.

Effective for other cancers
What's next? Neugut said researchers have launched studies to get a better understanding of aspirin's perceived effect on colon cancer. But the results won't be available for at least 10 years, he noted.

"There is a good chance that aspirin may also prove effective for other cancers in the future," Neugut said, "but there is much less data for any cancer other than colon."

Patients are not routinely tested for HLA class I antigens, but Reimers said it wouldn't be expensive to do so.

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Mediterranean Diet May Help Women Live Longer, Healthier Lives

Study finds that following diet during middle age ups odds of living past 70 by 40 percent

Middle-aged women who follow a heart-healthy Mediterranean diet may live a healthier, longer life, a new study suggests.

"Women with healthier dietary patterns at midlife were 40 percent more likely to survive to age 70 or over," said lead researcher Cecilia Samieri, a postdoctoral fellow who conducted the study while at Harvard Medical School and Brigham and Women's Hospital in Boston. She is now a researcher at INSERM and Universite de Bordeaux, in France. INSERM is the French equivalent of the U.S. National Institutes of Health.

The women who ate healthier not only lived longer, but they also thrived. They were less likely to have any major chronic diseases and more likely to have no impairment in physical functioning, mental health or thinking skills. The research did not, however, prove a cause-and-effect link between better eating and longer life.

Samieri said she considers the 40 percent boost substantial. Those who closely followed the Mediterranean diet were more likely to live past age 70 without heart disease, diabetes or other chronic diseases. They also were more likely to be classified as "healthy agers" than those who didn't follow the diets closely or at all. However, Samieri said, "only 11 percent of our participants were classified as healthy agers overall."

The study is to be published Nov. 5 in the journal Annals of Internal Medicine. It was funded by the U.S. National Cancer Institute and the U.S. National Institutes of Health.

For the study, Samieri and her colleagues evaluated the diet and medical records of more than 10,000 women who participated in the much larger Nurses' Health Study. The women were in their late 50s or early 60s between 1984 and 1986, and were free of major chronic diseases. About 15 years later, they again provided information on their diet and their health.

"The Mediterranean diet is characterized by greater intake of [fruits, vegetables, legumes, whole grains] and fish; lower intake of red and processed meats; moderate intake of alcohol; higher amounts of [monounsaturated fats, mostly provided by olive oil from Mediterranean countries]; and lower amounts of [saturated fats]," Samieri said. Saturated fats are found in baked goods, fatty meats and other foods.

Although the study did not look at men, Samieri said, previous studies on diet and healthy aging have found no gender differences, "so it seems reasonable to believe that the benefit would be similar." She added, however, that the assumption remains to be proven.

Although Samieri did not study the effect of how long someone was on a diet, she said adopting it earlier rather than later is probably better.

What's the key to the diet seeming to give more years? Samieri said the analysis suggests that the overall healthy diet patterns had a greater impact rather than any individual food.

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