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An aspirin a day? Not so fast

Aspirin might prolong the lives of men who have been treated for prostate cancer, a recent study suggests.

And a clinical trial is under way to test aspirin as an add-on treatment for people with bipolar disorder whose prescription drugs are not working as well as needed.

We already know that a daily aspirin has been shown to prevent cardiovascular disease, including heart attack and stroke.

New studies about aspirin typically do not generate the same publicity and interest as red wine or dark chocolate studies. Still, it would be easy to selectively point to research to justify popping a daily aspirin (and perhaps washing it down with a glass of Chianti).

Easy, but wrong. A daily aspirin — or “aspirin therapy” — is not recommended for everyone, and there are certain people who definitely should not take aspirin more than every so often because the risks of chronic use outweigh the potential benefits, said Dr. Gordon Ewy, director of the University of Arizona Sarver Heart Center in Tucson.

Chronic aspirin use can cause gastrointestinal bleeding and other serious health problems. “So you can't just read an article and decide, 'I should do that,'” Ewy said.

Recent articles are compelling, though, including the prostate cancer study published in August in the Journal of Clinical Oncology. Previous studies have indicated that aspirin and other anticoagulation medications might slow tumor cell growth, but clinical data had been limited. The newer study looked at nearly 6,000 men who had prostate cancer and were treated with surgery or radiotherapy. The risk of death from prostate cancer was compared between those taking anticoagulants, including aspirin, and those who were not. Researchers found that the 10-year mortality rate from prostate cancer was significantly lower in the group taking anticoagulants, compared to the others — 3 percent versus 8 percent, respectively.

“Prostate cancer is the most common cancer in men outside of skin cancer and also the second-leading cancer killer in the U.S., so the idea that a commonly used, inexpensive medication may improve outcomes is potentially very rewarding,” said the study's lead author, Dr. Kevin Choe, assistant professor of radiation oncology at UT Southwestern Medical Center in Dallas.

However, “We need to better understand the optimal use of aspirin before routinely recommending it to all prostate cancer patients,” he said.

The bipolar study will test whether aspirin, an anti-inflammatory, alleviates symptoms.

“Because chronic inflammation and stress seem to be involved in mechanisms of depression and bipolar disorder, we want to test the hypothesis that continued aspirin use might help,” said Dr. Jair Soares, principal investigator and chairman of the Department of Psychiatry and Behavioral Sciences at the University of Texas Health Science Center in Houston.

There are no findings to report yet.

“As of now, this is totally experimental and that is why we are doing the study — to test and see if it could help patients,” Soares said.

Bottom line: Do not take a daily aspirin unless your physician recommends it based on your medical history and risk factors.




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