One medication present in almost every household around the world is a wonder drug called acetylsalicylic acid, popularly know as aspirin.
Besides acting as a mild blood thinner, taken by millions to help minimize the risk of blood clot formation in heart arteries and the chances of a heart attack, aspirin has been found to help lower the risk of the development of cancer of the colon, as previously reported by Medical Oncology, stating that “aspirin and other related nonsteroidal anti-inflammatory drugs might exert a chemopreventive effect.”
Previous randomized placebo-controlled trials have revealed that the use of aspirin, or of its “relatives,” celecoxib and rofecoxib, significantly reduced the risk for the formation of adenoma (pre-cancerous lesion) among patients at high risk for colorectal cancer.
And now, adding to its amazing versatility, newer studies revealed that aspirin taken regularly by those who have already been diagnosed to have primary cancer of the colon, specifically the type with the so-called “high COX-2 expression”, even in stage II and III, lowers the mortality rate and prolongs life, compared to those colon cancer patients not taking aspirin. A fabulous drug, indeed!
The improvement in the survival rate was reported in an article in the Journal of the American Medical Association August 12, 2009, which stated that “the overall 5-year survival for patients using aspirin regularly was 88%, compared with 83% for those who did not, and the ten-year survival rates were 74% for regular aspirin users and 69% for those who were not.”
While taking aspirin as a part of a regimen to lower the risk of colon cancer, and those with colon cancer might on their own start aspirin therapy, this is at this stage not an official medical recommendation, nor a standard of care.
“These results are observational and, in the absence of a clinical trial, we can’t make a clinical recommendation,” according to Andrew Chan, MD, MPH, assistant professor of medicine at Harvard Medical School in Boston, Massachusetts, who authored the study.
Dr. Chan further stated that the most encouraging results of this study provides a very compelling justification to do a randomized controlled trials, in a much larger patient population, in order to confirm and validate the impressive initial clinical observations.
How common is cancer of the colon and rectum?
Colorectal cancer is the third-most common cancer in humans, topped only by cancer of the lungs and female breasts. More than 150,000 people in the United States each year discover they have cancer of the colon or rectum, and approximately 46,000 will die from it this year alone. The incidence starts to rise at the age 40 and the peak is between ages 60 to 75. Colon cancer is more common among women and cancer of the rectum among men. About 5% of the patients have both (synchronous cancer).
Are meat-eaters more prone to colorectal cancer?
It appears to be so, because colorectal cancer is found more prevalent in populations that eat diet low in fiber (too little vegetables, fruits, nuts and grains) and high in animal proteins, saturated fats, and refined carbohydrates. The incidence of colorectal cancer is indeed high among those who eat red meat (pork, beef, etc) compared to those who eat high fiber diets (vegetables, fruits, wheat, bran, etc) and fish.
What are the signs and symptoms of colorectal cancer?
The person may not have symptoms at all. It could be so subtle, like fatigue and anemia. Blood in the stool (black or bloody red stools) is one common sign. The others include change in the bowel habits, diarrhea or constipation, stools more slender or flatter than usual, stomach discomfort, bloating, fullness, abdominal cramps, frequent gas pains, unexplained weight loss, a sensation that the rectum does not empty completely. Not all these symptoms and signs need to be present or necessary, to suspect possible presence colorectal cancer. Any one of these, if persistent, should alert one to seek medical help.
When should colonoscopy be done?
Everyone 50 years old and older should have an annual fecal occult blood test and a prophylactic colonoscopy every 3 to 5 years. Since blood in the feces is one of the earliest sign of colorectal cancer, testing for blood in the stools yearly among those 50 and older is essential, and could be lifesaving. And so with prophylactic colonoscopy.
How do we prevent colorectal cancer?
As alluded to above, a high-fiber (fruits and vegetables, bran, oat, wheat) and fish diet will tremendously reduce the risk of colorectal cancer. Therefore, staying away from animal protein, like red meat (pork, beef and anything made of these) is a big factor in preventing the development of colorectal cancer, besides heart attack and stroke. Daily exercises make our body healthier and more resistant to illnesses. Abstinence from tobacco is a must. Checking our stools for blood every time we defecate and reporting any warning signs listed above to your physician, are essential. For those 50 and older, having a yearly fecal occult blood test and a colonoscpy every 3 to 5 years, are strongly recommended for early detection and cure of the disease.
What is the treatment for colorectal cancer?
Depending on the stage and location of the colorectal cancer, the primary strategy is wide surgical resection of the cancer and regional lymphatic drainage. Cure is possible in 75% of surgical patients. For cancer limited to the mucosa (surface lining of the wall of the colon), 5-year survival is about 90%; those cancer going deeper into the mucularis propia (muscle-layer of colon), 80%; those with positive lymph nodes, meaning cancer already spreading to the lymph nodes, 30%. Other modalities of treatment include pre-operative radiotherapy, adjuvant radiotherapy, and chemotherapy. When surgery and/or any of these other modalities are indicated will depend on the location, extent and stage of the colorectal cancer. Someday, the use of aspirin as discussed above could be an official part of the modality in the management of this malignancy.
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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Email:[email protected]
