Aspirin Dramatically Reduces Prostate Cancer Death Rate






 

A new study shows that aspirin reduces the risk of death from prostate cancer by 60 to 80%.


 

ASPIRIN DRAMATICALLY REDUCES PROSTATE CANCER DEATH RATE

 

Prostate cancer is the most common of all major cancers in men, and the second most common cause of cancer-associated death in men.  Based upon data from the American Cancer Society, 242,000 men will be diagnosed with prostate cancer in the United States in 2012, and more than 28,000 American men will die of this disease this year.

 

As I discuss in my bestselling book, A Cancer Prevention Guide for the Human Race, there are multiple evidence-based strategies available for men to decrease their risk of developing prostate cancer.  However, one area where prostate cancer prevention research in humans has been lacking is in the assessment of non-steroidal anti-inflammatory (NSAID) medications for the prevention and treatment of prostate cancer.  There is abundant scientific evidence that this class of medications (which includes aspirin, ibuprofen, naproxen, and other common anti-inflammatory drugs) can significantly reduce the risk of other types of cancer, including, notably, colon and rectal cancer.  Now, a new study involving nearly 6,000 men with prostate cancer indicates that the humble aspirin tablet appears to dramatically reduce the risk of cancer-associated death in men diagnosed with prostate cancer.

 

The prospective Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) Study enrolled 5,955 men with early-stage prostate cancer.  All of these men underwent either surgery (prostatectomy) or radiation therapy as primary treatment for their prostate cancer.  Among these nearly 6,000 patient volunteers, 2,175 were taking one or more blood thinning medications for other illnesses, including aspirin, Coumadin (warfarin), Plavix (clopidogrel), or Lovenox (enoxaprin).  The outcomes of these nearly 6,000 prostate cancer patients were carefully monitored over an average follow-up period of 70 months.  Importantly, throughout the course of this large prospective clinical study, patients were required to provide updated health information on a quarterly basis.  Moreover, their Urologists also separately provided ongoing clinical updates on these patients.  This unique study design, along with its prospective nature and its large cohort of patient volunteers, provides a very high level of clinical evidence for this study’s findings.

 

The results of this study were striking.  While the non-aspirin blood thinners appeared to have minimal impact on the death rate due to prostate cancer, the regular use of aspirin was associated with a whopping and highly significant 57 percent reductionin the risk of death due to prostate cancer among these nearly 6,000 patient volunteers.  Even more impressive was the finding that men with high-risk forms of prostate cancer were almost 5 times less likely to die of prostate cancer if they took aspirin (i.e., 4 percent risk of death versus 19 percent risk of death at 10 years, respectively), which equates to a nearly 80 percent reduction in the risk of dying from prostate cancer.

 

The findings of this study have significant public health implications.  For men already diagnosed with prostate cancer, and especially men who have prostate cancer with high-risk features, aspirin appears to dramatically reduce the risk of cancer-associated death for a period of at least 10 years, based upon the findings of this ongoing study.  Additionally, this finding that aspirin dramatically reduces the risk of cancer-associated death in men diagnosed with prostate cancer also strongly suggests that there may also be a role for aspirin as a prevention agent for prostate cancer, much as it is currently used to prevent colorectal cancer in high-risk patients.  I consider the findings of this clinical study to be of very high significance, and it should, in my opinion, compel a new randomized, placebo-controlled, double-blinded prospective study to validate these extremely impressive and encouraging findings.

 

Although favorable data supporting aspirin as a powerful cancer prevention agent continues to accumulate, the regular use of aspirin can be associated with serious, and even life-threatening, side effects, including ulcers of the GI tract, GI tract bleeding, kidney injury, and allergic reactions, among others.  Therefore, if you are thinking of adding aspirin to your list of medications, then I urge you to first discuss this with your doctor!

 

A Cancer Prevention Guide for the Human Race is now available in both printed and digital formats from all major bookstores.  Get your copy now, and begin living an evidence-based cancer prevention lifestyle now!

 

Please be sure to check out Dr. Wascher’s latest music video:

Dark as Night, Part 1

 


Dark as Night, Part 1

Dark as Night, Part 1


At this time, more than 8 percent of Americans are unemployed.  According to the Bureau of Labor Statistics, however, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is now more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.




Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


 

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 






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Watchful Waiting (Observation) Versus Surgery for Prostate Cancer





 

A new landmark study suggests that some patients with early-stage prostate cancer can be safely observed rather than undergoing radical surgery.


 

 

WATCHFUL WAITING (OBSERVATION) VERSUS SURGERY FOR PROSTATE CANCER

In the United States, prostate cancer is the most common type of non-skin cancer occurring among men, and the second most common cause of cancer death in men.  (Lung cancer, an almost completely preventable form of cancer, sadly, remains the most common cause of cancer death for both men and women.)  The American Cancer Society estimates that, in 2012, more than 240,000 new cases of prostate cancer will be diagnosed, and more than 28,000 men will die from this form of cancer.

The debate surrounding the ideal management of early-stage prostate cancer has revolved around “watchful waiting” (observation) versus aggressive treatment with surgery or radiation therapy.  In many cases, prostate cancer is a slow-growing cancer, and when it arises in older men in particular, it seldom leads to death.  On the other hand, there are more aggressive variants of prostate cancer that spread rapidly, and these forms of prostate cancer can indeed lead to death.  The dilemma regarding which patients can be safely observed and which should be subjected to aggressive treatment has been difficult to resolve, however, because it can be difficult to determine, up front, which patients will benefit from treatment and which will not.

Last year, I reviewed a prospective randomized clinical research study from Sweden which revealed a significant improvement in survival among patients with prostate cancer who underwent prostate cancer surgery, when compared to patients who were managed with “watchful waiting”  (Prostate Cancer: Watchful Waiting Versus Surgery (Prostatectomy).)  Now, a similar new prospective randomized clinical research study provides additional important clinical information that may help doctors to identify selected prostate cancer patients who can be safely observed, thus avoiding radical cancer treatments that are associated with a high incidence of incontinence and impotence, as well as other potentially serious complications.  This new study appears in the current issue of the New England Journal of Medicine, the same journal that published last year’s Swedish prostate cancer clinical research study.

In this prospective randomized study, 731 men with newly diagnosed prostate cancer were randomly assigned to undergo radical prostate cancer surgery (prostatectomy) versus observation only.  This group of research volunteers, with an average age of 67 years, was then followed for approximately 10 years, and their outcomes were carefully monitored.  It is important to note that all of these men had early-stage prostate cancer, which appeared not to have spread outside of the prostate gland.

Following 10 years of monitoring, on average, 47 percent of the men who underwent prostatectomy died, while 50 percent of the men in the observation group died (this small difference in overall survival was not statistically significant.)  When the researchers looked at the risk of death caused specifically by prostate cancer, or due to complications associated with prostatectomy, 5.8 percent of the men in the prostatectomy group died directly as a result of either their prostate cancer or due to complications of surgery, while 8.4 percent of the men in the observation group died due to their prostate cancer, for a relative cancer-specific survival difference of 37 percent and an absolute difference of 2.6 percent in favor of the men who underwent surgery instead of observation.  Importantly, however, this observed difference in cancer-specific survival did not quite achieve statistical significance, suggesting that the cancer-specific survival benefit of radical prostatectomy in men with early-stage prostate cancer is, in general, either nonexistent or very small, at least over a 10-year period of time.

Importantly, when the authors of this study assessed prostate-specific antigen (PSA) levels, specifically, as a predictor of survival among the two groups of men who participated in this study, they found that prostatectomy did, in fact, significantly improve survival among men with a PSA level greater than 10 nanograms per milliliter (ng/ml), compared to observation alone.

As is often the case, pundits on either side of the prostate cancer treatment debate will find some ammunition in this study’s findings to support their respective positions.  Those experts who espouse aggressive treatment for most or all early-stage prostate cancers will note the nearly 3 percent improvement in absolute survival associated with radical prostatectomy, although, in this study, this difference in absolute survival was not considered to be statistically significant.  (However, it should be noted that the observed survival advantage associated with surgery in this study would have actually been higher, and perhaps statistically significant as well, had there not been a postsurgical death of one of the patients in the prostatectomy group.)  On the other hand, proponents of “watchful waiting” will point to the very small difference in observed death rates between these two groups of patients, and the relatively large number of adverse events associated with radical prostatectomy (21 percent).  However, in my view, this study’s findings offer a reasonable, evidence-based, “middle ground” strategy, based upon patients’ PSA levels.  Specifically, for older patients who have a PSA level below 10 ng/ml and no worrisome microscopic features that suggest an aggressive variant of prostate cancer, observation may indeed be a reasonable alternative to prostatectomy, based upon the findings of this landmark study.  (Unfortunately, this study did not assess radiation therapy, which is the other common form of treatment for early-stage prostate cancer.)

In completing my review of this important clinical study, I should also note that 1 out of 5 patients who enrolled in this prospective study did not remain within their assigned groups and, therefore, crossed over into the opposite group after they entered into this study.  However, while this factor does somewhat complicate the analysis of the data collected in this study, it probably does not affect the overall accuracy of the study’s conclusions.

I do not believe that this important but admittedly imperfect study will, by itself, completely resolve the ongoing debate regarding the optimal management of early-stage prostate cancer.  However, as one of only a very few well-performed randomized prospective clinical studies that have directly compared radical surgery with observation alone, and with reasonable long-term follow-up of patients, this is a very important clinical research study for both patients and their prostate cancer physicians alike.  Because of this study, both patients and their doctors will now be better able to make individualized, evidence-based decisions regarding the likely risks and benefits of surgery versus careful observation as an initial approach to prostate cancer management.


At this time, more than 8 percent of Americans are unemployed.  According to the Bureau of Labor Statistics, however, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is now more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I urge you to hire a veteran whenever possible.


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.




Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


 

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 






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CT Scans and Cancer Risk in Children





 

A new clinical study suggests that performing CT scans during childhood may significantly increase the risk of leukemia and brain cancer.


 

 

CT SCANS AND CANCER RISK IN CHILDREN

As I discuss in my bestselling book, A Cancer Prevention Guide for the Human Race, exposure to medical x-rays, and particularly exposure to radiation from CT scans, is an under-appreciated cancer risk factor.  Based upon even conservative estimates, exposure to medical radiation is thought to cause at least 1 to 2 percent of all new cancer cases, and most of this medical x-ray exposure comes from CT scans.  Additionally, as I also discuss in my book, there is enormous variation in the amount of radiation exposure associated with CT scans between different hospitals, and even within individual hospitals.  Now, a newly published clinical study suggests that the risk of cancer in children due to medical x-rays may be of particular concern.  This new paper appears in the forthcoming issue of the journal The Lancet.

In this study from the United Kingdom, nearly 180,000 patients who underwent CT scans as children, between 1985 and 2002, were followed.  The incidence of cancer in this very large group of patients was then monitored.

In this study, CT scans that delivered a cumulative radiation dose of at least 30 milligray were associated with three times the subsequent risk of leukemia as was observed in patients who received radiation doses less than 5 milligray.  The incidence of brain cancer was also three times higher among patients who received a cumulative radiation dose of 50 milligray or more from CT scans, when compared to patients who received less than 5 milligray.  Now, it is important to mention that these increases in cancer risk were increases in relative risk.  Since both leukemia and brain cancer are rare diseases, the absolute increase in cancer risk was actually quite small (one excess case of leukemia and one excess case of brain cancer per 10,000 CT scans of the head).  However, the findings of this important study point out the need to reduce radiation doses associated with CT scans to as low a level as is possible, especially for CT scans performed on children.  Moreover, alternative imaging studies to CT scans, such as ultrasound and MRI scans, should be used whenever possible to further reduce the exposure of both pediatric patients and adult patients to medical x-rays.


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.




Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


 

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 





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