By Kim Polacek
Could daily aspirin use be beneficial for those at risk for ovarian cancer or those who have been diagnosed with the disease? New research suggests the answer is yes. Two groundbreaking studies examining the use of aspirin and non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) in connection to ovarian cancer found that women could benefit from daily aspirin consumption to reduce their risk and improve survival after diagnosis. The research, published in Journal of the National Cancer Institute and Lancet Oncology, analyzed data from several very large studies, including the Nurses’ Health Studies and Ovarian Cancer Cohort Consortium. The results showed that daily use of aspirin may reduce ovarian cancer risk by 10 percent and provide as much as a 30 percent improvement in survival.
Ovarian cancer is the most fatal gynecological cancer, largely due to lack of early detection strategies. There is tremendous potential for improvement in both screening and therapy options for this disease. Chemoprevention, or use of a medication to lower risk or prevent cancer, is one area that may offer new approaches to reduce ovarian cancer burden.
There has been increasing evidence indicating that inflammation plays a role in ovarian cancer development and can worsen patient outcomes. Previous research has already shown that anti-inflammatory medications, such as aspirin and non-aspirin NSAIDs including ibuprofen (Advil) or naproxen (Aleve), can lower the risk of certain types of cancers.
Reducing Ovarian Cancer Risk
Inflammation is the immune system’s response to infection and injury. It is necessary for the body to heal itself. During an inflammatory response, white blood cells make substances that cause cells to divide and grow in order to rebuild tissue. However chronic inflammation can trigger the body to initiate this response even if there is no injury. Over time, chronic inflammation can cause DNA damage and lead to cancer. Aspirin and non-aspirin NSAIDs contain anti-inflammatory substances that have the ability to block factors that increase the growth and spread of cells.
A new study based on the Ovarian Cancer Cohort Consortium and led by researchers at the National Cancer Institute and Moffitt Cancer Center was published in the Journal of the National Cancer Institute. In it, a group of researchers pooled data from 13 studies from around the world to determine if aspirin and non-aspirin NSAIDs could reduce ovarian cancer risk. The women in these studies were initially asked about aspirin and non-aspirin NSAID use. Subsequent efforts identified those who developed ovarian cancer. Of the more than 750,000 women participating, over 3,500 women were diagnosed with ovarian cancer. The new study found that daily use of aspirin reduced ovarian cancer risk by 10 percent.
“This study gives us a new perspective on whether aspirin and non-aspirin NSAIDs can impact cancer risk. Not only does it look at ovarian cancer, which hasn’t been studied before, but our sample size is three-quarter of a million women who were followed for several decades,” said Dr. Shelley S. Tworoger, senior study author and associate center director for Population Science at Moffitt. “The results of the study support that aspirin can reduce ovarian cancer risk, but further studies will need to be performed before a recommendation of daily aspirin can be made. For example, we need to examine baby aspirin versus regular aspirin, and the best dose for women.”
Improving Ovarian Cancer Survival
There is growing research indicating aspirin and non-aspirin NSAIDs can inhibit mechanisms involved in cancer progression. The anti-inflammatory medications can block the creation of prostaglandins, a hormone-like substance that may promote the growth and spread of cancer. The over-the-counter drugs also have an antiplatelet effect. Nearly a third of ovarian cancer patients suffer from thrombocytosis, a disorder in which the body produces too many platelets. Studies suggest an increased platelet count may play a role in ovarian cancer growth.
Using data from the Nurses’ Health Studies based at the Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health, researchers at University of Hawai’i and Moffitt analyzed nearly 1,000 ovarian cancer cases to determine if regular use of anti-inflammatory medications provided benefit. Their study, published in Lancet Oncology, found women who used aspirin and non-aspirin NSAIDs after their ovarian cancer diagnosis saw as much as a 30 percent improvement in survival. If results are confirmed, the potential next step would be to determine if the use of anti-inflammatory medications in combination with standard therapies can become an intervention to improve the survival rates of women diagnosed with ovarian cancer, as well as determining which specific doses are the most protective.
This study is believed to be the first comprehensive assessment of use of several types of common analgesic medications after diagnosis in relation to ovarian cancer survival. The results demonstrate the importance of common medication in increasing survival rates of ovarian cancer, and will encourage more studies to be conducted to confirm the results and broaden the discovery.
In addition to improved survival and decreasing the risk for ovarian cancer, research has shown daily aspirin also reduces risk for cardiovascular disease and colon cancer. The myriad benefits of low-dose aspirin consumption should compel more women to discuss options with their healthcare providers.