By, Robert A. Wascher, MD, FACS
Last Updated: 03/1/2009
The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.
ASPIRIN & COLORECTAL CANCER PREVENTION
Non-steroidal anti-inflammatory drugs, or NSAIDs, have previously been shown to reduce the incidence of polyps and cancers of the colon and rectum. This class of drugs includes the well-known medications ibuprofen, naproxen, sulindac, indomethacin, Celebrex, Vioxx, and aspirin, among others. However, enthusiasm for using NSAIDs as colorectal polyp and cancer prevention drugs has cooled significantly after several large prospective clinical research studies linked several of these drugs, including Celebrex and the subsequently discontinued Vioxx, to an increased risk of heart disease. Fortunately, aspirin, which is a weak NSAID, is still thought to protect the heart against coronary artery disease. However, previous clinical research studies have suggested that daily aspirin use only provides very modest protection, if any, against polyps and cancers of the colon and rectum. Now, a new study, just published in the Journal of the National Cancer Institute, comprehensively reviews the results of 4 prospective clinical colorectal cancer prevention research studies, and suggests that the humble aspirin pill may, indeed, offer significant protection against the type of colorectal polyps (adenomas) that are believed to give rise to virtually all colorectal cancers.
This new study performed a complex statistical evaluation, called a meta-analysis, of 4 prospective, randomized, placebo-controlled colorectal cancer prevention trials that, together, included almost 3,000 patient volunteers. The average age of these patient volunteers was 58 years, and average patient follow-up of these nearly 3,000 patients was about 3 years. Colonoscopy was performed on about 2,700 of these patients during the course of these 4 studies. Among the patients who were secretly randomized to receive placebo (sugar) pills, 37 percent were found to develop polyps (adenomas) of the colon or rectum during the course of these clinical studies. Among the patients who were secretly assigned an aspirin pill each day, 33 percent were found to harbor colorectal adenomas while being observed. Advanced precancerous adenomas were also identified in 12 percent of the patients in the placebo group, while 9 percent of the patients in the daily aspirin group were found to have advanced premalignant adenomas.
After analyzing the data, the authors of this study determined that any dose of aspirin between 81 mg and 325 mg per day was associated with a 17 percent reduction in the relative risk of colorectal adenomas, and an absolute reduction in the risk of adenomas of about 7 percent. Moreover, a daily aspirin pill was associated with a 28 percent relative reduction in the risk of developing advanced high-risk adenomas (i.e., the type of colon or rectal polyp that is most likely to subsequently progress to become a cancer).
In summary, based upon data from 4 different prospective, randomized, placebo-controlled clinical colorectal cancer prevention research studies, a daily baby aspirin, or a daily 325 mg “regular aspirin pill, significantly reduced the incidence of colon and rectal polyps, and especially the high-risk forms of adenomatous polyps that are more likely to progress to colon and rectal cancers.
If you are not already taking aspirin, you should first consult with your physician before beginning aspirin therapy. Aspirin, like all NSAIDs, can cause ulcerations in the GI tract, as well as kidney damage, in susceptible patients. If there are no contraindications to taking aspirin in your case, however, then you may be able to reduce not only your risk of cardiovascular disease, but also your risk of colorectal cancer as well, by taking a daily aspirin tablet.
FISH OIL & RESPIRATORY INFECTIONS IN CHILDREN
The available research evidence suggests that a diet rich in coldwater fish may significantly reduce the risk of heart disease. There is also additional research suggesting that oil from coldwater fish might also improve immune system function, particularly in young children. A newly published study in the Journal of Pediatrics now suggests that fish oil supplements may actually reduce the risk of common acute illnesses in school children.
In this study, nearly 200 schoolchildren between the ages of 9 and 12 years were randomized to receive either a placebo (sugar) pill or a fish oil supplement pill 5 days per week. The children were all monitored for 6 months, and logs were kept of all illnesses that occurred in these kids.
At the end of the study, the researchers determined that the kids who were randomized to receive the fish oil supplements had a significantly lower incidence of acute childhood illnesses, and respiratory infections in particular, when compared to the children who had been randomized to receive placebo pills instead. Respiratory infections, when they occurred, also appeared to resolve more quickly in the group of children who had received fish oil supplements, when compared to the kids in the placebo group. The researchers also measured the levels of several different immune-system-related substances in the blood of these patient volunteers, including TGF-beta protein, a substance which is known to impair the function of immune system cells. Among the children in the fish oil supplement group, TGF-beta levels in the blood were actually significantly lower than was observed among the children in the placebo group. The researchers, therefore, concluded that fish oil supplements appeared to decrease both the frequency and duration of acute illnesses in schoolchildren, and respiratory illnesses in particular. Immune-suppressing TGF-beta blood levels were also lower among the children who were randomized to receive fish oil supplements.
Before considering fish oil supplements for your child, please make sure to consult with your pediatrician first. Large doses of fish oil can expose children to potentially toxic doses of heavy metals and pesticides, and can also excessively thin the blood.
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, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California
Send your feedback to Dr. Wascher at:
Dr. Wascher’s Biography
Links to Other Health & Wellness Sites
Robert A. Wascher, MD, FACS
All rights reserved
Dr. Wascher’s Archives:
2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer
2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones
2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum
2-1-2009: Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence
1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up Before Surgery?
1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors
Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure
1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood
12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps
12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection
12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome
12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival
11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk
11-23-2008: Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk
11-16-2008: Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?
11-9-2008: Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level
11-2-2008: Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk
10-26-2008: Smoking & Quality of Life
10-19-2008: Agent Orange & Prostate Cancer
10-12-2008: Pomegranate Juice & Prostate Cancer
10-5-2008: Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer
9-28-2008: Publication & Citation Bias in Favor of Industry-Funded Research?
9-21-2008: Does Tylenol® (Acetaminophen) Cause Asthma?
9-14-208: Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke
8-23-2008: Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles
8-12-2008: Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration
8-3-2008: Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients
7-26-2008: Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer
7-13-2008: Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer
7-6-2008: Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins
6-29-2008: Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer
6-22-2008: Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer
6-15-2008: Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort
6-8-2008: Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer
6-2-2008: Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut
5-25-2008: Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely
5-18-2008: Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers
5-11-2008: Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension & Risk of Cardiovascular Disease
5-4-2008: Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room
4-27-2008: Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function
4-20-2008: BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke
4-13-2008: Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention
4-6-2008: Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)
3-30-2008: Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria
3-23-2008: Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children
3-16-2008: Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer
3-9-2008: Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity
3-2-2008: Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death
2-23-2008: Universal Healthcare Insurance Study; Glucosamine & Arthritis
2-17-2008: Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps
2-10-2008: Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for Down’s Syndrome?
2-3-2008: Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer
1-27-2008: Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology’s Gastrointestinal Cancers Symposium
1-20-2008: Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly
1-12-2008: Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer
1-7-2008: Testosterone Supplements in Elderly Men; Colorectal Cancer– Reasons for Poor Compliance with Screening Recommendations
12-31-2007: Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?
12-23-2007: Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease
12-16-2007: Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality
12-11-2007: Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease
12-2-2007: Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer