Aspirin and ibuprofen may reduce breast cancer risk
He said, N said
You may have heard the news that the regular use of aspirin or ibuprofen may help prevent breast cancer. An HSI member named Tina heard, and wrote with this question: “There has been media coverage lately of a large study showing that women taking aspirin 3 times weekly cut their risk of breast cancer by as much as 30%. Comments?”
On the surface, this appears to be promising news. But there are a number of ifs, ands, and buts to consider, as well as an important warning.
In other words: don’t start an aspirin or ibuprofen regimen until you have all the facts.
This is according to a study from Ohio State University, published in the Proceedings of the American Association for Cancer Research. The OSU researchers examined data from the Women’s Health Initiative (WHI), an ongoing National Cancer Institute study of more than 80,000 postmenopausal women between the ages of 50 and 79. None of the women had cancer at the outset of the study, and their use of non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as well as acetaminophen (which is not a NSAID) was recorded in surveys.
The findings: Women who took standard doses of NSAIDs two or more times each week for five to nine years showed a 21 percent breast cancer risk reduction, while those who took the same drugs for more than ten years had a 28 percent risk reduction. As I mentioned above, ibuprofen intake approximately doubled the benefits, but neither acetaminophen nor low doses of aspirin (less then 100 mg) were shown to lower the risk of breast cancer at all.
But of course, there’s a down side. As we’ve discussed in other e-Alerts and Members Alerts, all NSAIDs, including aspirin and ibuprofen, have been shown to contribute to liver and kidney impairment, and gastrointestinal conditions such as bleeding and ulcers. Add to that a study late last year that associated NSAIDs with an increased risk of hypertension in women, and you have an over-the-counter medication that rivals its pharmaceutical brethren for side effects.
In addition, as I told you in an e-Alert last fall (“Still Booming” 11/26/03), mixing different NSAIDs, or NSAIDs with acetaminophen, can lead to other kinds of problems.
Say, for instance, you take an 81 mg tablet of aspirin daily to reduce heart attack risk. If you begin taking ibuprofen to help prevent breast cancer, according to a 2001 study the ibuprofen will block aspirin’s antiplatelet abilities. So you decide to drop the ibuprofen, and increase your aspirin intake. But sometimes you have arthritis flare-ups that the aspirin doesn’t relieve, so instead of relying on the ibuprofen, you take acetaminophen. Now the problem is the aspirin and acetaminophen interaction – because a high intake of acetaminophen can cause serious damage to the liver and other organs, and when acetaminophen and aspirin intake are combined, that risk doubles!
Obviously, once an NSAID medication is put to work as a preventive (whether for breast cancer or hearth health) it may complicate the additional use of NSAIDs for reducing pain.
Such studies are almost certainly in the works already – probably underwritten by the makers of Celebrex or Vioxx. I have to think that any pharmaceutical company that makes a high-profile Cox-2 inhibitor would like nothing more than to be able to say that its best selling arthritis medication also lowers risk of breast cancer. But of course, along with the extra strength of the prescription drugs comes a list of side effects that make the NSAIDs side effects look like child’s play.
At least two doctors associated with the National Cancer Institute have disagreed with Dr. Harris’ optimism about recommending NSAIDs for breast cancer prevention at this time, and I think their caution is wise. It’s a package that looks good on the outside, but inside there’s a tangle of pros and cons that may help prevent one deadly disease, while triggering other chronic conditions.
To Your Good Health,
Jenny Thompson
Health Sciences Institute
Sources:
“Inverse Association of Breast Cancer and NSAIDs: Results from the Women’s Health Initiative (WHI)” Abstract #4893, Proceedings of the American Association for Cancer Research, Vol. 44, March 2003
“Some Pain Relievers May Cut Risk of Breast Cancer” Megan Rauscher, Reuters Health, 4/8/03, reuters.com
“Painkillers Help Prevent Breast Cancer – Ibuprofen Can Reduce Risk by 50%, Study Finds” Salynn Boyles, WebMD, 4/9/03, content.health.msn.com
“Study: Use of Acetaminophen, NSAIDs, Linked to Hypertension” Harvard University Gazette, 10/31/03, news.Harvard.edu/gazette
