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TIME: Almanac 1995
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<text id=91TT2790>
<title>
Dec. 16, 1991: Can Aspirin Prevent Cancer?
</title>
<history>
TIME--The Weekly Newsmagazine--1991
Dec. 16, 1991 The Smile of Freedom
</history>
<article>
<source>Time Magazine</source>
<hdr>
MEDICINE, Page 66
Can Aspirin Prevent Cancer?
</hdr><body>
<p>A new study suggests there may be yet another benefit from the
world's most popular medication
</p>
<p>By Michael D. Lemonick--Reported by Andrew Purvis/New York
</p>
<p> Less than a decade ago, aspirin seemed to be losing some
of its luster. Marketed since the beginning of the century as
a uniquely effective pain and fever fighter, it was suddenly
forced to compete with two major rivals--acetaminophen
(Tylenol, Anacin-3) and ibuprofen (Advil, Nuprin)--that had
many of aspirin's benefits without some of its side effects.
Worse, aspirin had been linked to Reye's syndrome, a rare but
sometimes deadly condition that can afflict children after a
bout of flu or chickenpox. Doctors immediately ceased to
recommend it for most youngsters, and liquid Tylenol replaced
orange-flavored children's aspirin in the family medicine
cabinet.
</p>
<p> But the wonder drug has made a wondrous comeback. In
recent years it has been shown to be a powerful inhibitor of
heart attacks and strokes--a virtue neither acetaminophen nor
ibuprofen can match. And last week came preliminary evidence of
another major benefit: aspirin reduces the risk of death from
colon cancer, a disease that kills 50,000 Americans a year. A
major study by the American Cancer Society, reported in the New
England Journal of Medicine, found that people who took 16
aspirin tablets or more each month (or equivalent doses of
related but lesser known anti-inflammatory drugs) cut their risk
of dying from colon cancer as much as 50%. "It is a very strong
and consistent finding," says Dr. Michael Thun, lead author of
the report.
</p>
<p> Still, many questions remain. Since study participants
were not randomly assigned to take aspirin, it is possible that
those who did were generally more health conscious than average
and less likely to develop cancer in the first place. Or
perhaps aspirin users had more internal bleeding than the others--a common side effect of aspirin--and therefore had their
colon cancers detected early and cured readily. The study did
not measure the actual incidence of colon cancer, just deaths
resulting from it.
</p>
<p> But the age-old pain-killer may very well have direct
anticancer properties. Unlike acetaminophen, which acts only on
the central nervous system, aspirin (chemical name:
acetylsalicylic acid) has an extraordinarily broad range of
effects. The reason is that it interferes with the production
of a diverse class of substances known as prostaglandins, which
are found in nearly every body tissue. (Ibuprofen does too, but
in a much more limited way.)
</p>
<p> Some prostaglandins promote inflammation, fever and pain
by sensitizing nerves to other chemicals released from injured
cells. Aspirin's most familiar benefits come from interfering
with these noisome processes. However, prostaglandins are also
responsible for stimulating the production of the stomach's
protective lining of mucus, which explains why too much aspirin
can cause gastric distress and bleeding. Aspirin's ability to
prevent strokes and heart attacks stems from its disruption of
a prostaglandin that promotes blood clotting. As for
colon-cancer prevention, it is possible that aspirin inhibits
substances that play a role in cell proliferation. At least one
such prostaglandin has been identified in lab animals. If
aspirin does have this effect, it might prove useful in reducing
the risks of other cancers as well.
</p>
<p> Aspirin's list of unexpected benefits may not end with
cancer. There is at least some evidence that it may be useful
in preventing gum disease, gallstones, cataracts, miscarriages
and even in treating viral diseases. Researchers in several
fields eagerly await the results of the Women's Health Study,
an ambitious trial involving 40,000 women, half of whom will be
randomly assigned to take low doses of aspirin every other day
for at least five years. Originally designed to see if aspirin
can prevent heart disease in women as it does in men, the study
will also look at rates of colon cancer, migraines, stroke and
gum disease.
</p>
<p> Until the results are in, doctors are not recommending
that anyone go out and gulp aspirin for good health. The drug
can have unpleasant and even dangerous side effects, including
ringing in the ears and blurred vision, as well as stomach
bleeding. A more serious problem is hemorrhagic stroke, caused
not by a clot blocking the brain's blood vessels but by vessels
that rupture. Moreover, prostaglandins appear to work in
opposing pairs. The ones that promote clot formation, for
example, are countered by partners that do the opposite. Too
much aspirin can therefore cause the very problems that lower
doses relieve.
</p>
<p> Even if follow-up studies show that aspirin really does
protect against cancer, doctors warn that it will never be a
substitute for exercise, a low-fat, high-fiber diet or not
smoking. Too many heart-disease patients have latched on to
aspirin as a panacea and as an excuse to avoid changing lethal
habits. The latest findings will probably, alas, tempt others
to do the same.
</p>
</body></article>
</text>