Aspirin—a Miracle Medicine

Even though most people think of aspirin as that old standby drug that relieves pain and helps prevent heart attack and stroke, researchers now are finding strong evidence that it may fight other devastating medical conditions-including cancer and dementia.

Latest development: A study recently published in The Lancet showed that people who regularly take aspirin have a dramatically lower risk of dying from cancer-up to 58% lower, in some cases. Other recent research suggests that aspirin also may help promote prostate health and perhaps even curb one's risk for Alzheimer's.

With such positive findings, you might assume that everyone should now be taking aspirin, a nonsteroidal anti-inflammatory drug (NSAID). But aspirin can have certain serious and sometimes hidden side effects. Here's how to safely take aspirin to reduce your risk for…

Cancer

Previous studies have shown that regularly taking aspirin may reduce one's risk of dying from colorectal cancer by 35% and one's risk of dying from the most common form of breast cancer (estrogen-receptor positive) by up to 28%.

But the recent Lancet study, which looked at data from more than 25,000 patients, concluded that taking low-dose aspirin daily was associated with even greater reductions in some cancer deaths.

For example, aspirin reduced mortality from colorectal cancers by 40%...lung cancer by 30%...and esophageal cancer by 58%.

How aspirin helps fight cancer: It inhibits the effects of cyclooxygenase-2 (COX-2) enzymes, which promote a type of cell damage that can lead to cancer.

My advice: I often recommend daily low-dose (81 milligrams (mgl) aspirin for patients who have one or more risk factors for any of the cancers mentioned earlier. For example, a patient with multiple polyps in the colon would be a good candidate. So would those with a personal or family history of breast, lung or pancreatic cancer.

Enlarged Prostate

A Mayo Clinic study, published in the American Journal of Epidemiology, found that men who took aspirin or some other NSAID, such as ibuprofen (Advil), daily were 25% less likely to develop moderate-to-severe symptoms of prostate enlargement-also known as benign prostatic hyperplasia (BPH). Symptoms include frequent and/or urgent urination and a weak urine stream.

Researchers speculate that inflammation plays a role in BPH, which would explain the benefit of aspirin and other NSAIDs.

My advice: If you suffer BPH symptoms, ask your doctor about taking aspirin daily.

Alzheimer’s Disease

A study of nearly 13,500 people, published in the journal Neurology, found that people who regularly used aspirin or some other NSAID were 23% less likely to be diagnosed with Alzheimer's than those who didn't take one of these drugs. It's possible that the drugs reduce the accumulation of plaques in the brain, which have been linked to Alzheimer's.

My advice: Don't take aspirin as an Alzheimer's preventive. The research isn't quite strong enough yet to make it worth risking aspirin's side effects. However, if you regularly take aspirin or another NSAID for some other condition, such as arthritis, you may also be reducing your Alzheimer's risk.

Heart Attack And Stroke

About one of every five American adults now takes a daily aspirin to help prevent the blood clots that can lead to a heart attack or stroke.

Even patients who go to emergency rooms with heart attack symptoms such as chest pain or discomfort are now routinely given aspirin. A large multicenter study found that people who took aspirin within 24 hours of a heart attack were 23% less likely to die than those who didn't get aspirin therapy.

For men of all ages and women age 65 and older, daily aspirin has been shown to help prevent or reduce the risk for a first and second heart attack. For women of all ages, studies show that aspirin therapy reduces risk for a first stroke. For unknown reasons, aspirin does not appear to prevent stroke in men.

My advice: Talk to your doctor about your risk factors for heart attack and stroke the most common include high blood pressure, elevated cholesterol, diabetes, a sedentary lifestyle and or a family or personal history of heart disease. Your doctor may recommend that you take 81 mg of aspirin (one baby aspirin) daily if you have one or more of these risk factors.

If you think you're having a heart attack: Immediately chew, then swallow, one uncoated regular-strength (325 mg) aspirin or two to four baby aspirin. Taking aspirin this way can reduce clotting within 10 to 15 minutes. Do not take aspirin if you think you may be having a stroke-testing is needed to determine whether the stroke is caused by a blood clot or bleeding in the brain (aspirin can worsen bleeding).

The Downside Of Aspirin

About 50,000 Americans die every year from GI bleeding caused in part by aspirin or other NSAIDs. High doses are more likely to cause problems, but even low-dose aspirin can cause bleeding in some patients.

To protect yourself: Be sure to talk to your doctor before taking aspirin-at any dose-on a daily basis. Let him/her know if you develop stomach pain, cramping or other symptoms after taking it.

If you experience symptoms when taking aspirin, ask your doctor about trying the enteric-coated variety. It's less likely to cause stomach upset, and it appears to thin the blood and reduce cancer risks as effectively as regular aspirin. However, enteric-coated aspirin can still cause bleeding in some people.

What most people don't know: Aspirin-related damage to the stomach/GI tract may not cause symptoms. To detect problems: Ask your doctor to perform a fecal occult blood test about three months after you start aspirin therapy and annually thereafter.

If it's more convenient, consider using an over-the-counter test (such as Hemoccult or ColoCARE) that detects small amounts of blood in the stool, which can indicate damage to the GI tract. Discuss this first with your physician.

Caution: Bleeding risk is increased if aspirin is combined with certain prescription medications such as warfarin (Coumadin), corticosteroids and some antidepressants, as well as some supplements, including ginkgo biloba, fish oil and willow bark. Taking another NSAID, such as ibuprofen, with aspirin also increases bleeding risk.

Using high doses of aspirin has been shown to cause ringing in the ears (tinnitus) and/or hearing loss in some people, so be sure to have your hearing checked if you notice any changes in your hearing while taking aspirin.