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Aspirin May Decrease Risk for Head, Neck Cancers
< Nov. 22, 2006 > -- Along with its other benefits, an aspirin a day may help keep head and neck cancers away, suggests a new long-term study reported in the Archives of Otolaryngology.
Aspirin, a medication that has been in use for over 100 years, is well known for its therapeutic effects for conditions such as heart disease, arthritis, headaches, and minor aches and pains.
Recent studies have suggested that aspirin may also be beneficial in preventing certain types of cancer, although no study has definitively proved this link.
The new study showed that it was not so much the amount of aspirin that was taken but the length of time that people were on the drug that mattered, says study co-author Mary E. Reid, Ph.D., an assistant professor of oncology at Roswell Park Cancer Institute in Buffalo, N.Y.
"We found that duration really seemed to make a difference," Dr. Reid says. "It was more duration than frequency. Taking aspirin for under 10 years did not have a significant effect, [but] taking it 10 years or more was associated with a 30 percent reduction in cancer."
The protective effect was not seen in heavy smokers and drinkers, however.
According to the National Cancer Institute (NCI), head and neck cancers comprise about 2 percent to 5 percent of all malignancies in the United States, with about 39,000 new cases diagnosed each year. Experts estimate that about 85 percent of these cancers are linked to tobacco use.
The study by Dr. Reid and her colleagues included patients treated at Roswell Park - 529 with head and neck cancer, another 529 without the malignancy. Participants were matched for age, sex, and smoking status. They were also asked about their use of aspirin over the preceding decades.
"A consistently decreasing trend in risk was noted with increasing duration of aspirin use," the researchers reported. "Risk reduction was observed across all five primary tumor sites, with cancers of the oral cavity and oropharynx [upper throat] exhibiting greater risk reduction."
Earlier studies have linked aspirin use to reduced risk of other forms of cancer, such as prevention studies of colorectal cancer that Dr. Reid herself has worked on.
But it is still too early to recommend routine use of aspirin as a cancer-preventive measure, says Dr. Michael Thun, vice president for epidemiology and prevalence research at the American Cancer Society (ACS).
The new retrospective study "does not have the strongest kind of design" because participants were asked about aspirin use after they were diagnosed with cancer, Dr. Thun notes.
Still, he says, "the results were internally quite consistent, with a lower risk the longer they used aspirin."
The idea that aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) can help prevent cancer is "quite plausible, but the evidence is limited," Dr. Thun adds.
However, the theory is plausible enough for the National Cancer Institute to sponsor a large-scale study using Celebrex®, also a member of the NSAID family. Results are expected in about two years, Dr. Thun says.
Aspirin's cancer-fighting effect appears to be linked to the molecular mechanism by which NSAIDs fight pain, Drs. Reid and Thun both say. The medications inhibit an enzyme called cox-2, whose activity is known to increase in pre-malignant lesions. Inhibiting the enzyme may also help slow the growth of cancer cells, Dr. Reid says.
Anyone who wants to take aspirin as a cancer preventive should first consult their physician, Dr. Reid cautions. "You should always talk to a physician before taking anything chronically," she says.
Taking aspirin each day does have its risks, Dr. Thun says. "At this point, aspirin is still not recommended for prevention of any cancer because of the risks of bleeding, particularly gastrointestinal," he says. "What is still missing is proof that the benefits of taking aspirin outweigh the risks."
Always consult your physician for more information.
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There are many types of cancers included in the category of "head and neck cancers." A few of these cancer types are briefly discussed below.
Oral cancer:
Oral cancer is cancer found in the mouth and the throat. It is estimated to be diagnosed in almost 30,990 US adults in 2006, according to the American Cancer Society (ACS).
The oral cavity includes:
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the lips, teeth, and gums
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the lining inside the lips and cheeks (buccal mucosa)
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the floor of the mouth (under the tongue)
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the top of the mouth (hard palate)
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the small area behind the wisdom teeth
The oropharynx includes:
Esophageal cancer:
Esophageal cancer is cancer that develops in the esophagus, the muscular tube that connects the throat to the stomach.
The esophagus, located just behind the trachea, is about 10 to 13 inches in length and allows food to enter the stomach for digestion. The wall of the esophagus is made up of several layers and cancers generally start from the inner layer and grow out.
The ACS estimates that 14,550 Americans will be newly diagnosed with esophageal cancer during 2006, and 13,770 deaths are expected.
Laryngeal cancer:
Laryngeal cancer includes cancerous cells found in any part of the larynx - the glottis, the supraglottis, or the subglottis.
The larynx, often referred to as the voice box, is a two-inch long tube-shaped organ located in the neck at the top of the trachea (windpipe). The cartilage in front of the larynx is sometimes called the "Adam's apple."
The vocal cords (or vocal folds) are two bands of muscle that form a "V" shape inside the larynx.
The area of the larynx where the vocal cords are located is called the glottis. The area above the cords is called the supraglottis, and the area below the cords is called the subglottis. The epiglottis is a flap at the top of the trachea that closes over the larynx to protect it from food that is swallowed into the esophagus.
Approximately 9,510 people are expected to be diagnosed with laryngeal cancer in the US in 2006. Close to 4,000 deaths are expected to occur this year, reports the ACS. About 2,770 cases of hypopharyngeal cancer are expected in 2006.
Always consult your physician for more information.
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American Academy of Otolaryngology - Head and Neck Surgery
American Cancer Society
Centers for Disease Control and Prevention (CDC)
National Institutes of Health (NIH)
National Library of Medicine
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