Aspirin Linked To Reduced Risk Of Bile Duct Cancer

Bile duct cancer is a rare malignancy which usually occurs in patients older than 50 years of age. It is a very aggressive cancer which is considered to be incurable and patients who develop this condition have a relatively poor prognosis if the primary tumour and any metastases are not removed surgically. No potential cure exists for this cancer, besides surgery, but by the time patients present to doctors with this issue it is inoperable and can then only be managed conservatively and symptomatically.

The study

One of the largest hospital based studies was done in order to determine whether Aspirin use had any significant effect in reducing the risk of developing gastrointestinal cancers.

Researchers used nearly 2,400 patients, who were diagnosed with bile duct cancer and seen at the Mayo Clinic in Rochester, New York between 2000-2004, as well as nearly 5,000 healthy people as the control group in the study who matched the patients' age, race, gender and area of residence.

The findings

Regarding the 3 subtypes of bile duct cancer, the following issues were noted:

• Primary sclerosing cholangitis was more strongly associated with perihilar than distal or intrahepatic or cholangiocarcinoma (CCA).
• Diabetes was more associated with distal than intrahepatic or perihilar CCA.
• Liver cirrhosis, not related to primary sclerosing cholangitis was associated with both perihilar and intrahepatic CCA. 
• Isolated inflammatory bowel disease, without primary sclerosing cholangitis, was not associated with any of the cancer subtypes. 

READ How Not Smoking But Using Aspirin Could Reduce Your Risk Of Female Cancers

Bile duct cancers can develop due to chronic inflammatory conditions, such as those mentioned above, causing persistent inflammatory changes to the bile ducts. Since Aspirin is an anti-inflammatory medication, use of this drug would then help to reduce the inflammation caused by the mentioned conditions and diseases. Besides this, Aspirin is also known to block other biological pathways which are associated with the development of cancers.

The clinical significance

The suggestion of this study would then be that long term Aspirin therapy would be beneficial in patients who are known to be high risk candidates to develop bile duct cancer.

The only issue that still needs to be addressed though is whether chronic Aspirin use in these patients would be safe and cost effective, as this is the first study done to address this possibility. Further research is therefore necessary to answer this question. 

Benefits And Risks Of Aspirin

Long term use of Aspirin has been researched and discovered to be safe for patients diagnosed with certain conditions.

Those patients, who have experienced a stroke or a heart attack or who are at high risk for developing these issues, may be prescribed low dose Aspirin to be used in order to help prevent further cardiovascular events. 

Occasional Aspirin can be used to manage issues such as fevers, headaches or general pain. Long term Aspirin use though needs to be suggested and prescribed by a doctor as this medication does have some problematic side-effects.

Mechanism for preventing heart attacks

When a person has a build up of fatty deposits in the coronary arteries, these plaques can burst and clots can then form and result in obstruction of these arteries and ultimately compromise flow of blood to the heart muscle.

Aspirin interferes with the clotting mechanism of blood by reducing the clumping ability of platelets to form clots, and thereby possibly help prevent a heart attack from occurring.

Indications

The following people are prescribed long term Aspirin therapy if they fulfill any of the following criteria:

• They had a previous episode of a stroke or heart attack.
• A stent has been placed in a coronary artery.
• Previous coronary artery bypass graft (CABG).
• The person is at high risk of experiencing a heart attack, even though they haven't had one.
• The patient is diagnosed with diabetes, has any one other heart disease risk factor (such as hypertension or a high LDL level), and if they are men over 50 years of age or women over 60 years of age.
• Patients who have a 10% or more chance of experiencing a stroke or heart attack over the next 10 years, don't have a bleeding risk and who are between 50-59 years old.

READ Can Aspirin A Day Keep Cancer At Bay?

Precautions and side effects

As mentioned, a person needs to consult their doctor in order to determine what the benefits and risks are to that individual before starting Aspirin therapy. 

Conditions exist which can be exacerbated by the use of Aspirin and this drug may then be contraindicated in specific patients. These can include:

• Worsening of a bleeding or clotting disorder.
• Increased risk of a haemorrhagic stroke, even though it decreases the chances of a clot-related stroke.
• Increased incidence of bleeding of stomach ulcers.
• Aspirin allergy which can result in anaphylactic shock.

Drug interactions

Patients using Aspirin should be cautious when using other anti-inflammatory medications such as ibuprofen, naproxen or diclofenac. These drugs can increase the risk of bleeding when used in combination.

Stopping Aspirin