Prevent Breast Cancer with Aspirin and Motrin – Not!

"Risk of Breast Cancer Cut Sharply by Regular Ibuprofen" announced the headlines in newspapers nationwide on April 10, 2003.1  The story claimed women can reduce their risk by as much as half by regular use of aspirin or ibuprofen (Motrin, Advil, Nuprin)*.  The source of funding of this study will not be known until it is published; however, there are ties between this kind of research and the drug industry already.  

Randall Harris, a professor of epidemiology and biometrics at Ohio State University and lead investigator of a study on breast cancer and certain anti-inflammatory drugs, said the following, " The evidence . . . is compelling and converging that relatively harmless and inexpensive compounds such as aspirin and ibuprofen, already used by millions, reduce the risk of breast cancer and other forms of cancer."2 Dr. Harris said he thinks women should begin to "seriously consider" taking a standard dose of ibuprofen (200 milligrams) or ASA (plain adult aspirin at 325 mg) daily beginning at age 40 as an effective means of lowering their risk of breast cancer. He himself swallows an ibuprofen tablet daily because he believes it will be proven to prevent other forms of cancer as well. Randall Harris' research is funded by a pharmaceutical company, G.D Searle & Co.3  Searle produces a COX-2 inhibitor, Celebrex, which is a nonsteroidal anti-inflammatory drug (NSAID), and was linked to 10 deaths and 11 gastrointestinal hemorrhages in the three months following approval in January, 1999 for use in rheumatoid arthritis.4  Nearly 40 million prescriptions were written for COX-2 inhibitors over a 12-month period in the United States as reported in 2000.5 Searle also makes another NSAID, Arthrotec.

A thorough review of the possibility of reduction of breast cancer risk by these types of drugs was published in December of 2002 in the journal Cancer Epidemiology Biomarkers and Prevention and no breast cancer reduction benefits were found with NSAIDs other than aspirin.6  This study, supported by the National Cancer Institute, suggested a 20% reduction in risk of breast cancer for women taking aspirin six or more times a week.  However, other studies have failed to support this breast cancer benefit (even for aspirin).7

NSADs and Cox-2 drugs

These drugs are classified as nonsteroidal antiinflammatory drugs (abbreviated NSAIDs). They exert their effects by inhibiting enzymes involved in inflammation, called prostaglandins.  The enzymes they inhibit are called cyclo-oxygenase (abbreviated COX). There are two forms of COX: COX-1 and COX-2. Traditional NSAIDs like aspirin and ibuprofen inhibit both of them, whereas the newer COX-2 inhibitors selectively inhibit COX-2. The mechanism for cancer inhibition by these drugs is not known, but some possibilities are a reduction in tumor growth activities and an improvement of the immune system.

The most frequent adverse effect of NSAIDs is gastrointestinal, including heartburn and ulcers, edema and fluid retention, dizziness, headaches, rash and ringing in the ears.  Less commonly, people, particularly the elderly, suffer from exacerbation of heart failure, hypertension and impaired kidney function.  The advantage of selective COX-2 inhibition is it reduces the adverse effects on the stomach which are so common with this type of medication. There are additional increased adverse effects of COX-2 inhibitors including an increased risk of heart attacks – an increase as high as four times greater than regular NSAIDs.8,9

Is This Treatment Worthwhile?

Connections between medications and diseases are made frequently, and when the findings are positive the public relations departments of the pharmaceutical companies give the story the biggest spin money can buy.  One recent example of this is the fairy-tale about hormone replacement therapy (HRT) and heart disease.  Several studies in the 1980s found women who took HRT had less heart disease; and as a result women have been told for 20 years that HRT prevents heart disease.  However, when the definitive studies – those actually comparing a group of women who took HRT with those who did not – were completed, investigators discovered HRT actually increased the risk of dying of heart disease (and breast cancer and suffering blood clots and gallbladder disease).

The reason for the initial false conclusion was because women who took HRT were generally better educated women who also took better care of themselves – they ate healthier and exercised – so they had less heart disease.  Likewise, the connection between NSAIDs and breast cancer may be similarly incorrect.  It may be that women who take pain killers are suffering so much from painful conditions like arthritis or headaches that they do not eat very much food – and as a result they eat less fat, fewer calories, and are thinner – and that is why they have less breast cancer.

Don't Be Sold by the Drug Companies

In the future do not be surprised to see claims splashed across the national media about miracle drugs saving you from common diseases – remember, hundreds of billions of dollars are behind this information.  And these messages are also well received, because most people think, "How easy; I don't have to change my diet now – all I have to do is take pills. And these are the same pills that I happen to take for my arthritis and my headaches anyway – how convenient."

If the truth be known, your headaches, arthritis and your increased risk of breast cancer are all caused by your high-fat, high-meat, high-dairy, highly-processed diet, and taking pain pills is going to do little or nothing to change your sufferings and your risks.

References:

1)  Press Democrat News Service.  Risk of Breast Cancer Cut Sharply by Regular Ibuprofen. The Press Democrat April 10, 2003, Page A15,

2)  http://www.workopolis.com/servlet/Content/fasttrack/20030409/
UCANCN_2?section=Healthcare

3)  Harris RE.  Chemoprevention of breast cancer in rats by celecoxib, a cyclooxygenase 2 inhibitor. Cancer Res. 2000 Apr 15;60(8):2101-3.

4)  Brower V. Business and Regulatory News. June 1999 Volume 17, Number 6, p 519.

5)  Retail & Provider Perspective, National Prescription Audit, 1999-2000. Plymouth, Pa: IMS Health; 2000.

6)  Johnson T.  Association of aspirin and nonsteroidal anti-inflammatory drug use with breast cancer. Cancer Epidemiol Biomarkers Prev. 2002 Dec;11(12):1586-91

7)  Egan K. Prospective study of regular aspirin use and the risk of breast cancer.
J Natl Cancer Inst. 1996 Jul 17;88(14):988-93.

8)  Bombardier C, Laine L, Reicin A, et al for the VIGOR Study Group. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. N Engl J Med. 2000;343:1520-1528.

9)  Frankish H.  Why do COX-2 inhibitors increase risk of cardiovascular events?
Lancet. 2002 Apr 20;359(9315):1410.

10)  Shah SH.  Hormone Replacement Therapy for Primary and Secondary Prevention of Heart Disease. Curr Treat Options Cardiovasc Med. 2003 Feb;5(1):25-33.