Muriel Lights' Candle Designs: No Easy Answers about Whether Aspirin Lowers Cance...

Muriel Lights' Candle Designs: No Easy Answers about Whether Aspirin Lowers Cance...: No Easy Answers about Whether Aspirin Lowers Cancer Risk As optimism for aspirin’s apparent anticancer effects grows, unanswered questio...

No Easy Answers about Whether Aspirin Lowers Cancer Risk

As optimism for aspirin’s apparent anticancer effects grows, unanswered questions remain.

One of the most intriguing prospects in cancer prevention is a cheap and very familiar drug: aspirin. In fact, the U.S. Preventive Services Task Force is working on recommendations for the use of aspirin to reduce cancer risk.

Aspirin is already widely used. Tens of millions of people in the United States take it daily to reduce their risk of heart attack or stroke. And numerous studies over the last two decades have suggested that taking aspirin on a regular basis may substantially lower a person’s risk of developing or dying from cancer. 

In 2011, for example, a meta-analysis of eight randomized clinical trials that compared the risk of cancer death among participants who took daily aspirin for 4 years or more and those who took no aspirin found that, overall, aspirin use lowered the risk of dying from cancer by approximately 20 percent.

By looking at data from individual participants in these trials, the researchers, led by Peter Rothwell, MD, PhD, FRCP, of the University of Oxford, showed that this risk reduction was due mainly to fewer cancer deaths among participants who took aspirin for at least 5 years. The largest drop in risk was for gastrointestinal cancers, particularly colorectal cancer. The study also showed more modest risk reductions for several other common cancers, including lung and prostate.

The research findings on aspirin, however, are not clear cut. Not every study of aspirin and cancer has shown that it reduces the risk of developing or dying from cancer. And most of the research linking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) and a lower risk of developing or dying from cancer have had limitations; most have been either observational studies, which cannot establish causal effect, or analyses of clinical trials testing aspirin’s effect on other health measures, most often vascular outcomes. None of the trials included in the 2011 meta-analysis, for example, was designed specifically to assess whether aspirin reduces the rate of cancer or cancer deaths.

But more definitive evidence may be on the horizon. In particular, researchers in search of answers are looking to several large clinical trials that have been launched to test whether aspirin reduces the risk of cancer incidence, death due to cancer, or both. (See the table.)

Trials of Aspirin for Cancer Prevention

Trial Name	Trial Design	Status
CAPP3	Enrolling 3,000 people with Lynch syndrome. Trial will test whether 100, 300, and 600 mg of aspirin per day for 2 years, followed by 100 mg per day, can reduce the risk of all Lynch syndrome-related cancers.	Currently enrolling participants
ASCOLT	Enrolling patients recently treated for colorectal cancer to see if 200 mg of aspirin per day for 3 years can improve disease-free or overall survival	Currently enrolling participants
ASPREE	Enrolling 19,000 healthy U.S. participants aged 65 or older to see if the overall benefits (prevention of heart disease, stroke, certain cancers, and dementia) of taking daily low-dose aspirin for 5 years outweigh the risks, especially bleeding. Incidence of nonfatal and fatal cancers is a secondary endpoint.	Ongoing, enrollment complete
AspECT	Enrolled 2,500 participants to test whether two different doses of an acid reflux drug with or without aspirin can reduce the risk of esophageal cancer in people with Barrett esophagus	Ongoing, enrollment complete

Consistent Findings, Mixed Opinions

The mounting evidence of aspirin’s strong anticancer effect for some malignancies is hard to ignore, said Dr. Rothwell, who led several more-recent studies that have strengthened the case for aspirin. The newer studies include a 2012 meta-analysis, which linked aspirin to a reduced risk of developing metastatic cancer.

"At a minimum, the data indicate that aspirin, in combination with the appropriate screening, would be highly effective in preventing esophageal and colon cancer," he said.

Dr. Rothwell is not alone in his opinion. "I do believe there is a role for using [NSAIDs] at a subtherapeutic level for various types of tumors," said Randall Harris, MD, PhD, of Ohio State University. A decade ago, Dr. Harris published findings from a prospective observational study of participants in the Women’s Health Initiative (WHI), which found that women who took aspirin or ibuprofen at least twice a week for 5 years or more had a reduced risk of breast cancer.

But that sentiment is not universal. John Baron, MD, MS, MSc, of the University of North Carolina Lineberger Cancer Center, agreed that there is strong evidence that aspirin reduces the risks of certain cancers. But, he noted, it’s still not enough. "More formal study is needed to nail down [aspirin’s] risks and benefits," he said.

How Does Aspirin Work against Cancer?
Researchers believe that aspirin may work, at least in part, by blocking the activity of COX-1 and COX-2 enzymes, lynchpins in the body’s inflammatory response. Inflammation is a normal response to tissue injury or infection that helps the injured tissue to heal or to clear the infection. In chronic inflammation, the inflammatory process does not end when it should. Over time, chronic inflammation can cause changes, such as the formation of new blood vessels and DNA mutations, which can promote tumor development and growth.

Reasons for Caution

Much of the hesitation expressed by Dr. Baron and others stems in part from the fact that few randomized clinical trials specifically designed to test the effect of aspirin on outcomes like cancer risk and mortality have been carried out. "Only when you do a randomized clinical trial do you get the complete picture of what’s going on," explained Asad Umar, DVM, PhD, of NCI’s Division of Cancer Prevention.

Progress is being made on this front. Take, for example, a large randomized placebo-controlled trial conducted in the United Kingdom called CAPP2. In that study, people with Lynch syndrome—an inherited disorder that substantially increases the risk of several cancers, including colorectal—who took high-dose aspirin (600 mg) for at least 2 years had a substantially lower incidence of colorectal cancer than participants who took a placebo.

Clinical trials can also highlight potential safety concerns that aren’t always apparent in observational studies or trials involving different patient populations. Dr. Umar cited the experience with a different NSAID, celecoxib (Celebrex®). Evidence of potential adverse cardiac effects from regular long-term treatment with celecoxib only emerged when it was tested in large trials with longer patient follow-up, including the NCI-funded Adenoma Prevention with Celecoxib trial.

The available data on aspirin’s safety are somewhat reassuring, Dr. Rothwell noted. In the trials included in the 2011 meta-analysis, for example, there were more fatal bleeding events among participants who took a placebo than among those who took aspirin (60 versus 40 events), even though aspirin increased the risk of nonfatal bleeding. And, in the CAPP2 trial, the number of cases of gastrointestinal bleeding in the aspirin group and placebo groups were very similar (11 versus 9 cases), according to the study’s lead author, Dr. John Burn of Newcastle University.

Filling in the Blanks

According to several researchers, several important questions need to be answered before aspirin can be considered for use as a cancer prevention measure, including: what dose provides the most protection against cancer and the lowest risk of serious side effects; who is most likely to benefit from aspirin use; which cancers does aspirin protect against; and how long after stopping aspirin does its anticancer protective effect last.

"Even for colorectal cancer, the data are incomplete or even conflicting regarding those details," Dr. Baron said. A recent case-control study, for example, found that use of low-dose aspirin after a colorectal cancer diagnosis did not improve cancer survival.

Dose is definitely a critical question, said Dr. Umar. "With an increased dose, the possibility of side effects increases," he said.

As for which cancers aspirin protects against, several studies have suggested that it may specifically prevent those that have certain molecular features. An NCI study published in April 2014 showed that regular aspirin use reduced colorectal cancer risk in people with tumors that overexpressed the gene15-PGDH but not in those with tumors that did not overexpress the gene. Another study by researchers at the Dana-Farber Cancer Institute suggested that aspirin use prevents the development of cancers that have the normal version of a gene called BRAF, which has been implicated as a key driver of several cancers, but not cancers that have a mutated form of the gene. And some of the same researchers found that aspirin use after a colorectal cancer diagnosis only reduced death from cancer if a patient’s tumor produced large amounts of COX-2, an enzyme involved in inflammation. (See the sidebar.)

Although the results make biological sense, "these findings need to be replicated before we can be sure of them," Dr. Umar cautioned.

Reference

Updated: April 9, 2015 National Cancer Institute 

http://www.cancer.gov/cancertopics/causes-prevention/research/aspirin

APRIL CANCER AWARENESS

Testicular Cancer

1. Signs and symptoms of testicular cancer include:
2. • A lump or enlargement in either testicle.
   • A feeling of heaviness in the scrotum.
   • A dull ache in the abdomen or groin.
   • A sudden collection of fluid in the scrotum.
   • Pain or discomfort in a testicle or the scrotum.

   • Enlargement or tenderness of the breasts.
   • Back pain
3. 
   

Head and Neck Cancer

eople with head and neck cancer often experience the following symptoms or signs. Sometimes, people with head and neck cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer.

• Swelling or sore that does not heal, the most common symptom
• Red or white patch in the mouth
• Lump, bump, or mass in the head or neck area, with or without pain
• Persistent sore throat
• Foul mouth odor not explained by hygiene
• Hoarseness or change in voice
• Nasal obstruction or persistent nasal congestion
• Frequent nose bleeds and/or unusual nasal discharge
• Difficulty breathing
• Double vision
• Numbness or weakness of a body part in the head and neck region
• Pain or difficulty chewing, swallowing, or moving the jaws or tongue
• Ear and/or jaw pain
• Blood in the saliva or phlegm, which is mucus discharged in mouth from respiratory passages
• Loosening of teeth
• Dentures that no longer fit
• Unexplained weight loss
• Fatigue

Esophageal Cancer

Signs and symptoms of esophageal cancer include:

• Difficulty swallowing (dysphagia)
• Weight loss without trying
• Chest pain, pressure or burning
• Worsening indigestion or heartburn
• Coughing or hoarseness

Early esophageal cancer typically causes no signs or symptoms.

When to see the Doctor

Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.

If you've been diagnosed with Barrett's esophagus, a precancerous condition that increases your risk of esophageal cancer caused by chronic acid reflux, ask your doctor what signs and symptoms to watch for that may signal that your condition is worsening.

Screening for esophageal cancer isn't done routinely because of a lack of an easily identifiable high-risk group and the possible risks associated with endoscopy. If you have Barrett's esophagus, discuss the pros and cons of screening with your doctor.

1. www.mayoclinic.org/diseases...

1. 
   

Muriel Lights' Candle Designs: Leah With The Fight Of Her Life Stage 4 Cancer In ...

Muriel Lights' Candle Designs: Leah With The Fight Of Her Life Cancer In ...:    Devon Still with his daughter Leah who is in remission  wearing plaid and a vest. Still, 25, a defensive tackle, had originally be...

Leah With The Fight Of Her Life Stage 4 Cancer In Remission

  

Devon Still with his daughter Leah who is in remission  wearing plaid and a vest.

Still, 25, a defensive tackle, had originally been cut from the Bengals roster, but once the team learned his daughter had stage 4 cancer, they resigned him to their practice squad. He has since been placed on the active roster.

Leah underwent surgery and chemotherapy after doctors found a cancerous growth in her abdomen in June, according to The Associated Press.

Leah cancerous growth required a six hour surgery, she has underwent chemo therapy, and Leah still stands strong with the love and support of her father,family and fans. My hope is that Leah Still continues to win her battle against cancer. Like so many families facing the same who don't have the same forum. 

What are the key statistics for childhood cancer?

Childhood cancers make up less than 1% of all cancers diagnosed each year. About 10,380 children in the United States under the age of 15 will be diagnosed with cancer in 2015. Childhood cancer rates have been rising slightly for the past few decades.

Because of major treatment advances in recent decades, more than 80% of children with cancer now survive 5 years or more. Overall, this is a huge increase since the mid-1970s, when the 5-year survival rate was about 58%. Still, survival rates vary depending on the type of cancer and other factors. Survival rates for different cancer types are listed in the section “Surviving childhood cancer.”

Cancer is the second leading cause of death in children (after accidents). About 1,250 children younger than 15 years old are expected to die from cancer in 2015.

Last Medical Review: 01/13/2015
Last Revised: 01/13/2015

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NATIONAL YOUTH HIV & AIDS AWARENESS DAY – APRIL 10

Today's young people are the first generation that has never known a world without HIV and AIDS. In the United States, almost 40 percent of new HIV infections are young people ages 13 to 29. Despite this harsh reality, young people and their allies are determined to end this pandemic once and for all.

It’s more important than ever to recommit to the fight against HIV and AIDS. We must continue to invest in scientific advancements like a vaccine and a cure - without forgetting the importance of prevention strategies and ensuring equal access to information and healthcare for everyone.

And most importantly, we must invest in young people  - bring them to the table not only as partners, but as leaders that can truly turn the tide of the HIV and AIDS epidemic. Only by fully investing in young people - in their health, their education, and their leadership - can we reach an AIDS-free generation.

WHY A NATIONAL YOUTH HIV AND AIDS AWARENESS DAY?

The creation of NYHAAD is a step toward acknowledging and addressing the needs of young people in the HIV and AIDS response.  Each year, young activists in high schools and at colleges and universities across the country will use this day to organize and educate about HIV and AIDS. They will promote HIV testing, fight stigma, and start the necessary conversation we need to deal honestly and effectively with the challenges we face. NYHAAD will also provide a yearly date for all of us to hold our leaders responsible to their commitments and invest in realizing an AIDS-free generation

rResources                                                                                                        http://www.advocatesforyouth.org/nyhaad-home

Muriel Lights' Candle Designs: KENYA

Muriel Lights' Candle Designs: KENYA: In memory of the 148 lives taken April 2 2015, you are in our prayers

Muriel Lights' Candle Designs: KENYA

Muriel Lights' Candle Designs: KENYA: In memory of the 148 lives taken April 2 2015, you are in our prayers

KENYA

In memory of the 148 lives taken April 2 2015, you are in our prayers