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Aspirin is not a cancer drug but sits in cancer care in two places: low doses prevent clots in polycythaemia vera and essential thrombocythaemia, and long-term use lowers colorectal cancer in people with Lynch syndrome, while a trial in the healthy elderly found no benefit and possible harm.
In the myeloproliferative neoplasms, low-dose aspirin is given to almost everyone with polycythaemia vera and to low-risk and high-risk essential thrombocythaemia, because activated platelets cause both the microvascular symptoms (erythromelalgia, headache) and the arterial clots that drive mortality; the ECLAP trial in polycythaemia vera showed fewer combined cardiovascular events with aspirin. In prevention, the CAPP2 trial in Lynch syndrome found that 600 mg of aspirin a day for at least two years roughly halved colorectal cancers over the following decade, and long-term follow-up of cardiovascular trials suggested fewer colorectal cancer deaths. Against that, ASPREE, a trial in healthy adults over 70, found more cancer deaths on aspirin than placebo, so aspirin is not recommended for cancer prevention in older people without a specific indication. The Add-Aspirin trial is testing aspirin after treatment for breast, colorectal, gastro-oesophageal and prostate cancer. Its harms are bleeding, especially in the gut, and it must be avoided in essential thrombocythaemia with acquired von Willebrand deficiency.
Irreversibly blocks cyclo-oxygenase 1 in platelets, stopping thromboxane production and platelet clumping; at higher doses also blocks cyclo-oxygenase 2 and prostaglandin-driven inflammation, the proposed route to its effect on colorectal cancer.
1.Aspirin slips into a pocket on its target.
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People with Lynch syndrome should be offered daily aspirin, which roughly halves bowel cancer risk with a delayed and durable effect. Whether a lower dose (as tested in CAPP3) is as effective, and whether the finding extends to the general population, are separate questions.
Query for this drug: (TITLE:"Aspirin" OR ABSTRACT:"Aspirin" OR TITLE:"Acetylsalicylic acid" OR ABSTRACT:"Acetylsalicylic acid" OR TITLE:"Low-dose aspirin" OR ABSTRACT:"Low-dose aspirin") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Aspirin, not a curated reading list.
Shares Essential thrombocythaemia (ET), Polycythaemia vera (PV), Primary myelofibrosis and the tag mpn.
Shares Essential thrombocythaemia (ET), Polycythaemia vera (PV), Primary myelofibrosis and the tag mpn.
Shares Essential thrombocythaemia (ET) and the tag mpn.
Shares Polycythaemia vera (PV) and the tag mpn.
Shares Polycythaemia vera (PV) and the tag mpn.
Shares Polycythaemia vera (PV) and the tag mpn.
Shares Polycythaemia vera (PV) and the tag mpn.
Shares Polycythaemia vera (PV) and the tag mpn.