SIDEBAR: Expect Questions from Patients


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A recently reported study finding that anticoagulants and particularly aspirin were associated with a reduced risk of prostate cancer–specific mortality1 has the potential to generate a lot of questions because of the large number of patients potentially affected. As the study’s corresponding author, Stanley L. Liauw, MD, noted, “Prostate cancer is the most common cancer among men in the United States, and aspirin is one of the most commonly used medicines, especially in an elderly population, which is predisposed toward having prostate cancer.” Dr. Liauw is Associate Professor, Department of Radiation and Cellular Oncology at the University of Chicago

“We are excited about the outcome and the possibilities, but we can’t really say that the evidence is strong enough to say that men with prostate cancer should start taking aspirin,” Dr. Liauw told The ASCO Post. “You worry about people overinterpreting the strength of the data,” and based on that, start taking aspirin.

“We know that aspirin is pretty safe—it’s used by so many people,” Dr. Liauw said, but there are risks of bleeding, including hemorrhagic stroke and gastrointestinal bleed. He cited a meta-analysis published in The Lancet in 2009 that showed that low-dose aspirin taken for primary or secondary prevention of vascular disease increased the risk of major gastrointestinal and extracranial bleeds from 0.07% to 0.10% per year.2 “So, overall, although risk is pretty low, it is still elevated with low-dose aspirin,” Dr. Liauw stated. ■

Disclosure: Dr. Liauw reported no potential conflicts of interest.

References

1. Choe KS, Cowan JE, Chan JM, et al: Aspirin use and the risk of prostate cancer mortality in men treated with prostatectomy or radiotherapy. J Clin Oncol. August 27, 2012 (early release online).

2. Antithrombotic Trialists’ (ATT) Collaboration, Baigent C, Blackwell L, Collins R, et al: Aspirin in the primary and secondary prevention of vascular disease: Collaborative meta-analysis of individual data from randomized trials. Lancet 373:1849-1860, 2009.


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