Common over-the-counter medication slashes colorectal cancer recurrence in half

A common over-the-counter medication could significantly reduce the risk of colorectal cancer coming back.

In a Swedish study, a low dose of aspirin was shown to slash recurrence in half for patients with colon and rectal cancer whose tumors had a specific type of genetic mutation.

Researchers at Karolinska Institutet and Karolinska University Hospital followed more than 3,500 cancer patients from 33 hospitals in Sweden, Norway, Denmark and Finland, according to a press release. All patients had undergone surgery to remove their tumors.

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Among those who had a particular gene mutation in the PIK3 signaling pathway, half of them received 160 milligrams of aspirin daily and the other half received a placebo.

After a three-year period, the risk of cancer recurrence was reduced by 55% in those who took the aspirin compared with the placebo group.

"The ALASCCA trial shows for the first time in a randomized setting that low-dose aspirin significantly reduces recurrence in colorectal cancer patients with somatic PI3K pathway alterations," study author Anna Martling, M.D., Ph.D., professor at the Department of Molecular Medicine and Surgery, Karolinska Institutet, and senior consultant surgeon at Karolinska University Hospital, told Fox News Digital.

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"This applies to more than one-third of all patients with resected colorectal cancer."

The effect was stronger in women, which warrants further investigation, according to Martling.

The findings were published in the New England Journal of Medicine.

Aspirin is a drug that is readily available globally and extremely inexpensive compared to many modern cancer drugs, Martling noted.

Intended to relieve pain, fever and inflammation, aspirin is a non-steroidal anti-inflammatory drug (NSAID). Low doses of the medication are also used to prevent blood clots.

This research confirms what prior observational studies have suggested, this time in a randomized study.

Dr. Marc Siegel, Fox News senior medical analyst, was not involved in the study but shared his reaction in an interview with Fox News Digital.

"Aspirin is an anti-inflammatory and is involved with mitigating growth factors," he said. "Numerous studies have shown that regular use of NSAIDs have decreased the risk of developing and dying from colon cancer."

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The PIK3CA mutation in the study leads to rapid cell growth in cancers, found in 55% of breast cancers and about 30% of colon cancers, Siegel noted.

"This large, randomized Scandinavian study reveals a greater than 50% reduction of recurrence in those with colon cancer and the PIK3 mutation," he reiterated, adding that more research needs to be done. 

The study did have some limitations, the author acknowledged. "As with any trial, there are caveats. The study was not powered for detailed subgroup analyses, and patients older than 80 were not included," Martling said.

"Longer follow-up is also needed to confirm effects on overall survival."

Some common side effects of aspirin include stomach problems and an increased bleeding tendency, according to the researchers. It should not be used by people with stomach ulcers, bleeding disorders or asthma.

Those using other blood-thinning agents or alcohol should use aspirin with caution, experts advise.

Despite the limitations, the researchers believe that the results are "immediately relevant" for clinicians and guideline committees.

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"Testing for PI3K pathway alterations should be considered in colorectal cancer patients after surgery," Martling recommended. "However, for patients, it is important to know that aspirin is not recommended outside of a medical context until guidelines and treating physicians adopt these findings."

The trial is a strong example of "precision medicine," according to the researcher, and of high-technology platforms meeting a well-known, low-cost drug. 

"If broadly implemented, the regimen could prevent thousands of recurrences and save lives each year, especially in settings where access to expensive novel drugs is limited," she added.

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When asked if everyone who has experienced colon cancer should be given regular aspirin, Siegel said it should be more commonly used for this than previously, but that doctors need to analyze the risks and benefits of aspirin use on a case-by-case basis.

The study was funded in part by the Swedish Research Council and the Swedish Cancer Society.