Use of aspirin or other NSAIDs increases survival

Regular use of aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) seems to reduce the risk of developing various cancers, including prostate cancer. Now it appears that such drugs may help men with prostate cancer live longer, according to a Fox Chase Cancer Center study presented today at the 46th Annual Meeting of the American Society for Therapeutic Radiology and Oncology in Atlanta, Ga.

“NSAIDs have been associated with reductions in the risk of developing various gastrointestinal cancers and improvement in their treatment outcomes,” said the study’s lead author, Fox Chase radiation oncologist Khanh H. Nguyen, M.D. “However, any impact NSAIDs may have on treatment for prostate cancer has been unclear. We wanted to see if patients who used these drugs regularly before their diagnosis and treatment gained any benefit.”

The Fox Chase study involved 1,206 men who had definitive radiation therapy for localized prostate cancer. The researchers compared long-term treatment outcomes of 232 patients who had used NSAIDs regularly before treatment with the outcomes of the 974 men with no history of regular NSAID use. Other characteristics, such as smoking, were balanced between the two groups. The follow-up period averaged more than four and a half years.

“Pretreatment NSAID use was associated with significant delays in distant metastases, decreased rates of second cancers and improvement in overall survival,” Nguyen said. “Our data suggest a potential benefit of NSAIDs in managing prostate cancer.”

NSAID use remained an independent predictor for improved overall survival, even after taking into account other variables such as age, Gleason score and radiation dose.

Laboratory studies have suggested that by inhibiting the COX-1 and COX-2 enzymes, NSAIDs may enhance programmed cell death (apoptosis) and inhibit the development of blood vessels (angiogenesis) that feed a tumor. The Fox Chase researchers concluded that inhibiting these COX enzymes holds promise in prostate cancer treatment and warrants further studies.

In addition to Nguyen, study authors included research biostatistician Debra Eisenberg, M.S., statistician Alexandra L. Hanlon, Ph.D., radiation oncologist Eric Horwitz, M.D., and radiation oncology chairman Alan Pollack, M.D., Ph.D., all of Fox Chase Cancer Center’s department of radiation oncology.