HEALTH STUDY Drugs aid men's cancer fight

Most of the men in the study were aspirin users.
MILWAUKEE JOURNAL SENTINEL
MILWAUKEE -- Men treated for prostate cancer fared substantially better if they had been regular users of aspirin and other pain relievers before treatment, according to research presented Monday.
Over the past several years, several studies have linked the use of nonsteroidal anti-inflammatory drugs (NSAIDs) to a reduced risk of developing prostate cancer, although the benefit still is uncertain and the drugs have potential side effects.
Now, for the first time, a study has found significantly better overall survival, fewer secondary cancers and delayed spread of the initial cancer beyond the prostate among users of such pain relievers who were treated with radiation for localized prostate cancer.
Caution
However, doctors not associated with the study cautioned that the research was retrospective in nature and that its strongest finding -- an 80 percent improved overall survival rate -- might be explained by something other than the effect of NSAIDs on prostate cancer itself.
For instance, in some studies use of regular aspirin and other such pain relievers has been associated with a reduced rate of heart attacks and other cancers.
The study, which was presented Monday at the Therapeutic Radiology and Oncology meeting in Atlanta, involved 1,206 men who received radiation therapy for localized prostate cancer.
Among the 232 men who said they were regular NSAID users before treatment, the five-year survival rate was 99 percent, compared with the 94 percent for nonusers. The respective 10-year survival rates were 91 percent and 68 percent.
Included in drug class
NSAIDs are anti-inflammatory medications that include over-the-counter drugs such as aspirin, ibuprofen, acetaminophen and naproxen as well as prescription drugs such Celebrex and Vioxx, which was recalled last week because it was found to increase the rate of heart attacks and strokes.
Most of the men in the study had been aspirin users, said lead author Dr. Khanh Nguyen, a radiation oncologist at Fox Chase Cancer Center in Philadelphia.
He noted that laboratory research suggests that NSAIDs may work in several ways that benefit prostate cancer patients, including enhanced programmed cell death and by inhibiting the formation of new blood vessels that can feed a tumor. Programmed cell death, also known as apoptosis, is a healthy process that prevents cells from dividing indefinitely and, thus, becoming cancerous.
"It is retrospective so it is not perfect," Dr. Nguyen said. "What we need is clinical trials to verify these findings."
Such a prostate cancer prevention trial, using Vioxx, was scheduled to start in the coming weeks at centers around the country, but it has been canceled because of the recall, said Dr. William See, chairman of urology at the college and chief of urology at Froedtert Memorial Lutheran Hospital in Milwaukee.
While other NSAIDs have not been associated with the problems caused by Vioxx, they also can have side effects, primarily gastrointestinal bleeding, he said.
Dr. See said the new study is fascinating, but it does not warrant the use of NSAIDs to prevent or treat prostate cancer.
Where the study may have some practical application is for people at risk for heart disease who may be considering taking a daily aspirin.
"This is another little piece of evidence that might push you one way or they other," he said.
Some research suggests that NSAIDs may enhance the cancer cell-killing ability of radiation, said Mark Ritter, an associate professor of radiation oncology at the University of Wisconsin-Madison.
However, Ritter said that when the study's results were adjusted to take into account several variables, only the improved survival rate remained significant.