NSAIDs

This is a follow-up to my aspirin post.  The literature on non-steroidal anti-inflammatory drug [NSAID] use suggests differential effects on PCa risk.  There is not much consistency between the studies.  Men who take NSAIDS chronically have a different health profile to those who don't.  Even those who take low-dose aspirin typically do so because they are at increased risk for CVD.

A.  Ibuprofen (Advil, Nuprin, Motrin)

A paper last month from Finland [A.1] reported that:

"Weekly use of ibuprofen was associated with an increased risk of PCa overall {+43%} ... and with metastatic PCa {+49%} ... compared to less frequent use."

In contrast, a 2012 U.S. study found no association [A.2]

From a 2011 Canadian study [A.3]:

"Any use of propionates (e.g., ibuprofen ...) was associated with a modest reduction in prostate cancer risk {-10%} whereas use of other NSAIDs was not."

A 2010 paper from the VITAL study [A.4] reported that:

"Low-dose aspirin, regular-strength aspirin, ibuprofen, and any nonaspirin NSAID ... were not associated with prostate cancer risk."

B. Acetaminophen (Tylenol, Paracetamol, Panadol.  Note that Excedrin contains acetaminophen, aspirin, and caffeine.)

Wiki: acetaminophen "is generally not considered an NSAID because it has only little anti-inflammatory activity. It treats pain mainly by blocking COX-2 mostly in the central nervous system, but not much in the rest of the body."

A 2014 paper [B.1] from the same Finnish study as [A.1], looked at prescription use of acetaminophen:

"Prostate cancer risk was elevated among current NSAID prescription users irrespective of screening {+45% & +71%} ... in the screening and control arm, respectively), but not for previous use of NSAIDs"

"The risk increase was similar among coxib and acetaminophen current users, and stronger for metastatic prostate cancer {+141% & +244%} ... in the screening and control arm, respectively)."

In contrast, in a 2011 paper from the VITAL study [B.2]:

"Acetaminophen (paracetamol) is a widely used over-the-counter drug, but concerns of genotoxic effects have been raised. After we recently found an almost two-fold increased risk of hematologic malignancies associated with high use of acetaminophen in the prospective VITamins And Lifestyle (VITAL) study, we herein further examined the association between acetaminophen use and cancer risk in the VITAL cohort."

"This study failed to provide evidence of an association between acetaminophen use and total cancer risk or incidence of nonhematologic malignancies."

&, also from 2011 [B.3]:

"During follow-up from 1992 through 2007, 8,092 incident prostate cancer cases were identified. Current regular use of acetaminophen (30 or more pills per month) for 5 or more years was associated with lower risk of overall prostate cancer {-38%} ... and aggressive prostate cancer {-51%} ..."

"Current regular use of less than 5 years duration was not associated with prostate cancer risk."

C.  Naproxen  (Aleve)

From a 2011 Canadian study [C.1, same as A.3]:

"Any use of propionates (e.g., ... naproxen) was associated with a modest reduction in prostate cancer risk {-10%} whereas use of other NSAIDs was not."

-Patrick

[A.1] ncbi.nlm.nih.gov/pubmed/269...

[A.2] ncbi.nlm.nih.gov/pmc/articl...

[A.3] ncbi.nlm.nih.gov/pmc/articl...

[A.4] ncbi.nlm.nih.gov/pubmed/209...

[B.1] ncbi.nlm.nih.gov/pmc/articl...

[B.2] ncbi.nlm.nih.gov/pubmed/219...

[B.3] ncbi.nlm.nih.gov/pubmed/215...

[C.1] ncbi.nlm.nih.gov/pmc/articl...

2 Replies

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  • Since there is nothing definite in the literature that you cite, common sense says doing low dose NSAIDs with the hope of benefit.   

  •  Thanks again Patrick! Great info. I have used naproxen for years  as  my "go to" pain reliever for most any reason. I find it helpful for early-stage nagging pain from tumors as well until it becomes severe then out comes the Hydromorphone. 

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