New study getting much attention in the media [1] [2] [3].
My interest in aspirin is due to a possible role in preventing unwanted coagulation & perhaps thereby having an inhibitory role in metastatis. There are currently 76 PubMed hits for <prostate[title] aspirin[title]>. Studies are a mixed bag, but I expect that some have influenced men with PCa.
There are two stages to clot formulation: (i) the aggregation of platelets & (ii) the accumulation of fibrin. While low-dose aspirin is sufficient to inhibit the clumping of platelets, I prefer to use nattokinase to eliminate fibrin (using D-dimer to determine dosage).
But a lot of men are chronically using low-dose aspirin to prevent cardiovascular disease. I posted a study 2 months ago that found that aspirin was only useful for those who had already suffered a cardiovascular event. There was no preventative benefit for healthy individuals.
We hear that men with PCa have increased CVD risk, & I wouldn't be surprised to find that greater than half of this group uses aspirin. In the general U.S. population, 30% are users, with 22% being "healthy" & 8% having had an event.
For the new study:
"we enrolled community-dwelling men and women in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or disability."
"The rate of major hemorrhage was 8.6 events per 1000 person-years {in the aspirin group} and 6.2 events per 1000 person-years {in the placebo group}, ... (hazard ratio, 1.38 ...)"
"The use of low-dose aspirin as a primary prevention strategy in older adults resulted in a significantly higher risk of major hemorrhage and did not result in a significantly lower risk of cardiovascular disease than placebo."
...
From [2]:
"Higher all-cause mortality was observed among apparently healthy older adults who received daily aspirin than among those who received placebo and was attributed primarily to cancer-related death. In the context of previous studies, this result was unexpected and should be interpreted with caution."
For some reason, I continue to irrationally use daily small doses of aspirin.
I think it is because these studies say that these deaths are caused by gastric bleeding, and it seems as though I do not have any gastric bleeding. And if I did, I would expect it to show itself in my stool, and if it showed itself in my stool... then I would stop taking it and talk to my doc about getting something to counteract it.
Any comments on how rational or irrational my behavior is?
I found baby aspirin lead to more under skin bleeding (purpura), especially with the prednizone I take with Zytiga.
I'm not sure what else you said about asprin. How does clotting factor encourage metastasis? A reveling study would be to compare men who take baby aspirin to men not, for heart attacks.
[1] "The ability of tumor cells to initiate coagulation and subsequent platelet aggregation is believed to facilitate the metastatic process."
[2] "There is extensive evidence from both clinical and experimental studies for an interaction between the coagulation system and the spread and growth of malignant disease
1985), whilst animal experiments have suggested that the
coagulation system may play an important role in the
pathogenesis of blood borne metastasis (Koike, 1964;
Agostino et al., 1966; Brown, 1973; Wood, 1974; Poggi et
al., 1978)."
[3] "One of the common surgical procedures used in the management of prostate cancer is transurethral resection of the prostate in which the possibility of the escape of tumor cells and their encounter with the hemostatic system is reported to contribute to the threat of hematogenous dissemination. We are reporting about the role of the hemostatic system involving the platelets and coagulation factors in the dissemination process in a tumor model carrying Dunning's R3327 AT3 adenocarcinoma of the prostate whose metastatic behavior is similar to that of human prostatic cancer."
[4] "... we add new insights on the interconnections between blood coagulation disorders in cancer patients and thrombin activation in malignant effusions ..."
[5] "Inhibition of coagulation greatly limits cancer metastasis in many experimental models. Cancer cells trigger coagulation, through expression of tissue factor or P-selectin ligands that have correlated with worse prognosis in human clinical studies. Cancer cells also affect coagulation through expression of thrombin and release of microparticles that augment coagulation. In the cancer-bearing host, coagulation facilitates tumour progression through release of platelet granule contents, inhibition of Natural Killer cells and recruitment of macrophages. We are revisiting this literature in the light of recent studies in which treatment of clinical cohorts with anticoagulant drugs led to diminished metastasis."
I take low dose aspirin daily to ward off the threat of stroke when I have the occasional atrial fibrillation episode. If this helps prevent PC metastasis, so much the better. I'm not keen on industrial strength blood thinners. I also had my TURP surgery for BPH 10 years prior to the prostate cancer diagnosis. TURP was also a positive for subsequent HIFU treatment.
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