Aspirin and BAT

[PCaWarrior]

Aspirin’s Role in Prostate Cancer

Aspirin, a nonsteroidal anti-inflammatory drug (NSAID), has been studied for its potential to prevent or slow the progression of various cancers, including prostate cancer, primarily due to its ability to inhibit COX-2 (cyclooxygenase-2) and its anti-inflammatory properties.

The proposed mechanisms through which aspirin might influence prostate cancer include:

1. COX-2 Inhibition: COX-2 is often upregulated in prostate cancer. By inhibiting COX-2, aspirin may reduce the inflammatory processes that contribute to cancer progression.

2. Anti-Tumor Effects: Aspirin might inhibit tumor growth and metastasis by affecting the signaling pathways that regulate cell proliferation, apoptosis (cell death), and angiogenesis (formation of new blood vessels to supply the tumor).

3. Synergy with Chemotherapy or Other Treatments: Some evidence suggests that aspirin may enhance the effects of chemotherapy or other cancer treatments, potentially improving patient outcomes.

Potential Synergy Between Aspirin and BAT

While aspirin and BAT target different mechanisms of prostate cancer biology, they may complement each other in several ways:

1. Enhanced Anti-Inflammatory and Anti-Tumor Effects:

o Aspirin’s ability to inhibit inflammation (via COX-2) could enhance BAT’s effects on prostate cancer by reducing the inflammatory environment that may promote cancer cell growth and resistance to therapy.

o Inflammation is often a key driver of cancer progression, and BAT itself could induce some inflammatory responses, so aspirin’s anti-inflammatory effects may provide a balancing mechanism.

2. Impact on Tumor Microenvironment: BAT can alter the androgen receptor signaling and potentially reprogram the prostate cancer cells, making them more susceptible to apoptosis. Aspirin, through its ability to modulate immune responses, may enhance the immune system’s ability to target and kill these newly reprogrammed cancer cells.

3. Increased Efficacy in Castration-Resistant Prostate Cancer: Aspirin’s ability to modulate the tumor environment could potentially work in synergy with BAT to reduce the resistance mechanisms that are often seen in CRPC, enhancing the overall effectiveness of treatment.

4. Synergistic Cytotoxic Effects: There’s some evidence that aspirin, when combined with other treatments, can enhance cell death (apoptosis) and reduce tumor proliferation. When combined with BAT, which induces a form of cytotoxicity in cancer cells, there could be an additive or synergistic effect that slows the progression of prostate cancer.

Challenges and Considerations:

• Safety and Side Effects: Both aspirin and BAT have potential side effects, and combining them may lead to unforeseen toxicities. For example, high doses of testosterone in BAT could affect cardiovascular health, while aspirin may increase the risk of bleeding. Clinical trials would be required to assess the safety of this combination. On the other hand, androgens increase red blood cell production. Aspirin thins the blood and reduces heart attack risk.

• Individual Variability: Not all patients may respond the same way to BAT or aspirin. Some tumors may be inherently resistant to these treatments, and the optimal dosages and schedules would need to be fine-tuned for each patient.

I discussed with my MO and we added twice a day baby aspirin (81 mg).

[petabyte]

After some research I was just about to add 80mg daily. Is there evidence that twice daily is more effective or is it specific to your situation?

[PCaWarrior in reply to petabyte]

It might be specific to my situation. I was taking 81 mg daily until recently. I'd probably reduce it to 81 mg every night (with my last meal) if I wasn't doing BAT.

[GreenStreet]

Thanks. I was an early participant in an add asprin clincial trial in the UK about 7 years ago. They were testing to see if adding aspirin showed any evidence in delaying metatasis in those that had primary treatment but where BCR was likely. If I remember correctly they may also be doing a D3 test too but neither have reported yet. I came off the trial after about a year because they belatedly complained about the other supplements that I was taking and which I had declared I was taking at the start of the trial. They were not worried from a health perspective more that it could influence any results. I came off because I was not willing to drop my other supplements and I also could have been taking a placebo. Since then I have opted to take a baby aspirin 75mg every 3 days. This is just a punt/judgement call as there are side effects. From memory the upper dosage in the trial (2 dose levels and 1 placebo) may have been around what you are taking now. In fact I think it may have been 150 mg. I think the field work for the trial was meant to last c 5 years?

[PCaWarrior in reply to GreenStreet]

I've been watching the add aspirin trial. I hope they report results - supposedly 2026-2027.

addaspirintrial.org/

[Maxone73]

100 mg 3 times per week here...

[petabyte]

This is the article from the BBC that triggered me to research aspirin. bbc.com/news/articles/c1d4n...

The study itself:

nature.com/articles/s41586-...

An RCT they mention

addaspirintrial.org/

[PCaWarrior in reply to petabyte]

Thanks for the links.

[GreenStreet]

This was the trial that I was in. I was wrong the top dose was higher than you were taking

pmc.ncbi.nlm.nih.gov/articl....

[Maxone73 in reply to GreenStreet]

I have found interim data but only about toxicity, not about efficacy

[PCaWarrior in reply to Maxone73]

Interim data for the add-aspirin trial?

Where?

[Maxone73 in reply to PCaWarrior]

here: discovery.dundee.ac.uk/ws/p...

[PCaWarrior in reply to Maxone73]

So, if they conclude that aspirin lowers PCa death rate by more than 3 hundredths of a percent it outweighs increased bleeding risk - bleeding, not death.

"Aspirin does increase the risk of bleeding though the magnitude of

this effect is often over-estimated. The most extensive randomised data from the Antithrombotic Trialists’

13

Collaboration meta-analysis encompassing ~95,000 individuals demonstrated only a very modest increase

in the risk of extracranial and major gastrointestinal bleeds from 0·07% per year to 0·1% per year"

[GreenStreet in reply to Maxone73]

Thanks that is helpful and from an early side effects perpsective encouraging

[MateoBeach]

Hrd to get any good info on whether higher dose (than 81mg daily) might or might not have further anti-cancer actions. I take 81 mg 3X/week for CV protection but also 400mg daily of the specific COX-2 inhibitor celecoxib (Celebrex) since my BCR 15+ years ago.

[PCaWarrior in reply to MateoBeach]

Yeah, I haven't been able to drudge up any good dose data. Most of these researchers seem to be under the impression that taking x is the same as taking 100 x or 10,000 x. Even worse are the ones who don't even list the doses used. Another bad habit is not estimating amount of x consumed to get a specific molar concentration in the serum.

I sometimes take celecoxib. I'll revisit that subject.