I am a retired GP. I was diagnosed with stage 3 PPC (on the ovarian cancer spectrum) in September 2009, and am now in my 2nd remission, since March 2011. From my own experience taking ibuprofen, and from my review of recent medical literature, I am convinced that patients with stage 3 and 4 ovarian cancer or PPC should all be put on aspirin or ibuprofen after their first relapse shows that the disease has not been cured, ie aspirin or ibuprofen should be started a few weeks after finishing chemo for their first relapse, when they are in a 2nd remission.
I was told after my 2nd course of chemo that I was highly likely to relapse within 6 months, as I had only just over 6 months of remission after finishing my first chemo course (with surgery in middle of the course). Thanks to ibuprofen, I am sure, I am now 22 months into my 2nd remission, feeling totally fit and healthy, playing competitive tennis etc, with a normal CA125, even though the cancer was not totally cleared at last CT scan in April 2011.
for the full story, and detailed website links to my references, etc. Also see the story of Sandy in that blog.
Based on the medical research and my own experience, there is ample evidence that aspirin or ibuprofen, very cheap drugs which have been around a long time, have a part to play in the fight against cancer. They are particularly effective against adenocarcinomas like ovarian cancer and many other common cancers.
Aspirin trials are currently being carried out in 3 cancers (not ovarian cancer), to see if they can prevent spread, ie metastases, in cancer patients. There is already abundant evidence that they can (see previous blog).
My point is to question why all stage 3 or 4 OC patients in the above category are not started on low-dose aspirin or on ibuprofen routinely. I know that scientists are still trying to find out how they work, but the main point for cancer patients is that they do seem to work, in many patients anyway. Surely they should be tried in those of us with progressive disease, who are not going to be cured in the long term by conventional chemotherapy.
My goodness, they are extremely cheap drugs, as compared to Avastin which costs a fortune, and makes a fortune, of course, for the drug company which makes it. Aspirin and ibuprofen are also pretty safe drugs, when taken after discussion with your GP or oncologist, with full awareness of any side effects, and with omeprazole cover in the case of ibuprofen (or aspirin if necessary) to protect the stomach.
I would think OC patients in this category would jump at the chance of trying them out. As my GP said when she agreed to prescribe me ibuprofen and omeprazole, as she was aware of the research, “What have you got to lose?”
From my own experience, I can recommend it. I have got an extra 16 months of healthy life I was not expecting, and enjoyed my daughter’s wedding in October 2011. Hopefully I will see my grandchildren.
I ask OC oncologists, why wait for trials? As Lord Saatchi, whose wife died of PPC, says, be innovative. JUST DO IT!
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I don't know how I missed your first blog .... but a huge THANK YOU for this one. It's not going to do any harm to try Aspirin or Ibroprofen so I really can't understand why the medical profession don't pass on this piece of advice, and I'll certainly mention it to my oncologist and give it a go. It'll be interesting to hear what she says. She hadn't even heard of the Budwig Protocol and sniffs at the idea that what you eat or do can affect the cancer.
I felt at one with you as my diagnosis was in March 2011. I've been in remission but the CA125 is going up now and I've come to terms with the likelihood that more chemotherapy is on the cards. More than just coming to terms with it. I realise I'm lucky if chemotherapy still continues to work so I should be happy to be having it.
Your advice is therefore very timely - and what is even more encouraging is that you have had a better remission the 2nd time round even though there were some residual tumours.
I'm taking your advice and that of Lord Saatchi. I'm sure many others will do after your helpful blog.
Thank you for this post, it is very interesting. I had heard about aspirin trials for other cancers and did see your earlier post. I was stage 3C and haven't had a relapse as yet but am grateful for the information. As Iboprofen is usually my preferred painkiller of choice, what would the recommended dose be?
See my other blog. My dose is 400mg three times a day with food, and omeprazole 20mg daily to protect my stomach. This is because this is a standard dose in people with arthritis on long term treatment. Do have a good look at the other blog.
Good luck.
Love,
Eileen x
Dear Eileen,
I was diagnosed with high grade serous OVCA 3c with lymph node involvement in Feb 2012
I asked to be prescribed aspirin immediately having read the research.
I also have green tea and cur cumin capsules.
It is early days yet but I have nothing to lose.
I am also interested in research for metformin for non diabetics as it does appear to be having a positive effect.What are anyone's thoughts on this?
Yes, I have heard about metformin. I haven't looked into it as yet, but my oncologist thinks it is promising. Will try to find out more.
Eileen x
Hi Eileen,
I had read your earlier blog and read some other notes on asprin and Ibuproven. I had been prescribed with Ibuproven after surgery possibly as an anti inflamitory but have continued to take it with omaprezole.
I finished 1st line chemo in October, still had disease so haven't been in remission. I can only hope that the disease will stay stable for a long time but being stage 1V that seems unlikely.
I am seeing my oncologist next week and will mention this to her.
How very interesting I am going to ask my onc about aspirin and ibrufen. I am already on clexane every day due to pe's so not sure if I can have aspirin as well. What is the dosage please? Wouldn't this be wonderful if it helped to keep OC at bay. Thank you drdu xx
No, you couldn't take aspirin along with clexane. The best dose of aspirin is in some doubt - that is part of the problem. 75mg (one small aspirin) daily is certainly of some help, but it may be that 150mg daily is better.
Hi Eileen what a very interesting blog I was wondering what your thoughts are on diclofenac as an alternative and what dose ibuprofen has been researched . I am going to discuss with my oncologist next week .
The doses of ibuprofen and the like that have been researched are the standard ones for chronic arthritis in the long term. So a standard dose of diclofenac is 50mg three times a day with food, and ibuprofen is 400mg with food three times a day. Diclofenac probably works just as well, but it is a slightly stronger drug than ibuprofen, and a bit harder on the stomach, especially if taken longterm, and so ibuprofen would be safer.
Do have a look at my other blog, which has a lot of info.
Sorry, I realise my last answer was very brief. Yes, am sure diclofenac is helping. There is a range of NSAIDs like ibuprofen and diclofenac that seem to all have the same anti-cancer effect. If you are ok on diclofenac with omeprazole, probably just as well to stick with it for anti-cancer effect. I took diclofenac for 3 months at the start for my hamstring strain, and it appeared to help against the cancer (see my other blog). Ibuprofen is just a bit easier on the stomach in the longterm.
Thanks, Eileen. Very interesting, as is the fact that in former days, willow bark was used as a pain killer, so aspirin has a long old history! I have read so many claims about a daily dose of 75ml aspirin. I will be taking it from now on. Just a word of caution though ....... Not to be taken if you're about to have surgery! A good tip, though
Thanks again for posting this information and for taking the time to reply to us all.
I so regret not knowing this 2 years ago after finishing chemo for my first recurrence. I also have PPC and had mild stranding left but a CA125 of 10 and had 7 months before any sign of another recurrence. I am now on my 3rd recurrence chemo, gem/carbo and this time it is taking a long time to get my numbers down and to show improvement on scans. I understand ibuprofen should not be taken during chemo, but wonder if you have encountered any research on taking it if " remission" is not reached by the end of treatment. I have looked but did not find anything. My consultant is keeping me on the chemo as long as the CA125 is dropping. I printed your first post and took it to my wonderful GP she was very positive and said she would have no problem with prescribing omeprazole with ibuprofen once treatment is over. I do not really have anything to lose.
There really is no research yet on that, as it is all very new. But I am sure it would at least help. What a sensible GP. Glad you printed it all out, as am keen to help others in same position. I was very lucky I went on ibuprofen when I did, as it was pure coincidence because I had another injury. I didn't believe it at first when my CA125 kept staying down, but after I was convinced ibuprofen must be the cause I wanted to let as many others as possible know about it, and aspirin.
Do you think this would work for clear cell? Also, I currently take ranatidine due to acid(long term use of diclofenac years ago)so have a hard time using ibruprofen, so would have to look at asprin use. Very interesting tho.
Ranitidine is a very old-fashioned anti-acid drug, and modern proton pump inhibitors like omeprazole are far more effective. I would suggest you ask your GP for that, ie 20mg daily. Or 40mg daily at first if acid symptoms are bad. Omeprazole is very cheap, as it is off patent, and has been around for years, and so your GP should have no objection to prescribing it. Maybe you just buy ranitidine over the counter?
Anyway, good luck with trying aspirin, but would suggest in your case you maybe sort out omeprazole first, as even low dose aspirin can have slight effect on stomach - increased acid.
Sorry, I realise I didn't reply re clear cell. I am not an expert, but think it could work. Indeed Richard O, who commented in my last blog, and is on ovacome medical advisory board, ie oncologist, thought aspirin could be effective in clear cell.
Oh my goodness, this is such heartening news for me! I have clear cell OC, 3C. Right now I'm doing chemo, so should I wait until it's finished to start Ibuprofen?
Yes, wait until you have finished chemo eg 4 weeks afterwards, when chemo is out of your system. Discuss it with your oncologist or GP as omeprazole needed with it, and they know your medical history etc and know if you can take it. Aspirin is alternative, but again needs discussed with doctor.
Eileen, thank you for posting. It is heartening to see that you are a retired GP and advocating the use of aspirin and ibuprofen for some of us here. I am also of the same opinion that if there is evidence that it "may" be of benefit and will not harm us, then it is worth a try.
Last year, I printed out reputable articles about the benefits of metformin and other things to my GP who was initially interested but needed to run things by my Oncologist. It was no surprise that he said that he could not recommend these due to the low number of participants in the clinical studies, and it wasn't a standard course of treatment and would not be prescribed on the NHS. I don't feel we have time to wait around waiting for the clinical trials (if any) for dirt cheap drugs, and wait for the results to be published.
I am taking a daily blood thinner (fragmin) and I read everywhere that aspirin/ibuprofen shouldn't be taken in conjunction. What are your thoughts on this?
In anycase I take curcumin tablets anyway, which apparently have blood thinning properties and haven't had any ill effects.
I agree that we can't wait around forever till they get round to doing big trials. It is something that really annoys me, when there are people like ourselves who need things done quickly. I thought of suggesting people try aspirin or ibuprofen after their first course of chemo, but then they would never know if the disease would have recurred without aspirin or ibuprofen, as you would never know if the chemo alone had done the trick or not. But I think everyone should do what they think best for themselves. It is certainly an idea for stage 4 patients anyway. Used sensibly aspirin or ibuprofen should do no harm.
In your case, I think you can't take aspirin while on fragmin, and ibuprofen would be a bit risky, even with omeprazole cover. I don't know your circumstances, but sometimes aspirin in a higher dose can be used instead of fragmin to prevent clotting. Maybe you could discuss that with your doctor.
Another suggestion would be that you could be prescribed metformin privately by your GP. I haven't looked into the metformin research in cancer yet, I must admit. But I believe it is very promising. Metformin is a dirt cheap drug, and so wouldn't cost much privately (or shouldn't!)
Many thanks Eileen, I really do appreciate the advice. I don't think my GP is willing to go against the wishes of my Oncologist unfortunately. There are reputable UK websites where you can get online doctors to write prescriptions and purchase online. That could be something to consider.
I agree that everyone should do what they think is best for themselves. Ultimately it's up to us to look up the research and decide if we want to give it a try. What have we got to lose?
I'm currently trying to use diet as well to delay a recurrence. Worth a try, or else I would always be wondering.
I am interested to know why you are only recommending this for stage 3 and 4?
I was stage 1c clear cell. I thought about taking the 75mg gastro resistant aspirin after it was in the news last year. I even bought a pack.
However, I held back as I also have IBS and thought it may aggravate it. Would you recommend it for somebody in my situation? The IBS only affects my large intestine, not the stomach or small intestine.
It is just that stage 3 and 4 have the worst long term outlook for survival. There is a small risk of side effects from taking even a 75mg aspirin, and for people well under 60 with a good outlook anyway they might not consider it worth the risk, to take an aspirin for the rest of your life. Also you would never know if the cancer would have recurred without aspirin. I am not an expert on clear cell OC, and so do not know what the longterm prospect of survival is for you. Really it is up to you to weigh up the risks and benefits of what is best for you, as I am not an expert, and don't know anything about your other medical history etc. You maybe should discuss it with your GP and/or oncologist.
Sorry, specifically about your IBS, if you are otherwise in good health aspirin may be ok, and not aggravate it. But you really should talk to your GP who knows you better than I do.
E xx
I absolutely agree that this needs more attention; there seems to be no reason why aspirin and ibuprofen aren't used more widely. But on a cautionary note, I took a daily aspirin for five years before I was diagnosed and I frequently also used diclofenac and ibuprofen. I still ended up with ovarian cancer.
I know that the Oasis of Hope in Tijuana - run by some maverick doctors - routinely prescribes diclophenac for late stage cancers.
Data gathered by the Clearity foundation shows that there's a wide variation in ovarian tumours, levels of Her2, EGRF, COX2 and so on. This goes some way to explaining why a treatment will work on one women but not on another. It strikes me that there is no need for a standard clinical trial, observation of results would suffice.
Also, Watson's very recent paper on cancer, published in Open Biology, raised the possibility that chemotherapy works because of an inflammatory process, therefor anti inflammatories should not be used during chemo. (Watson hypothesises that particularly Vit E could be causing some cancers...)
I'm very glad it's helped, and thanks so much for bringing it to the attention of the rest of us,
Yes, I agree that anti-inflammatories should not be taken during chemo, as I said in my previous blog, which went into a lot of detail, and is worth looking at. Yes, all tumours are different, and what works for one person may not work for another. I am not suggesting aspirin or anti-inflammatory is a magic cure, just that it may help some people quite a lot, see all the references in my other blog.
Yes, I agree with you that there is no need for a trial, as hopefully seeing an improvement in survival would speak for itself, as you say by observing the results.
Yes, someone else said that they had taken aspirin before diagnosis. I think the longer you take it the more the protective effect (see research), and indeed it is not the magic pill that prevents all cancers.
Do please have a look at my other blog. If you click on the link in my statement at the start of this blog, it will lead you straight into it.
I am very interested in the use of Ibuprofen and aspirin, I was diagnosed in May 2011 with stage 3 PPC, I have had 6 Chemos and as the tumour has shrunk and my Ca125 is down to 7,So it was decided no surgery required at present and I will be monitored again in February, but my Gynae consultant gave me Naproxen 500mgs twice daily, is this as good as Ibuprofen?
Yes, Kaskin, Naproxen is another good old-fashioned non-steroidal anti-inflammatory drug (NSAID) like ibuprofen, and has been around a good while. It should be just as effective, as far as I know, though I haven't looked into it in great depth, as to how much research has been done on it.
Sorry, I should have said that it is very interesting that your gynae consultant has given you Naproxen. Is it for its anti-cancer effect, do you know? I presume it is. If so, I wonder if he is carrying out his own trial/experiment on his own patients. Good to know if an oncologist is doing that - excellent!
Yes, Brenda, you could. You don't say what stage your OC is. Certainly if it is stage 3 or 4 then it is probably well worth trying, to prevent relapse, as long as there is no contra-indication in your medical history - best to discuss with your GP or oncologist. If you are stage 1 or 2, then it is really up to you. I am not an OC expert, but I understand stages 1 and 2 have much less risk of relapse - your oncologist will tell you what your risk is. The thing is if you start taking aspirin/ibuprofen it is probably necessary to take it for the rest of your life, and so you need to weigh up the pros and cons.
I suggest you take a look at my other blog for references, if you haven't already.
To add to what I said there, as I said before, there is some doubt (as per cancer research uk website) what the best dose of aspirin is, 75mg daily or 150mg daily. Personally, if I were taking aspirin instead of ibuprofen, I think I would go for the 150mg dose to be on the safe side, though you can judge for yourself from reading the evidence. It is still a small dose, and should be taken with or just after food, preferably a meal, eg breakfast. The enteric-coated 75mg aspirin tablets might be best in that case, to protect the stomach. Do discuss with your GP or oncologist.
All this information seems to be pointing the finger at inflammation being a culprit in the spread and re-occurance of tumours and that in dampening down the the natural inflammatory response in our bodies can slow it down.
I guess that cheap off the shelf anti-inflammatories like aspirin/ibuprofen and natural products curcumin etc are not "money making oportunities" and thus the initial investment required to carry out major trials is not done for this reason. But certainly there are products that can help and supplement existing treatments out there that are often overlooked or brushed aside. Not trying to sound cynical of Big Pharma, but their profits come first.
I quite agree with what you say about funding. I don't know about curcumin at all, but it is clear that aspirin and ibuprofen and similar non-steroidal anti-inflammatory drugs have an anti-cancer effect. And Big Pharma is not interested, as no profit in it for them. Very predictable, but very disillusioning. I just wish our oncologists could do more about this.
Eileen......Hi again, well with your information re ibrufen, I went to see my oncologist. I am in Berkshire.... And she has prescribed the 400 mg three times a day along with omeprazole 20 mg.... Easy as that first dose went in today.......
When diagnosed last Xmas (with 3C Probably more like 4c as metastasised in 3 places) I read Dr David Servan-Schneider book... Anti cancer a new way of life? He talks a lot about inflammation and how cancer cells love inflammation..... He suggested anti inflammatories for longevity... Great book I learnt such a lot from him, about diet, environment , lifestyles etc
He says if inflammation markers are below 12 ( I think from memory) there was more chance of longevity. Mine at the time were 135! So I started taking volteral and the next time they took blood I asked them to check my inflammation markets CRP and the reading was 4!!! I was so pleased.... Food for thought girls luv gill x
Thanks, Gill. That is very good news that your oncologist has prescribed ibuprofen and omeprazole. Hope others will follow her example. Interesting about the book too. Hopefully we are getting somewhere. I wrote a few days ago to Lord Saatchi in the House of Lords about aspirin and anti-inflammatories in ovarian cancer and PPC, and about my blogs. He has a bill introduced in House of Lords, asking oncologists to be more innovative, as his wife died of PPC (primary peritoneal cancer, related to OC) in 2011, and he is very keen for new treatments to be tried out for cancer, as things seem to move on so slowly. So I hope to hear from him.
Thanks again. Good luck. Best wishes to you and everyone.
Many thanks for your encouraging information regarding taking Asprin or Ibroprofen to keep OC or PPC from recurring.
My Mum was diagnosed with stage 3C in June 2011 at the age of 60. She had 6 cycles of Carbo/Taxol after complete debulking and temporary colstomy. She was put in remission Dec 2011 with a CA125 of 11. In June 2012 she was due to have her colostomy reversed. She had CA125 taken, CT scan and there was no trace of a recurrance.
However, during the operation the surgeons noticed some peritoneal seeding - she was stitched up (no reversal) and given the bad news that the beast had returned upon awakening!!! Only a rubbish 7 month remission! Following 6 cycles of Gem/Carbo her CA125 dropped steadily throughout and ended up at 13... End of term scan 3rd Dec 2012 showed that the cancer had shrunk by 50% but there was still some visible trace on her peritoneum but it was inactive - she was put back in remission again!
She was really poorly over Christmas with a horrible Flu/Chest Infection which really knocked her for six and she still isn't 100%. Her abdomen aches from endless coughing but at the back of her mind know she's thinking that "its" making its return... She went for her 6 week check up on Monday this week, her onc examined her thouroughly and said that nothing was giving her any cause for concern, however when the blood results came back they'd had a dramatic rise from 13 to 108 in just 6 short weeks... As you can imagine were all really shocked and hope to god that the rise is due to the illness she's had and not a recurrance! The nurse did mention that the CA125 can rise due to infection/inflammation etc...
She's now due for another CT Scan and bloods to be taken on 24th Jan with results 28th Jan. Yet another week worrying.....
I have forwarded your information on to her and have suggested that she talks about taking either ibroprofen or Asprin with her Onc on the next visit. As you say such a cheap drug and sooo worth a go! She'd try anything to try and keep it at bay as know she's a lot of living to do yet.....
Many thanks for your research and your time..... I hope you continue your remission!
Drdu can you tell me what dosage of ibuprofen you take per. day and also asperin. On my second line treatment now carbo./taxol and want to follow your lead when chemo. finishes. very kind wishes glad your doing so well Jenny xxx
Update. Had to come off ibuprofen, as had added in aspirin, which was silly, and got gastritis. Am now off both, and taking high dose omeprazole till my stomach heals. Was fine on ibuprofen alone, and should have stuck to it. I hope to be back on an anti-inflammatory soon, but only when I know my stomach is fully healed - so be warned!! My GP thinks I would be ok back on ibuprofen, but will probably go back on a different anti-inflammatory, safer on the stomach, for a few months - celecoxib. So BE WARNED BE CAREFUL.
Hi Can you tell mr what dose you take ?? I am taking it since I finished chemo at 700 a day then dropped it to 200 am not sure what is the right amount ?? Thanks Jane
Hi Dr. Eileen, thanks for this, I always point newcomers to your posts as I am sure you are right. I take Naproxen 500mg twice a day with meals for my aches and pains and am still in remission. I think I was very fortunate in that I had been taking it for tennis elbow and a painful wrist injury for 18 months before I was diagnosed at stage 1. My oncologist and GP are in agreement but would prefer me to take aspirin, however I find it irritates my stomach too much. Glad to hear you are well. x
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