Aspirin Could Prevent Bile Duct Cancer

• Aspirin use could prevent bile duct cancer and gallbladder cancer
• Prolonged inflammation of the bile duct due to gallbladder stones and cholecystitis (inflammation of gallbladder) leads to carcinogenesis
• Aspirin has been found to reduce this inflammation

Aspirin is found to prevent gallbladder cancer which will help in reigning in this silent killer. Gallbladder cancer is one of the most common biliary tract cancer and is caused largely due to chronic inflammation of the bile duct. This form of cancer is seen most often in American Indians and South East Asian population. Gallbladder cancer develops without significant symptoms and is noticed only in the advanced stages, leading to fatality.

• Rate of survival is 6 months
• Only 5% chance of survival up to 5 years
• Gallbladder cancer is often detected when patients undertake surgery for cholelithiasis. This helps in early detection and treatment
• There are no clear markers for gallbladder cancers yet
• Gallstones increase the risk of developing gallbladder cancer

A population based study in China on the effect of aspirin consumption and the risk of gall bladder offers hope for protection against this disease. Enju Liu and colleagues studied 627 cancer patients out of which 328 had gallbladder cancer, 68 had ampulla of Vater and 191 had extra hepatic bile duct cancer. Individuals without cancer were selected as controls for the study.

The study subjects were subjected to an interview with specially trained interviewers. Information collected during the interview included whether the participant took aspirin at least twice a week for a period longer than one month, within one year of the interview.

The results of the study showed that:

• The use of aspirin showed a 63% decrease in gallbladder cancer.
• There was a 77% reduction in risk for gall bladder cancer among participants who currently used aspirin.
• Bile duct cancer and ampullary cancer risk were also lowered with the use of aspirin, however, the number of patients with these types of cancers was low.
• There was no correlation between the use of aspirin and bile stones.

A considerable proportion of study participants who had gallstones had gallbladder cancer (81%). The intake of aspirin was found to lower the risk of developing gallbladder cancer for patients who had gallbladder stones, though aspirin did not prevent the development of gallbladder stones.

Aspirin aids in preventing gallbladder cancer by controlling inflammation. Evidence for this is obtained from the fact that gallbladder cancer cells exhibit cyclooxygenase 2(COX-2), which is a marker for inflammation while normal cells do not. Nonsteroidal anti-inflammatory drugs (NSAIDs)are known to inhibit COX-2 enzymes, which is the mode of action of aspirin.

Another study published in the journal Hepatology correlates the risk of aspirin use and bile duct cancer. Bile duct cancer is a rare form of cancer and its symptoms include yellowing of the eyes and skin, itchiness and white stools. This study by Lewis Roberts and colleagues showed that people who took aspirin had 3.5 times lower risk of developing bile duct cancer.

Though prolonged use of aspirin has shown a reduction in gallbladder cancer and bile duct cancer risk, it cannot be used as a preventive medication for these cancers right away as further research is required to support these studies. However, the results from these studies are promising and people who consume aspirin for cardiovascular health may have additional benefits due to aspirin use.

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Currently, in India, few people regularly use aspirin, as aspirin is obtained over the counter as a medication for pain and for short term use. Additional research and further understanding of the mechanisms involved in cancer prevention may aid in promoting this drug in association with cancer prevention.

References:

1. Enju Liu, Lori C. Sakoda, Yu-Tang Gao, Asif Rashid, Ming-Chang Shen, Bing-Sheng Wang, Jie Deng, Tian-Quan Han, Bai-He Zhang, Joseph F. Fraumeni & Ann W. Hsing; "Aspirin Use and Risk of Biliary Tract Cancer: A Population-Based Study in Shanghai, China"; Cancer Epidemiology, Biomarkers & Prevention 2016.
   http://cebp.aacrjournals.org/content/14/5/1315.full
2. Gallbladder Cancer Epidemiology and Outcome
   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952897/
3. Gallbladder Cancer Statistics
   http://www.cancer.org/cancer/gallbladdercancer/detailedguide/gallbladder-key-statistics
4. http://www.cdc.gov/cancer/dcpc/research/articles/gallbladder.htm

Source-Medindia