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An Old, Over-the-Counter Drug May Help Prevent Ovarian Cancer. How Old? Try 2,000 Years

October 4, 2018, 10:36 PM UTC

Hippocrates used it. As did Pliny the Elder—and then, too, Galen of Pergamon, perhaps the greatest physician-scientist of antiquity. Passed down from the Greeks and Romans, Sumerians, Assyrians, and Egyptians, the remedy drawn from the bark of a willow tree, was known to have extraordinary powers for reducing pain, swelling, and even fever. Pliny was said to have burned the bark and turned the ash into a paste, which he then used to remove corns.

In 1763, the good Reverend Edward Stone of Oxfordshire (who also went by Edmund), wrote a letter to the Right Honorable George Parker, Second Earl of Macclesfield (and, importantly, then, the president of the Royal Society), detailing the remarkable antipyretic powers of the substance, which he procured by drying willow bark for three months next to a baker’s oven and then pounding it into a fine powder.

(Fans of Monty Python will enjoy reading Stone’s original letter, which was published in the Royal Society’s Proceedings: “…About fix years ago, I accidentally tafted it, and was furprifed at its extraordinary bitternefs which immediately raifed me a fufpicion of its having the properties of the Peruvian bark.”)

A Frenchman named Charles Frédéric Gerhardt managed to synthesize the active chemical, acetylsalicylic acid—but never marketed it. Years later, though, a German chemist, working at Bayer, synthesized it anew. This time, in 1897, the 2,000-year-old natural remedy was reborn under the now-familiar name of “aspirin.”

Even then, it almost never made it to market. Colleagues at Bayer were more excited about pushing another drug synthesized at Bayer the very same year. (Called “heroin,” it was to be sold as a “cough remedy.”) Aspirin, though, ultimately survived the internal politicking at the company—and it’s a damn good thing it did.

Witness today, when not one, but two scientific papers published in the journal JAMA Oncology, unveiled yet more compelling evidence to support aspirin’s truly rare wonder-drug status.

In the first article, senior author Dr. Shelley Tworoger and colleagues, conducted a prospective analysis using data from 205,498 women followed over some three and a half decades in two ongoing epidemiological studies (the famed Nurses’ Health Studies I and II). In short, the investigators asked women about their use of aspirin and other non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) over time, and then followed those women to see who developed ovarian cancer.

The results are striking. Women who regularly (more than two times per week) took low-dose aspirin (under 100 milligrams) had a 23% lower risk of getting ovarian cancer, the research team found. Ovarian cancer, which most often is a silent killer—progressing without notice in the body for years before it is caught—is the fifth-leading cause of cancer death among U.S. women. This year, according the American Cancer Society, an estimated 22,240 new cases of the disease will be diagnosed in the U.S., and 14,070 women will die from it. (For more, see the special section that begins on page 28 of the organization’s latest Cancer Facts & Figures.)

Notably, those taking standard doses of aspirin on a regular basis had no reduction in risk—and other types of NSAIDs, when used frequently, seemed to have an opposite effect to low-dose aspirin. “We actually saw a suggestion that there might be an increased risk with very long-term and high-frequency use of non-aspirin NSAIDs,” Tworoger, a senior researcher at the Moffitt Cancer Center, told me in an interview by phone this afternoon.

The study, importantly, builds on previous work Tworoger and others have done suggesting that aspirin might help protect against ovarian cancer—as well as the huge body of work showing that aspirin might play a similar chemopreventive role in the case of colorectal cancer, other malignancies—and, of course, in heart disease.

Now, add one more cancer to the list—at least tentatively. Also today (and in the same journal, as I mentioned), Dr. Andrew Chan and colleagues have published a study demonstrating that “long-term aspirin use appears to be associated with a reduced risk” of hepatocellular carcinoma, or liver cancer. Unlike the findings in Tworoger’s study, though, the measured risk reduction here seems to increase along with the dose consumed and the duration of use.

Importantly, any potential benefit for taking aspirin has to be weighed carefully against the potential for increased bleeding, which can be particularly risky in some people. So talk to your physician before taking this (or any) drug on your own.

“But to me,” says Tworoger, “one of the most exciting things about this finding, is that some women are already being recommended to take low-dose aspirin on a regular basis for the prevention of cardiovascular disease. Now there’s evidence that this could help prevent ovarian cancer.”

And there’s more evidence, too, that the world’s first wonder drug might be its all-time best.

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