The non-steroidal anti-inflammatory drugs (NSAID) include aspirin (acetylsalicylic acid, ASA). Long term use of NSAIDs is associated with a reduced risk of colorectal cancer (CCR), but the use is hampered by adverse effects. Understanding biological effects of NSAIDs may help developing new preventive medical strategies.
Colorectal cancer (CRC) is a major health problem worldwide. CRC is the third most common cancer and the one with the highest mortality in Western populations. The incidence is increasing due to demographical changes and due to the implementation of Western lifestyle in the developing countries. Lifestyle factors, including diet, are considered to be the main cause of CRC. High intake of red meat, animal fat, alcohol and smoking has been associated with increased risk of CRC whereas high intake of dietary fibres, fruit and vegetables, and physical activity are considered protective in relation to CRC.
Aspirin, the ester acetylsalicylic acid, was introduced in the clinic in 1899, being used as an analgesic, anti-inflammatory, antipyretic and an antithrombotic. Once in the organism, the acetylsalicylic acid is hydrolyzed to salicylate which is also active.
The analgesic and anti-inflammatory properties of acetylsalicylic acid are similar to those of other non-steroid anti-inflammatory. Acetylsalicylic acid is used in the treatment of numerous inflammatory and auto-immune reactions such as juvenile arthritis, rheumatic arthritis and osteoarthritis. Because of its antithrombotic properties, it is used to prevent or reduce the risk of transient ischemic heart disease and strokes. During the greater part of the 20th century, aspirin was only used as an analgesic, anti-inflammatory drug but after 1980, its properties for inhibiting platelet aggregations made it more widely used for this condition. More recently, it has been demonstrated that chronic treatment (more than 10 years) with acetylsalicylic acid reduces the risk of colon cancer. Today it is known that aspirin possesses antiproliferative properties.
Aspirin can bring on the following secondary effects:
- Stomach ache
- Stomach acidity
Some of the secondary effects can be serious. A doctor should be seen immediately if you have:
- Skin rash
- Inflammations of the eyes, face, lips, tongue and lips
- Wheezing (breathing with an unusual whistling) or difficulty breathing
- Increased heart rate
- Rapid breathing
- Damp, cold skin
- Whistling in the ears
- Loss of hearing
- Vomit with blood or looks like coffee grounds
- Bright red blood in the stools or black/tarry stools