Posting in Cancer
What Holmes found was those breast cancer patients who reported they were routinely taking aspirin, usually a low-dose tablet for heart health, had fewer recurrences of the disease.
A lot of women are going to be excited, and rightly so, over a study just published at the Journal of Clinical Oncology indicating aspirin may impact survival rates from breast cancer.
(Bayer Leverkeusen, right, currently tops the table in the German Bundesliga. This does not mean they will win the title this spring.)
But the result also offers a teaching moment on how observations become treatments. It is a long and winding road.
The aspirin study is, for now, only an observation. Michelle Holmes and her Harvard colleagues looked at data from the Nurses Health Study, a population study of 238,000 nurses that began in 1976,
In that group 341 died of breast cancer, and 400 had a re-occurrence of the cancer, there or elsewhere. What Holmes found was those who reported they were routinely taking aspirin, usually a low-dose tablet for heart health, had fewer recurrences of the disease. There were similar results with other common pain relievers like ibuprofen.
Well, maybe. But maybe not.
What Holmes has found is a clue, an avenue for investigation. She admits she hasn't proven anything.
How much aspirin should be taken? When? How does this work? Does this work? Will this work with all sorts of people, or is this just one of those statistical anomolies you find in databases -- after all we're talking of just 400 metastatic breast cancers out of 238,000 people.
A hypothesis is just the start of study, not its end. Most observations like this don't pan out. But a few do. It would be great if this were one of the few. But caution is required.
Aspirin has side effects. Aspirin can wear away the stomach lining, leading to ulcers. It can cause nasal congestion. These risks are underappreciated. Justin Schwan writes that "aspirin may kill as many people as it saves."
The wellness fringe makes other claims against aspirin. These include deadening the nerves and "polluting the blood." I can't comment on those claims, but what's true is that aspirin is a drug and, like any drug, needs to be treated with respect, not popped like a chocolate whenever a news story says eat it.
A personal note. I am now nearly 10 years older than my father was when he had his first heart attack. At my doctor's recommendation I take an aspirin each day, alongside other drugs and supplements, and my doctor said yesterday my blood pressure is normal.
But is that because of the aspirin, or could the apple I'm eating at my desk have more to do with it? I don't know.
It is worth looking into, however. (Oh, and Leverkusen's unofficial nickname is "neverkusen," because like most hypotheses they tend to fail at the end.)
Feb 17, 2010
That is very profound but overlooked by many journalists and the general population. Too many other confounding factors that obfuscate any attempt at making a substantial conclusion. Experiments are controlled with defined and formal procedures. They must be replicable in order to compare data with other results and to validate the conclusion with the original hypothesis. Another area that is suspect is advertising but that consideration is either ignored or in the very fine print. Then, to protect liability, they say it is an opinion protected by First Amendment rights. Critical ability must be at a premium else many things around us would be much more suspect for their claims. Nice piece and enjoy your apple.