Ibuprofen for Cancer?


Ibuprofen is a medication commonly used to reduce pain and inflammation, but a new study suggests its benefits do not stop there.

Dr, Marisa Bittoni & colleagues presented data from the Third National Health and Nutrition Examination Survey (NHANES III), an 18-year study following 10,735 adults that enrolled between 1988-1994 at the IASLC 17th World Conference on Lung Cancer.

“Overall, the team found that former or current smokers who regularly used ibuprofen were 48 percent less likely to die from lung cancer than those who did not use the drug.”

Surprising? Yes. New? Not really.

The research has consistently found that the ibuprofen may reduce the risk of death from other cancers as well.

Findings reported July 13, 2003 (13 years ago!) at the annual meeting of the American association of Cancer Research in Washington, D.C., from following nearly 81,000 women for four years indicate that..

“Using ibuprofen – a non-steroidal anti-inflammatory drug (NSAID) – on a regular basis for more than 10 years may decrease a woman’s chance by nearly 50 percent that she will develop breast cancer.”

Another review, from the Saskatchewan Prescription Drug Plan from 1981 to 1995, with over 29,000 women…

“NSAID exposure 2-5 and 6-10 years preceding diagnosis was associated with significantly reduced risks of presenting with a large tumour (> 5 cm diameter) or distant metastasis, but not regional lymph node metastasis. The use of NSAIDs may retard the growth of breast cancers and prevent distant metastasis.

(Br J Cancer 2000 Jul;83(1):112-20)

So Breast cancer too? Amazing…any other cancers?

Randall Harris, the study’s lead author and the co-director of the Center of Molecular Epidemiology and Environmental Health at Ohio State University, stated, “There’s too much converging and compelling evidence to deny the effects of NSAIDs, most malignant tumors, including colon, breast, prostate, and lung, appear to be inhibited by NSAID use.”

Just Ibuprofen? Or Aspirin too?

“We examined the association of prostate cancer and non-steroidal anti-inflammatory drugs (NSAIDs) in a case control study of 417 prostate cancer patients and 420 group-matched control subjects. Regular daily use of over the counter NSAIDs, ibuprofen or aspirin, was associated with a 66% reduction in prostate cancer risk.” 

(Oncol Rep 2000 Jan-Feb;7(1):169-70)

Is there more than just these few large studies, so we can feel confident about this conclusion?

“We comprehensively reviewed the published scientific literature on non-steroidal anti-inflammatory drugs (NSAIDs) and cancer and evaluated results based upon epidemiologic criteria of judgment: consistency of results, strength of association, dose response, molecular specificity, and biological plausibility. Sufficient data from 91 epidemiologic studies were available to examine the dose response of relative risk and level of NSAID intake for ten human malignancies. Dose response curves were fitted by exponential regression. Results showed a significant exponential decline in the risk with increasing intake of NSAIDs (primarily aspirin or ibuprofen) for 7-10 malignancies including the four major types: colon, breast, lung, and prostate cancer. Daily intake of NSAIDs, primarily aspirin, produced risk reductions of 63% for colon, 39% for breast, 36% for lung, and 39% for prostate cancer. Significant risk reductions were also observed for esophageal (73%), stomach (62%), and ovarian cancer (47%). NSAID effects became apparent after five or more years of use and were stronger with longer duration. Observed protective effects were also consistently stronger for gastrointestinal malignancies (esophagus, stomach, and colon). Results for pancreatic, urinary bladder, and renal cancer were inconsistent. Initial epidemiologic studies of malignant melanoma, Hodgkin’s disease, and adult leukemia also found that NSAIDs are protective. A few studies suggest that ibuprofen has stronger anticancer effects than aspirin, particularly against breast and lung cancer. Overexpression of cyclooxygenase-2 (COX-2) and increased prostaglandin biosynthesis correlates with carcinogenesis and metastasis at most anatomic sites. Preclinical investigations provide consistent evidence that both selective and non-selective NSAIDs effectively inhibit chemically-induced carcinogenesis of epithelial tumors.

Oncol Rep. 2005 Apr;13(4):559-83

So how DO these humble pain relievers accomplish this?

NSAIDS like Ibuprofen and Aspirin are anti-inflammatories. They inhibit the COX-2 enzyme that promotes inflammation…and inflammation is the basis of all chronic diseases of aging.

At first glance, cancer seems to have nothing in common with an inflamed knee or a raging fever. But research suggests that the same COX-2 enzymes that provoke pain, inflammation, and fever may have a role in certain malignancies. Here is some of the evidence to date. COX-2 appears to promote angiogenesis, the process that generates new blood vessels to support the rapid growth of tumors. COX-2 may also interact with various growth factors to stimulate the multiplication of malignant cells, and it appears to inhibit apoptosis, a natural defense mechanism that helps prevent runaway tumor growth by triggering cell death by suicide.

COX-2 is far from the only thing that contributes to the unrestrained growth of cancer cells, but experiments in test tubes and animals suggest that inhibiting COX-2 can prevent various chemicals from turning normal cells malignant. Similar research also suggests that tamping down COX-2 can slow the growth and the spread of existing cancers. The information about COX-2 inhibitors and human cancer is less complete, but scientists have already discovered that many of the most aggressive colon cancers have unusually high levels of COX-2, as do many prostate cancers. In addition, randomized clinical trials have demonstrated that COX-2 inhibitors help prevent people at high risk of colon cancer from producing colorectal adenomas, the benign polyps that give rise to nearly all colon cancers. In fact, the FDA has already approved celecoxib for patients with familial adenomatous polyposis, an uncommon genetic disorder that carries an extremely high risk of colon cancer.

So there is no safety concerns?

Unfortunately, nothing comes without risks, since Ibuprofen and Aspirin also inhibit COX-1, which among other things generate substances that protect the stomach lining. So always take with food, and avoid them if you have ulcers. NSAIDS also thin blood, so speak to your doctor before initiating daily use, especially if you are taking anti-platelet or anti-coagulant medications.

So what is “daily use?”

Most of us are aware of the recommended dose of 81mg for aspirin use daily, the dose used in most studies on aspirin.

Ibuprofen use in the studies has been considered 200mg daily, or at least twice a week. Again, speak to your doctor first, but don’t be surprised if your doctor looks at you funny if you say ibuprofen or aspirin inhibit cancer, very, very few are aware of this.

Why?

Because Ibuprofen and Aspirin are many, many decades old, generic, OTC, and cost pennies a day. Why would the drug companies want you to know this when they can charge $100,000 a year for a brand new, patented drug?


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