If you want to choose the top 10 legendary drugs that have changed human history, aspirin must be counted as one, and almost everyone has eaten aspirin.
The global production of aspirin is as high as 50,000 tons per year, and if they are made into 500 mg of tablets per tablet, they can be arranged in length enough to circle the earth 25 times!
Aspirin was first widely used as a antipyretic analgesic fever reducer, and during the Republic of China, aspirin advertising was many, specializing in the treatment of headaches, toothache, cold, cold and fever and other symptoms.
(Source: Network)
In 1971, scientist John Vane discovered that aspirin can reduce the risk of blood clots, and the role of aspirin in cardiovascular disease was first discovered.
(Scientist John Vame, who later won the Nobel Prize.) Source: Network)
Today, aspirin is the recommended drug for primary and secondary prevention in people at high risk of cardiovascular and cerebrovascular diseases, and can also be used to treat some special diseases: such as saving children with Kawasaki disease from inflammatory response, and for the treatment of diabetes and Alzheimer's disease.
More than 120 years after its birth, aspirin has once again become a rising star in the field of scientific research.
This time, it is because of anti-cancer: "the new favorite of anti-cancer" - aspirin.
(Source: giphy)
In the medical field, when a drug is included in the guideline recommendation, it means that the efficacy of the drug has a solid evidence base and is recognized by the medical community.
In 2016, the U.S. Preventive Medicine Task Force (USPSTF, U.S.) officially approved aspirin as a primary preventive drug for colorectal cancer [1].
(Source: giphy)
In fact, as early as 2009, The Lancet Oncology summarized the results of aspirin in preventing colon cancer and other cancers, but due to insufficient research data, the scientific community believed that aspirin was an anti-cancer drug, and there was still a lot of controversy [2].
In a sense, this has also become the starting point for aspirin to open the road to anti-cancer efficacy.
(Source: soogif)
Fortunately, the dawn soon came.
Two years later, The Lancet published an academic paper on aspirin, suggesting that long-term aspirin use could reduce the cancer incidence of hereditary colon cancer[3]; subsequently, the JAMA sub-journal (a sub-journal of the Journal of the American Medical Association) also demonstrated that aspirin has a therapeutic effect on colon cancer patients, and the mortality rate of patients taking aspirin is significantly lower than that of the group that did not take it [4].
One clinical study data after another is consolidating the evidence base for the treatment of colorectal cancer with aspirin!
Until 2016, aspirin became the recommended drug for the primary prevention guidelines for colorectal cancer. Aspirin has finally "become a daughter-in-law for many years" and officially entered the field of cancer treatment!
(Source: giphy)
A year later, scientists found that the clinical effect of taking aspirin after diagnosis of colorectal cancer depends on the tumor subtype, fortunately, the subtype with the best effect of aspirin happens to be the most common subtype of colorectal cancer, and the mortality rate is reduced by 40%[5]!
Many studies have demonstrated the role of aspirin in preventing cancer, taking colorectal cancer as an example, an article published this year in Ann Oncol shows that for colorectal cancer, the higher the dose of aspirin used, the greater the risk reduction: 100 mg per day, the risk of disease reduction is 13%; 325 mg per day, the risk of onset is reduced by 35%; 500 mg per day, the risk of onset is reduced by 50%.
That's right, eating 500mg of aspirin a day reduces the risk of colorectal cancer by 50%!
(Source: soogif)
In addition to dose, studies have shown that the longer you take aspirin, the greater the risk of colorectal cancer [6]. With 1 year of routine use of aspirin, the risk of colorectal cancer is reduced by 4%; after 5 years of use, the risk of developing the disease is reduced by 19%; after 10 years of use, the risk of developing the disease is reduced by 29%!
The anti-cancer effects of aspirin go far beyond colorectal cancer:
Researchers at the Mayo Clinic found that people who took aspirin had a significantly lower risk of developing cholangiocarcinoma [7].
At the Society of the American Association for Cancer Research (AACR), Ph.D. from Harvard Medical School proposed a 11 percent and 23 percent reduction in mortality in breast and prostate cancer patients taking aspirin [8].
Daily aspirin reduced the risk of esophageal and stomach cancer and a 35 to 50 percent lower risk of dying from these cancers [9].
(Source: giphy)
Speaking of which, someone has to ask:
Isn't aspirin a fever-reducing, analgesic, anti-inflammatory, cardiovascular drug? Why is it that "not doing the right thing" has the effect of anti-cancer?
The anti-cancer mechanism of action of aspirin is mainly from two aspects:
(Source: giphy)
The first is the anti-inflammatory effect.
What many people don't know is that chronic inflammation is precisely a huge accomplice to tumor development!
Medical inflammation refers to the process of the vascular system resisting damage, and the whole process is simply injury, anti-injury, and repair.
Inflammation promotes blood vessel growth, which in turn brings oxygen and nutrients to tumor cells, while free radicals are produced that further damage DNA [10].
(Source: giphy)
Aspirin fights cancer by controlling the development of inflammation!
The second is the antithrombotic effect.
If cancer cells want to spread from their original position to the whole body, they must find a way to break through the blood vessel wall, enter the blood circulation system, and after reaching the destination, then break through the blood vessel wall and invade the corresponding organ tissues, thus completing metastasis and spread [11].
(Source: giphy)
In this process, if many and many cancer cells are grouped together, the success rate of metastasis is higher, so the clever cancer cells "hold" the platelets with adhesion effect, pack themselves together with their peers, and quietly metastasize in the body [9].
(Source: soogif)
Aspirin inhibits the metastasis of cancer cells by inhibiting the activation of platelets, reducing the adhesion function so that cancer cells cannot "hold" platelet clumps.
Reading this, someone said—
Aspirin is so good, do you want to immediately forward it to your parents, grandparents, seven aunts and eight aunts?
Can I eat aspirin to prevent cancer?
Aspirin does prevent cancer, but only for people with the appropriate indications.
In 2016, the U.S. Preventive Services Task Force recommended aspirin as a guideline for primary prevention of colorectal cancer, explicitly stating that low-dose aspirin should be considered for low-dose aspirin for the prevention of cardiovascular disease and colorectal cancer in 50 to 69-year populations aged 50 to 69 years with a 10-year cardiovascular risk ≥ 10 percent and no increased risk of bleeding [4].
In addition to colorectal cancer, the anti-cancer effect in other fields is still being studied, and it has not yet been recognized by the scientific community, so it is not recommended to take medication to prevent it.
It is a medicine three points poison. All medications have side effects, and aspirin is no exception. Only when taken by the indication group, the benefits to the body are greater than the side effects.
Side effects of aspirin include gastrointestinal bleeding, allergies, and neurological symptoms such as dizziness.
One of the most noteworthy side effects is gastrointestinal bleeding. Because aspirin has the effect of resisting platelet coagulation, so for people with blood system disorders or excessive intake, there will be a risk of spontaneous bleeding, such as bleeding gums when brushing teeth, skin epidermal bleeding ecchymosis and other phenomena, the most dangerous is gastrointestinal bleeding, severe can be life-threatening.
In this regard, if you have a family member who is taking aspirin, you don't have to worry too much, and studies have shown that the cumulative gastrointestinal bleeding rate of those who take aspirin and those who do not take aspirin have a cumulative gastrointestinal bleeding rate of 7.8% and 6.9%, respectively, and there is no significant difference [12].
But in the end, it is still that sentence, aspirin is a medicine, not a nutritional product, and people who are not sick should not eat it!
It is important to discuss with your doctor the potential risks of using aspirin and its possible benefits, and then decide whether to take aspirin, especially if you have drug allergies, low thrombocytopenia, peptic ulcers and other diseases, you should consult your doctor carefully.
Aspirin has undergone a legendary evolution, the resume is still being updated, and it may be that one day in the future, aspirin will play a role in unexpected places.
In fact, why not just aspirin?
From the invention to the market, modern drugs often take more than ten years and cost more than one billion US dollars, but the listing is not the end, just a milestone.
Many old drugs are constantly creating new surprises, and the current terminal illness may be cured by a certain drug we know in the future, and science is always progressing in twists and turns, spiraling upwards.
(Source: giphy)
Review expert: Song Yongchao | The First Hospital of Hebei Medical University is a pharmacist in charge and a practicing pharmacist
bibliography
[1] Bibbins-Domingo, K. and U.S.P.S.T. Force, Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement [J]. Ann Intern Med, 2016. 164(12): 836-45.
[2] Cuzick, J., F. Otto, J.A. Baron, et al., Aspirin and non-steroidal anti-inflammatory drugs for cancer prevention: an international consensus statement [J]. Lancet Oncol, 2009. 10(5): 501-7.
[3] Antonoff, M.B. and J. D'Cunha, Killing two birds with one salicylate: aspirin's dual roles in preventative health [J]. Semin Thorac Cardiovasc Surg, 2011. 23(2): 96-8.
[4] Reimers, M.S., E. Bastiaannet, R.E. Langley, et al., Expression of HLA class I antigen, aspirin use, and survival after a diagnosis of colon cancer [J]. JAMA Intern Med, 2014. 174(5): 732-9.
[5] Hua, X., A.I. Phipps, A.N. Burnett-Hartman, et al., Timing of Aspirin and Other Nonsteroidal Anti-Inflammatory Drug Use Among Patients With Colorectal Cancer in Relation to Tumor Markers and Survival [J]. J Clin Oncol, 2017. 35(24): 2806-2813.
[6] Bosetti, C., C. Santucci, S. Gallus, et al., Aspirin and the risk of colorectal and other digestive tract cancers: an updated meta-analysis through 2019 [J]. Ann Oncol, 2020. 31(5): 558-568.
[7] Choi, J., H.M. Ghoz, T. Peeraphatdit, et al., Aspirin use and the risk of cholangiocarcinoma [J]. Hepatology, 2016. 64(3): 785-96.
[8] Yin Cao, Meir Stampfer, Walter Willett, Donna Spiegelman, et al. Long-term aspirin use and total and cancer-specific mortality [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3012. doi:10.1158/1538-7445.AM2017-3012
[9] Cuzick, J., M.A. Thorat, C. Bosetti, et al., Estimates of benefits and harms of prophylactic use of aspirin in the general population [J]. Ann Oncol, 2015. 26(1): 47-57.
[10] Murata, M., Inflammation and cancer [J]. Environ Health Prev Med, 2018. 23(1): 50.
[11] Lucotti, S., C. Cerutti, M. Soyer, et al., Aspirin blocks formation of metastatic intravascular niches by inhibiting platelet-derived COX-1/thromboxane A2 [J]. J Clin Invest, 2019. 129(5): 1845-1862.
[12] Bosetti, C., C. Santucci, S. Gallus, et al., Aspirin and the risk of colorectal and other digestive tract cancers: an updated meta-analysis through 2019 [J]. Ann Oncol, 2020. 31(5): 558-568.
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
*The copyright of this article belongs to Tencent Medical Code, unauthorized media reprinting is prohibited, and illegal reprinting will be investigated for legal responsibility according to law. Individuals are welcome to forward to the circle of friends.