Originally published 12/11/2017
In one sense, the greatest cure for cancer is to keep it from happening in the first place. Your local drugstore may be the source of inexpensive products that help protect men against prostate cancer (PCa): non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, acetaminophen, etc. A review of 43 published papers on NSAIDs as PCa prevention lends support to the blog we posted in 2017. According to Shang, et al., the results of their analysis suggest “…a protective effect of the intake of any NSAIDs on the risk of PC, especially in those who took the NSAIDs for a long period.”[i] This was true for any long-term non-aspirin NSAID use (greater than or equal to 5 years), which resulted in 11.8% reduced PCa risk. As for aspirin itself, it appears to offer at least a 7% risk reduction, but it was the once-daily dose and not the duration that was linked with lower incidence of advanced PCa and PCa with a Gleason score ≥7.
The authors attribute the chemopreventive effects of NSAIDs and aspirin to their suppression of inflammation. Research demonstrates that chronic inflammation is a precursor for prostate cancer, especially high grade PCa. In a chronically inflamed environment, the body produces pro-tumor molecules as well as biochemicals that suppress the immune system’s response. NSAIDs and aspirin counteract this effect. The fact that common anti-inflammatory aspirin has value for PCa prevention appears to be true for other cancers as well. Check out our blog, “Aspirin Use and Cancer.”
Finally, we want to draw attention to the latest (October 2021) revised recommendations regarding the use of low-dose aspirin as primary prevention for cardiovascular disease (CVD), as follows: “The decision to initiate low-dose aspirin use for the primary prevention of CVD in adults ages 40 to 59 years who have a 10% or greater 10-year CVD risk should be an individual one. Evidence indicates that the net benefit of aspirin use in this group is small. Persons who are not at increased risk for bleeding and are willing to take low-dose aspirin daily are more likely to benefit. However, for persons age 60 and older, the USPSTF recommends against initiating low-dose aspirin use for the primary prevention of CVD.” For more information, read the news story (USA Today).
A growing body of research is increasingly pointing to over-the-counter (OTC) medicines like ibuprofen and acetaminophen as protective agents against prostate cancer (PCa). I have previously written about the link between aspirin use and reduced PCa risk. Now, a new analysis of data from a French population-based study reveals that non-steroidal anti-inflammatory drugs (NSAIDs) without aspirin also lower the chance of developing prostate cancer.
The EPICAP study
The particular study from a French team is called the EPICAP (EPIdemiology of Prostate Cancer) study. It involved detailed records of 819 newly diagnosed prostate cancer patients (less than 75 years old) and 879 age-matched controls (no prostate cancer). Each patient and control was personally interviewed using a standardized questionnaire. The information that was gathered included “socioeconomic characteristics, personal medical history and drugs use, family history of cancer, diet, tobacco, and alcohol consumption, physical activity, and residential and occupational history.”[ii]
In addition, they were asked about the name, frequency and duration of any NSAIDs they had used throughout their lives. Details included why they used the drugs, and if they were prescription or OTC. For the PCa patients in the study, clinical factors such as PSA at diagnosis and Gleason score were obtained from medical records.
What the data showed
Once all the facts and figures were analyzed, the research time found that men who took one or more pills per day had a 62% lower risk of PCa compared with men who never used NSAIDs. In the group that used NSAIDs had a 51% less chance of developing higher risk PCa (Gleason 4+3 or higher).
Of special note is that the protective effect was even greater among men with a history of prostatitis. This group had a 79% decreased risk compared with non-NSAID users. Why is this important? It is now widely accepted that prostate inflammation can be a precursor of PCa. Therefore, it seems to be more than just theory that preventing or controlling prostate inflammation lowers the odds of PCa.
What does this mean for you?
Let’s start by saying what this does NOT mean for you! This study does not mean that you should take ibuprofen or acetaminophen every day if you don’t need it. There is no established standard of care suggesting that NSAIDs should be used as a daily preventive – for PCa or for anything else.
However, if you use an NSAID appropriately (as directed in the instructions) for relief of pain from headaches, muscle aches, injury, arthritis, etc., or the aches and fever of a viral or bacterial infection, you are also benefiting in terms of reducing any inflammation in your body at the time of use. This includes your prostate.
So you may consider keeping your preferred brand (or generic) of NSAID in your medicine cabinet. Meanwhile, if you have known risk factors for PCa (family history, ethnicity, exposure to environmental toxins, etc.) you should do the following:
- Talk with your doctor about screening, genomic testing, and the merits of using NSAIDs on a regular basis
- Have a baseline 3T multiparametric MRI (mpMRI) of your prostate at age 50, if not sooner.
Remember the age-old saying: An ounce of prevention is worth a pound of cure.
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.
[i] Shang Z, Wang X, Yan H, Cui B et al. Intake of Non-steroidal Anti-inflammatory Drugs and the Risk of Prostate Cancer: A Meta-Analysis. Front. Oncol., 23 October 2018. https://doi.org/10.3389/fonc.2018.00437
[ii] Doat S, Cénée S, Trétarre B, Rebillard X, Lamy PJ et al. Nonsteroidal anti-inflammatory drugs (NSAIDs) and prostate cancer risk: results from the EPICAP study. Cancer Med. 2017 Oct;6(10):2461-2470.
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
