Attention stage IIIs! Celecoxib and aspirin use during adjuvant chemo...

[lpas]

I'm not sure if this was already posted but I don't recall seeing it, so am providing a link. New study finds significant increases in recurrence-free survival for stage III colon cancer patients who took aspirin or a COX-2 inhibitor (presumably Celebrex/celecoxib) during adjuvant chemo. For example, COX-2 inhibitor use was associated with recurrence-free survival rates of 85.6% vs 74.5% at five years. If I'm recalling correctly, those stats are even better than the added benefit of FOLFOX vs. 5FU alone.

While the use of celecoxib during adjuvant chemo is currently being studied in a large clinical trial, results aren't due for many years. The linked study was observational and looked at self-reported use by patients during an earlier study of 5FU alone vs. FOLFIRI, but it sounds pretty promising if you ask me. If you aren't taking one or both of these already, talk to your doctor!

http://www.medscape.com/viewarticle/837899

[radnyc]

I've been a regular aspirin user since diagnosis. Lots of studies say it can be a very powerful tool to prevent recurrence.

[testing765]

How much aspirin do you use?

[Mastan]

This maybe the basis for Dr. Lin's ADAPT therapy.

[NZJay]

Haha damn. Oh well, maybe if I draw a short straw in the next lifetime!
TBh that kind of annoys me, as I specifically asked my oncologist about taking any extra drugs (I specifically asked about aspirin) during chemo, and she told me absolutely not. That I should Only take what she prescribed me.

[lpas]

I don't think it's too late to benefit, Jay. You could still take baby aspirin. I really hate how some doctors are so conservative they refuse to consider anything outside the current standard of care -- no matter how promising. Call me a cynic, but I can't help thinking they'd be a lot more willing to look at new approaches for an **incurable** disease if they were the ones who were sick.

Testing -- I take 80mg of aspirin a day and 400mg of celecoxib.

[dontwanttobehere]

Thanks a million for this information. I go to chemo class Thursday and will definitely be asking about this.

[vilca11]

Lpas, I would be very careful combining aspirin (even the baby aspirin) with Celecoxib.... I remember warning that these two should not be taken together - they both are blood thinners and both could be responsible for stomach bleed. More is not always better... I would just stay on Celecoxib and discharge aspirin. Look into it. And thanks much for posting!
Hugs, Vilca

[rp1954]

We have to try to balance the chemistry, risks and benefits. Higher stages and higher risk factors, may make higher risk treatments considerations. Aspirin and celecoxib do have different capabilities, hopefully additive benefits and in some ways, balancing effects. Sometimes I think we hemorrhoidally strain at gnats off standard, while not equally considering so much more about iri-, oxi-, Avastin, stivarga and -tix/-tux.

We've both used 81 mg aspirin for 5+ years, and added 300-400 mg celecoxib for over two mCRC patient-years, as a careful necessity. Because of unimaged met activities, possible mutations, and complex chemistry, coagulation is somewhat unstable but somewhat responsive to oral chemistry changes, generic and mostly natural. We haven't gotten entirely satisfactory medical answers about how to best monitor coagulation, and simply monitor PT/INR, ESR and the liver panel, frequently. Also PTT, hsCRP, d-dimer and fibrinogen less frequently. Additionally we consider bruising and wound healing, especially oral wound healing, as important health indicators to be well maintained (super)nutritionally.

For gastrointestinal integrity, including the stomach, cabbage intake, zinc, niacin(amide), C, glucosamine and glutamine, are part of the regimen.

[horizon]

Interesting. I didn't take aspiring during chemo but I now take a daily baby aspirin.

[nicola smith]

With my oncologist's support, I took a daily baby aspirin during chemo. And I continue to take it. Furthermore, my oncologist takes it too.

[dontwanttobehere]

So I asked about this at my chemo class Thursday and doc said aspirin can be used to prevent CC but shouldn't be used during treatment as it can possibly interfere with chemo. I hadn't printed the article assuming he would know the latest and greatest. Apparently not so much. Here lies the delicate balance between trusting your doctor and being your own advocate. Obviously I want to be completely honest with staff about what meds I am taking. Should I "tell" them I am taking a baby aspirin a day or should I start up the conversation again. I printed this article now but do I look like a bossypants telling my doctor how to do his job??? Thanks! First chemo is Wednesday.

[nbrandt]

My Mayo Oncologist told me as a IIIC CC patient I was in the group most likely to recur. I prepared for the worst but hoped for the best. My research, this club and my local naturopath encouraged one 80 mg aspirin after I finished Folfox 12 treatments. I believe prayer, Mediterranean Diet, exercise, Vitamin D from the sun, and the aspirin helped me as I approach 5 year NED. Praying the next scan will be my last on Year 5 Sept 2015.

[dontwanttobehere]

nbrandt, thank you for that reply. That is exactly the type of info I was looking for. Did you get a rationale as well that you should not start with aspirin therapy until after Folfox? Also, I just started another thread about healthy choices; I'll see if you commented there and if not I may PM you. Thanks again!

[lpas]

So I asked about this at my chemo class Thursday and doc said aspirin can be used to prevent CC but shouldn't be used during treatment as it can possibly interfere with chemo. I hadn't printed the article assuming he would know the latest and greatest. Apparently not so much. Here lies the delicate balance between trusting your doctor and being your own advocate. Obviously I want to be completely honest with staff about what meds I am taking. Should I "tell" them I am taking a baby aspirin a day or should I start up the conversation again. I printed this article now but do I look like a bossypants telling my doctor how to do his job??? Thanks! First chemo is Wednesday.

You know, my doctor may think I'm a bossypants myself, but I feel very free to print out articles and take them to him when I find something relevant. If he's a good doctor, he'll be grateful to you for brining his attention to an important study that he may not have been aware of. I figure it's my life and I'm more concerned about staying alive to live it than I am about how I come off to my doctor, if that makes sense? I think you should talk to him again. If he has literature that backs up his concern about aspirin therapy interfering with chemo, maybe he can provide you with a citation. Good luck!