Possible new recommendations on less Aspirin use

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plastikos
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Possible new recommendations on less Aspirin use

Postby plastikos » Tue Oct 12, 2021 11:30 am

https://www.nytimes.com/2021/10/12/heal ... troke.html

Hi all. Just saw this and wanted to share since I think a lot of us, myself included, take a baby aspirin daily. I think for now I’ll continue it. Any thoughts?
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roadrunner
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Re: Possible new recommendations on less Aspirin use

Postby roadrunner » Tue Oct 12, 2021 12:45 pm

For a cancer patient it’s easy, I think—consult with your oncologist. Cancer creates a hypercoagulable state, so the risk balance may well be different for us than the general population. I would want to be sure my oncologist is aware of this new guidance, but after that I’d weigh his or her advice heavily. To the extent you no longer consult with an oncologist, I think I’d go back to the last practice you worked with to get their view. This will be an issue for them.
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
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rp1954
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Re: Possible new recommendations on less Aspirin use

Postby rp1954 » Wed Oct 13, 2021 5:01 am

I consider the media howl likely part of the normal pincer movements to remove or restrict cheap therapies.

First, comes the academic cautionary notes to pose a problem, sometimes in some ignorant or cocked way, carefully avoiding solutions and inconvenient facts. Tsk, tsk, tut, tut. Then comes the tame media chorus, with their pharma advertising ever more financially dominant. Then comes a regulatory "solution" to restrict or remove the cheap therapy. This dance has been working beautifully, and very profitably, for decades. It's all part of how drug prices are jacked up 5 - 10 - 100x (or more) in the US.
---
Let's take the case of aspirin. Those of us who have survived the posited "initial risk period" are in the benefit cohort and they are not ready to mess with us - yet. First, cut off the new users, allow time to thin the herd then take additional steps. Personally, I think those who are "at risk" likely have nutritional problems from prior nutritional and medical misunderstandings, misadventures, known, knowable and/or undiagnosed risks. There is no "aspirin technical support system" to address minor problems, or fend off subtle competitive marketing attacks.

There are plenty of commercial adversaries that would be happy to see aspirin restricted or disappear, if not stick a knife in it by carefully doling discretionary funds out to hungry, ambitious academics or journalists and/or making good friends at NIH and FDA.
----
I definitely see ASA value for inflammation, clottiness - CV and CRC risk, I'm continuing.
I buy 1000 count, 325 mg aspirin bottles every decade or two, $6 - $10, I'm not worried about expiry.
Fractional aspirin probably nukes some cancer pathways, with both clottiness and PIK3CA relevant to CRC.
I'm worried about the ongoing corruption at the FDA against cheap generics.
Last edited by rp1954 on Wed Oct 20, 2021 9:41 pm, edited 3 times in total.
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itsfineimanurse
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Re: Possible new recommendations on less Aspirin use

Postby itsfineimanurse » Wed Oct 13, 2021 7:00 am

It sounds to me, like they are just dialing back the blanket use of aspirin. Obviously, if your provider recommends your taking aspirin you should continue. Always follow advice of provider vs random Internet article, even from The NY Times. As far as its being a big pharma conspiracy, I’d dial that back too. It reads more to me like they are saying not everyone needs to take an aspirin. I work with the elderly and have seen first hand the bleeding it can cause, it’s no joke. Ultimately, do what you and your provider deem appropriate.
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catstaff
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Re: Possible new recommendations on less Aspirin use

Postby catstaff » Wed Oct 13, 2021 12:01 pm

The new recommendations are against "preventive" low-dose aspirin use in people without diagnosed problems that NSAIDs might address. As itsfineimanurse says, this is particularly hazardous for older people due to the risk of bleeding. It also can interact with a lot of other drugs. Incidentally, an awful lot of "botanicals," e.g. curcumin, are also blood thinners and could interact with it. Some botanicals even contain salicylates (the natural precursors to aspirin, the name comes from the willow genus name Salix, which was the original source). Cinnamon contains coumarin, the precursor to warfarin.

The benefit for colorectal cancer, if any, is particularly murky and may rely on whether the patient's cancer has a particular mutation (which is fairly common but not universal). It seems to have no benefit as a general preventive. My husband was using aspirin for a while but had to quit due to some stomal bleeding, and we're not concerned he's missing anything right now.
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beach sunrise
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Re: Possible new recommendations on less Aspirin use

Postby beach sunrise » Wed Oct 13, 2021 1:45 pm

Priceless...eat what "we" feed you...
Noble lies. Aspirin has been around for 100 yrs or better. Use CFS!
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catstaff
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Re: Possible new recommendations on less Aspirin use

Postby catstaff » Thu Oct 14, 2021 2:59 pm

Aspirin has been around longer than that (developed in 1853) and its side effects are very well understood. There's a reason they keep inventing new NSAIDs; they are trying to reduce the bleeding risk (so far without much success). I personally take aspirin as needed and that's not controversial; taking it consistently in the hope of preventing something is what's problematic.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

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CRguy
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Re: Possible new recommendations on less Aspirin use

Postby CRguy » Wed Oct 20, 2021 8:20 pm

Just chekkin' in here with an IMO :shock: :shock: :mrgreen:

The CRC ( colorectal cancer ) and CVD ( cardiovascular ) issues are distinct.

I do NOT take 81 mg ASA for any CRC issues
I take daily 81 mg ASA for potential benefits for CVD issues

As for " bleeding issues " YES they are legit with regular ASA use and
it has the longest persistence of platelet inhibition of any NSAID
AFAIK
WHICH is in fact why it is used for CVD in coronary artery clot prevention

JMO

Cheers all
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
14 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

catstaff
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Re: Possible new recommendations on less Aspirin use

Postby catstaff » Thu Oct 21, 2021 7:37 pm

Platelet inhibition *may* be helpful for colorectal cancers since at least some of those seem to travel through the bloodstream with platelet "escorts" to protect them, but whether regular aspirin use would be the solution for that issue seems to be quite unclear and the side effects may outweigh any benefit.

The new guidelines were specifically for people who had no diagnosed cardiovascular disease who were just hoping to prevent it. DIagnosed CVD is a different situation, and aspirin use was still regarded as beneficial in that case.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-


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