Aspirin Limits Prostate Cancer Therapy

Dec. 26, 2007 -- Men with prostate cancer may have to quit hormone therapy -- upping their death risk -- if they take aspirin, a small study suggests.

Regular aspirin helps many men avoid heart attacks and stroke. But it also takes a toll on the liver for some.

That's not a problem for most men. But men with prostate cancer often need hormone therapy to suppress the male hormones that speed the growth of their cancers.

The powerful drugs used to suppress male hormones include the anti-androgen drug Eulexin. Eulexin can be toxic to the liver. Doctors discontinue treatment if patients have abnormal liver-function tests.

Dana-Farber Cancer Institute researcher Anthony V. D'Amico, MD, PhD, and colleagues enrolled 206 men with high- or intermediate-risk prostate cancer in a six-month study. Half the men got hormone therapy including Eulexin, and half got radiation therapy alone.

Abnormal liver-function tests forced some of the men to quit Eulexin treatment before they could finish the six-month study. This happened to 37% of men taking aspirin, but only to 16% of the men not taking aspirin.

As it turned out, the men who got radiation therapy alone were 6.1 times more likely to die than men who finished six months of hormone therapy (and also got radiation therapy). Those who had to stop taking Eulexin were 3.5 times more likely to die than men who finished six months of hormone therapy.

It's not clear what would have happened to the men if they had stopped taking aspirin. But D'Amico and colleagues warn doctors that aspirin can make cancer treatment harder to tolerate.

The warning comes in a letter published in the Dec. 27 issue of the New England Journal of Medicine.