Aspirin, from simple pain killer to all-rounder?
Ask someone to name a drug and chances are they will say aspirin. Like many drugs, aspirin is derived from nature. Around 2000 BC, various concoctions of willow leaves were used to treat the pain of inflamed joints . In 1763, the Englishman Edmund Stone described the pain relieving and fever-reducing effect of extracts of willow bark. In the course of time aspirin (acetyl salicylic acid) was developed from these extracts and eventually patented by Bayer laboratories. It came on the market as the painkiller Aspirin in 1899. Arthur Eichengrün was the inventor but Bayer attributed the discovery to his assistant, Felix Hoffmann. An independent (Scottish) investigation revealed that although Eichengrün was the inventor, Bayer had probably preferred not to name Eichengrün because of his Jewish background.. Chemical-pharmaceutical company Bayer is often cited as one of the major sponsors of Hitler and his National Socialism.
Analgesic, antipyretic and anti-inflammatory
There is some confusion about “aspirin”. Many people think that paracetamol is equivalent to aspirin. No, aspirin is aspirin, paracetamol is quite different. Paracetamol is a pain reliever that also has antipyretic (anti-fever) effect. Aspirin has analgesic (pain relieve) and fever-reducing effect but also an anti-inflammatory effect.
Side effects
Unlike paracetamol, aspirin has side effects such as indigestion, stomach aches, sometimes bleeding (esp. of the stomach) or bruising. This is a result of the blood-thinning effect. Because of this, many doctors prefer paracetamol for pain relief.
Aspirin for cardiovascular diseases.
Supplied as a painkiller, aspirin usually consists of tablets of 300 or 500 mg. However, it was discovered that the mild blood thinning effects of low dose aspirin (usually 30 to 100 mg), has a beneficial effect in the prevention of cardiovascular (heart and bloodvessels) disease. Aspirin inhibits the blood clotting abilities of platelets and so reduces the risk of a stroke or heart attack by about 40%. Aspirin is now prescribed worldwide to patients with cardiovascular disease to prevent stroke and heart attacks. Recent research (2014) showed that the best time to take aspirin is with, or after dinner because most cardiovascular incidents occur during the night. Unfortunately, many people still take their aspirin with breakfast or lunch. Low dose aspirin is not referred to as “junior” or “baby”-aspirin anymore as its use is not recommended in people under 16 years of age.
Aspirin and cancer
Over the years, it has been found that people taking low-dose aspirin because of cardiovascular disease, have a lower risk of getting certain types of cancer. This is explained by the fact that aspirin inhibits the clumping of platelets. Tumor cells often mislead the immune system by “hiding” in a small clot. Aspirin stops that process so that the tumor cells are recognized by immune cells and thus inhibiting the spread of cancer. Since then, many studies have been performed worldwide. It has now been found that patients on a low dose of aspirin, survived
cancers of the gastrointestinal tract twice as long compared to patients not taking aspirin. Prospective studies on the effects of aspirin in prostate cancer and breast cancer are currently being conducted. Preventative prescription of aspirin in healthy humans of 50-64 years of age would prevent 7-10% of these cases of cancer.
Is aspirin a new miracle cure for cancer? Placebo-controlled studies will have to prove it conclusively. For now, we know that aspirin appears to protect to some degree against cancers of the gastrointestinal tract (around 30%), and to a lesser extent also against breast cancer, prostate cancer and lung cancer (around 10%). As to the role of aspirin against other cancers, worldwide investigations are still ongoing. In the future, aspirin may well be a very useful, relatively safe and inexpensive addition in the treatment of cancer patients.
Aspirin for everybody?
The current debate is whether everyone over 50 years of age should start taking aspirin. Opponents argue that giving drugs to healthy people is undesirable and leads to “medicalisation” of society. Aspirin also has side effects, especially in people over 70 years of age.The risks of side effects (bleeding, especially of the stomach) is increased in people who smoke, drink a lot of alcohol or regularly take anti-inflammatory pain killers. Patients with asthma have a substantially increased risk of allergic reactions to aspirin. For these groups prevention with low dose aspirin seems less clear-cut. It can be argued that although aspirin may seem promising for cancer prevention, so is stopping smoking or losing weight when obese. On the other hand, if a proper cost-benefit analysis shows that a relatively harmless drug like aspirin results in a lower probability of developing serious illnesses, who can possibly argue against this form of medicalisation?
You are what you eat
More and more often we hear of the importance of healthy eating in the prevention of cancers. We should have more as well as a large variety of fruits and vegetables.We should incorporate olive oil, some oily fish, less meat and more excercise. More and more however, the health of our actual food is being questioned. The demand for food by the ever-increasing world population, means that food has to be produced in an industrial manner, using genetic engineering and pesticides, to achieve the highest possible yield. It has been repeatedly demonstrated that eating large amounts of fruits and vegetables is essential in a healthy diet. How do we balance this knowledge with the fact that pesticides, whose long-term health effects are not yet sufficiently known, get into our food chain. Some of these pesticides are carcinogenic (may cause cancer). Manufacturers deny this and authorities re-assure us, but many scientists have their doubts as to their safety.
At this moment, January 2017, a controversial and widely critcised mega-merger between two of the worlds largest companies involved in food production is awaiting approval by the authoities. One is a European chemical giant, the other the heavily contested US Monsanto, one of the largest seed and pesticide producers in the world. The company resulting from this merger will have a major impact on all aspects of our food supply and therefore on our health. The name of the European chemical giant? Right, Bayer.
Fortunately “unsere Freunde”, (“our friends”), also produce aspirin!
Dr J.O.L, updated January 2017
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