Talk to Your Patients About Aspirin Therapy

By Karin Krisher

Asprin therapyLet’s begin with a fair warning. This post has nothing to do with supplements or Complementary and Alternative Medicine, except that it relates to something with which 100 percent of your patients are familiar: aspirin therapy. 

We’re bringing it up now because it’s in the news, and so often, that’s where patient concerns are generated. Advocating for or against aspirin therapy might be a little touchy, so instead, let’s just examine the facts. Familiarizing yourself with these ideas, theories and data will equip you to better answer patients’ questions when they arise, or to start the conversation yourself.

First, the most recent news: Two studies published last Thursday indicate that taking daily doses of aspirin can lead to reduced risk of cancer. The results of the studies are no less than staggering.

Writes Rony Carin Rabin for The New York Times, “One of the new studies examined patient data from dozens of large, long-term randomized controlled trials involving tens of thousands of men and women. Researchers at the University of Oxford found that after three years of daily aspirin use, the risk of developing cancer was reduced by almost 25 percent when compared with a control group not taking aspirin. After five years, the risk of dying of cancer was reduced by 37 percent among those taking aspirin.”

The second study found that over an average of 6.5 years, daily use of aspirin reduced the risk of adenocarcinomas by 46 percent. As the findings are hailed as promising and doctors the world over make points of recommending daily aspirin intake in preventative regimens, some are still taking pause. It is widely known that aspirin increases the risk of hemorrhagic strokes and gastrointestinal bleeding, so recommending it, as we mentioned, can be touchy.

Writes Rabin, “An analysis in Archives of Internal Medicine in January found that for every 162 people who took aspirin, the drug prevented one nonfatal heart attack but caused about two serious bleeding episodes.” It’s a matter, then, of weighing the risks and benefits for each patient. If a patient has a long history of colonic cancers in his or her family, perhaps aspirin would be overall beneficial rather than harmful.

If a patient is otherwise healthy with no family history of cancers, recommending daily doses of aspirin could be more detrimental than preventative. Generally, those that take daily aspirin now do so because their perceived cardio risk is greater than the risks of popping that daily pill.

When studies like this come around, many consumers get popping right away, without understanding the study itself or the risks associated with making those types of quick decisions. The Oxford studies, for example, were designed to determine aspirin’s effects on vascular disease, not cancer, though the summarized results don’t generally reveal that information.

Talking to your patients to assess the risks and potential benefits of an individualized aspirin regimen will allow them to make informed decisions. We still don’t know what the “right” amount of aspirin is, or how frequently that amount should be ingested to hit the Goldilocks zone of prevention—studies use anywhere from 75 mgs to 1200 mgs daily as control levels.

While some consumers might take negative comments on aspirin to heart and stop their daily doses suddenly, some might take the positive comments as fact and begin an unnecessary regimen on their own. Neither of these acts will be beneficial—guidance should be individualized.

Keep that in mind with every patient, and approach the conversation about aspirin therapy from an educational, but still exploratory, standpoint.