Over-the-counter pain relievers may reduce the risk of breast cancer as much as 49 percent, according to a study spearheaded by an Ohio State researcher.
The study shows low doses of ibuprofen, brands of which include Advil or Motrin, can reduce the risk of breast cancer by 49 percent. Aspirin may reduce the risk of breast cancer by about 21 percent, while acetaminophen, or Tylenol, showed no decrease in risk.
"The idea that inflammation and cancer are linked together is nothing new. It's been around for decades," said Dr. Randall Harris, professor of pathology and lead author of the study. "But the proof is, I think, now irrevocable."
Harris said the effects were seen when women took one standard ibuprofen tablet - 200 milligrams - per day. One 325 milligram aspirin tablet was effective as well. Baby aspirin, on the other hand, was too low of a dose to achieve results.
Harris, who also serves as director of the Center of Molecular Epidemiology and Environmental Health at OSU, led a national team of researchers in compiling the information.
Data came from 80,741 postmenopausal women between the ages of 50 and 79 across the United States. It was collected by the Women's Health Initiative, a national organization that studies disease risk in older women.
Although the study hints that prescription drugs may be even more effective in blocking cancer, the majority of the study focused on over-the-counter medicines.
"One of the reasons that we can look at these effects is because so many people use these types of compounds for the treatment of arthritic conditions or inflammatory conditions, and they use them on a regular basis," Harris said.
The report also shows high-risk women, such as those who are overweight or have a family history of breast cancer, had results consistent with other women.
Harris said many other studies indicate ibuprofen and aspirin may also fight different types of cancer. Most of those studies focused on colon, lung and testicular cancer, as well as breast cancer. They all show a similar reduction in the incidence of cancer.
Harris has been studying the cancer-fighting effects of ibuprofen and related drugs since 1987. In that time, his studies and others have given clues as to how the compounds function in terms of cancer risk reduction.
The human body manufactures two types of cyclooxygenase, or COX genes, Harris explained.
COX-1 is a typical gene found throughout the body. COX-2, however, is present under special circumstances.
"The gene is normally a silent gene. It is turned on when we have exposure to inflammatory agents - bacteria, viruses, foreign bodies, radiation ..." Harris said.
He said the COX-2 gene initiates the inflammation response and is normally turned off when the response has run its course.
However, when COX-2 is not regulated it can start a chain of events leading to cancer.
"In cancer cells, for some reason, the COX-2 gene is turned on and gets stuck in the 'on' position," Harris said.
His studies stem from the realization that drugs like ibuprofen and aspirin block both the COX-1 and COX-2 genes. Blocking COX-2 limits inflammation and thus potentially reduces the risk of cancer. Tylenol, on the other hand, does not block COX-2, which could be the reason it showed no reduction in cancer risk.
Despite the positive results, it is too soon to recommend a dosage for women, Harris said.
"People always worry about the dose," Harris said. "And we worry about the dose too because higher doses are associated with gastrointestinal problems in a small frequency of patients."
Dr. Ernie Hawk, from the Division of Cancer Prevention at the National Cancer Institute, agreed with Harris.
"It's not the sort of study that would lead to a health recommendation," Hawk said.
He said a clinical trial is necessary, in addition to the survey data.
"It allows you to make more specific recommendations - dose, duration needed to see the effect, who would benefit and who wouldn't," Hawk said.
Hawk estimated a clinical trial for this type of breast cancer research could last five to seven years and cost around $100 million.
Still, Harris said the low dosage required to produce effects will have little effect on health. He saw results at doses as low as one pill twice per week.
"Adults over the age of 40 should seriously consider taking one of these compounds because the evidence is very compelling that they reduce the risk of multiple (cancers)," Harris said.
He said a person considering regular use of the drugs should contact his or her physician.
The study, published in the Sept. 15 issue of Cancer Research, took five years to complete.
The findings have generated international attention.
Harris received calls from New Zealand, Australia, Europe, Canada and from across the United States, said Joanne Beebe Donk, program manager at the Center of Molecular Epidemiology and Environmental Health.
"We were amazed by it," Donk said. "I think this is one of the groundbreaking releases on COX-2."
Both Harris and Donk agreed that such interest will benefit OSU.
"When you get this type of international recognition, it's a very strong reflection on the institution you represent," Donk said.
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