Cancer patients who take aspirin could help reduce their risk of death by up to 20%, according to a recent review of 118 published observational studies of 18 different cancers from researchers at Cardiff University. 

Lead researcher Peter Elwood at Cardiff University has studied the effects of aspirin on cancer patients for more than 50 years.

There is a considerable body of evidence suggestive of about a 20% reduction in mortality in patients with cancer who take aspirin, and the benefit appears not to be restricted to one or a few cancers. Aspirin, therefore, appears to deserve serious consideration as an adjuvant treatment of cancer, and patients with cancer, and their carers, have a right to be informed of the available evidence.

The research identified that aspirin helps to cut the risk of death but also slows the spread of cancer (metastatic growth) within the body. They want to stress, however, that aspirin is not a replacement for traditional cancer therapy. The research began in 1974 when Professor Elwood and Professor Archie Cochrane at the Medical Research Council's Unit in Wales were the first to show that taking an aspirin tablet a day reduced deaths from heart disease and stroke by about 24%. At the time, approximately 100 papers were written about aspirin use. Today more than 1,000 publications about the effects of aspirin are published every year. 

There is always a concern when taking aspirin for additional bleeding as aspirin can act as a blood thinner. However, the study showed that although a small number of patients had experienced a bleed, there were no patients who died due to excessive bleeding. 

Does the research hold true in multiple myeloma? Dana Farber researchers (Catherine Marinac, PhD and colleagues) led a study of 567 myeloma patients who were diagnosed with myeloma between 1980 and 2021 in the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS). Participants in both groups took aspirin for two years on follow-up questionnaires beginning in 1986 in HPFS and 1980 in NHS.

After a median follow-up of 40 months, results were as follows:  

The results show that patients diagnosed with myeloma using aspirin had a lower death rate compared to patients not using aspirin (HR for MM−specific mortality of 0.55 (95% confidence interval [CI], 0.41, 0.73) and for overall mortality of 0.58 (95% CI, 0.45, 0.75). 

They noted an association between post-diagnosis aspirin quantity for both myeloma-specific and overall death rates.

In a subsample of 225 diagnosed myeloma patients with clinical data available, there was not a significant difference in clinical features of their multiple myeloma (examples could include levels of bone damage, m-protein levels, etc).

There was also not an observed association with the quantity or duration of aspirin taken prior to a myeloma diagnosis related to overall death rates. 

The reasons behind why aspirin is helpful are unknown. A recent article shared that aspirin lowers BLIMP1, ATF and CHOP in multiple myeloma, but more research is needed.

Many patients who use myeloma immunomodulatory drugs that can cause blood clots, regularly take aspirin. Perhaps such a simple tool may be helpful for all myeloma patients to improve our outcomes. As always, have these important conversations with your doctor before adding anything new to your treatment protocols.