Common painkillers such as aspirin and ibuprofen may be tied with a lower risk of skin cancer, according to a new study
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen may help protect against certain types of skin cancer -- including melanoma, the most dangerous form of this disease.
Danish researchers analyzed medical records from northern Denmark over a period of nearly two decades and found people who regularly took aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) – especially at high doses – had a significantly lower risk of developing skin cancer over time, regardless of age or gender.
“Previous studies suggest that NSAIDs decrease the risk of some cancer types, especially colorectal cancer,” lead researcher Sigrún Alba Jóhannesdóttir, BSc, at the Department of Clinical Epidemiology, Aarhus University Hospital in Denmark told FoxNews.com.
“Also, some studies exist on the association between NSAIDs and skin cancer in specific, and they largely support a protective effect.”
“Our study had advantages in the methods used compared with previous studies,” Jóhannesdóttir added. “We were able to investigate various types and patterns of NSAID use in the general population, we used validated registry data, and we used reliable prescription data collected before cancer diagnosis instead of relying on patients recalling their use.”
The study
The new study hints at a possible link between NSAID use and skin cancer risk. It does not prove that a link exists or speak to how these medications may stave off skin cancer risk. Other studies have produced conflicting results. The findings appear online in the journal Cancer.
This study focused on the three major types of skin cancer: basal cell carcinoma, squamous cell carcinoma and malignant melanoma.
Approximately 13,000 cases of basal cell carcinoma, 2,000 cases of squamous cell carcinoma, and 3,200 cases of malignant melanoma were identified in the study, which were then compared to information, including prescription data, from approximately 179,000 patients who did not develop skin cancer.
People who filled more than two NSAID prescriptions from 1991 through 2009 were 15% less likely to develop squamous cell skin cancer and 13% less likely to develop melanoma than people who filled two or fewer NSAID prescriptions during the study period. Researchers only looked at prescription NSAIDs, not over-the-counter forms.
The effect was particularly strong among patients who took NSAIDs for seven or more years at ‘high intensity.’
“We were not able to determine the minimal daily or weekly doses needed,” Jóhannesdóttir said.
“However, we did find that the protective effect was greatest when used frequently and over a long time period (over 7 years). Other studies need to investigate details of minimal dose and length of treatment.”
While the results did not indicate there was a general reduced risk of developing basal cell carcinoma among NSAID users, there was evidence that these individuals did have a 15 percent and 21 percent reduced risk of developing the cancer on less-exposed areas of the body (other than the head and neck) if they took the pills over a long period of time or at a high intensity, respectively.
According to Jóhannesdóttir, NSAIDs may exhibit these protective effects because the medications work by inhibiting specific enzymes involved in inflammation (COX enzymes).
“Previous studies show that elevated levels of these enzymes are found in skin cancer and that they are involved in important steps of cancer development such as inhibition of cell death, suppression of the immune system, and stimulation of angiogenesis and invasiveness,” she said.
The difference for basal cell carcinoma patients may be explained by dissimilarities in the expression of COX enzymes. In addition, some NSAIDs can actually increase sensitivity to the sun.
“It is possible that this adverse effect or sun exposure itself outweighs the beneficial effects of NSAIDs at some sites and for some cancers,” Jóhannesdóttir said. “However, we could not examine the molecular mechanism behind our results.”
But...
However, while NSAIDs may be protective against skin cancer, it is important to note that the medications do come with certain risks that may need to be weighed against the potential benefits. Prolonged usage of NSAIDs has been associated with side effects such as kidney damage, stomach problems and excessive bleeding.
“Because there are also risks associated with the use of NSAIDs, we cannot give recommendations on NSAID use in general. As with all types of drugs, it is up to the patient and his or her physicians to balance benefits and harms,” Jóhannesdóttir said, adding that other studies need to look further into the association between NSAIDs and reduced skin cancer risk.
And even if the findings are confirmed in future studies, NSAIDs should never take the place of other skin cancer prevention measures, including regular use of sunscreen and wearing sun-protective clothing, says Zeichner. "The positive results from this study will hopefully pave the way for future research on NSAIDs and other ways to treat and prevent skin cancer," he says.
But "there is no safe way to tan," he says. "The only safe tan is the one you get from bottle of self-tanning cream." Importantly, "if you protect yourself from the sun, you won't need any preventive treatments."
Julie Russak, MD, agrees. She is a dermatologist in New York City. NSAIDs are known to help treat painful sunburns, but they do confer their share of risks when used for long periods of time, including bleeding and heart risks.
"Sunburns cause inflammation that may lead to the development of skin cancer," she says. "It is a parallel pathway."
Risks of NSAIDS
The analysis spanned studies including a total of more than 116,000 patients. Scientists looked at trials that had compared NSAIDs with other NSAIDs or placebo.
Of the drugs studied, they found that ibuprofen (sold as Advil and others) carries the highest risk of stroke, etoricoxib (Arcoxia outside the United States; not sold in the U.S.) has the highest risk of cardiovascular death, and rofecoxib (previously sold as Vioxx in the United States, but it has since been withdrawn) carries the highest risk of heart attack. For certain drugs such as celecoxib (sold as Pfizer's Celebrex), the cardiovascular risk appears to go up with dosage.
So...
While there appears to be some protective benefits from NSAIDS toward skin cancer, there also is a confirmed cardiovascular health threat of taking them. Remember, the skin cancer study found that ibuprofen and naproxen had the best results for limiting the incidence of skin cancers when taking in large doses for at least 7 years!
The cardiovascular risk incurred by the prolonged use of NSAIDS far outweighs the possible benefits of skin cancer protection, especially when ibuprofen carried the highest risk of stroke from the NSAIDS study! Of the NSAIDs examined in the trials, naproxen, the key ingredient in Aleve and other medications, was the safest. "This drug still carries cardiovascular risk, but perhaps not as much as others such as ibuprofen", experts said. That is a slight glimmer of hope, I guess.
I would say that shade, clothing and sunscreen are still the preferred methods of skin cancer prevention. I don't see that doctors will be recommending taking ibuprofen in place of the other prevention methods any time soon. It is worth watching for further research on the subject, though.
Sources:
http://www.foxnews.com/health/2012/05/29/common-painkillers-tied-to-lower-risk-skin-cancer/#ixzz1wHuRuxzD
http://thechart.blogs.cnn.com/2011/01/11/risks-of-nsaids-backed-in-new-study/
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