Thursday, March 14, 2013

Skin cancer risk down by a third in women who regularly take aspirin

There may be something in this.  Aspirin does seem to be widely  beneficial.

Aspirin could help protect women from skin cancer, a study claims.   Researchers found that the longer the painkiller is taken, the lower the risk of developing melanoma.

The study of data from almost 60,000 women over 12 years found that regular aspirin users were 21 per cent less likely to develop skin cancer than non-users.

But those who had taken it for five or more years were 30 per cent less likely to develop melanoma. Data for men was not part of the study.

Every year, around 13,000 people in the UK are diagnosed with malignant melanoma, and 2,200 die from the disease, which is thought to be caused primarily by intense sunbathing or frequent use of sunbeds.

Aspirin has been dubbed the wonder drug, with a recent study claiming that it cut the risk of stomach and bowel cancers by around 40 per cent in regular users. However, long-term use has been linked with stomach bleeds and ulcers.

The research of women aged between 50 to 79 was published in the Journal of Cancer and formed part of the Women’s Health Initiative – a major US investigation into links between lifestyle and the disease.

Study leader Dr Jean Tang said: ‘Aspirin works by reducing inflammation and this may be why using aspirin may lower your risk of developing melanoma.’  She said other painkillers, such as paracetamol, did not lower melanoma.

Ministers will this year consider whether some patients should be prescribed the drug as a preventative measure.

Aspirin has already been shown to be particularly effective against bowel cancer – one of the most common forms of the disease – particularly if patients have a family history of the illness.

It is an established treatment for heart disease patients because it helps prevent the formation of blood clots in the artery which can lead to a heart attack.  For this reason, it is already taken daily by two million UK angina sufferers.

Jessica Harris, of Cancer Research UK, advised caution, however. She said: ‘Aspirin has a range of serious side effects, and at the moment it’s not clear whether the benefits would outweigh the harms, what the right dose might be, or which group of people are most likely to benefit.’

Despite drastic efforts to improve diagnosis and treatment, Britain’s cancer survival rates still lag behind other countries.

Ministers estimated that 11,400 lives could be saved each year if our cancer survival rates matched those elsewhere in Europe.


The inconvenient truth about antibiotics

Doctors, patients and pharmaceutical companies must work together to tame the bacterial threat

When I’m not writing for The Daily Telegraph, I work for the pharmaceutical industry (or vice-versa, depending upon which employer is on the phone to me at the time). It’s difficult to know, sometimes, which is held in lower esteem by the public: newspapers aren’t exactly surfing the crest of a golden era, with the succession of Leveson-aired grievances. But tell people you work for “big pharma”, and depressingly – regardless of how many of them have had their lives improved by the medicines we research, license and sell – too many noses turn up. Yesterday’s news about the paucity of new therapies for antibiotic-resistant infections won’t help. “You make money out of illness” has felt at times the common, if unspoken, complaint.

Well, of course we do: make money, that is. Such income fuels the immense costs of research and development, the basic lab research and clinical development that produces new drugs. In the case of our health-care industries, that model has worked largely to society’s advantage, but the presence of profit doesn’t mean that those of us who work in such research aren’t motivated primarily by a very human mission. Our families acquire infections during routine stays in hospitals, too.

In the new fight against antibiotic resistance, we might learn from the past. I am of the generation of gay men that first confronted the reality of HIV, a virus that we thought would wipe us out. HIV remains a deadly threat, but the combination of refocused research and development, and an educated, activist population, led to the transformation of millions of lives: indeed, it led to the continuation of millions of lives.

A profitable drug industry – one of Britain’s last world-class endeavours – can work for the common good, as that fight against HIV demonstrates, so it is insufficient to lay the blame for the growing resistance of bacterial infections solely at industry’s door – which is not to say that industry shouldn’t change (again, as demonstrated by the retroviral breakthrough). That the threat from drug-resistant strains is real, and will have terrible consequences if not addressed, is not a matter of opinion. The Government’s chief medical officer, Professor Dame Sally Davies, is as right today to raise the danger of that growing resistance, and to demand that bacterial infections rise up the political priority list, as the health secretary, Norman Fowler, was to raise the stakes with viral infections in the Eighties.

The potential health-care crisis can be averted, but it will take a combination of players: big pharma, yes; but governments too (because their regulatory agencies, such as the US Food and Drug Administration or the EU’s European Medicines Agency, set the framework within which we operate, and license our medicines for sale); physicians (because the over-prescription of newer antibiotics in many countries is most probably driving the genetic mutations which lead to ever-more resistant strains; and although the evidence that prescription patterns across a community correlate with resistance within it is mixed, there is quite strong evidence to indicate that the more patients demand an antibiotic, the more likely their GP is to provide it); and farmers.

It beggars belief that American chickens are fed so many antibiotics. If livestock are prone to infection, then we might start by no longer rearing chickens in conditions so inhumane that we shudder to see images of them. The pressure for free-range animals shouldn’t be a middle-class fetish: 80 per cent of the antibiotics sold in the US are used to treat intensively reared chickens, pigs and cows. What’s more, American meat producers aren’t required to document and disclose how they use the drugs.

Regardless, the pharmaceutical industry is continuing to work on new models for R&D, to make antibacterial development more feasible, because the current requirements for such research are so burdensome that few players remain in the field. The EU’s Innovative Medicines Initiative – part-funded by industry – is bringing together major companies to target the development challenges.

Could we, for example, find a way to include data from previous clinical trials, when interpreting the results of the test of a new medicine? Regulators are cautious about such proposals – correctly so, since the use of such “historical controls” can occlude the interpretation of that new drug’s safety and efficacy profiles, upon which a licence to market a medicine is granted. But that challenge, though daunting, is not insuperable, which partly explains why yesterday I was reviewing the CVs of potential PhD students, who want to develop clinical trial methodology that would meet the needs of both regulators and drug developers. Find an acceptable way to maximise the power of existing data, and it could have a dramatic effect on the time required to get a new medicine to the market.

Patients have a role to play, too. When the doctor writes a script for an antibiotic, how many of us take only some of it – up until Friday night, perhaps, when it’s too much of a bore to avoid a drink? Or up until the point that our tummy feels a little queasy? Or until the symptoms diminish, even if doctor patiently underlined the importance of completing the course? How many of us demanded an antibiotic in the first place, when our physician’s opinion was that we didn’t have a bacterial infection?

If we – as physicians and as patients – continue with such behaviour, it will take more than a new clinical trial paradigm to save us. Listen to Dame Sally’s warning: this time, doctor really does know best.


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