DoctorOz: Can Daily Aspirin Prevent Cancer?

Should you take a daily aspirin to prevent cancer? Aspirin, commonly used to treat pain, fever, and inflammation, now for the first time, is being recommended by a panel of medical experts as a means of preventing some forms of cancer. Aspirin is already used by nearly 40% of American adults over 50 for prevention of cardiovascular disease. Growing evidence shows daily low-dose use of aspirin could also be a potent weapon in the fight against gastrointestinal and colorectal cancer. Colorectal is the third most common cancer in the United States, claiming nearly 50,000 lives last year alone. But it's not without controversy or a quick fix. People needed to take aspirin at least 5 to 10 years to have the protection. And the recommendation isn't for everyone, which is causing even more confusion and questions, especially about risks and serious potential side effects. So, how do you know if you should be taking aspirin for cancer prevention? By the end of this segment, I'm going to give you the one question, the one question you need to ask about taking a daily aspirin. But first, I want to hear from the audience. If I can, if you're taking a daily aspirin or thinking about it right now, please stand. All stand up. A lot of folks standing. Let's start with you. Are you taking it yet or you're just thinking about it? Yeah, I've been taking it since 1997 because I have heart disease. You have heart problems in your family or you have it yourself? No, my sister, my father died from it. So, family history? Family history. How about yourself? Yes, I've been taking aspirin for the past three years because of hypertension, diabetes. So, my doctor put me on a regimen of aspirin every day. But again, you don't have any heart problems yet? No. But it's put on prophylactically because we know those conditions. You just mentioned high blood pressure and diabetes can lead to it. It's been out of control. So, he put me on a regimen. So, you're already on it. You feel pretty comfortable about it? No, because I suffer with acid reflux. So, I'm kind of wondering if it's still good to take aspirin or not. Come on over here. I got a little demonstration for you. Everyone have a seat, please. I'll come back to you in a second. So, there's some challenges and some controversies over most things we recommend. But an aspirin is particularly important because it's not without risks. And some of you may be aware of these, but I wanted to make it really come clear to a lot of folks. So, this is why experts are concerned. So, this honey represents, go ahead and pick that up, represents your blood. And it's sort of syrupy and, you know, it flows. Blood needs to flow. But the thing about your blood is if you were to be bitten by a saber-tooth tiger or more likely fall off your steps, right, you want the blood to clot. You don't want it coming pouring out of your body, right? You want to be able to protect yourself. That's the good news. The problem is if you happen to have a blockage of your artery, let's say that high blood pressure or that diabetes you have has led to damage, you don't want the blood to get stuck in the artery. That could cause a stroke or a heart attack, right? So, this isn't ideal then. So, what doctors learned is you could take an aspirin. Here, put that down. Take an aspirin. So, take that little hot water, if you don't mind. Add it to the jar of honey. It's heavy, isn't it? That's why I'm having you do it. See, I could have done it, but you would have said, God, Dr. Oz is so weak. He's got no energy at all. I mean, right? So, when you mix your blood with aspirin, I bet you want to taste that. I do, right? It's a great thing because if your blood's about to cause a heart attack, it's nice and loose. See how it's loose? But if you cut yourself or have a hole in your stomach like an ulcer or gastritis, the blood starts to come out of there. So, you end up having blood coming out when you don't want it to come out. Okay. So, again, you got two worlds here. You want to have a little too much looseness in your blood or you want your blood to be really sticky. It depends, doesn't it? Right. There are times you want one. There are times you want the other. And that's why this conversation has become so loud in America because we're all different. One size doesn't fit all. But when you understand this principle, you can decide what works for you. So, if you've got a stomach bleeding problem, you say you have reflux, but you haven't had ulcers yet, right? No, no. But if you were to get, let's say, gastritis and irritation and pain in your stomach, you wouldn't want that happening. I have had pain in the stomach. Oh, you have? Yeah. All right. Serious pain. Yeah. So, then maybe you want this, right? So, you got to figure out what risk works for you. I hope that's helpful, but I got an expert to help a bit more. Come sit down here. Thank you very much for your comments. I'll give you that jar of honey when we're done, by the way. Joining us now is gastroenterologist and core team member, Dr. Rashini Raj. She's a gastroenterologist, as I mentioned, and so she worries both about colon cancer, which is what the study was about, and the bleeding risks that I just showed up top. So, you were actually torn about this recommendation as an expert. I was as a gastroenterologist because, as you said, colon cancer prevention, I'm all about that. In my daily practice, I'm talking about it. I'm doing colonoscopies to really help prevent colon cancer. And when the task force came out with this draft recommendation, it was pretty significant. They're fairly conservative as a group, and they're talking about this recommendation. Now, it is based on science, so they're talking about over 130,000 patients followed for 32 years, 10 years of aspirin use did reduce the risk of colon cancer by 25%. So, that's pretty impressive. It's a big difference. It's a big difference, and we think, well, should we all be on it? It's cheap. It's easy to use. However, as a GI doctor, I see the other side of the coin, which are the side effects. Ulcers, you just mentioned. Gastritis, which is irritation or inflammation of the lining of your stomach. Being on aspirin will increase your risk of bleeding from these conditions or other types of bleeding. So, it's really, you have to weigh the risks and the benefits on an individual basis. How would the average person watching us right now decide if taking aspirin for that 25% reduction in cancer risk is worthwhile? You really have to determine, with the help of your doctor, are you at an increased risk, first of all, for heart disease or colon cancer? However, you also have to think about your risk of bleeding or all of those GI side effects. Do you have a history of ulcers? Do you have a history of gastritis? Are you on blood thinners, which are already thinning your blood, so then this will be another hit to your blood? A lot of things to consider to figure out which is the right decision for you. So, I promised the audience we would give them one question, one question that they had to ask. Once they have that answer, at least they'll be able to guide themselves in the right direction. What's the question? Very simple. You ask your doctor, should I be taking an aspirin to prevent colon cancer or heart disease? It sounds so simple, but the fact is many people never have this conversation with their doctor. Don't wait for your doctor to bring it up. You should bring it up, and that's the good thing that comes out of news like this. Even though it's somewhat confusing, it sparks that conversation, and that's when you're going to get the right information for you as an individual person. Today's show is all about how to take all the health information out there and know how to use it to make the best decisions for you. Now, to help, I wanted to bring in one of the greatest minds in medicine, and he's telling you what he wants you to know about cancer now. Dr. Siddhartha Mukherjee is here. He's a Pulitzer Prize-winning author and a world-renowned cancer researcher. He also happens to be one of my colleagues at Columbia. Welcome to the show again. Thank you. Breakthroughs, they happen all the time. I'm going to ask you straight up what everyone's always wanted to know from me. Are we making progress in the war on cancer? Enormous progress, progress every day, progress in prevention, treatment, and cure. Some cancers still remain a big obstacle, but for the most part, we're making progress every day, and there are new treatments, new prevention mechanisms, new cures coming along right down the pipeline. It's the most exciting part of medicine for most of us, and that's Wise Insights. Let's go through a couple of studies that have come out. A big one just came out that you may have read about this past week. The Mediterranean diet has been linked to a reduced risk of breast cancer. We know about the Mediterranean diet and heart disease. Why breast cancer? Why would you even expect that? Well, it's an extraordinary study. It's a very interesting study. It was a large study, almost 5,000 women, and they were randomized to diets. And a randomized study means it's a very powerful study. That means that there was no biases. And it turns out that the group of women who ate a diet rich in olive oil, particularly Mediterranean diet, did the best. They had the least rates of breast cancer. Now, it needs a lot of follow-up. We need to know whether these women actually have breast cancer that is significant, et cetera, so there's a lot of new questions. But at least preliminarily, it looks very positive. It wasn't just olive oil. It was healthy fats like nuts, which is what I like as well. So, again, we're going to learn more about this, but you're going to hear frequently insights about how diet can reduce chances of you getting cancer. It's something we actually haven't studied as much as we probably should have. All right, next, there's a new treatment that's been out there. A lot of folks have heard about this because someone very prominent has been receiving it. This treatment, you know, in the old days, we used to attack cancer cells with chemotherapy. This actually helps your body's immune system respond. It's called immunotherapy. Jimmy Carter, our past president, has melanoma, and he reported doing pretty well, apparently. Here's a kiss cam of him with his wife at an Atlanta Braves game. But he's been getting this therapy. So, even if you have metastatic cancer, which is what President Carter has, why is it that immunotherapy for melanoma has been so promising? Well, for many cancers, including melanoma, in the metastatic setting, cancer was present all over the body. It was very hard to treat those cancers with standard chemotherapy. You'd try to kill all the cells, but you'd get all the toxicities from chemotherapy. Now, the crucial change, or the big change here, is that immunotherapy teaches your own body to fight the cancer cells. And for some reason, we don't fully understand the reasons, but for some reasons, when cancers begin to grow in your body, they've already escaped the immune system. So, immunotherapy goes back and re-educates your body, re-educates your own immune system to try to now attack those cancer cells back and send them back into remission. You've got some compelling images. I show x-rays sometimes on the show, but this one really blew my mind. This is an image of somebody who had advanced metastatic cancer. And if you don't mind, Dr. Mukherjee, point out where the cancer is. By the way, intestinal system here. There's your backbone, your spine. Yep. So, this is one of the first patients who was treated with two immunotherapy drugs in combination. And here's her tumor. You can actually see it. It literally jumps out at you. You barely need any complicated equipment to see it. Large tumor now exuding out in this kind of chest wall area. And this is quite soon after she received those two drugs. Quite soon after she received those two drugs. And look at what's happened to that same tumor. It's shrunk dramatically. It's gone. Yeah. Profound remission. This was unheard of in melanoma. Really unheard of. Now, we don't know which patients will respond yet. We don't know for sure, if you will or will not respond, which tumors respond. But seems like an extremely positive, very promising area. It's like a dream. You couldn't take us out surgically or anything else. It gives everybody who has cancer, even advanced cancers, some hope. Yep. Just hold on, guys. Hold on, because we're coming up with solutions. All right. The laws of medicine. Uh-huh. There are a couple of them that Dr. Mukherjee has wandered upon. He feels they can help all of us gain control of our health. The first one is that a strong intuition is much more powerful than a weak test. That will help people understand how to do this. We've got a little experiment. So, Dr. Mukherjee, come over here. We're going to do this together. All right. It's a very simple experiment you do with a coin, right? A coin. It's a half dollar, right? So, go ahead and flip it. I'll throw it in my hand anyway. Maybe you beg. All right. So, what is it? It's a head. Heads. Okay. I'm going to flip it once, right? All right. Ready? Read it again. You see, it's heads. Okay? Now, here's the question. What are the odds it's going to be heads the third time I flip it? Who's got the – there's the mic. What did you say? Fifty-fifty. Still the same. Who agrees it's fifty-fifty? You agree back there it's fifty-fifty? Yeah. All right. I'm going to flip it. You ready? Ready. Fifty-fifty chance. Fifty-fifty. It's heads. Heads again. Yeah. That's three times. What is it this time? Dr. Mukherjee, you get to flip this time because I don't want them thinking I'm cheating. What are the odds that it's heads this time? I'm going to do it every – What are the odds? Fifty-fifty. Still fifty-fifty? Okay. Who doesn't think it's fifty-fifty? Everyone agrees. Okay. Flip it again. I flipped it. I turned it around in my head. Have this wonderful one. Look at it. Go ahead. It is? Heads. Heads again. Yeah. All right. What is the chance this fifth time it's going to be heads? Fifty-fifty. It's a two-headed coin. Now, Dr. Mukherjee, what is the point here? Have a seat and educate the audience. The lesson here is about intuition. I think this experiment illustrates a very important thing that we think about in medicine. You see, in medicine, tests never occur in a vacuum. Your doctor never thinks of you in a vacuum. He or she is always using what we know prior about you, what we know about you beforehand. Their intuitions about your health to make future decisions. Tests don't live in vacuums. They live in real life and they live with history. They live with the past. If I flip the coin again, what is it going to be? Use your intuition. I think I... Thank you for watching. Don't forget to subscribe and turn on notifications so you never miss out on new videos to live the good life.