Date Published: 5 February 2007

Cancer Researchers trial aspirin to help prevent cancer of the foodpipe

Doctors from around the UK are investigating whether the humble aspirin can be used to prevent cancer of the foodpipe – known as oesophageal cancer.

The drug is being used with an anti-ulcer drug to try to prevent a condition called Barrett’s oesophagus from developing into oesophageal cancer.

Barrett's oesophagus affects up to 2% of the UK population and is responsible for around half of all oesophageal cancers. Patients with the condition have stomach acid that rises from the stomach into the oesophagus usually causing frequent heartburn. The acid damages the cells in the lining of the oesophagus and in some cases they turn cancerous.

The Cancer Research UK funded trial aims to see if aspirin and the anti-ulcer drug can prevent this condition of the oesophagus worsening and its progression to cancer. The number of cases of oesophageal cancer has climbed quickly in recent years - increasing more than 10% over the last decade. There are over 7,000 cases in the UK every year. Deaths from oesophageal cancer are increasing as the number of new cases rises.

The trial is one of the largest cancer prevention trials in the world, now with 5000 men and women who have Barrett’s oesophagus being recruited for the trial from over 50 UK centres. Previously the trial was only open to men.

Professor Janusz Jankowski, lead researcher based in the department of clinical pharmacology at Oxford’s Radcliffe Infirmary, said:

" Only a small proportion of those with Barrett's oesophagus will develop oesophageal cancer but an increasing number of people in the UK are developing this cancer. Cases of oesophageal cancer are high in the UK compared to the rest of the western world, at three to four times the level seen in Europe or the US.

_ This research should provide us with valuable knowledge on how to prevent oesophageal cancer. Anyone who has Barrett’s oesophagus and would like more information should call 02070618355."

The researchers will use combinations of aspirin and a drug called esomeprazole to treat Barrett’s oesophagus. Aspirin is an anti-inflammatory drug and it is thought this property may reduce the chances of the Barrett’s cells to turn cancerous. Esomeprazole works as an anti-ulcer drug by reducing the amount of acid produced by the stomach. A high dose of esomeprazole may also minimise damage to the lining of the oesophagus and promote healing – helping to prevent cells becoming cancerous.

One of aspirin's side effects is an increased risk of stomach ulcers and it is hoped that esomeprazole will minimise this risk. People with Barrett's oesophagus are also more likely to suffer from heart problems - another area where aspirin has been shown to be of benefit.

Those who take part in the trial will receive one of four different combinations of the drugs for up to eight years: aspirin and a high dose of esomeprazole; a high dose of esomeprazole but no aspirin; aspirin and a lower dose of esomeprazole; or a lower dose of esomeprazole but no aspirin. Each drug is taken as a daily tablet.

Professor Janusz Jankowski added:

" The UK is at the epicentre of researching new ways to tackle this cancer. We hope these drugs will offer a simple method of preventing this particularly aggressive form of the disease.

_ We are at the crucial stage of recruiting men and now women with Barrett's oesophagus to this important trial. These people will not only get the best possible care, they will also help uncover key clues in the fight against cancer."

Professor John Toy, medical director at Cancer Research UK, said:

" Preventing cancer is a major focus for Cancer Research UK. This large trial may be the first step towards a way to prevent many cases of a cancer that kills over 7000 people a year in the UK. It’s an opportunity to reverse the trend and close the stable door before the horse has bolted."


Source: Cancer Research UK.

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