[stann]

Aspirin and multiple myeloma

by stann on Tue Jul 01, 2014 12:50 pm

I have received different advice on taking aspirin.

Myeloma specialist says unless you have some obvious issues with ulcers or stomach bleeding, everybody should take a baby aspirin (81mg) once a day to prevent heart, stroke, and probably many other benefits (after age 50).

Regular oncologist says to not take aspirin. Says studies do not support what doctor above supports.

Platelets lower than normal but not bad ...150 or so.

Any thoughts?

I have always read that aspirin is the wonder drug.

Thanks, Stann

[Jonah]

Re: Aspirin and multiple myeloma

by Jonah on Tue Jul 01, 2014 1:11 pm

Hi Stann,

Are you taking Revlimid, thalidomide, or Pomalyst right now? If so, you almost certainly should be taking aspirin to reduce the chance of having blood clots in your legs and, even worse, a pulmonary embolism. Or, if not aspirin, something even stronger.

If you're just thinking about taking aspirin for your general health, then there are a couple of questions to consider.

First, are you at risk of having a heart attack anytime soon? If so, taking some aspirin regularly might be a good idea, since, if I'm not mistaken, aspirin is particularly recommended for people at higher risk of having a heart attack.

Second, do you have any risk factors for getting colon cancer? If so, aspirin may NOT be such a good idea, since some studies have shown, I believe, that regular aspirin use can (somewhat) increase your risk of colon cancer.

Third, could taking aspirin increase your risk of internal bleeding due to your lower platelet count? As I understand it, one thing aspirin does is reduce the tendency of platelets to come together to form blood clots. If you are at risk of having a heart attack, this is a good thing. But if you already have low platelet counts, then taking aspirin could increase the chances that you could experience internal bleeding as a result of blood not clotting when it should. This risk is something you probably should discuss in more detail with your doctors.

Finally, the big unanswered question is whether aspirin will have any effect on your myeloma. There has been some research lately to suggest that aspirin may have an anti-myeloma effect. There was this laboratory study which had that sort of finding,

"Aspirin inhibits proliferation and induces apoptosis of multiple myeloma cells through regulation of Bcl-2 and Bax and suppression of VEGF"
http://www.ncbi.nlm.nih.gov/pubmed/24766194

and here is a recent study that found that people taking aspirin had a reduced likelihood of developing multiple myeloma,

"Regular aspirin use and risk of multiple myeloma: a prospective analysis in the health professionals follow-up study and nurses' health study"
http://www.ncbi.nlm.nih.gov/pubmed/24282256

My general impression from having looked at this research is that most of the papers published in the last few years about aspirin and myeloma recently suggest that, as is the case in the above studies, aspirin tends to have an anti-myeloma effect.

Hope this helps!

[Stann]

Re: Aspirin and multiple myeloma

by Stann on Fri Jul 04, 2014 4:35 pm

Thanks Jonah for the nice answer.

I'm not on any therapy now. I started taking aspirin when on Revlimid. I stopped Revlimid last November and my internist told me to stop taking it. My myeloma doctor disagreed. All his reasoning was for things other than myeloma. Heart disease, stroke, reduced risk of other cancers. Some research shows risks of getting Parkinsons and Alzheimers are lessoned with daily low dose aspirin.

But, as you suggested, with moderate to low platelet numbers, is it worth the risk?

Here is a non scientific article that cites scientific studies on benefits of aspirin. Looks like a good thing to me ...

http://www.thedailybeast.com/articles/2012/03/22/can-taking-aspirin-once-a-day-reduce-risk-of-cancer-stroke-and-more.html

[Dr. Ken Shain]

Re: Aspirin and multiple myeloma

by Dr. Ken Shain on Sat Jul 05, 2014 9:51 am

You do not need it for your multiple myeloma. However, generally ASA [acetylsalicylic acid, aspirin] is not bad for you and has been associated with improvements in other disease states. However, it is not necessary, which may have been your PCP's point. If your platelets are less than 50, then there is a potential risk for increased bleeding issues while on ASA.

In this end, with ASA, it is up to you.

[stann]

Re: Aspirin and multiple myeloma

by stann on Sat Jul 05, 2014 3:10 pm

Thanks doc.