Patients with Barrett's esophagus, a precursor to developing esophageal cancer, can benefit from aspirin therapy complemented with antacids.
In a new study presented at this year's American Society of Clinical Oncology annual meeting, physician-researchers take a look at patient data from Canadian and British hospitals.
The Findings
Over a median follow-up period of nearly nine years, the participants received either 20 or 40 milligrams of Nexium twice daily. The patients were then divided into groups that did and did not take aspirin. The researchers analyzed the results based on whether the patients had worsened symptoms.
Out of the 2,563 patient-participants, 313 developed cancer, worsened their Barrett's, or died. Researchers concluded that a high dose of antacid yields greater benefits than a low dose and that taking aspirin alongside showed 20 percent overall risk reduction.
"The bottom line is if you have Barrett's esophagus, you probably ought to be on high-grade acid suppression therapy, maybe with aspirin. The incremental benefit of aspirin was small but significant," said Dr. Richard L Schilsky, senior vice-president and chief medical officer of ASCO.
What Is Barrett's Esophagus?
Barrett's esophagus is a condition characterized by the changes in the esophageal tissues. People with gastroesophageal reflux disease or GERD eventually develops Barrett's esophagus due to chronic inflammation.
Although most patients with Barrett's esophagus will not develop cancer, a condition called dysplasia is precancerous, according to the American Society for Gastrointestinal Endoscopy.
Those who smoke cigarettes and drink alcohol have higher risks of esophageal cancer than those who do not. African Americans are also at risk of this disease, as well as white males with increased body weight.
Approximately 2 percent of the adult population in Western countries have Barrett's esophagus, but authorities said the disease could be underdiagnosed. About 80 to 90 percent of esophageal cancers are preceded by Barrett's esophagus.
Side Effects Of Aspirin Plus Antacid Therapy
Although the results of aspirin plus antacid medication in Barrett's patients show promise, experts said it is probably not safe to administer it almost immediately.
"Based on these data, we believe people with heartburn should talk with their doctor about their risk of Barrett's esophagus, but they should not self-medicate with these medications," said Dr. Janusz Jankowski, the deputy vice-chancellor at Royal College of Surgeons in Ireland and consultant clinical adviser for the National Institutes for Health and Care Excellence in the UK.
Dr. Jankowski noted that the treatment was generally safe and only 1 percent of the patients have experienced serious adverse events. Side effects include diarrhea, stomach bleeding, hemorrhage for people with hypertension, allergic reactions, and osteoporosis.
