Aspirin: The Elixir of Life?

At last we have found the elixir of life, more or less. It is called aspirin.

Previous elixirs of life have, of course, proved illusory; the historian of Chinese science, and Maoist fellow-traveler, Joseph Needham, published a list of emperors who died poisoned by their supposed elixirs. Indeed, Maoism itself was once supposed to be an elixir of life. Here, for example, is something published during the Cultural Revolution:

Under the guidance of the great thought of Mao Tse-tung, the Mao Tse-tung’s thought medical team of the Chinese P.L.A. Unit 3125 treated 105 students of the Fuhsien School for Deaf-Mutes in Liaoning Province, enabling all of them to recover their hearing and speaking faculties. Now everyone of them can cheer “Long live Chairman Mao!” and recite quotations from Chairman Mao. After some training many can already sing The East Is Red and recite Chairman Mao’s “good old three” articles. This is a tremendous achievement gained in the upsurge of struggle-criticism/transformation of the great proletarian cultural revolution.

It turns out that the elixir of Maoism killed incomparably more people than the old superstitious emperors’ elixirs; so that now we are more modest in our hopes.

Three recent papers in The Lancet propose the benefits of low-dose aspirin both in the prevention of certain cancers and in their spread once they have developed. Professor Rothwell, of Oxford University, was the main author of all three papers, but this should not affect their validity or otherwise.

The first of the papers compared the rates of cancer deaths in those who took part in randomized controlled trials of daily low-dose aspirin to prevent cerebrovascular events (strokes). The risk of cancer death was reduced by something like 15 percent in those who took long-term aspirin. The longer the aspirin was taken, the stronger the protective effect.

In the second of the papers, the authors analyzed the effect of low dose aspirin on cancer metastasis (the spreading of cancer beyond its original site). The aspirin was also given in controlled trials to see whether it reduced the incidence of stroke; among those who were given aspirin and subsequently developed cancer, the chances of metastasis — a leading cause of death from cancer — was 36 percent lower than among those given a placebo and who subsequently developed cancer

In the last of the papers, the authors used a case control study to demonstrate that those who took low-dose aspirin (but not in controlled trials) were at lower risk of developing colorectal cancer than those who did not; aspirin also protected against the development of esophageal and stomach cancers.

Does this mean that those of us who have reached the age of cancer — the incidence of cancer rises with age — should all be taking low-dose aspirin prophylactically? There is no indubitably correct answer to this question, and it all depends on your scale of values. In the first trial, about 35,000 people had to take aspirin for five years in order that 100 cancer deaths were avoided. Would you take a pill daily for five years for a 1 in 350 chance of saving your life?

True, the tablet is a small one, but the papers did not set out to answer the question whether taking it daily for a long time resulted in any bad outcomes other than stroke and cancer. I, alas, shall not be taking it, though for purely personal and psychological reasons. I so detested the taste of aspirin as a child that I have only to think of aspirin to make myself feel really sick. My best friend, on the other hand, adores the taste of aspirin. Perhaps he is lucky. And aspirin is very cheap.