Can NSAIDs Prevent Melanoma?

April 06, 2011

By Alison McCook

NEW YORK (Reuters Health) Apr 01 - New findings add to confusion over whether taking aspirin, ibuprofen or related painkillers reduces the risk of developing melanoma.

Animal experiments have suggested that nonsteroidal anti-inflammatory drugs (NSAIDs) could play a role in preventing melanoma, but a large prospective study reported in 2008 failed to find any evidence to support this possibility.

Now, a smaller study that asked people with and without melanoma to recall their use of NSAIDs has found that taking these drugs - particularly aspirin - at least once a week for more than 5 years may have offered some protection.

The findings are interesting, but should not lead people to conclude that painkillers will reduce their risk of skin cancer, cautioned Dr. Maryam Asgari of the University of California, San Francisco, who co-authored the 2008 study.

"I think it's just too early" to say NSAIDs offer any protection, she said. "I think the jury is still out."

There's reason to hope NSAIDs might offer some protection against this type of cancer, however - earlier this year, a review found that people who use painkillers such as ibuprofen on a regular basis may be less likely to get bladder cancer. Other research has consistently supported the benefits of NSAIDs in preventing colorectal cancer, and provided some evidence they may work for breast, esophagus, and stomach cancers, as well.

Melanoma is the most lethal form of skin cancer, killing almost 9,000 people in the U.S. last year, according to the National Cancer Institute.

To investigate whether NSAIDs offer any protection, Dr. Clara Curiel-Lewandrowski of Harvard Medical School and the University of Arizona asked 400 people diagnosed with melanoma and 600 similar people without the disease to recall their use of the painkillers.

The researchers found that people without cancer had a longer history of taking NSAIDs than people who eventually developed melanoma. Specifically, more than 40% of people who were cancer-free said they'd been taking NSAIDs at least once per week for more than 5 years, versus only 28% of those who developed melanoma. Overall, regular use of NSAIDs for more than 5 years appeared to reduce the risk of developing cancer by more than 40%, the authors reported online March 10th in the Journal of Investigative Dermatology.

Unfortunately, the technique -- comparing people with melanoma to those without - is fraught with potential problems, said Dr. Asgari. For one, you have to get the comparison right, she noted; there's always a concern that people without cancer who agree to participate in the study may be more health conscious to begin with, and it's this that protects them from cancer, not their use of NSAIDs.

Her 2008 study analyzed data from nearly 64,000 people who were melanoma-free at the beginning of the investigation, then followed them for a few years to see who developed the disease. She and her colleagues found no evidence that taking NSAIDs had any effect on risk of developing the deadly skin cancer.

As a result, "I wouldn't recommend (taking NSAIDs to reduce melanoma) just based on this" new study, Dr. Asgari said.

SOURCE: http://bit.ly/hjf0o1

J Investigative Dermatol 2011.

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