Interactions of Aspirin and Hormonal Therapy in Men with Prostate Cancer

By Carol L. Kornmehl, M.D., FACRO

Prostate cancer is a common diagnosis in men, especially in the older population. Other medical problems, such as heart disease, are also frequent in this age group.

Hormone therapy is a helpful treatment for many men with prostate cancer and aspirin is protective for those with heart disease. Since many of these men are diagnosed with both heart disease and prostate cancer, it seems intuitive that they should take both aspirin and hormone therapy.

Hormone therapy reduces the blood level of testosterone, the male hormone that prostate cancer cells tend to thrive on. Aspirin, on the other hand, is a blood thinner that helps to prevent blood clots and heart attacks. In addition, hormonal therapy can raise a man’s risk of having a heart attack, so taking baby aspirin seems like a sensible approach to decrease this possibility.

However, a recent study published in the New England Journal of Medicine evaluated the finding of elevated liver function blood tests in men using both agents. The study included 206 men with localized prostate cancer who were enrolled in a clinical trial to compare the outcome of radiation therapy alone versus radiation therapy plus six months of hormonal therapy.

Men who completed six months of hormonal therapy were three and a half times less likely to die from prostate cancer than men who received less than the full course. When liver function tests were found to be elevated, the implication was the hormone therapy had to be discontinued until the tests normalized.

As it turned out, men who took aspirin were more likely to need to discontinue hormone therapy. Extrapolating from animal data, investigators inferred that the amount of aspirin that entered the bloodstream was magnified 100-times in men who received hormone therapy.

Whenever treating a person, medical doctors need to weigh the benefits and risk of their medical decisions. Therefore, a compromise appears to be the following: men who take aspirin for prevention can forego it for the six months of hormonal therapy. On the other hand, a man who absolutely needs aspirin will forego hormone therapy instead.

The good news is that by practicing holistic medicine, such as by looking at the whole man and not just his medical problem(s), physicians can make the best decisions that affect the prolongation of the person’s life.

Copyright 2008 by Carol L. Kornmehl. All rights reserved. No part of this article may be reproduced without express written permission from the author or

Dr. Kornmehl is a board certified radiation oncologist and author of the critically acclaimed consumer health book, “The Best News About Radiation Therapy” (M. Evans, 2004). She may be contacted via , her website.

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