Intended for healthcare professionals

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All you need to read in the other general journals

BMJ 2009; 339 doi: (Published 19 August 2009) Cite this as: BMJ 2009;339:b3350

N Engl J Med 2009;361:664-73

Aspirin holds promise as adjuvant treatment for colorectal cancer

Aspirin is known to prevent colorectal tumours, and in animal models it has been shown to prevent cancer growth and improve survival. A cohort study of 1279 health professionals with non-metastatic colorectal cancer, with nearly 12 years’ median follow-up, suggests that aspirin may improve colorectal cancer specific survival and overall survival. The effect was largely restricted to people who started taking aspirin after the diagnosis and to people whose primary tumours overexpressed the gene encoding cyclo-oxygenase-2 (COX-2).

Of the 549 participants who regularly used aspirin after they were diagnosed with colorectal cancer, 81 (15%) died from colorectal cancer during follow-up, compared with 141 (19%) of the 730 participants who did not regularly use aspirin after diagnosis (hazard ratio 0.71, 95% CI 0.53 to 0.95). Overall mortality was also reduced with aspirin (0.79, 0.65 to 0.97). The effect was stronger for people who did not regularly use aspirin before the diagnosis (0.53, 0.33 to 0.86). Importantly, aspirin use after diagnosis reduced mortality from cancer in participants whose primary tumour overexpressed COX-2 (0.39, 0.20 to 0.76), but not in the rest of the participants (1.22, 0.36 to 4.18).

The linked editorial (p 688) predicts that COX-2 expression may soon become a standard predictive biomarker and aspirin standard adjuvant treatment for colorectal cancer.

Weight lifting is safe for survivors of breast cancer with lymphoedema

Women who have recovered from breast cancer but are left with lymphoedema are usually advised to avoid lifting children, heavy bags, or other heavy objects with the affected arm. A trial tested the effects of twice weekly weight lifting for one year against the control group—in which participants were asked not to change their exercising habits—in 141 survivors of breast cancer with stable lymphoedema of the arm.

At one year, the change in the swelling of the arm and hand (primary outcome) …

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