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Could two simple pills help prevent bowel cancer?

21st September 2010

A new study funded by the MRC and managed by the NIHR EME programme, will investigate whether a daily dose of fish oil extract and aspirin can help stop pre-cancerous growths from developing in the bowel.

Bowel cancer is the third most common cancer worldwide, with over a million new patients being diagnosed each year. In most cases, the cancer develops from tiny, slow-growing nodules on the bowel wall, known as polyps, which can be detected and removed during a ‘colonoscopy’ camera examination. Doctors currently remove all polyps that they see because they cannot tell which ones will turn cancerous.

Like all invasive procedures, having a colonoscopy carries a small risk of complications. Although these complications are rare, cutting off polyps can occasionally cause bleeding or even leave holes in the bowel wall. Because of this, doctors want to find drugs or dietary supplements that can shrink existing nodules and prevent new ones from forming.

Previous studies have shown that a substance found naturally in fish oil known as Eicosapentaenoic acid (EPA) and aspirin can – each taken on their own - provide some protection against bowel polyps. Taken together, the protective effect may be even greater.

“A major advantage of EPA and aspirin is that they are both safe, have few side effects and they are already used widely by people who have heart disease or who have had a stroke,” says Professor Mark Hull from the University of Leeds who is leading the trial. “Other drugs that have been shown to prevent bowel polyps have been linked to an increase in heart attacks, so they are unsuitable for widespread use.”

The researchers plan to recruit around 1000 people from the NHS Bowel Cancer Screening Programme (BCSP) in England who have already had several polyps removed.

Some members of the study group will be given both EPA and aspirin. Others will be given just one of the drugs on its own together with ‘dummy’ capsules or tablets, whilst another group of people will only be given the pretend tablets. None of the people taking part in the study or the medical staff will know who is getting the real drugs.

Follow-up camera tests will be used to check how effective EPA and aspirin are at stopping new polyps from forming. Other tests will be carried out on blood, urine and tissue samples to learn more about how both agents work.

“If this treatment is shown to be safe and effective, then in future it could be given to more patients who have been found to have these pre-cancerous bowel polyps and are at risk of developing others in the future,” says Professor Hull.


 

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The Efficacy and Mechanism Evaluation programme is funded by the MRC and NIHR, with contributions from the CSO in Scotland and NISCHR in Wales and the HSC R&D, Public Health Agency in Northern Ireland. It is managed by the NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC) based at the University of Southampton.

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