Aspirin and cancer trial doomed to failure?

Hailing it as the “world’s largest clinical trial to investigate whether taking aspirin every day stops the recurrence of some of the most common cancers”, the NHS and Cancer Research UK are taking more than 11,000 patients from 100 centres across the UK.

The study will run for 12 years and involves different groups taking different doses of aspirin

Somewhat bizarrely, the dosages will be 100 and/or 300 mgs.

What is odd about this is that the original discovery of the aspirin effect, John Vane (who won a Nobel Prize and a Knighthood for his efforts, showed clearly that the dose need be no more than 75 mgs. This research was confirmed by the Mayo clinic who felt the benefit came from a small dose (81 mgs).

Further large studies from Oxford University and The Radcliffe Hospital, and from the Francis Crick Institute in London have confirmed that aspirin can reduce inflammation throughout the body (a precursor to cancer), can greatly reduce cancer spread and increase survival times, and can even prevent the cancer from hiding from the immune system.

Prof Ruth Langley, the chief investigator at the Medical Research Council’s clinical trials unit at University College London, said: “There has been some interesting research suggesting that aspirin could delay or stop early-stage cancers coming back, but there has been no randomised trial to give clear proof. This trial aims to answer this question once and for all.

“If we find that aspirin does stop these cancers returning, it could change future treatment – providing a cheap and simple way to help stop cancer coming back and helping more people survive.

“But, unless you are on the trial, it’s important not to start taking aspirin until we have the full results, as aspirin isn’t suitable for everyone, and it can have serious side-effects.”

And this is a real problem. CANCERactive has consistently informed of the increasing research on the benefits of aspirin, but in the small dose size. Even then we have known patients develop serious side-effects like stomach ulcers.

We are extremely concerned that patients taking the higher 300 mgs dose especially will show a greatly increased risk of stomach ulcers, with the whole trial having to be curtailed.

We predict high levels of side-effects and publicity saying aspirin is dangerous, when at the smaller dosage it has already-proven significant benefits.

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Is Wikipedia misleading the public on health?

Wikipedia, the online encyclopedia, contains errors in nine out of 10 of its health entries, and should be treated with caution, say scientists in the USA.

The research covered in the Journal of the American Osteopathic Association stated that ‘Most Wikipedia articles representing the 10 most costly medical conditions in the United States contain many errors when checked against standard peer-reviewed sources. Caution should be used when using Wikipedia to answer questions regarding patient care’.

But then, the whole area of ‘volunteers’ ‘editing’ articles has been fraught with allegations of bullying, offensive comment to contributor writers and is, anyway, clearly open to bias and even misuse and abuse by people with agendas such as skeptics or pharmaceutical companies.

A spokesman for Wikipedia UK stated to the BBC that “Wikipedia can be edited by anybody, but many volunteers from the medical profession check the pages for inaccuracies”. Well, that’s all right then. And, of course, none of these volunteers have any links whatsoever to Pharmaceutical companies.

Entries for some areas of health such as Complementary and Integrative Medicine, even though written by scientists of competence, are known to have been sabotaged and altered by people with such agendas. This has received a great deal of negative comment on the Internet.

The American researchers in the study compared entries on Wikipedia on conditions such as heart disease, lung cancer, depression and diabetes with peer-reviewed medical research.

They said most articles in Wikipedia contained “many errors”.

Lead author Dr Robert Hasty, of the Wallace School of Osteopathic Medicine in North Carolina, said: “While Wikipedia is a convenient tool for conducting research, from a public health standpoint, patients should not use it as a primary resource because those articles do not go through the same peer-review process as medical journals.”

Yet, often when patients search for a health topic, Wikipedia is in the top two or three headings listed – it is the sixth most popular Internet site in the world. It is incorrectly read by many people with health problems as if it is some sort of consumer bible.

There are now even ‘clones’ of Wikipedia, like the Skeptic ‘gutter rag’ RationalWiki, which can feature totally subjective ‘articles’ using repeated 4 letter words and claims so wild they border on the false and defamatory. Readers looking for health information might easily mistake these clone sites for the real thing, making their quest for health even more difficult. It’s becoming a mess.

Wikimedia UK, its British arm, said it was “crucial that people with health concerns spoke to their GP first “.

Worryingly, Wikipedia UK claim that about 70% of physicians and medical students use the website.

Stevie Benton, at Wikimedia UK, said there were a “number of initiatives” in place to help improve the articles, “especially in relation to health and medicine”.

He said the charity had a project to bring together volunteer Wikipedia editors with a medical knowledge to identify articles that need improvement, find credible sources and make entries more “accurate and more readable”. Presumably this team will include practitioners in complementary medicine too. We can only hope. We can’t have the bias and errors being judged by more of the same, surely?

A couple of years ago it was announced that help was at hand – Wikipedia would be working with Cancer Research UK to review cancer-related articles by clinical researchers and writers to keep them accurate and up-to-date.

This may help with the accuracy, but it’s hard to know how that endorsement is going to make the Internet claims of bias go away.

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