Could daily doses of a fish oil extract and aspirin help stop pre-cancerous growths from developing in the bowel? That's what a study led by the University of Leeds hopes to find out.
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. If effective 'polyp prevention pills' could be found, then patients at risk of developing these pre-cancerous bowel nodules would need far fewer 'check-up' colonoscopies.
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, as researchers now intend to find out.
"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," said 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. Around 25 to 30 hospitals will be involved.
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," Professor Hull said.
"Our studies may also indicate which patients the drugs are likely to work in best - another step towards the current vision of personalised medicine."
The work is being financed by a research grant awarded by the Efficacy and Mechanism Evaluation (EME) programme, which is funded by the Medical Research Council (MRC) and managed by the National Institute for Health Research (NIHR).
Professor Hull and researchers from the Universities of Leeds, Bradford and Nottingham, and South Tyneside NHS Foundation Trust and Gateshead NHS Foundation Trust, will be working with doctors and nurses from the BCSP. The trial is being managed by the Clinical Trials Unit at the University of Nottingham.
For further information: Paula Gould, University of Leeds press office: Tel 0113 343 8059, email email@example.com
Notes to editors:
1. One of the UK's largest medical, health and bioscience research bases, the University of Leeds delivers world leading research in medical engineering, cancer, cardiovascular studies, epidemiology, molecular genetics, musculoskeletal medicine, dentistry, psychology and applied health. Treatments and initiatives developed in Leeds are transforming the lives of people worldwide with conditions such as diabetes, HIV, tuberculosis and malaria. www.leeds.ac.uk
2. The Efficacy and Mechanism Evaluation programme (www.eme.ac.uk) is funded by the MRC and managed by the NIHR Evaluation, Trials and Studies Co-ordinating Centre (NETSCC), based at the University of Southampton.
3. The NIHR provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. www.nihr.ac.uk
4. The Medical Research Council is dedicated to improving human health through excellent science. It invests on behalf of the UK taxpayer. Its work ranges from molecular level science to public health research, carried out in universities, hospitals and a network of its own units and institutes. The MRC liaises with the Health Departments, the National Health Service and industry to take account of the public's needs. The results have led to some of the most significant discoveries in medical science and benefitted from the health and wealth of millions of people in the UK and around the world. www.mrc.ac.uk
5. The NHS Bowel Cancer Screening Programme started being rolled out in July 2006 and achieved nationwide coverage by 2010. It offers screening every two years to all men and women aged 60 to 69, although the age range is currently being extended to include those aged up to 75. Men and women older than the age limit can request a screening kit by calling the freephone helpline 0800 707 6060. Bowel cancer screening aims to detect bowel cancer at an early stage (in people with no symptoms), when treatment is more likely to be effective. Regular bowel cancer screening has been shown to reduce the risk of dying from bowel cancer by 16 per cent.