Low-dose aspirin use does not seem to reduce the overall risk for prostate cancer death at the population level. However, results for extended exposure periods suggest that low-dose aspirin might be inversely associated with prostate cancer mortality after 5 years from cancer diagnosis. Findings from a nationwide cohort study are published in Annals of Internal Medicine. Recent studies suggest that aspirin use may improve survival in patients with prostate cancer, but study results are inconclusive.

Researchers from the Danish Cancer Society Research Center, Aarhus University Hospital, Copenhagen University Hospital, and University of Southern Denmark used nationwide registries in Denmark to assess the association between postdiagnosis use of low-dose aspirin and prostate cancer mortality. Their analysis did not find convincing evidence of an overall protective effect of low-dose aspirin for men with prostate cancer. However, they did find a reduced risk for prostate cancer mortality with low-dose aspirin use among patients with low Gleason scores, meaning that their prostate cancer was unlikely to progress, and among those who took low-dose aspirin for an extended period of time.

The authors of an accompanying editorial from Tampere University and Tampere University Hospital in Finland speculate that improved prostate cancer-specific survival among aspirin users with low Gleason scores might be explained by inaccurate tumor grading occurring less frequently in aspirin users than nonusers. Aspirin is an anti-inflammatory drug that lowers serum prostate-specific antigen levels; however, whether this leads to accurate determination of tumor aggressiveness in aspirin users remains to be determined in further studies, according to the authors. They suggest that future research evaluate aspirin exposures longer than those studied to date and investigate the effects of aspirin exposure on disease classification.

Low-grade PIN is not thought to be related to a man’s risk of prostate cancer. On the other hand, high-grade PIN is thought to be a possible precursor to prostate cancer. If you have a prostate biopsy and high-grade PIN is found, there is a greater chance that you might develop prostate cancer over time. PIN begins to appear in the prostates of some men as early as in their 20s. But many men with PIN will never develop prostate cancer.

In PIA, the prostate cells look smaller than normal, and there are signs of inflammation in the area. PIA is not cancer, but researchers believe that PIA may sometimes lead to high-grade PIN, or perhaps directly to prostate cancer. Some prostate cancers grow and spread quickly, but most grow slowly. In fact, autopsy studies show that many older men (and even some younger men) who died of other causes also had prostate cancer that never affected them during their lives. In many cases, neither they nor their doctors even knew they had it.

Prostate cancer begins when cells in the prostate gland start to grow out of control. The prostate is a gland found only in males. It makes some of the fluid that is part of semen. The prostate is below the bladder (the hollow organ where urine is stored) and in front of the rectum (the last part of the intestines). Just behind the prostate are glands called seminal vesicles that make most of the fluid for semen. The urethra, which is the tube that carries urine and semen out of the body through the penis, goes through the center of the prostate.

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