Daily low-dose aspirin for a minimum of 5 years appears to have more
benefits than harms in terms of cancer prevention.

The review found reduced cancer incidence and mortality at doses
between 75 and 325 mg per day, starting between ages 50 and 65, with
longer duration of use appearing to confer the greatest benefits.

The researchers found substantial benefit in terms of colorectal,
esophageal, and gastric cancer incidence and mortality. Reductions in
breast, lung, and prostate cancers were more modest.

As expected, aspirin use was associated with increased risk for
bleeding events, but the cancer-prevention benefits outweighed this
risk.

-Annals of Oncology

The addition of three-dimensional breast imaging, to digital
mammography is associated with increased cancer detection rates,
compared with digital mammography alone, according to an industry-
funded, retrospective study in JAMA.

The authors note: “The association with fewer unnecessary tests and
biopsies, with a simultaneous increase in cancer detection rates,
would support the potential benefits of tomosynthesis as a tool for
screening. However, assessment for a benefit in clinical outcomes is
needed.”

JAMA article

High red meat consumption (1.6 servings per day) in early adulthood is
associated with a 22% increased risk for breast cancer, according to
longer-term follow-up from the Nurses Health Study II, published in BMJ.
Swapping out red meat for poultry or legumes one meal a day was
associated with significant risk reductions.

The authors conclude: “Consistent with the American Cancer Society
guidelines, replacement of unprocessed and processed red meat with
legumes and poultry during early adulthood may help to decrease the
risk of breast cancer.”

BMJ article

The American Society of Clinical Oncology has released three 
guidelines on treating problems commonly encountered by adult cancer 
survivors: chemotherapy-induced peripheral neuropathy, anxiety and 
depression, and fatigue. The guidelines are published in the Journal 
of Clinical Oncology.

To treat chemotherapy-induced peripheral neuropathy, clinicians may 
offer patients duloxetine. The group declined to make official 
recommendations on tricyclic antidepressants, gabapentin, and a 
topical gel (comprising baclofen, amitriptyline, and ketamine), but 
said they may be reasonable options in certain patients.

Patients should be periodically evaluated for depression and anxiety, 
and compliance with treatments should be assessed regularly. After 8 
weeks, if symptoms have not improved, clinicians should try a new 
approach.

Patients should be screened for fatigue at the time of cancer 
diagnosis and routinely thereafter, at least annually. They should be 
educated about ways to manage fatigue, such as through physical 
activity (150 minutes of moderate aerobic weekly plus two to three 
strength training sessions), cognitive behavioral therapy, and 
mindfulness-based approaches like yoga and acupuncture.