Aspirin

Status: Trial Discontinued

Results: Not Helpful - No Response in Tumors

The conclusion of the study done for management of indicates was on Aspirin is not helpful enough for management of vestibular schwannoma (VS) also known as acoustic neuroma (AN) tumors.^{[1, 2]}

Given the risk of the side effects, individuals looking for control of tumors should consider other options.

Side effects of Aspirin include; rash, gastrointestinal ulcerations, abdominal pain, upset stomach, heartburn, drowsiness, headache, cramping, nausea, gastritis, and bleeding.^[3]

Aspirin for the chance of Vestibular Schwannoma (VS)/Acoustic Neuroma (AN) - Studies so far reveal best chance is tumor stability, not a reduction. Are the side effects with the possible chance of stability?

The over-the-counter medication (OTC) aspirin, includes both blood thinners and nonsteroidal anti-inflammatory agents which has been found beneficial to Vestibular Schwannoma (VS) tumor control in mouse trials. Common side effects for the use of aspirin of tinnitus, nausea/vomiting, dizziness, hearing loss, and kidney failure are also common effects of VS tumor growth, specifically from vestibular nerve and cochlear nerve damage, as well as brain tumor-induced migraines.

Aspirin use for Vestibular Schwannoma (VS) may be a good option for individuals who have NF2 but have not developed any nerve damage from existing VS yet and are looking to delay issue development before it occurs. Options this simple are the reason for confirmed proof of NF2 diagnosis if another family has NF2, or if other symptoms of NF2 are present.

While aspirin is an over the counter medication, discuss considering it as something to take with your doctor if considering it.

* Many prescriptions and supplements are known to have negative interactions with aspirin.

Possible Side Effects

• difficulty hearing
• tinnitus (ringing in the ears)
• easy bruising/bleeding
• thin blood
• gastrointestinal bleeding
• kidney problems (watch for change in urine color or amount of urine)
• persistent or severe nausea/vomiting
• unexplained tiredness
• dizziness
• yellowing eyes/skin

Sources

1. "COX2 expression is associated with proliferation and tumor extension in vestibular schwannoma but is not influenced by acetylsalicylic acid intake." Acta Neuropathologica Communicationsvolume 7, Article number: 105 (2019)
   https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-019-0760-0
2. MacKeith S, Wasson J, Baker C et al (2018) "Aspirin does not prevent growth of vestibular schwannomas: a case-control study." Laryngoscope 27(S 02):547.
   https://doi.org/10.1002/lary.27114
3. "Aspirin." WebMd. (Date Reviewed: 2018)
   Source: https://www.webmd.com/drugs/2/drug-1082-3/aspirin-oral/aspirin-oral/details
   
   Source Importance: Possible Side Effects.
   
   
4. Van Gompel, Jamie J., et al. "Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on Emerging Therapies for the Treatment of Patients With Vestibular Schwannomas." Neurosurgery (2018).
   Source: https://academic.oup.com/neurosurgery/article/82/2/E52/4764051 | Source: http://europepmc.org/abstract/med/29309638 | DOI: 10.1093/neuros/nyx516 Source Importance Q/A Discussion:
   "Question: What is the role of aspirin, to augment inflammatory response, in the treatment of patients with vestibular schwannomas?"
   "Answer: It is recommended that aspirin administration may be considered for use in patients undergoing observation of their vestibular schwannomas."
   
   
5. Kandathil, Cherian K., et al. "Aspirin intake correlates with halted growth of sporadic vestibular schwannoma in vivo." Otology & Neurotology 35.2 (2014): 353-357.
   Source: https://journals.lww.com/otology-neurotology/Abstract/2014/02000/Aspirin_Intake_Correlates_With_Halted_Growth_of.25.aspx | DOI: 10.1097/MAO.0000000000000189
   Source Importance Percentage of change of stability versus growth.
   
   
6. Hunter JB. "Vestibular Schwannoma Growth With Aspirin and Other Nonsteroidal Anti-inflammatory Drugs." (2017) https://www.ncbi.nlm.nih.gov/pubmed/28692590
   Source Importance: "While previous studies have suggested a relationship between aspirin usage and VS growth, we found no significant association in our series of 564 observed VS. Furthermore, there was no apparent relationship between aspirin dosage, non-aspirin NSAID use, and COX-2 selectivity with VS growth, presenting tumor diameter at presentation, or mean VS growth rate."
   
   
7. Vijayan, M. "Structure and interactions of aspirin-like drugs." Proceedings of the Indian Academy of Sciences-Chemical Sciences. Vol. 92. No. 4-5. Springer India, (1983). Source: https://link.springer.com/article/10.1007/BF02839150 | DOI: 10.1007/BF02839150
   Source Importance: mechanism of action of aspirin-like drugs, as anti-inflammatory.