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Statins Cut Prostate Cancer Spread, Early Studies Show

Breaking News - April 2005 - Week 3

(Apr 20, 2005)

Healthcare in  the News

-- The statins that many men take to lower their cholesterol may be giving them an edge in the fight against prostate cancer, according to a study presented at the American Association for Cancer Research annual meeting.

Picture of an elderly man with his golf clubs

Men who used the medications had about half the risk of advanced prostate cancer and a third of the risk of metastatic or fatal forms of the disease when compared to men who did not use those medications, the study found.

Prostate cancer is the leading cancer in US men, with more than 230,000 cases discovered each year and over 30,000 deaths resulting from the disease.

Good News About Statins, More Study Needed

While these findings are promising, the researchers stressed that more studies are needed to confirm the link and to determine exactly how statins might protect against prostate cancer progression.

Prominent urologists said they are intrigued by the possibilities.

"I think this makes perfect sense," says Dr. Peter T. Scardino, chairman of the Department of Urology at Memorial Sloan-Kettering Cancer Center in New York City and head of the medical center's prostate cancer program.

Around the world, he says, the percent of men at autopsy with cancer cells in the prostate is more or less comparable.

"But the risk of dying from prostate cancer differs dramatically: tenfold from country to country," according to Dr. Scardino.

The greatest risk, he says, is in the US and European countries; less developed countries and Asia have a lower risk. And, he notes, when Asian men migrate to the West, their risk increases.

Dietary fat is believed to be the culprit.

"Cholesterol is the building block of the male hormone testosterone," says Dr. William J. Catalona, director of the Clinical Prostate Cancer Program of Northwestern University's Robert H. Lurie Comprehensive Cancer Center.

Since statins lower blood levels of this fatty substance, there may be less of it available to synthesize testosterone and dihydrotestosterone, he explains. And that may reduce male hormones that stimulate prostate cancer.

The findings deserve further investigation, says Dr. Catalona, who pioneered use of the PSA (prostate-specific antigen) test to screen for the disease.

This study is not the first to show the potential cancer-fighting properties of statins. Prior population-based studies suggest those who take statin drugs are at a lower risk of breast, colon, and prostate cancers.

In addition, lab research suggests statins induce cancer cell death, inhibit the spread of cancer throughout the body, and suppress inflammation within cells.

Based on this evidence, lead investigator Dr. Elizabeth Platz, an assistant professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health, and her colleagues at the National Cancer Institute and Harvard University, followed 34,428 US male health professionals, including dentists and veterinarians, for more than a decade.

The men, who were cancer-free in 1990, were asked to report on their use of cholesterol-lowering drugs every two years. By January 2000, 2,074 men were diagnosed with prostate cancer. Of these, 283 were advanced cases, including 206 metastatic or fatal cancers.

Men taking statins had a 54 percent lower risk of advanced prostate cancer than men who were not using those medications, the researchers found. Statin users' risk of metastatic or fatal cancer was 34 percent lower than those not on the medications.

Statins Linked To Preventing Cancer Spread

However, statin use was not related to prostate cancer overall or to prostate cancer that was still contained within the prostate, Dr. Platz notes.

"Taking the findings together by stage of prostate cancer, we hypothesize that statins do not influence the development of prostate cancer, but that they may influence whether the cancer has the ability to invade and metastasize," she says.

Dr. Platz says it would be premature for doctors to prescribe statins to help their male patients avoid advanced prostate cancer, and urologists agree.

"Would I put a patient on statin drug just to reduce his risk of prostate cancer? No," Dr. Scardino says.

"I don't think there's enough evidence to recommend statins to prevent death from prostate cancer," adds Dr. Catalona.

So what can men can do to reduce their risk for prostate cancer? Reduce fat intake, eat more fruits and vegetables, and exercise regularly, physicians say.

"The best way we know is to live a heart-healthy lifestyle," Dr. Scardino notes.

Always consult your physician for more information.

For more information on health and wellness, please visit health information modules on this Web site.

Statins Defined

The National Institutes of Health states that there are currently five statin medications on the market in the US: lovastatin (Mevacor®), simvastatin (Zocor®), pravastatin (Pravachol®), fluvastatin (Lescol®), and atorvastatin (Lipitor®).

The major effect of the statins is to lower LDL-cholesterol levels, and they lower LDL-cholesterol more than other types of medications. Statins inhibit an enzyme, HMG-CoA reductase, that controls the rate of cholesterol production in the body.

These medications lower cholesterol by slowing down the production of cholesterol and by increasing the liver's ability to remove the LDL-cholesterol already in the blood.

Statins were used to lower cholesterol levels in several studies.

The large reductions in total and LDL-cholesterol produced by these medications resulted in large reductions in heart attacks and heart disease deaths.

Thanks to their track record in these studies and their ability to lower LDL-cholesterol, statins have become the medications most often prescribed when a person with heart disease needs a cholesterol- lowering medication, according to the NIH.

Studies using statins have reported 20 to 60 percent lower LDL-cholesterol levels in patients on these medications.

Statins also reduce elevated triglyceride levels and produce a modest increase in HDL-cholesterol.

The statins are usually given in a single dose at the evening meal or at bedtime.

It is important that these medications be given in the evening to take advantage of the fact that the body makes more cholesterol at night than during the day.

A person should begin to see results from the statins after several weeks, with a maximum effect in four to six weeks. After about six to eight weeks, a physician can do the first check of LDL-cholesterol while on the medication.

A second measurement of LDL-cholesterol level will have to be averaged with the first to so that a physician can decide whether a dose of medicine should be changed.

The statins are well tolerated by most patients, and serious side effects are rare. A few persons will experience an upset stomach, gas, constipation, and abdominal pain or cramps.

These symptoms usually are mild to moderate in severity and generally go away as your body adjusts. Rarely a person will develop abnormalities in blood tests of the liver. Also rare is the side effect of muscle problems. The symptoms are muscle soreness, pain, and weakness.

Always consult your physician for a diagnosis.

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