Data suggest statins may lower prostate cancer risk

"In terms of safety, overall effectiveness, and price, there is probably no other prescription agent available today that has more pleiotropic effects and secondary benefits than statins," said Mark Moyad, MD, MPH, director of preventive and alternative medicine at the University of Michigan Medical Center (department of urology), Ann Arbor. "There is something about staying heart healthy that seems to impact our body on a number of levels."

Statins are the most prescribed drug in the world for reducing the risk of cardiovascular disease, the leading cause of death in men in the United States. (Prostate cancer is the second leading cause of cancer death.) Recent scientific evidence suggests that men who take statins to reduce cholesterol may also reduce their risk or the progression of prostate cancer, according to Dr. Moyad, who spoke at the International Prostate Update here.

Another study compared serum triglyceride levels in 504 men who had been diagnosed with prostate cancer with those of 565 men who had been diagnosed with BPH. The findings of this study showed a positive correlation (OR: 1.148 mmol/L; 95% CI: 1.003-1.315; p<.05) between elevated serum triglycerides and prostate cancer after correction for other factors (Prostate Cancer Prostatic Dis 2005; 8:316-20). These findings suggest that the factors that increase the risk of heart disease appear to also increase the risk of prostate cancer.

Preliminary data on statins have showed their ability to reduce the risk and aggressiveness of prostate tumors. A case-control study of 3,129 patients who were matched to 16,976 controls showed a 20% reduction in the risk (OR: .80; 95% CI: .66-.96) of developing any cancer if the patient had been taking a statin for 4 years or longer. However, a nonsignificant 63% reduction in risk was observed for prostate cancer (J Clin Oncol 2004; 22:2388-94).

"This study controlled for almost every single possible confounding variable you can imagine, making it the largest and best case-control study we've seen to date on cholesterol-lowering medication and its effect on prostate cancer," Dr. Moyad said. "The impact of lifestyle on heart disease and prostate cancer simultaneously cannot be ignored."

A large, prospective epidemiologic study involving more than 34,000 men who were taking statins over a 10-year period for cholesterol reduction also showed a 66% reduction in incidence of prostate cancer (Proc Am Assoc Cancer Res 2005; 46, abstract 4374).

In addition, statins have been shown to enhance the effects of conventional treatment in prostate cancer. One study of 905 men who were receiving radiotherapy found an 88.8% 5-year freedom from PSA recurrence among a group taking statins vs. 71.2% for men who were not taking the drugs (Int J Radiat Oncol Biol Phys 2003; 57:s271, abstract 1016).

Another study of 512 men who had been diagnosed with stage T1 to T3 prostate cancer and who had undergone brachytherapy showed 97% freedom from PSA recurrence at 8 years among those who took statins compared with 94.3% among men who did not (Urology 2006; 66:1150-4).

A recently published meta-analysis of 26 studies reported that statins have no effect on a number of cancers, including prostate cancer (JAMA 2006; 295:74-80). However, Dr. Moyad pointed out that only three studies in the meta-analysis pertained specifically to prostate cancer, and said the data from these studies were insufficient to abandon further research into the role of statins in reducing prostate cancer risk.