Statin drugs may lower prostate specific antigen levels

Statin drugs, used for the treatment of elevated cholesterol, appear to lower PSA values, according to researchers at the Duke University Prostate Center and the Durham, NC, Veterans Affairs Medical Center. But whether the drugs prevent prostate cancer growth or just mask it is still unknown.

“Our study represents a move to understand if and how statins influence prostate biology and whether they are really reducing cancer risk or simply making PSA a less effective screening tool,” said Stephen Freedland, MD, senior investigator of the study, published in the Journal of the National Cancer Institute (2008; 100:1511-8).

The team reviewed the medical records of 1,214 men who were prescribed statins between 1990 and 2006, excluding those who had prostate cancer. PSA levels declined by an average of about 4% after the men had started statins, compared with no decline in the year before they started the statins. The higher the PSA levels were initially, the more they were seen to decline.

“This is important because we had some men who started with PSA levels that looked to be headed in the direction of a recommended biopsy to look for prostate cancer, but they weren’t there quite yet,” said lead investigator Robert Hamilton, MD, a former Duke fellow now at the University of Toronto. “In a good proportion of these men, the PSA levels declined sufficiently to a point where physicians might not recommend a biopsy. It’s really important that we understand what’s at work here, so we can be sure we’re not missing cancers because of deceptively low PSA levels.”

The next step will be to further investigate the interplay between statins and prostate biology to determine whether their effect on PSA corresponds to, or is independent of, cancer growth.