In a study published in late June/early July 2010 (in the journal Cancer) investigators report that men who underwent surgery for prostate cancer and had been taking a common cholesterol lowering medication (“statins”), at the time of surgery, were overall 30% less likely to have a recurrence of their prostate cancer than men who were not taking this medication.
On further analysis, the authors describe a dose response relationship in the amount of statin medications taken and the relative risk of cancer recurrence (i.e. the higher the amount of the statin, the lower risk of recurrence.) They found that in those patients who took and equivalent of 20mg of a generic statin drug (“simvastatin”), the risk of recurrence was reduced 43 percent and among the men taking the equivalent of more than 20 mg of simvastatin a day, the risk of recurrence was reduced 50 percent. Men who took a statin dose the equivalent of less than 20 mg of simvastatin daily saw no benefit. These data support findings from numerous other studies that demonstrate ‘anti-tumor’ actions of statin medications on prostate cancer.
This study was a retrospective analysis of over 1,300 patients who had been treated at multiple institutions. The authors reported that the two groups of patients (statin users and non-users) had differences that may confound the results of the study. Statin users tended to be white, older and heavier than non-users (all are factors that may decrease the risk of prostate cancer recurrence.) The statin users also had lower clinical stages at diagnosis, but higher Gleason scores (a measure of tumor aggressiveness.) As with any retrospective study, there are potential limitations and biases in what can be concluded from the results. Future prospective randomized studies need to be conducted to evaluate these effects more rigorously.
Statin medications, although commonly prescribed and relatively inexpensive (approximately $30/month, retail), have numerous potential side effects (i.e, gastrointestinal symptoms, muscle aches, liver inflammation). Some of these side effects, albeit very rare, can be life-threatening (i.e. muscle breakdown- “rhabdomyolysis”, kidney failure, liver toxicity, etc.) If future studies are able to demonstrate the efficacy of statins in reducing the risk of prostate cancer progression, development or recurrence, these outcomes will need to be weighed against the potential risks since the vast majority of prostate cancers will grow very slowly and have little risk of shortening the length of a man’s life.
