In a first of its kind, a study suggests that statin use among men aged 60 and above lowers the risk of dying from prostate cancer.
Prostate cancer is one of the most common cancers among men in the United States. Furthermore, it is a leading cause of cancer death among men of all races.
In the year 2009, 28,088 men in the United States died from prostate cancer, according to the Centers for Disease Control and Infection (CDC, Atlanta). Treatment consists of several options depending on the condition: Active surveillance (watchful waiting), surgery (radical prostatectomy), radiation therapy, and hormone therapy. Prostate cancer treatments under investigation include: Cryotherapy, chemotherapy, biological therapy, and high-intensity focused ultrasound.
The latest study published in the journal Prostate involves 1,001 men with prostate cancer. The findings shows that among men with or without prostate cancer, taking cholesterol-lowering statins has a lower risk of dying from the cancer compared to men abstaining from these medications. However, the study does not deal with recurrence and progression from statin use.
In this population-based study, Janet L. Stanford, PhD, lead author of the study, epidemiologist, and co-director of the Prostate Cancer Research Program at the Fred Hutchinson Cancer Research Center in Seattle, and colleagues, followed the men, all based in Seattle, over an average period of 7.5 years. Of the participants, 29 percent were statin users before being diagnosed with prostate cancer, and 71 percent were non-statin users. Most of the patients in both groups (72%) were afflicted with localized prostate cancer, while 14% had regional prostate cancer. Statin users were slightly older (mean age of 63.1 years compared with 60.9 years for non-statin users), with possible diabetes, and probably on aspirin or other nonsteroidal anti-inflammatory drugs. Statins used by patients include atorvastatin, simvastatin, lovastatin, and pravastatin.The investigators found that men who used statins throughout their prostate cancer diagnosis and treatment to control their cholesterol showed a 1% risk of death compared with a 5% risk of death for non-statin users after 10 years. The results were significant even after controlling for major patient characteristics, including age, stage of prostate cancer, body mass index, type of treatment, history of other conditions (such as diabetes), and smoking. During the follow-up period, a total of 123 deaths, including 39 deaths from prostate cancer, were observed.
"I think this study goes along with the growing body of evidence of observational studies — which have their strengths and weaknesses — that statins may have a role for delaying prostate cancer progression," Stephen Freedland, MD, a prostate cancer oncologist at the Duke University Medical Center in Durham, North Carolina, said in a media interview.
"Previously, cohort-based studies have analyzed the link between statin use and prostate-specific antigen (PSA) levels, but this is the first study to link statin use and prostate cancer-specific mortality," said Dr. Stanford in the same media interview, with cancernetwork.com.
Previous studies suggested that statins may have an anti-cancer function. The key question is whether the anti-cancer activity of statins is related to their role in cholesterol-targeting.
Nonetheless, the study results are not a green signal for clinicians to recommend statins for either prostate cancer prevention or treatment. In view of the mixed results with previous studies - supporting the benefit of statins for prostate cancer, or showing no link, as well as a study that showed an increased risk of prostate cancer, experts advise caution on whether statins can benefit a patient's prostate cancer prognosis.
Additional large scale controlled clinical studies are needed to tease out the mechanisms involved, and to confirm unequivocally if indeed statins are here to stay, to prevent or delay death from prostate cancer, among elderly men.