Prostate news article, December 2005
DO STATINS HAVE A ROLE TO PLAY IN PROSTATE CANCER? Mr M. Goldstraw MB,BS BSc MRCS
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The cholesterol-lowering drugs known as the statins e.g. atorvastatin, simvastatin and pravastatin, are perhaps one of the most commonly used drugs in men over the age of 50. They work by blocking a key enzyme (HMGCoA reductase) involved in cholesterol synthesis. Statins are proven to reduce serum cholesterol levels but most importantly decrease the number of heart attacks, strokes and overall death rate.
Recent work has suggested that statins may also play a role in preventing a number of different cancers including colorectal, lung and prostate. The exact mechanism of anti-cancer action is unknown but may be independent of its cholesterol-lowering effect. In prostate cancer, increased dietary fat intake may be an important risk factor therefore statins could potentially have a dual impact on cancer development.
Laboratory data on the use of statins in prostate cancer looks promising and two recent clinical studies show encouraging results. A study of a group of airline pilots over a 9-year period found a significant reduction (~40%) in the serum PSA levels in those taking a statin (1). Although PSA does not directly correspond to the risk of prostate cancer any decrease may suggest a potential benefit. One study looking at the actual incidence of prostate cancer noted a 65% reduction in the risk of prostate cancer in statin users compared to non-users (2). Further analysis identified this reduction to be in the specific group of patients with a more aggressive type of prostate cancer.
The preliminary results outlined certainly look promising but are only in a small number of patients and more work is needed. Use of a statin in a large scale randomized control trial will be needed to definitively answer the chemotherapeutic effect of this class of drugs.
Reference List
(1) Cyrus-David M, Weinberg A, Thompson T, Kdmon D.
The effect of statins on serum prostate specific antigen levels in a
cohort of airline pilots: a preliminary report.
J Urol 2005 Jun 1;173(1923):1925.
(2) Shannon J, Tewoderos S, Garzotto M, Beer T, Derenick R, Palma A, et
al.
Statins and prostate cancer risk: a case-control study.
Am J Epidemiol 2005 Aug 15;162(4):318-25.