Originally published 8/30/2017
This update focuses only on the second point in the original blog: if you don’t care about your prostate gland, ignore your cholesterol levels.
In the nearly four years since the blog below was posted, research results on statin use and prostate cancer have led to different conclusions. For example, a Portuguese analysis of 273 prostate cancer cases found that men whose biopsies were positive for prostate cancer had lower LDL and total cholesterol levels than men with negative biopsies, suggesting that healthier cholesterol levels seemed linked with prostate cancer.[i] So, don’t take statins? On the other hand, a Spanish paper on the anti-tumor effects of statins—as well as biguanides like metformin—posits that statins “significantly reduced tumor aggressiveness in prostate cancer…”[ii] So, take statins? It’s confusing.
Evidence from a study comparing prostate cancer recurrence-free rates of prostatectomy patients who were on (or went on) statins within 2 years of surgery vs. those who did not supports the Spanish study. This retrospective analysis of 3,088 gives it more weight than the aforementioned studies. With an average follow-up of just over 4 years, the authors analyzed the rates of biochemical recurrence-free survival (no rising PSA after surgery). They found that statin use improved biochemical recurrence-free survival (93.3% for statin users vs. 88.6% for non-users). The authors note, “After 10 years, the progression-free survival (PFS) was 91.7% among statin users and 86.5% among nonusers.” [iii]
Given that the studies point in different directions, it’s hard to know what to make of statin use and prostate cancer. While the jury may be out on the impact of high cholesterol on prostate health—and particularly the onset, presence, and prostate cancer survival rates among statin users—there is universal agreement on statins’ benefits in saving lives by preventing cardiovascular disease. Perhaps the only certain thing we can say at this time is, one of the worst things you can do to your heart if you have high lipoproteins is skip taking statins.
What’s the worst thing you can do to your prostate gland? Many men forget that they have a prostate until it starts acting up. Although it’s small (an average gland is about the size of a walnut) it can complicate your life. As men age, the gland can gradually enlarge to the point where it begins to choke off the flow of urine. Worse still, prostate cancer is the most common organ cancer in men – and treatments for this disease can have a negative impact on urinary and sexual function. If you value your prostate – and you should! – here are the three worst things you can do to it.
Gain weight
Everyone knows that obesity is connected with heart disease and diabetes, right? But did you know you can practically measure your chances for developing prostate cancer by the size of your belt! The bigger your waistline, the greater your risk. In fact, not only do the odds of developing prostate cancer go up as body mass index (BMI) increases, but studies have shown that obese men who get the disease tend to have a more aggressive form of it, and have lower prostate cancer survival rates. If you haven’t already committed to losing those extra pounds, your prostate health is one more reason to get off those empty carbs and red meat.
Ignore your cholesterol levels
Cholesterol can do bad things when it accumulates on the lining of your blood vessels, so maybe you’re wondering what cholesterol has to do with the prostate. Normal cholesterol levels are a good thing, because this fatty substance acts as a nutrient for cell growth. This is true for healthy prostate cells. However, prostate cancer cells thrive on the “bad” cholesterol (low density lipoprotein or LDL). Men who don’t care about their prostate glands should just ignore their doctor’s advice and avoid taking statin drugs. On the other hand, there is plenty of research evidence that statin drugs may play an important part in curtailing the aggressiveness of prostate cancer, so consider doing your prostate a favor and follow your doctor’s instructions.
Urinary symptoms? Out of sight, out of mind
Prostate cancer isn’t the only prostate problem. A much more common condition is benign prostatic hyperplasia (BPH), an enlargement of the gland that happens with aging. Early signs that you may have BPH are things like having to get up in the middle of the night to urinate, difficulty starting your stream, a slow stream or trickle, incomplete emptying of the bladder, and even urinary tract infections. Another condition is pelvic pain, which may or may not be the result of a prostate infection (it could also be the result of carrying muscle tension in your pelvic floor). But hey, what’s a little toilet inconvenience or achiness in your bottom? Apparently, a lot of men learn to pay no attention to these symptoms and just live with them. If you’re one of them, that’s exactly what you should do, especially if you like the idea of an invasive procedure to “ream out” your gland at some future point. But if that doesn’t sound appealing, consider talking to your doctor at the first sign of symptoms.
The Sperling Prostate Center highly recommends having a high CQ (“Care Quotient”) for the humble prostate gland. If your lifestyle includes the 3 Worst Things to inflict upon your prostate, it very well may rebel by complicating your life as well as your quality of life. On the flip side, being kind to your prostate means:
- Eating a heart-healthy diet and losing weight
- Controlling cholesterol levels
- Seeing a doctor at the first sign of urinary problems, and having an annual physical. For that, talk with your doctor about the merits of annual PSA testing and DRE.
To optimize a happy and healthy life, take care of your prostate.
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.
References
[i] Garrido MM, Marta JC, Ribeiro RM, Pinheiro LC et al. Serum lipids and prostate cancer. J Clin Lab Anal. 2021 Mar 16;e23705.
[ii] Jiménez-Vacas JM, Herrero-Aguayo V, Montero-Hidalgo AJ, Sáez-Martínez P et al. Clinical, Cellular, and Molecular Evidence of the Additive Antitumor Effects of Biguanides and Statins in Prostate Cancer. J Clin Endocrinol Metab. 2021 Jan 23;106(2):e696-e710.
[iii] Prabhu N, Kapur N, Catalona W, Leikin R et al. Statin use and risk of prostate cancer biochemical recurrence after radical prostatectomy. Urol Oncol. 2021 Feb;39(2):130.e9-130.e15.
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
