If you’re at least 45 years old and never been diagnosed with prostate cancer (PCa), do you ever ask yourself, “Could I get prostate cancer?” If you have any of the familiar risk factors like family history of breast or prostate cancer, African American, or environmental exposure then you already know you should take steps to reduce your chances. However, if you have no known vulnerabilities for PCa, you probably never even wonder about it.
But let’s say you want to achieve the maximum health possible for a man of your age, and minimize the possibility of PCa. You eat nutritious organic non-inflammatory foods, you work out vigorously at least three times per week, you don’t drink alcohol on a regular basis and then only moderately, you don’t smoke, etc. Great! Statistics show such a lifestyle really does lower the odds. That said, if you’re going to be extra cautious, you might be interested in a new study about statins, the drugs used for cholesterol control. You may be surprised at the idea that statins have a bearing on PCa, and rightly so; the evidence of a preventive benefit against PCa has been mixed and no one has made a big enough deal about it in popular media for anyone to hear about it. That may be about to change. A new study suggests a powerful connection between statins and PCa.
Statins reduce prostate cancer risk
In December, 2019 the journal Cancer Medicine published a multi-center epidemiological study by Wang, et al.[i] The authors assembled electronic medical records of 13,065 men from 1994-2016, making it one of the largest longitudinal analyses ever. All records included cancer-free men older than 18 years with a follow-up period of at least a year (average follow-up was 6.6 years. Among the men who were using statins, some were taking lipophilic statins while others took hydrophilic statins; though formulated differently, the mechanism for controlling cholesterol is the same for both types.
During the follow-up period, 2,976 of the men developed PCa. When correlated with their statin use, the researchers found that during the early days of statin use (1-10 months) the risk of PCa briefly went up, but starting in the 11th month the news gets much better.
What do the numbers show?
Overall, those who used statins for a longer term had a 20% decreased PCa risk compared with no statin use. Lowered risk was even more pronounced for higher-grade PCa. Here’s how the results break down:
- Benefit was more observable with lipophilic-type statins than hydrophilic
- Statin use had to be for 11 months or longer, or taken at a higher dose, to reduce PCa risk
- Those taking statins were 15% less likely than non-statin users to have low-grade PCa, and 46% less likely to have high-grade cancer
- Risk reduction increased as cumulative duration and dosage amount grew
The authors concluded, “Statin use might be associated with reduced PCa risk only when used for a relatively longer duration, and the risk reduction was higher for PCa of higher Gleason score.” What is the explanation for this? Scientists aren’t sure, but the authors write that since statins lower blood and tissue cholesterol levels, this disrupts cellular lipid rafts, leading to reduced raft-dependent signaling and cell proliferation. You might think of lipid rafts as molecular clusters of fats that affect the function of cell membranes, and they have been implicated in signaling pathways in cancer progression.[ii] The exact mechanisms are not yet understood, however.
A news report in Urology Times quotes author Kai Wang, MD, PhD who commented, “Because this was an observational study, whether statins can be used for prostate cancer prevention or treatment in clinic remains uncertain before more clinical trial studies have been conducted.”[iii] The authors also caution that the nature of their analysis may have involved inherent subtle bias, another reason for necessary further study.
So, if you embrace a health-oriented philosophy, you may want to watch for future news—and continue to read the Sperling Prostate Center blog, where we share up-to-date news and research about PCa.
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.
[i] Wang K, Gerke TA, Chen X, Propseri M. Association of statin use with risk of Gleason score-specific prostate cancer: A hospital-based cohort study. Cancer Med. 2019 Dec;8(17):7399-7407.
[ii] S. K. Patra, “Dissecting lipid raft facilitated cell signaling pathways in cancer,” Biochimica et Biophysica Acta, vol. 1785, no. 2, pp. 182–206, 2008.
[iii] Lisette Hilton, urology Times. Nov. 4 2019. https://www.urologytimes.com/prostate-cancer/longer-term-statin-use-linked-prostate-cancer-risk-reduction/page/0/1
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.
