Video: Do Statins Have Anti-Cancer Activity in Prostate Cancer? | Helpline Questions

Helpline Questions | Transcription

A common question we get at the PCRI is, "Do statins have anti-cancer activity?" And by statins, we mean cholesterol pills like Lipitor, Crestor, Pravachol, Livalo. The general feeling is that they do have anti-cancer activity. And what would be the basis for that?

Well, we know that dietary restriction, particularly vegetarian diets, inhibits growth rates of prostate cancer. The statin drugs sort of mimic a diet. Lowering cholesterol levels is what happens when people go on a vegetarian diet. Cholesterol is also a precursor to testosterone. Cholesterol is a basic building block in the cell walls of new cells. So by depriving the cancer cells of LDL-cholesterol, you are inhibiting cancer growth.

So this is all theory, but in practicality is there any science to establish that this is a fact? Well, the scientific studies aren't prospective studies of the highest quality, but there are a number of retrospective studies looking at databases that show better outcomes for people that are taking statins compared to those that aren't. For example, people that are in the Azure category have high-risk prostate cancer and undergo radiation—cure rates are better in the people that are taking statins compared to those who aren't. 

Of course, there are a lot of other established benefits from statins such as reduced heart attacks, strokes, and possibly a reduction in the incidence of Alzheimer's disease. And these medicines are very tolerable. For the most part, probably more than 90% of people can take them without any noticeable side effects whatsoever. The 10% that do can be detected early, the treat stopped before any lasting harm occurs. 

So if you start on a cholesterol drug, what's the target? The bad cholesterol, the LDL-cholesterol, is normally 100-150 in an American who's not taking any therapy. In the cardiology world, the doctors recommend reducing LDL to about 60 in people that have had a previous heart attack, and I think that's a reasonable goal for someone who's starting on a statin drug to try and improve the overall profile and possibly obtain an anti-cancer effect. 

So in summary, the evidence is there that statin drugs have a modest anti-cancer effect. Certainly, not everyone with prostate cancer needs to be taking a statin. Some people have early forms of prostate cancer that are essentially harmless, and to get all riled up and go on a lot of medicines doesn't make a lot of sense merely from a cancer point of view. But for people with more advanced prostate cancer, it makes a lot of sense to take a medicine that is very unlikely to have side effects and might have a genuine benefit.