Can statins reduce the risk of prostate cancer recurrence?

Taking cholesterol-lowering drugs such as statins may prevent prostate cancer recurrence in men who undergo surgery for the disease, a study suggests.

Researchers followed 1,319 men who had a radical prostatectomy at one of four Veterans Affairs hospitals; 236 of these patients were taking statins at the time of the surgery. Statin users tended to be Caucasian, older, and more overweight than nonusers. But even after adjusting for those factors, men who took statins were 30% less likely to experience a relapse than those who did not take the drugs. Researchers defined recurrence as a 0.2 nanograms per milliliter (ng/mL) rise in prostate-specific antigen (PSA) levels.

The statin dose appeared to make a difference as well. Daily doses equivalent to 20 milligrams (mg) of the drug simvastatin reduced the recurrence risk by 43%, while doses greater than 20 mg slashed the risk by 50%. Patients taking less than 20 mg did not see any benefit in keeping prostate cancer at bay.

Studies about statin therapy and prostate cancer risk have arrived at varying conclusions, but many have found that statins reduce disease risk, severity, or recurrence. Several mechanisms have been identified; they involve altering the expression of cancer genes, affecting the growth of blood vessels or the ability of cancer cells to adhere and spread, and promoting apoptosis (programmed cell death). Some results also suggest that statins may strengthen the effects of standard cancer drugs or radiation.

Of note, researchers did not collect information about patients' diet and exercise habits or their smoking history, making it unclear if statins alone affected the risk of cancer recurrence. The study size was also relatively small. For those reasons, it's too soon to draw any solid conclusions about the potential impact of statins on prostate cancer or to prescribe statin therapy to prevent the disease or its recurrence. Still, men who need a statin to protect their hearts may be pleased to learn that prostate protection is a possible "side effect."