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Statins and Prostate Cancer = Groovy and ZERO?!

A Doctor Measuring His Patient's Blood Pressure Using a Sphygmomanometer

Over the last 25+ years I have debated several points in the medical literature. For example, I have argued that people should not be allowed to back their cars into parking spaces at the busy grocery store, because it wastes time, and does not allow other people (like me) to park their cars efficiently (because I am always waiting for them to back up their cars). Okay, well I have not argued that point in the medical journals, but in my funny mind I believe it should be debated, and there should eventually be a law to prevent people from backing into parking spaces while other people are trying to get by. But seriously, another more relevant point I HAVE discussed is that idea that heart healthy = prostate healthy, which suggests that after being diagnosed with prostate (or most cancers), patients should do whatever they can to reduce their risk of cardiovascular disease (CVD) to as close to ZERO (no pun intended) as possible. This could improve the chances of living a longer and better life, and could also reduce some of the side effects of some prostate cancer treatments (win-win-win, so to speak). 

Along these same lines is the idea that if you need a cholesterol lowering drug, such as a statin, it may also have a potential anti-prostate cancer effect. This is not proven, but is suggestive and needs more research, but my first publication on this subject was 20+ years ago and, even though we do not have a phase 3 trial, the data continues to suggest a potential benefit. “Yeah, but what if all you research folks are wrong?” Well, then I apologize that all these medications may be doing for you is helping you live longer (sarcasm alert). In other words, neither I, nor anyone else on this planet, knows for sure if a cholesterol lowering medication such as a statin, or any heart healthy lifestyle changes will help your conventional prostate cancer treatment work better. But we do know these medications (and lifestyle changes) have been associated with favorably impacting all-cause mortality or, in other words, increasing the probability someone could live longer by reducing the risk of a heart attack or another cardiovascular event. 

Recently, one of the more comprehensive reviews of past studies on men on statin medications and androgen impacting therapies for prostate cancer (androgen deprivation therapy or androgen receptor axis-targeted therapies) was published, and beautifully done by multiple members of the division of urology at the University of Toronto. It included 25 past studies of over 119,000 men, with over 65,000 of them using statins. Use of a statin was associated with a reduced risk of dying from all-causes and, potentially, a reduced risk of prostate cancer mortality1.

Now, the catch! This is not proof of cause and effect, but rather a suggestive potential association, because these studies are observational investigations and not randomized trials. However, I think these comprehensive studies continue to suggest a major trial is long overdue, and regardless, if it is done, or not, in my lifetime, the idea of encouraging men with prostate cancer and their partners to reduce their risk of cardiovascular disease to as close to ZERO (pun intended that time) as possible increases the odds of living longer and better. In fact, it is now 2023, my friends, and the word ZERO has more meaning to me than ever before. So, my word of the year is “ZERO!” How groovy and coincidental is that?! Yeah!  

PS. By the way, for those of you that thought Michigan would win the National Championship in football in 2023, I apologize! I feel your pain! I even feel some of the pain of our nemesis to the south (Ohio State) because, in my mind, they should have also won their semifinal game against Georgia. Ugh! This is precisely why I need to exercise daily, because it keeps me from thinking negative silly thoughts, and it is also a lifestyle change that helps me think of ZERO (my heart and prostate healthy word of 2023)!

  1. Jayalath VH, et al. JAMA Network Open 2022 published on-line November 30.