Prostate protection that comes from the heart
Can statins help not only the heart but the prostate? Finnish researchers say, 'Yes.'
By Howard Wolinsky
The Active Surveillor often drones on about the need for men on AS for low-risk prostate cancer to take care of their hearts since they are far more likely to die from heart disease than prostate cancer.
But a study from Finland shows that cholesterol-lowering statins appear to protect our prostates from cancer. I always like twofers.
Statins, a commonly used medication, help prevent strokes and heart attacks by reducing cholesterol.
I successfully controlled my high cholesterol through diet, eating oatmeal and flaxseed, for many years. But eventually, I couldn’t hold down my cholesterol, and I started on the low-dose statin path.
But around Valentine’s Day 17 years ago, I had a freak heart attack--known as a widow-maker. A virus apparently broke loose a chunk of plaque.
I only survived because I was a regular exerciser for more than 30 years and had built up collateral circulation, growing new vessels and saving them up for a rainy day/
When my left anterior descending artery (LAD), the main coronary artery, was nearly choked off (a 98% blockage), my collateral circulation took over and saved my life. Virtually no damage occurred.
I have done fine since. I take 80 mg of atorvastatin per day. My cholesterol reading is near perfect.
Could atorvastatin be protecting my prostate? Maybe. My urologist tells me that if my Prostate Health Index scores (a type of PSA) were any lower, I wouldn’t have cancer.
Research has shown that people taking statins are less likely to have prostate cancer in routine screenings.
Finnish researchers used subgroup analysis from a population-based randomized clinical trial using data from the population-based Finnish Randomized Study of Prostate Cancer Screening, randomizing men to PSA screening or routine care from March 1, 1996, to December 31, 1999, with follow-up continuing until December 31, 2015. The population included all men aged 55 to 67 years at baseline and residing in the Tampere or Helsinki districts of Finland. Information on statin purchases from 1996 to 2009 was obtained from a national prescription registry. Eligible men were identified from the population registry of Finland.
(Got to salute Finland for keeping such meticulous records.)
In the screening group, (38%) were statin ever-users; in the control group, 41% were statin ever-users. The median age at randomization was 59 years (range, 55-67 years) in both trial arms.
Arla Vettenranta, MD, of Tampere University (Go Violet), Faculty of Medicine and Health Technology, Tampere, Finland, and colleagues reported in JAMA Oncology that screenings found fewer low-risk cancers in statin users though there was no difference for high-risk cancers. [Click here for the study: https://jamanetwork.com/journals/jamaoncology/fullarticle/2786538]
The researchers speculated statin use could increase the accuracy of the blood test.
This would mean the dangerous cancers are still detected in both groups but statin users are less likely to be diagnosed with non-harmful cancers.
The researchers said: “PSA screening among statin users was associated with a decreased incidence of advanced prostate cancer that was similar among statin nonusers, but with less increase in detection of low-grade localized tumors in statin users than in nonusers. These findings suggest that statin use does not materially compromise the benefits of PSA-based screening.
“Our subgroup analysis of a cohort from the population-based FinRSPC found that, although PSA-based screening had a similar association with incidence of advanced PCa among statin users and nonusers, screening was not associated with an increase in the incidence of low-grade PCa among statin users. Therefore, PSA-based screening may cause less harm among statin users while the benefits remain similar.”
The researchers suggest statins may also reduce local inflammation in the prostate, which also would lower PSA.
The Active Surveillor mentioned recently that some experts recommend a combination of low-dose aspirin, metformin (usually for diabetes), and statins as an approach to lower risks for prostate cancer and heart attacks. Some envision a super-pill made from the three meds.
One example is Mark Moyad, MD, of the University of Michigan (Go Blue) routinely recommend metformin for the prostate along with aspirin for its heart benefits for some and statins for cholesterol control and possibly prostate benefit as a way to fend off the inflammatory risks even for men who have no prostate cancer issues.
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