Advanced Prostate Cancer
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Pitavastatin [Livalo]

New Dr Myers vblog post on Livalo [1] below.

It is something of a sales pitch.

When I asked my doctor for Simvastatin, based on sketchy evidence that it might be the best statin for PCa, Pitavastatin [Livalo] had not yet been approved by the FDA (2009). Until Dr Myers post, I had never heard of Livalo. There are no PubMed hits for <prostate pitavastatin>. No documented track record for PCa.

The rationale for using a statin in any cancer, is that cancer cells are known to accumulate cholesterol, & this is not a neutral event.

Additional rationale for using a statin in PCa while on ADT, is that (i) the cancer cells can use stored cholesterol to create androgens, & (ii) that, in a low cholesterol environment, PCa cells can even create the cholesterol needed for those androgens.

Dr Myers doesn't mention this, although he has spoken about it in a post on escape paths used by PCa while on ADT.

The problem with statins while on ADT, is that ADT induces the metabolic syndrome [MetS], and statins can worsen a poor blood sugar situation & accelerate progression to diabetes. So Myers is saying that, while Livalo may not be the most effective statin, it might be preferred while on ADT.

From a January paper [2]:

"Pitavastatin decreases HbA1c in patients with type 2 diabetes with a higher baseline HbA1c level. The benefit on HbA1c was also observed in patients with previous use of atorvastatin." All other statins seem to increase HbA1c.

{for an explanation of HbA1c see [3]}

& then Myers dangles a bonus feature - Livalo may raise adiponectin levels, & adiponectin may have anti-PCa effects. While he says this is an unproven hypothesis, there is a nod & a wink aspect to the information, quite uncharachteristic of him.

Visceral fat secretes the paired appetite hormones adiponectin & leptin. In a person with very little visceral fat, the dominant hormone is adiponectin. As the fat mass increases, there is less adiponectin & more leptin. Leptin is the hormone that signals that we have eaten enough. Unfortunately, the leptin receptors ignore the messenger when leptin secretion is chronic. It is a useless hormone in the obese.

From a 2011 paper [4]: "Leptin increases prostate cancer aggressiveness."

Dr Myers doesn't mention leptin, but, since adiponectin & leptin have an inverse relationship, I wondered whether an increase in adiponectin without a decrease in leptin would be beneficial.

From a 2012 paper [5]:

"Adiponectin was inversely associated with prostate cancer stage in overweight and obese men (OR 0.62 ...), but not in normal weight men (OR 1.48 ...)"

"There was no compelling evidence of associations between leptin or leptin to adiponectin ratio and prostate cancer stage."

So perhaps raising adiponectin via Livalo, without reducing leptin, might be beneficial.







1 Reply

I like your logical thinking.



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