Aggressive PCa - Cholesterol - Statins

[pjoshea13]

New German study below.

I often feel, in talking about statins, that I need to explain that I am horrified by the number of Americans using them. (& no, I haven't been overdosing on Dr. Mercola.) Coming up to age 70, I am not on any prescriptions except those I have chosen to be on for PCa - & that includes Simvastatin.

See my post of 5 months back: "Non-PCa Prescription Drugs: Statins".

While hypercholesterolemia might well be a problem, the main issues are that (a) all solid tumors want to overload on cholesterol, & (b) cholesterol in PCa cells can be used to manufacture androgens in men on ADT. So hypercholesterolemia is perhaps beside the point.

Nevertheless: "analysis identified hypercholesterolemia as a risk factor for aggressive and/or advanced PC" - double the risk.

... whereas statin use halved the risk.

What we lack are numbers for men with PCa who use statins but are not hypercholesterolemic.

"... we evaluated an association between hypercholesterolemia (≥5.0mmol/l), the use of statins, and advanced/aggressive PC in 767 men with histologically confirmed, clinically localized PC awaiting radical prostatectomy."

"We found that patients with {hypercholesterolemia} (n=287, 37.4%) had a significantly higher incidence of poorly differentiated PC (Gleason score ≥7b, 81.1% vs. 4.9%), advanced local tumor stage (≥pT3, 57.7% vs. 22.2%), and nodal involvement (19.8% vs. 1.6%)."

(Note that 5 nmol/L = 193 mg/dL.)

Incidentally, it would be interesting to have a separate analysis of hypercholesterolemic men with no symptoms of the metabolic syndrome. Were there any?

-Patrick

ncbi.nlm.nih.gov/pubmed/284...

Oncotarget. 2017 Apr 7. doi: 10.18632/oncotarget.16943. [Epub ahead of print]

Influence of serum cholesterol level and statin treatment on prostate cancer aggressiveness.

Schnoeller TJ1, Jentzmik F1,2, Schrader AJ3, Steinestel J3.

Author information

Abstract

Both cholesterol levels and the use of statins have been described to influence the development and prognosis of prostate cancer (PC). In this retrospective, cross-sectional analysis of consecutive cases from a tertiary referral center we evaluated an association between hypercholesterolemia (≥5.0mmol/l), the use of statins, and advanced/aggressive PC in 767 men with histologically confirmed, clinically localized PC awaiting radical prostatectomy. We found that patients with HCE (n=287, 37.4%) had a significantly higher incidence of poorly differentiated PC (Gleason score ≥7b, 81.1% vs. 4.9%), advanced local tumor stage (≥pT3, 57.7% vs. 22.2%), and nodal involvement (19.8% vs. 1.6%). Multivariate logistic regression analysis identified hypercholesterolemia as a risk factor for aggressive and/or advanced PC (OR 2.01, p<0.001) whereas statin intake showed an odds ratio of 0.49 (p=0.005) indicating a negative association with high-risk PC. Despite a limited number of patients using statins (~9.5%), adjusted and weighed multivariate logistic regression models revealed that preoperative hypercholesterolemia is associated with a diagnosis of high-risk PC which is negatively influenced by statin intake.

KEYWORDS:

biomarker; cholesterol; prostate cancer; statin therapy; tumor biology

PMID: 28445145 DOI: 10.18632/oncotarget.16943