Statin Use & Prostate Inflammation in the REDUCE Trial.

[pjoshea13]

New study below [1]. (Another study from Dr. Steve Freedland.)

First a recap of the REDUCE trial:

"The Reduction by Dutasteride of Prostate Cancer Events clinical trial is an international, multicenter, double-blind, placebo controlled chemoprevention study designed to determine if dutasteride 0.5 mg daily decreases the risk of biopsy detectable prostate cancer. A total of 8,000 men will be randomized to receive dutasteride or placebo for 4 years. Eligible men must be 50 to 75 years old, have a serum prostate specific antigen of 2.5 to 10 ng/ml (ages 50 to 60 years) or 3.0 to 10 ng/ml (older than 60 years). Men must have a negative 6 to 12 core biopsy within 6 months prior to enrollment. Repeat biopsies will be taken at 2 and 4 years. The rates of prostate cancer for each treatment group will be compared. Genetic and protein biomarkers of prostate cancer, and the effect of dutasteride on benign prostatic hyperplasia and prostatitis symptomatology and histopathology will also be assessed." [2]

"Statin use is associated with lower advanced prostate cancer risk. In addition to cholesterol lowering, statins have systemic anti-inflammatory properties."

"Chronic and acute inflammation affected 77% and 15% of men, respectively."

"Men with high HDL (≥60 vs. <40 mg/dL) had {21% less} presence of acute inflammation ... and were {a third} less likely to have severe acute inflammation"

"Statin users had {19% less} presence of chronic inflammation ... and were {20%} less likely to have severe chronic ... and {27% less likely to have} severe acute inflammation ..."

"Given the possible role for inflammation in prostate cancer, the inverse association between statins and prostate inflammation suggests a mechanism linking statins with lower advanced prostate cancer risk."

Note that cholesterol uptake in PCa, as in all solid cancers, is elevated & associated with aggression. In addition, a statin will inhibit the cancer from manufacturing cholesterol. For men on ADT, cancer cells can use cholesterol to make androgens. The anti-inflammatory aspect is an important add-on benefit.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/284...

Cancer Prev Res (Phila). 2017 May 9. doi: 10.1158/1940-6207.CAPR-17-0019. [Epub ahead of print]

Statin Use, Serum Lipids, and Prostate Inflammation in Men with a Negative Prostate Biopsy: Results from the REDUCE Trial.

Allott EH1, Howard LE2, Vidal AC3, Moreira DM4, Castro-Santamaria R5, Andriole GL6, Freedland SJ7,8.

Author information

1

Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

2

Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina.

3

Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, California.

4

Department of Urology, University of Illinois at Chicago, Chicago, Illinois.

5

Research and Development, GlaxoSmithKline, Inc., King of Prussia, Pennsylvania.

6

Washington University School of Medicine in St. Louis, St. Louis, Missouri.

7

Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, California. [e-mail].

8

Division of Urology, Veterans Affairs Medical Center, Durham, North Carolina.

Abstract

Statin use is associated with lower advanced prostate cancer risk. In addition to cholesterol lowering, statins have systemic anti-inflammatory properties. However, their effect on histologic prostate inflammation is not well understood, particularly among men at increased prostate cancer risk but with a negative prostate biopsy. We examined associations between serum lipid levels, statin use, and histologic prostate inflammation using data from 6,655 men with a negative baseline prostate biopsy in the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial. Statin use and lipid levels [total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides] were assessed at baseline. Inflammation was assessed by central review. Logistic regression was used to examine the effects of lipids and statin use on presence and extent of chronic and acute prostate inflammation [none, moderate (<20%), severe (≥20% biopsy cores)]. Chronic and acute inflammation affected 77% and 15% of men, respectively. Men with high HDL (≥60 vs. <40 mg/dL) had reduced presence of acute inflammation [OR, 0.79; 95% confidence interval (CI), 0.63-0.99] and were less likely to have severe acute inflammation (OR, 0.66; 95% CI, 0.45-0.97), but there were no other associations between lipids and inflammation. Statin users had reduced presence of chronic inflammation (OR, 0.81; 95% CI, 0.69-0.95) and were less likely to have severe chronic (OR, 0.80; 95% CI, 0.68-0.95) and severe acute inflammation (OR, 0.73; 95% CI, 0.53-1.00), relative to non-users. Given the possible role for inflammation in prostate cancer, the inverse association between statins and prostate inflammation suggests a mechanism linking statins with lower advanced prostate cancer risk. Cancer Prev Res; 1-7. ©2017 AACR.

©2017 American Association for Cancer Research.

PMID: 28487295 DOI: 10.1158/1940-6207.CAPR-17-0019

[2] ncbi.nlm.nih.gov/pubmed/153...

[BigRich]

Patrick,

I use 325mg. aspirin and Zyflamend, 3 capules a day to lower inflamation. Now not counting those two; I take 7 other perscriptions for my aliments. My total cholesterol is 150 without a statin. I just don,t want to take another pill.

Rich

[BigRich in reply to BigRich]

Patrick,

I made a typo my total cholestero is 105 without a statin.

Rich

[Hidden]

I am wondering how they would find participants for this study. If you have a negative biopsy why would you be interested?

[pjoshea13 in reply to Hidden]

80% of biopsies are negative. (5 biopsies to find 1 cancer case is considered acceptable). Most of the 80% simply don't have cancer. Don't know how high the percentage is of the 80%, who will ultimately need a repeat biopsy. If you think you are high-risk, you might sign up.

I wouldn't have signed up for anything that required a biopsy.

More civilized would be the 4K test. New paper out yesterday:

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

-Patrick