Association of statin use with risk of Gleason score‐specific prostate cancer: A hospital‐based cohort study

[pjoshea13]

New study below [1].

"Among 13 065 men, 2976 were diagnosed with PCa over median follow‐up of 6.6 years.

"Statin use was associated with lower risk of both Gleason low‐ (score <7: aHR {adjusted hazard ratios}, 0.85 ...) and high‐grade PCa (score ≥7: aHR, 0.54 ..).

"The protective association was observed only when statins had been used for a relatively longer duration (≥11 months) or higher dose (≥121 defined daily doses)"

Protection was "more pronounced for PCa of higher Gleason score":

<7: aHR, 0.85

7 [3 + 4]: aHR, 0.62

7 [4 + 3]: aHR, 0.49

8: aHR, 0.60

9‐10: aHR, 0.24

"Lipophilic statins (aHR, 0.83 ...) might be more protective than hydrophilic statins (aHR, 0.91 ...) against PCa."

-Patrick

[1] onlinelibrary.wiley.com/doi...

Full text: onlinelibrary.wiley.com/doi...

Association of statin use with risk of Gleason score‐specific prostate cancer: A hospital‐based cohort study

Kai Wang Travis A. Gerke Xinguang Chen Mattia Prosperi

First published: 08 October 2019

doi.org/10.1002/cam4.2500

Funding information:

None.

Abstract

Background

Conflicting evidence suggests that statins act chemopreventively against prostate cancer (PCa). Whether the association of statin use with PCa risk is Gleason score‐dependent, time‐, dose‐respondent is not well studied.

Methods

We conducted a cohort study at a tertiary hospital in the Southeastern US using longitudinal data of electronic medical records (EMR) from 1994 to 2016. Only cancer‐free men aged >18 years at baseline with follow‐up time of ≥12 months were included. Time‐dependent Cox proportional hazards regression was used to estimate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs).

Results

Among 13 065 men, 2976 were diagnosed with PCa over median follow‐up of 6.6 years. Statin use was associated with lower risk of both Gleason low‐ (score <7: aHR, 0.85; 95% CI, 0.74‐0.96) and high‐grade PCa (score ≥7: aHR, 0.54; 95% CI, 0.42‐0.69). The protective association was observed only when statins had been used for a relatively longer duration (≥11 months) or higher dose (≥121 defined daily doses), and were more pronounced for PCa of higher Gleason score (<7: aHR, 0.85, 95% CI, 0.74‐0.96; 7 [3 + 4]: aHR, 0.62, 95% CI, 0.43‐0.90; 7 [4 + 3]: aHR, 0.49, 95% CI, 0.29‐0.82; 8: aHR, 0.60, 95% CI, 0.37‐0.96; 9‐10: aHR, 0.24, 95% CI, 0.11‐0.54). Lipophilic statins (aHR, 0.83; 95% CI, 0.72‐0.95) might be more protective than hydrophilic statins (aHR, 0.91, 95% CI, 0.63‐1.33) against PCa.

Conclusion

Statin use might be associated with reduced PCa risk only when used for a relatively longer duration, and the risk reduction was higher for PCa of higher Gleason score.

[Graham49]

Patrick

I note this study only includes cancer free men at baseline. Do you think this would include men in remission after RP?

[pjoshea13 in reply to Graham49]

Graham,

My feeling is that there is protection after diagnosis, regardless of treatment/outcome.

I was never concerned about cholesterol before I was diagnosed. I have just returned from my annual medical, so it must be about 13 years since I asked my doctor for Simvastatin. I knew that (a) solid tumors accumulate cholesterol & would make the stuff if necessary, (b) PCa could, additionally, use it to make androgens if necessary, (c) a lipophilic statin might be more likely to be taken up by PCa cells, & (d) it is the easiest drug to get a prescription for.

I believe that all men with PCa should consider it.

-Patrick

[Graham49 in reply to pjoshea13]

Patrick

What does it mean by >121 defined daily doses?

[pjoshea13 in reply to Graham49]

Graham,

Defined-Daily-Doses-for-Statins:

researchgate.net/figure/Def...

-Patrick

[Graham49 in reply to pjoshea13]

Thanks Patrick

It seems a shame to me that they only looked at the effects of cumulative time and cumulative dose and not also the effect of variation of daily dose.

[LearnAll]

Just to inform...Lipophilic statin are:

(1) Lovastatin (red yeast rice)

(2) Atorvastatin and

(3) Simvastatin.

[Schwah in reply to LearnAll]

That was my next question. Thank

You. What dosage appears to be the best ?

Schwah

[LearnAll in reply to Schwah]

I took simvastatin a year ago. I had leg muscle aches and pain and therefore stopped.

For last 1 year, I am taking red yeast rice (nusa pure made) from amazon 1800 mg a day

I have no leg muscle aches and my lipid profile has never been better. (Toal C=176, LDL=99, HDL=57 and triglycerides= 68

Also, I eat garlic every day with each meal. Red yeast rice has lovastatin like substance in it.

I am planning to start Co Q 10 as it reduces the side effects of Red Yeast Rice especially muscle wasting or aches.

[Currumpaw in reply to LearnAll]

Hey LearnAll!

Don't eat grapefruit when on a statin. One of the best CoQ10 products is LE's Super Ubiquinol CoQ10 with advanced mitochondrial support.

I have been taking a 10 mg Atorvastatin every evening for a little over two years. Dr. Charles "Snuffy" Meyers prescribed a statin for his patients and Metformin as well. The herb berberine acts much as Metformin but also has some other benefits. As for the Atorvastatin, a couple months ago my cholesterol was 143. I'm hoping the 10 mgs at least gives me an edge by working synergistically with other things. At a cholesterol level of 143 I think the 10 mgs a day of Atorvastatin is my limit. You know-NEWS FLASH! MAN DIES FROM LOW CHOLESTEROL!

For garlic to be truly effective it should be diced, crushed or whatever and allowed to "rest" for at least 10 minutes for the alliums to be released. One of the supps I take is Kyolic Immune Formula 103, an aged garlic. Aging garlic enhances it's potency. It has some vitamin C, mushrooms, astragalus, oregano and olive leaf in it as well. I do both.

The study funded by the non profit featured in a Dr. Greger video on YouTube has spawned some supps containing a combination of these four ingredients, curcumin, cruciferous, green tea and pomegranate. Some uros even offer a combo formulated to their spec and are selling it. The study ended at these four supps because the $$ ran out. Do you think that maybe taking the garlic supp, some quercetin, resveratrol, a ginkgo blend, some mushrooms --especially Turkey Tail, ginger to work with the curcumin and magnify it's effectiveness and a few other things. To make sure they get absorbed a bromelain supp and some black pepper? I noticed that although curcumin is in the prepared blends for sale that an aid to enhance absorption wasn't included in the formulation. Turmeric? One manufacturer adds the entire root rather than the active derivative, curcumin. Why? The curcumin is one of the difficult supps for our bodies to absorb. Turmeric has roughly just a 3% curcumin content.

A uro that offers a product such as the study found to be effective added four more important ingredients to a formulation he offers for sale. He understands the importance nutrition. I was taking a combo of supps before his product was offered. I do spend some time on the net.

Cell Forte's IP6 & Inositol is largely brown rice bran. Now, it is said that those of us who cooked a pot of brown rice should limit the amount of rice we eat--because soil and water where it is grown imparts the inorganic, more dangerous than organic arsenic to the bran of the rice. White rice contains much less because the hull is removed.

How did this arsenic get into the rice? I read that in the states that grow a lot of cotton a lead and arsenic insecticide was used--until the 1980's!! Makes me wonder if the bran or rice itself is tested for lead! Brown rice grown in California was said to have the lowest arsenic levels --at least in articles I read.

Sorry to go off point but LearnAll--you brought up the garlic! LOL!

Ahh! In Dr. Greger's YouTube video the curcumin, pomegranate, green tea and cruciferous supps did little when given even at high amounts to men who had prostate cancer but smaller amounts of each combined were quite effective. How was this determined? Blood was drawn from the men in the study after they consumed the supps and the blood was drizzled on cultured prostate cancer cells. A combo in vivo, in vitro type of study.

Currumpaw

[kcc9993 in reply to Currumpaw]

Yes, it is true that CoQ10 levels decrease in the body when taking a statin. However, one thing to note about CoQ10 is that water and fat-soluble forms absorb better.

[jfoesq]

For what it’s worth

I had been taking Lipitor to treat high cholesterol for years before I was dx with metPC and Gleason 9, 7 years ago. at age 54.

[Graham49 in reply to jfoesq]

I also was on statins many years before PCa diagnosis but it appears you need to be on quite a high dose to reduce the odds of getting PCa. I don't think I was on a high enough dose.

[RonL in reply to jfoesq]

Yep, me to. 15 year before l develop G-9.

[Graham49]

Patrick

Sorry to bother you with the last post. Having now looked through the paper it seems not however a previous paper,

Prostate cancer survival among statin users after prostatectomy in a Finnish nationwide cohort

Roni M. Joentausta MD Antti Rannikko MD, PhD Teemu J. Murtola MD, PhD

First published: 16 January 2019

doi.org/10.1002/pros.23768

which you also posted on, was after RP and found similar results.

[Schwah]

Great find. Thank You. These articles talk about high dose statins. Any idea what is considered a “high dose”?

Schwah

[pjoshea13 in reply to Schwah]

Most studies that mention dosage report that higher is always better.

The new paper defines: "higher dose" as "≥121 defined daily doses"

Graham asked what "defined daily dose" means. See my response.

-Patrick

[donits in reply to pjoshea13]

Hi to all,

I participate in a clinical trial with Atorvastatin 80mg/placebo + Bicalutamide. The research doctor Teemu Murtola said that the highest dose (80mg) is the most effective. But I don`t know if I am receiving a drug or a placebo, so far I have no side effects, participating in the study about a month.

[pjoshea13 in reply to donits]

Thanks! Good luck. -Patrick

[cigafred]

Stupid here is still in the dark as to the meaning of 121 daily doses. Obviously not 121 times the recommended dosage of, say, 15 mg for Simvastatin.

[pjoshea13 in reply to cigafred]

They are defining "higher dose" in terms of having had at least 121 doses at the DDD level (or higher).

"Lower" dose would be less than 4 months (any dose), or not meeting the DDD (regardless of duration).

-Patrick

[cigafred in reply to pjoshea13]

Thank you sir.

[petercraig2]

I'm using 3x 500mg Metformin daily following a literature review study by Princess Margaret's Cancer Clinic in Toronto. It clearly showed enhanced survival rates for PC and for all other medical conditions.

My Oncologist read the study Report and gave me the script which I pay for but very very cheap and can't do any harm.

[dentaltwin]

Just saw this this morning on medpage today. Statins are so widely prescribed--and not without controversy. So it's all good--so long as it doesn't do in your liver, or cause rhabdomyolysis.

[j-o-h-n]

Dr. Google says:

Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents into the bloodstream. This can lead to serious complications such as renal (kidney) failure. This means the kidneys cannot remove waste and concentrated urine.

I think I'll stick to red kidney beans instead...

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 10/10/2019 5:59 PM DST