Here is another link on the benefits of combining metformin with a statin for improving overall survival in high-risk prostate cancer. It was especially strong for those who started them after prostate cancer had developed and were under treatment. Again, it is not a randomized prospective trial. But the benefit to risk ratio makes this a compelling to consider these well established and safe (for most patients) medications. Worth discussing with one's MO if not already on them.
Individual and joint effects of metformin and statins on mortality among patients with high‐risk prostate cancer
I take a statin and also metformin. I don't cycle metformin but I do cycle the statin. Fairly high dose for a few days and then nothing for a few days. I also add red yeast rice into the cycle and I make sure a day goes by without either.
So, maybe:
days 1-3 statin
day 4 nothing
days 5-6 red yeast rice
day 7 nothing
repeat
I might change this to lengthen up the time for each. So I might go to
month 1 statin
month 2 red yeast rice
month 3 statin
month 4 nothing
Based on this research and other research I have seen, perhaps no metformin on month 4 but on for months 1-3.
Please note in the study that lovastatin, which is the brand name given to red yeast rice sourced, has no significant relationship in predicting mortality.
Thanks, I saw that. But there are other studies that show some relationship. Overall it doesn't appear to be as beneficial as some of the others, true. But I have tried a number of other ones and each one has given me horrible insomnia. Even if I take them in the morning, every other day, at a low, non-therapeutic dose. So, it seems like lovastatin or nothing.
The bottom line for me is that my cholesterol was around 220-240 and now is around 125-160. I'll keep taking for the SOC purported cardio risk reduction. RYR with stanols/sterols is also extremely effective for me. Prior to starting a statin, I took a combo of RYR and stanols/sterols and my cholesterol went down to 128.
Big problems with retrospective observational studies like this. Prospective studies so far show there is no benefit to either. Statins may interfere with PSA tests. Metformin has GI side effects.
What caught my attention, Allen, this is not about PSA effects but overall survival (OS) differences. Yes, it is not prospective so it might not stand up in the years ahead. But still, it gives pause to consider in the meantime.
"Based on 12 700 patients with high‐risk PCa, statin alone or in
combination with metformin was significantly associated with reduced
all‐cause mortality (Hazard Ratio [HR]: 0.89; 95% Confidence Interval
[CI]: 0.83, 0.96; and HR: 0.75; 95% CI, 0.67‐0.83, respectively) and PCa
mortality (HR, 0.80; 95% CI: 0.69, 0.92) and 0.64; 95% CI, d 0.51‐0.81,
respectively. The effects were more pronounced in post‐diagnostic
users: combination use of metformin/statins was associated with a
32% reduction in all‐cause mortality (95% CI, 0.57‐0.80), and 54%
reduction in PCa mortality (95% CI, 0.30‐0.69). No significant
association of metformin alone was observed with either all‐cause
Fortunately, we have much better prospective data already. So we already know better than to "just do it."
I used to be an advocate for metformin, statins, and aspirin for PCa based on data like that posted here. I changed my mind as better data came in. It is important for patients to let go of conclusions based on lower levels of evidence when better evidence comes in. Sometimes, as was the case with Vitamin E, something thought to be beneficial turns out to be harmful.
Do you have links to the improved data? And I am sincerely curious: what constitutes "better data" in your opinion? 2020 vs 2019 or RCTs or? My SOC PCP thinks that metformin, statins, and low dose aspirin are beneficial for me (cardiac risk). If you can give me studies that state otherwise I would like to discuss this with him.
Vitamin E is a different story. I never bought into the marketed benefits from alpha-tocopherol but, as you probably know, there are many different forms and biological actions. Depending on one's particular biological makeup and state some of them may or may not make sense.
Better data means higher level of evidence. The OP here is a low level of evidence. The highest level is a large confirmed randomized clinical trial. The reason that some kinds of evidence is considered to be higher or lower is because it was found, long ago, that some kinds of evidence was conflicted from study to study, whereas others rarely ran into conflicts and was usually confirmed. I'll do a review article at some point.
The PSA test should perhaps be considered as a guide, not as a a standard of testing that should never be interfered with by any substances such as supplements or medications.
It is one of several biomarkers and diagnostic tools, but our most important one in most cases. One would be foolish to do anything unproven that might interfere with it.
Just curious if you agree with everything in this article? Seems it is saying I haven't gained anything from screening and treatment and that only non PSA producing PC is the real real threat.
All cancer is a threat. PSA is of course the amount of prostate specific antigen. Don't bet on PSA. I have had blood drawn on a Monday and Tuesday's results were a high number. Called my onco for another draw. On a Friday afternoon my PSA was 3.0 lower! Same lab. I never changed my supplements. He knows I take many. My onco has been involved in studies for prostate cancer and off label use of meds. He isn't a slouch. He has told me not to--not to stop taking supplements. I asked him if I could back off on alternative things that I do. The answer was no. if one is high risk and what one is doing is maintaining the status quo--why upset the apple cart? If I backed off on what I do to save some money and because it is a pain to do this for years --yes it is a pain--but I am still here.
Some men have cancer with a low PSA, some don't. A friend who is usually around 4.0 tests frequently, about every 6 weeks. He had a result of 17.0--and freaked! Phone call--emails. Calm down! Too high a rise in that short a time unless--an infection--nope--he had been good! Retested and his PSA was in "HIS" normal range.
I would read this with skepticism. I'm not an expert but I don't see how retrospective studies can weed out other reasons for an increase in overall survival. For example, maybe people who use metformin and statins are also more vigilant in seeking out the best doctors, cancer centers, and earlier use of cutting edge treatments.
You are correct and skepticism is appropriate. I am one who is vigilant and seeking out the best cutting edge as well as best established treatments. And I have been taking both metformin and atorvastatin. This certainly gives me no reason to stop.
Even if increased survival is not established with certainty. .its a good idea to use Metformin for high blood sugar and Statin for high Cholesterol/triglycerides. These meds can increase survival from Diabetes and Heart attacks and strokes.
Worth considering ..... if we keep waiting for their prospective studies.. we will be waiting in eternity. If some one is dying from dehydration.. will he be waiting to see if the water is clean enough or not ?
Lastly, this whole rumor that turmeric, metformin, statin "mask" PSA is a shaddy idea from sellers of new drugs.
If they were masking PSA, why Bone Alk Phosphatase, Hb, Calcium, Albumin etc ALL other markers also going in right direction. ? Are they masking these other markers too? Are they "masking" MRI images too ? Its utter nonsensical idea. When a new medicine lowers PSA ..its a miracle drug.. When an old medicine or herb/spice lowers PSA, it is just masking it. Are we all fools ? Or the sellers of expensive new drugs believe they can b*s us into selling their stuff by misleading us.
Why advise someone on AS with a maybe 3+4 that the supplements and drugs they are taking might be "masking" the real numbers of PSA testing which most consider the test to be somewhat to quite unreliable. If that man is coexisting with his cancer and may do so until he dies of other causes so be it. Why stop what might possibly--be keeping a state of balance ---which is a hell of a lot better than progression.
I don't expect a cure. I do hope for delayed or no progression. What is wrong with that? Would I rather have that? Or a possibly higher number on a PSA test?
That's a wise way of looking at this. In desire to live a few months more, we are willing to give up on many years of quality life. The entire narrative has been fed in our minds by constant chant of "survival ...survival..survival" at any cost. So what if we die a few months earlier..let it be...if we lived good ,active life for years...I am all for dietary interventions even if they help only 10% as side effects are none or minimal.
I was actually asked to stop taking Berberine and Statin when my liver acted up by my oncologist, since I am on Zytiga at the moment. I may go back to it since my liver levels are back to normal.
That's kind of what I do. I take a "drug holiday" once a quarter. And I rotate most things so that my liver gets a break from a particular toxin instead of constant pain.
Monitoring is one of our only ways to really know what might be going on.
Good post. I keep telling people that, if they read her book, she has some ideas that can be pursued but she did not focus on PCa (being a woman maybe has something to do with that?). Some of her ideas are good, some are half-baked, she skims or ignores some important factors.
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Metformin: Preliminary Results of Trial in Advanced Prostate Cancer (MANSMED)
Statins and prostate cancer 
Yet one more Metformin and statins query
Metformin - Are there any contraindications or reasons not to take it?
