Please spare me the guffaws and head shakes for asking once again about the value of these two medications in treating prostate cancer. I ask because I was informed recently that they may be beneficial if one has received radiation treatments particularly. No, my witch doctor did not tell me this. Bring on the sneers and hoots.
Yet one more Metformin and statins query - Advanced Prostate...
Yet one more Metformin and statins query
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ronton2
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You’ve been paying too much attention to one very opinionated member who doesn’t even have PCa. I do, and I use both metformin and Atorvastatin. Even got my MO to write the Script for the statin. You have plenty of company here.
j-o-h-n <---- takes out his kazoo and plays "Here we go again".......My kazoo not my KazooHooHoo..
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 02/18/2022 11:43 PM EST
Why ask if you don't want to hear the answer?
TA, I just re read with great interest, your blog as it relates to Metformin and it’s lack of any benefit for PC. Very convincing. However, you did not address one aspect of the conversation. Recently some studies (admittedly retrospective studies) have shown a major longevity advantage to the combination of statins and metformin. (See linkBelow). Interestingly this study showed no benefit to metformin alone but only in combination with statins. Any thoughts on statins and/or statins with metformin for PC??
Schwah
uspharmacist.com/article/st...
Much appreciated and thanks for not dismissing so quickly. I, like you, have support from my MO, who also advises green tea, exercise and a joyful outlook on life.
Exercise is very important!
Schwah are you taking metformin?
I included the Tan study, which is just a SEER database study. I'll requote here:
"Tan et al. used the SEER database to see if there was an association between metformin, statins, or the combination of the two on prostate cancer mortality in high-risk men. They found that metformin alone had no association. However, statins alone and the combination did have an association. The association disappeared in men with advanced (Stage IV) prostate cancer."
In fact, there was a randomized controlled trial of the combination (called the "LIGAND" trial) in Canada among recurrent men. They canceled the trial when it became apparent that there was no effect of the combination.
No reply needed!
Gosh, but I didn’t ask for a reply, especially from….
It's a public forum. You don't get to choose who replies. More importantly, one must approach such questions with humility - if you believe you have the answer before you ask the question - why ask? The way science works since the 16th century is that hypotheses (like, can metformin help with prostate cancer?) are tested with empirical experiments. There are also observations of retrospective data that help us form our hypotheses - but do NOT answer the question.
Many on this site do not seem to understand that association (from retrospective data) is not causation (from prospective randomized clinical trials). We all have to be very careful about the difference because using a treatment based on an association may be harmful.
Blah, blah and more blah. Please ,TA, relax and let some of us exercise the right to ask questions, even those you deem unscientific or frivolous. Are you being treated for PC? Cured? Flying above the fray? Congratulations, and best health. Please don't reply to my posts in the future.
Sounds like you've got the blahs. Do you ask your doctor if he is being treated for PC? I love questions, even yours. If you don't like my answers, ignore them.
Well said
But, for many variables, randomized studies can be difficult to do...few volunteers?
Yet they are done all the time.
TA, am exercising. Hired a trainer and limited all alcohol. Take pravastatin already and my oncologist suggested metformin at one point during a Lupron zytiga treatment to prevent elevated blood sugar. Is there any evidence that adding metformin will help me get rid of excess body fat?
I know it is taken for metabolic syndrome, which is often associated with obesity. But it also causes high blood sugar, which the metformin helps with. I haven't heard it helps get rid of excess fat.
I'm consulting with a plastic surgeon to do a male tummy tuck and gynocomastia surgery. My fat is very isolated.
We are a diverse group here.Not a tribe or cult with one mind set only. Except our shared PCa experience.
I'm a little confused as to why you would think you can just post here to the entire group and not get diverse comment and discussion.
If you are looking for a one vision shared social group maybe start a facebook page "Melatonin and Statin against PCa Tribe"
I don't recall this paper from November appearing here [1]:
"Improved survival with post-diagnostic metformin and statin use in a racially diverse cohort of US Veterans with advanced prostate cancer"
Objective: To examine the association between post-diagnostic metformin or statin use with all-cause and prostate cancer (PCa)-specific mortality in men with advanced prostate cancer.
Methods: Our study consisted of 4572 men (Black = 1352, White = 3192, Other Race = 28) diagnosed with advanced cancer (T4/M1/N1) between 1999 and 2013 in the Veteran Health Administration. The association between post-diagnostic (1) metformin and (2) statin use with all-cause and PCa-specific mortality was examined using multivariable, time-varying Cox Proportional Hazard Models. In a secondary analysis, models were stratified by race.
Results: Post-diagnostic metformin use was associated with a reduced risk of all-cause (Hazard Ratio (HR) 0.84 ...) and PCa-specific death (HR: 0.76 ...).
In stratified analyses, the inverse association between post-diagnostic metformin use and both all-cause PCa-specific mortality was limited to White men.
Post-diagnostic statin use was associated with a reduced risk of all-cause (HR: 0.75 ...) and PCa-specific mortality (HR: 0.72 ...).
In stratified analyses, similar inverse associations were observed for post-diagnostic statin use and all-cause and PCa-specific mortality in both Black and White men.
Conclusion: Post diagnostic metformin and statin use may prevent progression to lethal prostate cancer in men with advanced prostate cancer.
**************
This study from 2020 [2] also looked at the combination:
"... combination use of metformin/statins was associated with a 32% reduction in all-cause mortality .., and 54% reduction in PCa mortality ..."
-Patrick
[1] pubmed.ncbi.nlm.nih.gov/348...
Prostate Cancer Prostatic Dis
. 2021 Nov 22. doi: 10.1038/s41391-021-00475-5. Online ahead of print.
Improved survival with post-diagnostic metformin and statin use in a racially diverse cohort of US Veterans with advanced prostate cancer
Saira Khan 1 2 , Su-Hsin Chang 3 4 , Veronica Hicks 3 4 , Mei Wang 3 4 , Robert L Grubb 3rd 5 , Bettina F Drake 3 4
Affiliations expand
PMID: 34811499 DOI: 10.1038/s41391-021-00475-5
Abstract
Objective: To examine the association between post-diagnostic metformin or statin use with all-cause and prostate cancer (PCa)-specific mortality in men with advanced prostate cancer.
Methods: Our study consisted of 4572 men (Black = 1352, White = 3192, Other Race = 28) diagnosed with advanced cancer (T4/M1/N1) between 1999 and 2013 in the Veteran Health Administration. The association between post-diagnostic (1) metformin and (2) statin use with all-cause and PCa-specific mortality was examined using multivariable, time-varying Cox Proportional Hazard Models. In a secondary analysis, models were stratified by race.
Results: Post-diagnostic metformin use was associated with a reduced risk of all-cause (Hazard Ratio (HR) 0.84, 95% Confidence Interval (CI): 0.73, 0.96) and PCa-specific death (HR: 0.76, 95% CI: 0.63, 0.91). In stratified analyses, the inverse association between post-diagnostic metformin use and both all-cause PCa-specific mortality was limited to White men. Post-diagnostic statin use was associated with a reduced risk of all-cause (HR: 0.75, 95% CI: 0.68, 0.83) and PCa-specific mortality (HR: 0.72; 95% CI: 0.64, 0.81). In stratified analyses, similar inverse associations were observed for post-diagnostic statin use and all-cause and PCa-specific mortality in both Black and White men.
Conclusion: Post diagnostic metformin and statin use may prevent progression to lethal prostate cancer in men with advanced prostate cancer.
© 2021. The Author(s), under exclusive licence to Springer Nature Limited.
***********
[2] pubmed.ncbi.nlm.nih.gov/320...
Cancer Med
. 2020 Apr;9(7):2379-2389. doi: 10.1002/cam4.2862. Epub 2020 Feb 8.
Individual and joint effects of metformin and statins on mortality among patients with high-risk prostate cancer
Xiang-Lin Tan 1 2 3 , Jian-Yu E 1 2 4 , Yong Lin 1 5 , Timothy R Rebbeck 6 , Shou-En Lu 1 5 , Mingyi Shang 7 , William K Kelly 8 9 , Anthony D'Amico 10 , Mark N Stein 1 3 , Lanjing Zhang 1 11 12 , Thomas L Jang 1 3 , Isaac Yi Kim 1 3 , Kitaw Demissie 1 2 , Anna Ferrari 1 3 , Grace Lu-Yao 8 9 13
Affiliations expand
PMID: 32035002 PMCID: PMC7131852 DOI: 10.1002/cam4.2862
Free PMC article
Abstract
Background: Pre-clinical studies suggest that metformin and statins may delay prostate cancer (PCa) metastases; however, data in humans are limited. To the best of our knowledge, this is the first human study aimed to quantify the individual and joint effects of statin and metformin use among patients with high-risk PCa.
Methods: This population-based retrospective cohort study identified patients from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Exposure to metformin and statins was ascertained from Medicare Prescription Drug Event files. The association with all-cause and PCa mortality were evaluated using Cox proportional hazard model with competing causes of death, where propensity scores were used to adjusted imbalances in covariates across groups.
Results: 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 mortality or PCa mortality.
Conclusions: Statin use alone or in combination with metformin was associated with lower all-cause and PCa mortality among high-risk patients, particularly in post-diagnostic settings; further studies are warranted.
Keywords: all-cause mortality; high-risk prostate cancer; metformin; population-based cohort; prostate-cancer mortality; statins; time-varying Cox proportional hazard models.
© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Dr. Scholz MD and author of a well-regarded book about prostate cancer and treatments (revised recently) says some retrospective studies indicate a possible (not etched in stone) connection between PC men who also took metformin (for diabetes blood sugar control) and statins (to lower cholesterol) and longevity. He is presenting short videos on YouTube under the auspices of National Cancer Institute Research Forum. Check him out, you owe it to yourself.
As TA states, associations do not equal causations determined from randomized studies. Still, in many case, associations are the best we can do. ..but we want to know about about harms that could result from using the suggested treatment to obtain the associated benefit.
FWIW>>>>I have had PCa since mid 2015. I was on AS until last July when i finally went through SBRT. I do not have any metastases that i know of or test show. My PSA has gone down from 19.3 last March to 4.2 last month. I did not agree to any ADT as part of the treatment. I have been taking various statins for cholesterol control since 1994 and have been on two 500MG doses of Metformin a day for 2 years. Neither med prescription had any direct connection to my PCa but are due to Type 2 Diabetes and heart disease. I have no idea if either or both drug has been of any help to me in controlling my PCa and i have never discussed either with my Rad Onc, Cardiologist or Internist to get their take on it. Since i have to take b oth drugs for life it is a moot point for me, but maybe they have helped indirectly because both my heart disease and diabetes are under good control. I will be 82 next month so anything i can do to hang on is something i will definitely do whether or not it actually helps my PCa. If it is proven to help ti i will be a happy camper, but i cant point to anything i can think of in the past 7 years where there is any evidence that either or both drugs, taken alone or together, have helped my PCa.
Not sneers and guffaws, just sighs.
If you use the forum's <search> feature you will find dozens of posts and reams of information. You can make up your own mind.
I will do so.
Many of the studies here are cherry picked to reflect the poster's beliefs--which is fine and can be helpful--but still are "Today's Specials"
To get the "Full Menu" use the voluminous power of the net too.
Currumpaw
And the increased risk for those born on Tuesdays and Thursdays was also established by retrospectively studying the day of birth by those with PCa. Moon cycle and Tide height was excluded as no direct association or patterns could be established! Lmao!
Point is... Retrospective studies are, or have been shown to be, problematic largely due to selection bias, or cherry picking data to reach a predetermined conclusion, etc.
In an extreme example, let's use Schrödinger's Cat... Is the Cat dead or alive inside the box, or is it only once you look at it, does the physical manifestation become apparent between the two possible outcomes or states?..
Should we assume to think for a moment that this concept does not apply to biochemistry(?), that it's just physics... Because until the box is opened and an actual measurement, or observation taken of what exists... "Superposition of States" can apply to our simple world too, not just Quantum Mechanics! Lol...
Otherwise we can all arrive at whatever conclusion we like! What separates manifestation in the mind, and what is reality? How deep does one go to reach a conclusion of fact? Skim the surface, or to deep dive? Make an assumption, search for the supporting data and use it, discarding anything that would not support the conclusion. Or rather than that, actually create circumstance to observe cause & effect, as with RCT's!?
There is a huge difference between observation of the box unopened, and actually opening it! Until you do, the cat is both alive & dead! Lol
One problem with most non randomized studies on metformin are not able to separate the vast majority prescribed it for type II diabetes and pre diabetes from those taking it for off label use, such as an adjunct for PC or longevity hopes. Clearly a vey large separate risk factor. Though long term ADT is itself a risk for metabolic syndrome and pre diabetes. I am inclined to separate those of us who have advanced PC that is not yet fully metastatic and castrate resistant ( BCR, PL node positive only and HS PC) from those who are already fully advanced, T4 N1M1) as in the Veterans Cohort Study pjoshea13 sites above.
The former group may be likened to “the horses are out of the barn but still in the corral, vs the latter where they are have fully escaped all fences. What is the difference? It is the distinction between therapies that are used (or intended) to prevent the PROGRESSION of the hallmarks of cancer to the more advanced fully metastatic state, vs. treatments directed to TREATING already fully advanced metastatic cancer. The former addresses the sequence of cancer development known as “The Hallmarks of Cancer”. These 10 (or so) Hallmarks are ALL believed driven by just two factors: 1) genomic instability and accumulated mutations, and 2) inflammation. Protections against these two factors (and statins are an example of this) is a whole different tier of therapies and lifestyle interventions to slow the progression of PC to a more advanced state. I may post more on this soon. Or see my previous post on “The Hallmarks of Cancer”.
I like your analogy. Thanks for posting to my post, Mateo
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