Statin Drugs and Prostate Cancer recu... - Advanced Prostate...

Advanced Prostate Cancer

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Statin Drugs and Prostate Cancer recurrence

User2008 profile image

Hello all. A month or so ago, I wrote about my hubby's blood test showing a calcium level of 134. Many of you good folks responded and some suggested that it might be a mistake. Well, it WAS a mistake. His blood calcium level falls within the normal range. We learned that the 134 figure was referring to another blood level and his doctor suggested that he have a Cardiac Calcium Scan performed to look for calcium build up within his arteries. He had the scan and we got the test results today. We were told that he needs to go on a statin drug. No specific statin was suggested. My question (after searching the site) is - are there any contraindications for taking a statin if you have prostate cancer? Thank you for any insight you can provide.

39 Replies

Interesting. My husband was on a statin before PC and he's been advised for the last 3 years not to take the statin.

Did your husband's doctor tell you why he suggested stopping the statins?

3 years ago. I'll circle back to you after I find my notes.

Phew! No contraindications for statins. Take the minimum necessary to do the job. My cardiologist told me that statins don't get rid of plaques entirely, but harden and stabilize plaques so that they don't move to the heart.

Cholesterol is the raw material for Testosterone production. Cancerous cells flurish on Testosterone and lipids. A combined statin + Ezetimibe ( triglycerides lowering drug) reduces the supplies PCa feeds on.

I've not seen any evidence published that statin use increases cancer incidence or progression. To the contrary in fact. I'm no Biochemist but my basic understanding is that blood lipids and Testosterone are two factors that "fuel" the cancer. Statins are not without side effects but overall relative to a lot of other drugs, they are not very adverse typically. I'm on the lowest dose Simvastatin (I chose that one as it seemed to have the least potential for side effects). I have no side effects. I just started it 2.5 months ago. The next time I have my cholesterol checked, if it's not less than 150, I will up my dosage without hesitation given the below:

AUG 2018: pubmed.ncbi.nlm.nih.gov/297...

"Conclusions: Statin use at diagnosis was not associated with prostate cancer progression in the population-based, minority-enriched HCaP-NC. Greater healthcare engagement, including actively controlling serum cholesterol, may be linked to better prostate cancer-specific outcomes."

APR 2011 pubmed.ncbi.nlm.nih.gov/213...

"Conclusions: Our findings support the hypothesis that statin use may protect against prostate cancer with poorer pathological characteristics. We could not rule in or out that longer term statin use may protect against recurrence after prostatectomy."

User2008 profile image
User2008 in reply to jazj

Thanks so very much for your reply. I’m beginning to feel a lot better about hubs adding a statin to his regimen. ❣️

jazj profile image
jazj in reply to User2008

Also, I read that the lyophilic statins are the ones that have shown reduced incidence of cancer and/or potentially slow cancer progression. Lyophilic are atorvastatin, simvastatin, lovastatin, fluvastatin, cerivastatin and pitavastatin, while hydrophilic statins include rosuvastatin and pravastatin. Hydrophilic have a slightly lower chance of side effects, but I'd take the slightly higher chance of muscle pain with the chance to slow the cancer down.

MrG68 profile image
MrG68 in reply to jazj

Yeah, you know what the issue with statements like:'that statin use may protect against prostate cancer ' and

'may be linked to better prostate cancer-specific outcomes' are don't you?

I can equally and justifiably replace those statements with:

'that statin use may not protect against prostate cancer ' and

'may not be linked to better prostate cancer-specific outcomes'

I could also say that its possible you may want to be cautious with statements like those.

Also, I could say that IMO, I'd be even more cautious on relying on data which used multivariable regression analysis methods to extract some conclusion.

I am taking now crestor 40mg per day without noticable side effects. I started very low 5mg per day and slowly built up. 10mg per day then 20 mg per day. I did it through years. I started 7 years ago. If you are not Asian you could start with 10 mg per day.

Statins are wonder drugs! They change the destiny of many who would have otherwiseDied of Cardiovascular events according to their genetic propensity interacting with western lifestyle. No sense dying Of a heart attack while we are busy living and fighting prostate cancer. On balance, statins also have anti inflammatory effects so have benefit in slowing progression via the drivers of the hallmarks of cancer. If there are no adverse side effects then they should be taken at the maximum dose if possible. Such as atorvastatin 8 0 mg or rosuvastatin 40 mg daily. Coenzyme Q supplement can help protect from adverse muscle effects.

MrG68 profile image
MrG68 in reply to MateoBeach

A lot of people will disagree with that.I have family members on statins who have suffered heart attacks and other side effects. In fact I have family members who only had heart attacks once they started taking statins.

Not sure I'd consider either taking them or maxing out on any of the dosages.

jazj profile image
jazj in reply to MrG68

Statins have been one of the most studied drugs ever. The evidence is overwhelming that they are safe with a low incidence of serious side effects with significant benefit compared to many many other drugs. This is of course not to say some people may have anecdotal evidence otherwise but for everyone one of those there's probably 100 or 500 people with only good things to say. So if you don't trust your doctor, trust the large studies, not what one person's or one family's personal experience has been.

MrG68 profile image
MrG68 in reply to jazj

Probably 100 or 500 x the people eh?Where did you get those figures from? A magic 8 ball? That’s some spread. I could say the same thing - probably NOT 100 or 500 x the people. So basically it’s you ‘gut feeling’ then?

jazj profile image
jazj in reply to MrG68

Stains are one of those drugs that have some misinformation floating around about them which attracts people who, in my opinion, are the types that are generally distrustful of science and the medical community, or government, etc, etc.

MrG68 stated they had family members who had heart attacks once they started taking statins. This is just a conjecture that the statins were the cause of their heart attacks without any clinical evidence. Gee, could maybe the reason many people take statins in the first place be because at a late stage they found out they had heart disease and probably would have had a heart attack anyway whether they took statins or not?

"The risk of statin-induced serious muscle injury, including rhabdomyolysis, is <0.1%, and the risk of serious hepatotoxicity is ≈0.001%. The risk of statin-induced newly diagnosed diabetes mellitus is ≈0.2% per year of treatment, depending on the underlying risk of diabetes mellitus in the population studied. "

0.1% is 1 in 1000, .001 % is 1 in 100,000, 0.2% is 1 in 500 which out of the three major side effects, the diabetes risk can be mitigated easily by diet and exercise.

ahajournals.org/doi/10.1161...

MrG68 profile image
MrG68 in reply to jazj

I think you’ve misread my posting. The point I was making wasn’t that statin caused the heart attacks. The point was they didn’t prevent them.I am not mistrusting of science. The issue is more there is a lot of pseudoscience and people don’t actually read the papers to verify anything. They look at an abstract or conclusion and usually on a poor quality study.

I've been on various statins since way before the cancer diagnosis and I am not aware of anything adverse about them.

Are his current liver enzymes in normal range? My cholesterol has always been high thus my GP has recommended statins. I recently changed GPs who would not prescribe a statin because of my elevated liver enzyme’s. As a side note my new GP has been on statins for 20 years.

User2008 profile image
User2008 in reply to Bvilkid

I will check his most recent blood test results. Thanks for the "head's up".

As mentioned before, vitamin K2-7 is essential for calcium transport to bone, & to prevent arterial deposits.

MrG68 profile image
MrG68 in reply to pjoshea13

Yes absolutely. This is is so true and yet people lack in it. It's always understated IMO.

Ahk1 profile image
Ahk1 in reply to pjoshea13

Any recommendations please about a brand I should take? Thank you.

pjoshea13 profile image
pjoshea13 in reply to Ahk1

lifeextension.com/vitamins-...

or equivalent.

I've been on statins for 12 years for precisely the same reason as your husband (my calcium score was 880), two years after I was diagnosed with PC. One important side effect of statins is depletion of CoQ10 (related to fat-soluble vitamins), found in mitochondria, the energy factories of cells -- such depletion is also a normal effect of aging. So be sure your husband takes CoQ10 -- Ubiquinol is the most absorbable form -- which helps preserve the mitochondria's function.

Also, the first statin I took, atorvastatin (Lipitor), gave me severe muscle pain in my calves, since statins can break down muscle fibers. My cardiologist switched me to rosuvastatin (Crestor), and the pains vanished, so be ready to experiment with different statins to see which one works best. He also told me to start taking ubiquinol, and earlier this year my new doctor told me to increase my dosage to 300 mg daily (from 100 mg).

All this stuff about the relationships between statins, CoQ10 and statin myopathy are still kind of controversial, but I didn't know anything about it when I started taking statins -- I just knew my legs were hurting in a way they never had before, and that switching to a different statin fixed it.

User2008 profile image
User2008 in reply to kapakahi

Currently, my hubs is taking a combo of Red Yeast Rice with CoQ10 in one pill. I'm wondering if he'll need to stop the Red Yeast Rice when he starts the statin? I had read about the muscle side effects that some men notice - hubs would NOT do well with pain in his calves or anywhere else, for that matter - so we will have to work with the doctor to see which one works best for him. Thanks for sharing your experience. Quite helpful.

kapakahi profile image
kapakahi in reply to User2008

The problem with red yeast rice -- or so I've read and been told by doctors -- is that you don't always know how much statin it contains. That's true for all OTC supplements, unfortunately -- some manufacturers do a good job, others don't, and the amount of the active ingredient can vary from pill to pill, bottle to bottle, batch to batch. So taking supplements in general is kind of a crap shoot, though most likely you'd be getting some or most of what you need, if not more than you need, and not enough or too much could of course be problematic.

I guess RYR is cheaper than a prescription statin if you don't have a drug plan -- I was having to pay $300 a month for Crestor when I started because there was no generic available in the US and I wasn't on Medicare yet. So I started ordering it as a generic from India, where it's made for the US market as a brand name -- for like 1/10th the price (never had any issues with quality or credit card -- I've found Indian suppliers to be quite meticulous).

Of course, now that I have a drug plan, I'm paying $25 a month -- I could still get it for $15 a month in India, where AFAIK it's still made, but with shipping it works out about the same. I still get metformin from India for less than I'd pay here, but the main reason is that it's available as 1000mg sustained release, and CVS (the 4th largest corporation in the US, right behind Apple) can't seem to find that forumulation in one pill.

User2008 profile image
User2008 in reply to kapakahi

I understand. Supplements can vary wildly in their potency.

CAMPSOUPS profile image
CAMPSOUPS in reply to User2008

Work with, see, listen to your Dr. is an understatement. Please don't get lost in the weeds from trying to figure this out yourself.

MrG68 profile image
MrG68 in reply to kapakahi

Yes, CoQ10 is indeed ESSENTIAL for the electron transfer chain in your mitochondria. One of the reasons why statins should be considered with caution.

Give him the statins.............. Hubby will love you for it..........

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 05/12/2022 7:29 PM DST

Not that I know of. Ask the oncologist.

I was put on 20mg daily Simvastatin for a number of years before my heart attack in 2012 (probably lessened the severity of the attack). After the heart attack I was put on 80mg daily Atorvastatin (Lipitor). I was diagnosed with prostate cancer in 2019, the oncologist said keep on taking the tablets and I have and I do daily. My cholesterol level dropped from 7.3 to 3.2 on Atorvastatin (don’t know how to convert to US measurements) and remains around the 3 mark.

My PCP is happy, my cardiologist is happy and my oncologist is happy. I don’t know what drugs they take, they don’t share!

Follow the advice of a reputable doctor that you trust.

Hugh

MrG68 profile image
MrG68 in reply to Aodh

This is very interesting actually. You see I would be asking why you even had the heart attack after being put on statin, as opposed to 'probably lessened the severity'.

This also happened to a family member of mine.

After being on statins for years, he had a series of heart attacks. One artery was completely blocked, one was half blocked and another was clear.

He was told 'lucky you were taking the statins because it looks like it worked for the clean artery which probably saved your life.'

I thought at the time, these statins are quite remarkable. They can selectively choose an artery and target it, whilst ignoring another one completely, and sort of having half an attempt at another - maybe because it preferred one over the other.

Yes, quite unbelievable actually - literally.

Aodh profile image
Aodh in reply to MrG68

To answer your question “why did I even have a heart attack”, I believe that I had the heart attack because I continued to smoke, to have a bad diet, no time for exercise, worked too long hours and days, continued to be severely stressed (work mostly), didn’t listen to my body, didn’t listen to the nurse, didn’t like the nurse because she hit a nerve. A statin couldn’t counter all that as well as my familial hypercholesterolemia, which I only found out about after the heart attack.

Statins are really great drugs at lowering cholesterol, but the didn’t lower my stupidity but the heart attack did!

Hugh

MrG68 profile image
MrG68 in reply to Aodh

Well, that's quite a list. Regardless if you believe in statins or not, one thing is sure - they really do an exceptional job in lowering your cholesterol. Whether that's a good thing though, is a different discussion all together.

The question I would be asking is, is there any need to take a statin? Lots of people believe that statins are some wonder drug. This isn’t something I personally subscribe to. There are some serious issues with statins. A lot of people experience side effects. Your liver has to detoxify any drugs that you take. I have family members who had heart attacks after taking statins. That being said, I’m sure that you’ll get some replies with some research links stating that it’s beneficial in some way. If the benefit s are inflammation related, I personally would be looking at other ways to reduce inflammation.

If you do take statins, I strongly suggest that you discuss with your medical team the effects of Co enzyme Q10. Statins affect the electron transfer train in the production of ATP in your cells. That’s not a good thing.

jazj profile image
jazj in reply to MrG68

The commercials would like you to believe CoQ10 is a life saver, and necessary to avoid muscle pain while you are on statins. Not to say it may have benefits in some situations but in general:

Latest systematic review published in 2020:

"Conclusions: This systematic review and meta-analysis did not demonstrate that CoQ10 supplementation was beneficial for patients with statin-associated muscle pain or improved adherence to statin therapy."

pubmed.ncbi.nlm.nih.gov/321...

There's lots of studies to varying quality, some claiming benefit others no benefit.

Worse case, taking CoQ10 will provide no significant benefit and just hurt your pocketbook so I have nothing against it. I am only against false claims on effectiveness. I also want to start a supplement company with pretty labels and make millions.

MrG68 profile image
MrG68 in reply to jazj

I did a quick run over the study and there’s so many things I could point out with it - If I could be bothered to go through them all.... but as stated in the Discussion..

'This systematic review identified eight studies for inclusion in a

qualitative review of which seven were pooled for a meta-analysis. One

study presented as an abstract was omitted as complete results were not

available and the authors did not respond when contacted. The pooled

analysis neither favoured the use of CoQ10 to improve statin-associated

myalgia nor to enable patients to continue on statin therapy.' ......

...... 'All included studies had small sample sizes, likely due to their single

centre design and possibly due to lack of funding.'

Out of all the studies available they found only 7 that were applicable and formed a meta analysis on the data. Also they were possibly affected by lack of funding. It's hardly a bastion for any report, don't you think?

For every one of these type of studies, I could show one that gives the opposite result. I don't regard either one better than the other - even if it supports what I believe to be true. As interesting as these studies are, personally I wouldn't be relying on these types of studies to make any informed decisions.

Like I said previously, I suggest that he talks it through with his medical team.

jazj profile image
jazj in reply to MrG68

I think the Mayo Clinic sums it up nicely:

"Although a coenzyme Q10 supplement may be helpful for some people who take a statin medication, no research studies have confirmed that it has benefits for everyone who takes statins. For most people, a diet rich in fruits, vegetables, nuts and fish is enough to keep their coenzyme Q10 at a healthy level, and a supplement is not necessary."

newsnetwork.mayoclinic.org/...

So like I said, it might be useful, but at worst, it's a waste of money. I would guess that it is dependent on diet, dose, specific drug, and genetics. But as you say, best to get the opinion of your medical team.

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