A new meta-analysis of statin use and prostate cancer-specific mortality [PCSM] and all-cause mortality [ACM], below [1]. The analysis included 24 studies with 369,206 individuals.
It has been known for a century that solid tumors accumulate cholesterol. That may be reason enough to initiate statin use at diagnosis.
Castration therapy continues to be a "popular" PCa therapy. Early resistance continues to be common, even with add-on androgen-axis drugs. One form of resistance involves the generation of androgens from cholesterol - within the cancer cell. Statin use is insurance against that.
Some men say that their serum lipids are good & they do not need a statin. However, PCa cells may generate cholesterol itself, if serum levels do not meet their needs. Statins, which target liver production, can also prevent PCa cell generation. It seems that a lipophilic statin has the best chance of achieving that.
I have been on 40mg Simvastatin for 17 years. (I explained to my doctor that I wanted it for PCa, but you don't need a reason to get a statin script in the U.S.) I asked for Simvastatin by name, because of PCa sudies available back then. The FDA had recently banned the 80mg dose, although they did 'grandfather' those already on that dose. Studies have noted a dose-related benefit, regardless of brand, but I have been too lazy to look for the biggest equivalent dose among the 7(?) products.
Bottom line from the meta-analysis:
"... the use of statins is beneficial for ACM and PCSM, especially for postdiagnostic users. For patients who received either ADT or RP, statin use could decrease the PCSM. As for those who accepted either ADT or RT, statin use could decrease ACM. However, for patients accepting ADT, statin use may not always be beneficial for them."
Note: PCSM = prostate cancer-specific mortality; ACM = all-cause mortality.
For those puzzling over the " postdiagnostic users" comment, prediagnosis users include men in poor health, whereas postdiagnosis users man include many in good health (apart from the PCa, that is.)
Note, PCa, as with other cancers, and chronic diseases, is an inflammatory condition. The degree of inflammation affects mortality. There are a number of tests in the basic blood panel that relate to inflammation. I have relied on albumin as an indicator. <4.0 isn't good; my target is 4.5. (My albumin was 3.9 before prostatectomy. I used polyphenols, which are NF-kB inhibitors to get to 4.6..) Statins are anti-inflammatory. Unrelated to their effect on lipids. Anything that reduces subclinical inflammation will improve survival.
