By Robert Preidt HealthDay Reporter
FRIDAY, February 14, 2020 (HealthDay News) – The medications that many men with prostate cancer may already be taking, statins to lower cholesterol, can help extend their survival if they have a form of "high risk" disease , suggests new research.
High-risk patients include men with high blood levels of prostate specific antigen (PSA) and a "Gleason score" of 8 or more. Gleason scores are a calculation used to measure the prognosis in prostate cancer. Men with a high Gleason score may develop hard-to-treat cancers.
Previous research had suggested that statins and the diabetes medication metformin (often prescribed together) have anticancer properties. However, it is not clear which of the two drugs is the biggest cancer fighter, or if one could help against high-risk prostate cancer.
To help answer those questions, a team led by Grace Lu-Yao of the Sidney Kimmel – Jefferson Health Cancer Center in Philadelphia, tracked data on nearly 13,000 high-risk prostate cancer patients. All were diagnosed between 2007 and 2011.
The study could not prove cause and effect, but found that statins, taken alone or with metformin, seemed associated with an increase in survival.
Men who took statins and metformin had a higher median survival (3.9 years) than those who took statins alone (3.6 years), metformin alone (3.1 years) or those who did not take any of the medications (3.1 years).
The study was published on February 8 in the journal Cancer Medicine.
"Both metformin and statins have been associated with a longer life in prostate cancer patients, however, because they are commonly prescribed together, no study we know has analyzed these two medications separately," Lu-Yao said. in a press release from the center. She is associate director of population sciences in the center.
"With respect to prostate mortality, metformin plus statin was associated with a 36% reduction in the risk of death followed by statins alone," Lu-Yao added.
The study also found that those who took one of three types of statins (atorvastatin, pravastatin or rosuvastatin) had a longer survival than those who did not take any statins. A similar benefit was not observed with a fourth statin, lovastatin.
Because prostate cancer thrives on testosterone, patients often receive treatments that reduce the levels of male hormones (androgens). The new study found that among patients who received such therapies, those who took atorvastatin had a longer median time for prostate cancer progression than those who did not take statins.
It is not clear why such effects were limited to atorvastatin, Lu-Yao said, but it seems to have the best "bioavailability" of statins and stays longer in the body.
The research team believes that, based on existing evidence, a clinical trial should be conducted to assess the effectiveness of statins and the combination of statins / metformin to extend the survival of prostate cancer patients.
Two prostate cancer specialists unrelated to the new study agreed that the findings are promising.
"There seems to be a place in the treatment of prostate cancer for statins," said Dr. Elizabeth Kavaler, a urology specialist at Lenox Hill Hospital in New York City. "However, we are not yet at a point where we can use the data to direct patient care."
She believes that testosterone may be key here. According to Kavaler, higher cholesterol levels promote higher levels of androgens, which in turn helps to promote the growth of prostate cancer. Statins can help delay that process, Kavaler explained.
Dr. Manish Vira is vice president of urological research at the Arthur Smith Institute of Urology in New Hyde Park, New York. He agreed that the findings are encouraging and noted that "a dozen active recruitment of clinical trials with metformin or a statin in prostate cancer treatment" are already underway.
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SOURCES: Manish Vira, M.D., vice president of urological research, The Arthur Smith Institute for Urology, New Hyde Park, N.Y .; Elizabeth Kavaler, M.D., urology specialist, Lenox Hill Hospital, New York City; Sidney Kimmel Cancer Center-Jefferson Health, press release, February 10, 2020
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