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Lower plasma cholesterol levels are associated with a decreased risk of high-grade prostate cancer, according to study findings published in the October issue of the International Journal of Cancer.

“We previously found that statin users had a lower risk of advanced and possibly high-grade prostate cancer compared with nonusers,” write Dr. Elizabeth A. Platz, of Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and colleagues. “We hypothesize that statins’ effects on cholesterol synthesis may explain those findings because prostate cancer cells exhibit cholesterol dysregulation.”

To test this, the researchers examined data from the Health Professionals Follow-up Study for subjects who provided blood samples between 1993 and 1995. A total of 698 incident cases of prostate cancer were matched to 698 controls who had a PSA test.

Cholesterol levels below the 25th percentile, compared to higher levels, were not associated with total (OR = 0.93), organ-confined (OR = 0.87), or low-grade (OR = 1.06) prostate cancer.

However, low cholesterol was associated with a reduced risk of high-grade disease (OR = 0.61). This was especially true if the disease was organ-confined (OR = 0.54). A possible inverse association was also found between low cholesterol and advanced disease (OR = 0.42), but it did not reach statistical significance.

The associations remained after the team excluded men who used cholesterol-lowering medications.

“If our findings are borne out, they may provide support for conducting clinical trials in men at higher risk of prostate cancer or as an adjuvant to prostate cancer treatment,” Dr. Platz commented to Reuters Health.

“However, at this time there is inadequate evidence to recommend that men concerned about prostate cancer should take a statin, lower their cholesterol through medications or other means, or keep their cholesterol in the low range,” she explained. “Of course, keeping cholesterol in the normal range or lowering cholesterol to the normal range can reduce risk of cardiovascular disease and some other adverse health effects.”

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Men aged fifty and over are at risk for prostate problems and possibly even prostate cancer. Medical research has shown that there is a possibility that statin medications, normally used to lower cholesterol, may be helpful in cutting the risk of getting advanced prostate cancer in half. . This includes the use of drugs such as such as Lipitor, Mevacor, and Zocor. This research is based on ten years of data and is still in the early, observational stages. Preliminary findings are that they will not help with preventing or lowering the chance of getting early, curable prostate cancer.

How this was found

In 1990 there was a study of 34,438 men between the ages of 44 and 79 who did not have prostate cancer. Over the next years they filled out health surveys that included the use of cholesterol lowering medications. In the year 2000 ninety percent of the men in the survey said that they were taking statin drugs for their cholesterol and in the same year 2,074 men were confirmed as having prostate cancer.

The researcher compared the two groups of men in the study - the ones taking statins and the ones not taking it - and found that the risk of developing advanced prostate cancer was cut in half, and the risk of fatal cancer was cut by a third. They also found that the longer the patient took the statin medication, the less the risk of cancer became. They determined that there was a correlation between prostate cancer risk factors and taking medicines such as Lipitor.

The correlation between cancer cells and cholesterol

Medical researchers are now working on determining if statin medications actually has some properties that interfere with the cancer or if simply lowering cholesterol levels help lower the risk. Because cholesterol clogs arteries and has been found in prostate cancer cells, there is good indication that the medicine works on them as well, especially since it has already been found to dispose of damaged cells through apoptosis, which is the process of the cells dying the normal programmed death.

Statins have also been shown to possess anti-inflammatory properties. Inflammation is a big problem with many different cancers all over the body. Unfortunately the information on how statins work is still very informal and has not been reported in any medical journals yet. The medical community is conducting intensive research before making many announcements.

How Lipitor works

Lipitor, a possible statin that could be used for prostate problems, lowers cholesterol by blocking the production of cholesterol in the body. It helps prevent heart disease, hardening of the arteries, heart attack, stroke, and vascular disease. It also lowers the risk of all of these problems in patients with coronary heart disease and type 2 diabetes. Whether or not it will be useful in the treatment of prostate problems remains to be seen. Always make sure you take medicines such as Lipitor under the care and advice of your primary physician and never take it for conditions they have not recommended the medication for.

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Men who keep their cholesterol down might also help lower their levels of prostate specific antigen, a protein that can warn of prostate cancer, a new study says.

“Prostate cancer is controlled by the male hormone testosterone. The main molecule that forms testosterone is cholesterol,” said Dr. Murugesan Manoharan, an associate professor of urology at the University of Miami Sylvester Comprehensive Cancer Center, who was not involved in the study. “So it is known that prostate cancer is related to testosterone, and testosterone is related to cholesterol.”

The study’s inference is that by lowering cholesterol, you also lower PSA, which in turn may reduce the risk of prostate cancer, Manoharan said. “Obviously this is a very small study and does not confirm anything, but it is a very good start that could lead to something more at a later point,” he said.

The results of the study were expected to be presented Wednesday at the American Urological Association annual meeting, in Orlando, Fla.

For the study, researchers collected data on 1,214 men taking cholesterol-lowering drugs called statins. The researchers found that PSA levels were lower after starting the statins, and the drop in PSA was proportional to the drop in cholesterol.

The results of the study confirm those of a previous study that also found that lowering cholesterol lowered PSA, the researchers noted. If confirmed, the results of the new study would provide more evidence that cholesterol plays a role in the biology of the prostate, the researchers said.

It’s still not clear, however, whether lowering PSA with cholesterol-lowering drugs may actually hide developing prostate cancer, Manoharan said.

“Bringing down the PSA levels artificially does not mean necessarily decreasing the chance of developing prostate cancer,” he said. “It might just bring the blood test reading down without reducing the risk of prostate cancer. In fact, we could miss the prostate cancer, because the PSA readings are on the lower side.”

Manoharan said the new findings need to be studied further. “If statins do, in fact, reduce the incidence of prostate cancer that would be a very good thing,” he said.

Two other studies presented Wednesday confirmed that so-called “watchful waiting” of men with a low risk of prostate cancer is a viable option. Watchful waiting is a strategy in which no treatment is given, but the patient is monitored to check the progress of the cancer.

But, the researchers of one of the studies noted that PSA exams and digital rectal exams aren’t good predictors of the progress of prostate cancer. They suggest that better monitors of the disease need to be developed.

In another study presented Wednesday, researchers from Johns Hopkins University found that men 75 to 80 years of age with low PSA levels — less than 3 nanograms per milliliter of blood — may be able to stop regular prostate cancer screenings.

The researchers found that these older men who have PSA levels below 3 nanograms per milliliter have a low probability of dying from prostate cancer, while men with PSA levels of 3 nanograms or more have an increased risk of dying from the disease.

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Drugs that are commonly used to lower cholesterol can block the proliferation and promote the destruction of esophageal cancer cells in the laboratory, according to a report in the American Journal of Gastroenterology by UK researchers.

The esophagus is the tube that carries food, liquids and saliva from the mouth to the stomach - and adenocarcinoma is the most common type of cancer in this organ.

Statins, a type of popular cholesterol-lowering agents, which include drugs such as Lipitor, achieve this effect by inhibiting the signaling pathways that lead to the formation of the cancer cells, co-authors Dr. Olorunseun O. Ogunwobi, from Norfolk and Norwich University Hospital, and Dr. Ian L. P. Beales, from the University of East Anglia in Norwich, note.

A rapid rise in the number of esophageal cancers and deaths has been seen worldwide, leading many researchers to look for drugs that can prevent this cancer from occurring, report indicates.

Prior research has shown that statins, which have a good safety record, can reduce the availability of various biosynthetic intermediate molecules that are critical for cancer cell signaling. Whether this might translate into a beneficial anti-cancer effect, however, was unclear.

Using laboratory cultures of esophageal cancer cells, the researchers found that adding simvastatin, lovastatin, and pravastatin reduced the number of esophageal cancer cells and inhibited their growth. The higher the dose of the statin, the greater was the destruction of the cancer cells.

“As yet, it is not possible to extrapolate from our laboratory studies to clinical scenarios, but the current data do suggest that any effects of statins taken by patients with esophageal cancer and Barrett’s esophagus are possibly beneficial,” the investigators note.

Further examination of statins or other agents that inhibit the same signaling pathways that lead to the formation of esophageal cancer cells — in experimental models or in clinical trials with patients — should continue so researchers can “better define whether this class of drugs has a definite role in prevention or treatment of esophageal cancer,” the authors conclude.

SOURCE: American Journal of Gastroenterology, April 2008.

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The combination of anti-inflammatory and cholesterol-lowering drugs may be able to stop the progression of prostate cancer, according to new research so far carried out only in mice.

“The two drugs work through different mechanisms of action, but there is a synergistic effect that inhibits the growth of prostate cancer cells,” said Xi Cheng, assistant research professor at Rutgers, the State University of New Jersey, who conducted the study.

His team administered a combination of Celebrex, a non-steroidal anti-inflammatory drug used to treat arthritis and other pain, and Lipitor, a cholesterol lowering statin, to cultured mice tumors in order to measure the transition of early prostate cancer to its more aggressive and potentially fatal stage.

Both drugs are sold by Pfizer Inc, but the company played no role in the National Institutes of Health-funded study, Zheng said.

The researcher said both drugs have been shown in earlier studies to have some impact on cancer growth when used alone.

The Rutgers team found that the combination of low doses of Lipitor and Celebrex had a more potent impact on tumor growth than a higher dose of either agent when used separately.

Prostate cancer is the second-leading cause of cancer death in men in the United States, with more than a quarter-million new cases appearing each year, according to the American Cancer Society.

In the early stage of the disease, prostate cancer cells depend on androgen hormones, such as testosterone, to grow. Treatment involves either decreasing the production of the hormone or blocking its action.

“Anti-androgen therapy slows the prostate cancer but eventually the cancer becomes androgen-independent, the therapy becomes ineffective and the cancer cells become more aggressive,” said Zheng.

“Treatments available for the later stage cancers are not very good,” Allan Conney, director of cancer research at Rutgers, said in a statement. “Oncologists employ classical chemotherapy drugs which are very toxic and don’t work all that well.”

The objective of the Rutgers study was to indefinitely delay the transition to androgen-independence, prolonging the time during which the cancer would be responsive to low-toxicity, anti-hormone therapy.

Zheng said it appears that a cell signaling pathway for tumor cell growth is inhibited by the combination of the two compounds.

He said human clinical trials are being planned.

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