THE "NEW" PROSTATE CANCER INFOLINK

Also today, there are two new reports on the impact of treatment with statins (drugs like simvastatin/Zocor and atorvastatin/Lipitor) on prostate cancer risk.

In the first study, Loeb et al. have analyzed data from a series of > 1,300 patients who received a radical prostatectomy (RP) carried out by a single surgeon between 2003 and 2009. The authors were able to compare clinical and pathological features of the tumor between the 504 users of statins and the 847 patients who were not statin users. Their study showed that:

• Statin users were older and had a higher average body mass index (BMI) than the non-users.
• The pre-surgical serum PSA levels, tumor volumes, and percentages of cancer in the RP specimen were significantly lower in patients taking statins.
• Statin users had a lower risk for adverse tumor pathology, including a significantly lower risk of positive (cancerous) surgical margins.

Loeb and her colleagues suggest that, “the use of statins might be associated with more favorable pathological features at RP.”

In the second study, Platz et al. report that — in general –based on data from patients enrolled in the Prostate Cancer Prevention Trial (PCPT), men with low cholesterol levels have a reduced risk of high-grade prostate cancer.

In this cohort study of 5,586 men aged ≥ 55 years, who were randomized to the placebo arm of the PCPT between 1993 and 1996, the men’s serum cholesterol levels (as well as their PSA levels) were measured at entry into the study. By the end of follow-up, 1,251 prostate cancer cases were confirmed.

The study showed that:

• Men with low to normal cholesterol levels (< 200 mg/dl) had a lower risk of Gleason 8 to 10 prostate cancer than men with high cholesterol (≥ 200 mg/dl).
• There was no association between cholesterol levels and overall risk for prostate cancer,or for risk of prostate cancer with Gleason 2 to 6 disease or Gleason 7 disease.

Now these two studies are both retrospective analyses (which need to be interpreted with caution), but they add to the evidence that the clinical use of statins does indeed have specific impact on short-term surgical outcomes following RP and preventively on risk for high-grade prostate cancer (in men of 55 years or older).

There is clearly much more work to be done!