PCa Relapse Risk Linked to Cholesterol

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Lionel L. Bañez, MD
Lionel L. Bañez, MD

ORLANDO – Elevated cholesterol levels may increase a man's risk of prostate cancer recurrence following radical prostatectomy, data suggest.

 

“We found that for every milligram per deciliter increase in total cholesterol the relative risk for cancer recurrence increases by approximately 1%,” said lead investigator Lionel L. Bañez, MD, an assistant professor in the division of urologic surgery at Duke University School of Medicine in Durham, N.C.

 

“When we looked at LDL cholesterol levels, we found similar findings.” He reported study findings here at the American Urological Association annual meeting.

 

He and his colleagues identified 471 men from the Shared Equal Access Regional Cancer Hospital (SEARCH) database who underwent RP from 1998 to 2007. The researchers determined total cholesterol, LDL, and HDL levels, and statin use prior to surgery.

 

After controlling for numerous clinical features of prostate cancer and demographic characteristics, the investigators found that increased total serum cholesterol and increased serum LDL, but not HDL, significantly increased the risk of biochemical recurrence after surgery.

 

Overall, men in the highest quartile of serum cholesterol (217 mg/dL or greater) had a 2.5 times higher risk for biochemical relapse compared with men in the lowest quartile (less than 167 mg/dL).

 

Findings suggest that hypercholesterolemia may play a role in prostate cancer progression, Dr. Bañez said. This study, along with other research that has linked obesity to prostate cancer, magnifies the importance of diet and exercise in achieving sound urologic health, he said.

“Cholesterol-lowering drugs such as statins should be investigated for a possible role in the treatment of prostate cancer,” Dr. Bañez told Renal & Urology News.

 

As to how cholesterol might be involved in prostate cancer progression, he noted that cholesterol is a building block of testosterone and prostate cancer grows in response to testosterone. Another possibility is that cholesterol may interfere with the way prostate cancer cells communicate with each other.

 

J. Brantley Thrasher, MD, professor and chair of urology at the University of Kansas University Medical Center in Kansas City, said the findings may be important because elevated cholesterol levels and obesity are common among men over age 50 years.

 

Although he urges caution in interpreting the study's findings, he noted:  “I can now tell my patients with impunity that lowering your cholesterol is going to be heart healthy and now there is some information that it may be prostate healthy.”

 

In a separate study presented at the conference, another Duke University team found that increasing cholesterol levels were associated with increasing PSA levels in healthy men.

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