TORONTO—Statins may lower the risk of prostate cancer and its recurrence after radical prostatectomy (RP), according to studies presented here at the Canadian Urological Association Annual Meeting.
In one study, investigators at Mayo Clinic in Rochester, Minn., led by Rodney H. Breau, MD, a urologic oncology fellow, analyzed data from 2,427 men with a median follow-up of 14 years.
Of 634 men who used statins, 79 (13.7%) had a prostate biopsy and 38 (6.0%) were diagnosed with prostate cancer. Compared with men who did not use statins, those who did had a 69% and 64% decreased likelihood of undergoing a prostate biopsy and being diagnosed with prostate cancer, respectively.
In addition, statin users were 61% less likely than nonusers to exceed age-specific PSA thresholds.
“This study provides strong evidence supporting the association between statin use and decreased risk of prostate cancer,” Dr. Breau told Renal & Urology News. “However, in the absence of a randomized clinical trial, we cannot conclude that statins prevent the development of prostate cancer. Nonetheless, it seems that patients who take a statin medication for the prevention of cardiovascular disease may have the added benefit of decreased risk of prostate cancer.”
In another study—the first ever to examine the association between statin use and post-RP return of an elevated PSA—researchers analyzed data from 1,325 RP patients, of whom 237 (18%) were using statins. Statin users, on average, were two years older and had undergone RP more recently (median year of surgery 2004 vs. 2002) than nonusers.
After adjusting for clinical and pathologic factors, the researchers found that statin use was associated with a 30% reduced risk of biochemical failure. The reduction in risk was dose-dependent. Compared with nonusers, men taking a daily statin dose less than 20 mg had no reduction in risk, but patients who took daily doses of 20 mg or more had a 43% and 50% reduced risk, respectively.
If these results are confirmed in other studies, prescribing a statin to all prostate cancer patients undergoing RP might be prudent, the investigators concluded. The research team was led by Robert J. Hamilton, MD, MPH, a urology resident at the University of Toronto in Ontario, Canada, and a former research fellow at Duke University Medical Center in Durham, N.C., where the study was conducted.
Previous studies suggest that statins may decrease the risk of advanced prostate cancer, reduce PSA, and improve outcomes among prostate cancer patients treated with radiation. Study findings presented earlier this year at the Genitourinary Cancers Symposium in Orlando showed that statin use is associated with a nearly two-thirds reduced risk of death from prostate cancer (see the May 2009 issue, page 39).
The study looked at 760 men—380 who died from prostate cancer and 380 controls matched to case for race and age in five-year categories. Compared with men who did not use statins, those who did had a 62% decreased risk of dying after adjusting for potential confounders.