Statin Use and Cancer Risk Reduction News

I’m not a statins’ fan, I have a personal negative impression about these drugs, not specially related to anything but their name - “something-statin …” sounds bad (but sounds that it can “stat” certain cancers development). Beside my personal opinion, more and more evidence is available about the “generic” benefit of its use, at least in cancer risk reduction.
Long-term treatment with statins helps reduce cholesterol levels, heart attack and stroke incidence. There is good evidence about these benefits and these drugs are approved for this use (see links below).

The discussion now is about incidental benefits… two recent reports, from BMJ and JCO discusses the unintended effect of statins in England and Wales and the better outcome of men with prostate cancer using this class of drugs at Chicago University.

The facts:

The England and Wales study was a huge cohort study, with 2 million patients included, read it:
“Individual statins were not significantly associated with risk of Parkinson’s disease, rheumatoid arthritis, venous thromboembolism, dementia, osteoporotic fracture, gastric cancer, colon cancer, lung cancer, melanoma, renal cancer, breast cancer, or prostate cancer. Statin use was associated with decreased risks of oesophageal cancer but increased risks of moderate or serious liver dysfunction, acute renal failure, moderate or serious myopathy, and cataract. Adverse effects were similar across statin types for each outcome except liver dysfunction where risks were highest for fluvastatin. A dose-response effect was apparent for acute renal failure and liver dysfunction. All increased risks persisted during treatment and were highest in the first year.”

The study can be considered negative except for the esophageal cancer reduction, with considerable risk of toxic effects (liver, muscles, kidney, eyes). The study has a broad and generic view, and authors consider that future studies with individualized risk analysis are needed.

The University of Chicago Study identified better outcome for patients using statins and treated for prostate cancer. It is a retrospective study with 691 men, 189 used statins and all were treated between 1988 and 2006. Patients under statins stood longer without biochemical recurrence, longer for salvage treatment and longer relapse-free survival. In their analysis, lower levels of cholesterol (mainly LDL) were associated with better outcome from low to high risk patients.

We had preclinical evidence of potential anticancer activity of statins with antiproliferative, proapoptotic, and radiosensitizing properties.
Now we have some reasonable clinical evidence.

So what?

Should I get some statin pills to prevent prostate or esophageal cancer?
Or should I exercise to reduce my LDL level (where probably the benefit stands)?

Keep moving….

Link to evidence of benefit about statins use: http://ht.ly/1R7cM
England and Wales study: http://ht.ly/1R7iT
Chicago Study: http://ht.ly/1R7eS

Fixing Medicare’s Physician Payment System, going to the non-lean solution: cutting wages….

Most of us in Brazil know where this kind of solution is going to end: poorer services, higher costs, neglected quality…. Cut workers income is the best solution to worsen performance… any lean beginner is aware about the impact of cutting costs by cutting wages and personnel, it is formally recommended not to do such things…healthcare reform starts on that.
Back in Brazil quite similar reform took place few decades ago… the impact on healthcare quality is measurable: Brazil doesn’t have 500 (yes, it’s less than five hundred) nationally certified healthcare units/centers (hospitals, labs, clinics, etc.). Brazil has 200 million inhabitants and more than 200,000 healthcare units/centers. Sao Paulo State concentrates 2/3 of these quality certificates, and has more than 50,000 healthcare units/centers. Nobody worried about quality assurance…
Cut costs by cutting service reimbursement are another form of what people now call “brazilification” (I heard it for the first time back in 2000, now it’s getting popular…).
See NEJM publication: http://ht.ly/1IoJa

More on Vitamin D: breast cancer prevention

Recent report published in the American Journal of Clinical Nutrition found that women who take supplemental vitamin D (400IU/day) had reduced risk for breast cancer of more than 20%. No dose-response relationship was observed nor association with daily calcium or other vitamin intake.

Dietary intake of Vitamin D was a confounding factor and possibly biasing the results, but not affecting the risk. The study involved patients from the Ontario Cancer Registry diagnosed and a control group between 2002 and 2003. Authors used epidemiologic questionnaires and analyzed more than 6,000 women.

Once again seems that vitamin D intake is protective… see more at:

article abstract: http://ht.ly/1G49K

The Institute of Medicine (http://www.iom.edu/) will release this month a report about vitamin D adequate daily intake.

The www.veganhealth.com, info about calcium and vitamin D: http://ow.ly/1z4gE.

The University of Michigan, info about calcium and vitamin D: http://ow.ly/1z4hT.

Comments at Medscape: http://ht.ly/1G3P5 (for registered users).