Statin drugs to lower cholesterol may also reduce the risk of cancer death, a new study suggests. The study included 18,721 Danish adults who took statins before being diagnosed with cancer. They were compared with 277,204 cancer patients who had never used statins. People who took statins were 15% less likely to die of cancer or any other cause during a follow-up period. Researchers said that's about the average benefit of chemotherapy. But experts said this doesn't mean people with cancer should take statins. For example, death rates were not lower for those who took bigger doses of statins. Researchers look for that sort of relationship as evidence that a drug fights disease. The study also did not randomly assign people to receive a treatment or a placebo (fake). That means other factors could explain the results. The New England Journal of Medicine published the study. HealthDay News and Reuters Health news service wrote about it November 8.

By Robert H. Shmerling, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

It's hard to come to any other conclusion: Statins are a remarkable class of drugs.

These widely prescribed medicines include atorvastatin (Lipitor), simvastatin (Zocor), pravastatin (Pravachol) and others. They rather reliably lower LDL, the harmful type of cholesterol. More importantly, they reduce the risk of death among those who have (or are at high risk of) heart and blood vessel disease. And, while any medicine comes with a risk of side effects, the statins have a good safety profile.

A new study suggests there may be another important benefit of taking statins: a reduced risk of death from cancer.

This interesting study analyzed the effect of prior statin use among people with cancer. Here's what it found:

• Cancer patients who used statins in the past had a 15% lower rate of death from any cause than similar patients who had never taken statins.
• Statin users with cancer also had a similar reduction (about 15%) in cancer-related death rates.
• The dose of the statin drug did not seem to matter. People taking low or high doses had similar reductions in death rates.

These findings are not the first to suggest that statins might have a helpful effect among people with cancer. Prior studies have found that prostate and breast cancers are less likely to return after treatment for people taking statins than for similar patients who never took statins.

Why should statins help keep cancers from coming back? Statins block an enzyme (called HMG-CoA reductase) that is involved in the production of cholesterol. That's how they lower LDL. But blocking this enzyme may also hinder cancer cells from multiplying and spreading through the body.

So, if you are taking a statin and have a history of cancer, this new study could be good news. You may be getting even more out of your statin than you thought!

What Changes Can I Make Now?

These findings are intriguing. But I think it’s too soon to recommend statins for cancer patients as a way to slow the return or spread of cancer. The same goes for healthy people trying to avoid cancer in the first place. This study looked only at people who already had cancer. Past studies of statin use among people without cancer have not shown that they reduce diagnosis of new cancers or related deaths.

In the meantime, there are more established ways to reduce your risk of cancer or its complications. These are some of the most important things you can do:

• Get regular exercise.
• Improve your diet. For example, foods that are high in fiber and low in saturated fat may reduce your risk of colon cancer. Choose more fruits, vegetables and whole- grain fiber. Cut back on saturated and trans fats.
• Avoid excessive sun exposure. When you are out in the sun, use sunscreen.
• Drink less alcohol.
• Don't smoke.
• Lose excess weight.
• Get cancer screening tests. Advice on what tests to get varies based on age, gender and other risk factors. Evidence of benefit is best for:
  
  • Colonoscopy (for colon cancer)
  • Pap smears and HPV testing (for cervical cancer)
  • Mammograms (for breast cancer)
• See your doctor promptly if you have a health concern that could be an early sign of cancer. Examples include a breast lump or blood in the stool.

Learn about your family history. Some cancers run in families. Screening advice varies based on whether there is a strong family history of cancer. For example, earlier and more frequent screening may be recommended if you have a strong family history of colon cancer. Genetic tests for ovarian and breast cancer are available for those who have a strong family history of these diseases.

Talk to your doctor about how you can lower your risk of cancer. If you already have been diagnosed with cancer, ask how you can help to keep it from coming back.

What Can I Expect Looking to the Future?

I think it's too soon to recommend taking a statin drug for its anti-cancer effects. But this could change if more research confirms a link between statin use and better cancer survival.

Even if a benefit is confirmed, some important questions will need to be answered. For example:

• Which cancer patients will benefit most from statin treatment?
• Does the type or stage of the cancer matter?
• What about people without cancer? Prior studies have been disappointing in this regard. People without cancer who were taking statins had no reduction in newly diagnosed cancers or cancer-related deaths. But future research could find exceptions to these negative results.
• Does the effect of statin treatment vary in different types of patients? People in this new study were nearly all white adults of Danish descent.

It will take time to answer these questions. But it's quite possible that the list of benefits of statin drugs is about to get longer.