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Is statin use a good idea for "treatment" for PC?

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Tall Allen
Elite Member
Joined : Jul 2012
Posts : 10645
Posted 10/27/2017 11:43 AM (GMT -8)
I know that I have, in the past, advocated low doses of statins, metformin and aspirin for long-term disease management of PC. Although the evidence of any benefit is highly equivocal - there are as many studies that failed to show any effect as suggest some small effect. But I figured they are cheap, relatively harmless, and may have ancillary benefits for cardiovascular disease - so why not?

Today I read a good reason why not for statins. In people who are at high risk to develop diabetes, use of statins was associated with a 36% increase in the development of diabetes. This does not mean that statins should be withheld from those at risk for CV disease, but it does raise the "alert" level for unproven uses (like PC).

drc.bmj.com/content/5/1/e000438

/www.medscape.com/viewarticle/887472
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Fairwind
Veteran Member
Joined : Jul 2010
Posts : 4107
Posted 10/27/2017 11:55 AM (GMT -8)
Just when you thought it was safe to go in the water.....
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lapilot
Veteran Member
Joined : Nov 2012
Posts : 991
Posted 10/27/2017 2:21 PM (GMT -8)
It would be interesting to see if there is a correlation with BMI and statin use. Many friends I know that are on statins have a BMI greater than 25which is indicative of being overweight and also risk of type 2 diabetes. It is known that hyperlipidemia risks increase with increase BMI.
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Tony Crispino
Veteran Member
Joined : Dec 2006
Posts : 8160
Posted 10/27/2017 2:54 PM (GMT -8)
Good post Allen,
As with any medication being repurposed we lack sufficient data on them for recommending them as treatment. In fact the likelihood is that there is more harm than good when doing so. As you point out there is a significant increase in diabetes with statins. That's a good reason to not take them if you don't need too.
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Jerry L.
Veteran Member
Joined : Feb 2010
Posts : 3197
Posted 10/27/2017 3:40 PM (GMT -8)
Tony,

I think you meant to say..."As you point out there is a significant increase in diabetes with statins...(for those that are high risk for diabetes to begin with..)"

btw --- long time no talk...hope all is well...don't get round these parts too much and thought I'd nitpick...

Jerry L.
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Tony Crispino
Veteran Member
Joined : Dec 2006
Posts : 8160
Posted 10/27/2017 3:46 PM (GMT -8)
Hi Jerry,
TY for the nitpick! smile

But I digress, many people don't know if they are at high risk for diabetes. Even with a bathroom scale screaming it's time to lose weight. But I guess the good news there is that they are at risk for CP issues as well.

Things are going well. Still working behind the scenes Just yesterday I was appoint to the NCI Prostate Task Force for a three year term. Should be interesting I think.

I see you posting every once in a while on FB. I hope things are going well for you and yours.

T
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Jerry L.
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Joined : Feb 2010
Posts : 3197
Posted 10/27/2017 3:53 PM (GMT -8)
Like
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Reltnie
Veteran Member
Joined : Feb 2013
Posts : 722
Posted 10/28/2017 7:39 AM (GMT -8)
I watched my blood sugar rise while on statins, so I started taking them every other day. Cholesterol went up slightly, 135 to 155, but blood sugar dropped from 105 to 89. No real change in diet, just statin every other day instead of daily.

Tom
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InTheShop
Elite Member
Joined : Jan 2012
Posts : 11468
Posted 10/28/2017 8:19 AM (GMT -8)
I don't like statins - they make the world taste like a metal spoon.
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Break60
Veteran Member
Joined : Jun 2013
Posts : 1870
Posted 10/28/2017 3:07 PM (GMT -8)
I’ve been on them for years and every thing tastes great! Which is why I’m overweight!
Bob
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Paxton
Veteran Member
Joined : Aug 2016
Posts : 1465
Posted 10/28/2017 5:49 PM (GMT -8)
I've been on statins of one type or another for about 7 years. Didn't help me with PCa.

I had such bad muscle pain with most of them that I had to change to an old one (Pravachol) at a low dose to avoid the pain. It keeps my total cholesterol at "borderline-high" but my cardio and I think that is good enough. No blood sugar issues, though, so I'll stay where I am.
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lifeguyd
Veteran Member
Joined : Jul 2006
Posts : 691
Posted 10/28/2017 8:58 PM (GMT -8)
I have been taking statins for more than 25 years. First pravastatin then atorvastastin Yes, I was almost a beta tester. It sure didn't prevent prostate cancer. But I haven't had any heart disease, which I expected due to genetic inclination. It might have caused me to have neuropathy, kidney disease and pre diabetes, which might the downside.
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BillyBob@388
Veteran Member
Joined : Mar 2014
Posts : 4855
Posted 10/30/2017 8:58 AM (GMT -8)

Tall Allen said...
I know that I have, in the past, advocated low doses of statins, metformin and aspirin for long-term disease management of PC. Although the evidence of any benefit is highly equivocal - there are as many studies that failed to show any effect as suggest some small effect. But I figured they are cheap, relatively harmless, and may have ancillary benefits for cardiovascular disease - so why not?

Today I read a good reason why not for statins. In people who are at high risk to develop diabetes, use of statins was associated with a 36% increase in the development of diabetes. This does not mean that statins should be withheld from those at risk for CV disease, but it does raise the "alert" level for unproven uses (like PC).

drc.bmj.com/content/5/1/e000438

/www.medscape.com/viewarticle/887472

It may well "not mean that statins should be withheld from those at risk for CV disease". But OTOH, is diabetes not a rather stout risk factor for CV disease, as well as many other ailments? How much do the odds ratios for overall ( or heck, even CV specific death) mortality improve with the use of statin drugs compared to the increase in all manner of health problems- including increased overall and CV mortality- that comes with diabetes?

But I suppose if the statins improve the overall mortality in a large group, that large group would include those that either had diabetes, or even those that supposedly it does actually cause the diabetes in? So despite coming down with diabetes, they lived longer than those that did not get the statins? In RCTs?

I totally agree with you when you say: "but it does raise the "alert" level for unproven uses (like PC)."
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BillyBob@388
Veteran Member
Joined : Mar 2014
Posts : 4855
Posted 10/31/2017 6:55 AM (GMT -8)
From the medscape link in the OP:

Somebody said...
Over 10 years, statin use was linked to a 36% increased risk of being diagnosed with type 2 diabetes, falling to 27% after taking into account baseline risk factors and clinical criteria used to determine the need for statins.

The findings are consistent with previous studies suggesting that statin use substantially increases the risk of type 2 diabetes.

The new study was published online October 23 in BMJ open Diabetes Research & Care by lead author Jill P Crandall, MD, department of medicine and diabetes research center, Albert Einstein College of Medicine, New York, New York, and colleagues.

As previously reported by Medscape Medical News, a study of more than 8700 Finnish men aged 45 to 73 years showed that over 6 years of statins therapy were linked to a 46% increased risk of type 2 diabetes — more than double prior estimates.

This was followed by recent data from the Australian Longitudinal Study on Women's Health, which indicated that, among almost 8400 women aged 76 to 82 years, the risk of new-onset diabetes ranged from 17% with the lowest statin doses to 51% with the highest doses.

Despite accumulating evidence, the current researchers still maintain that the overall healthcare advice remains unchanged — the benefits of statins outweigh the risks.

So the 36% increased risk( or 27% if accounting for all baseline risk factors and clinical criteria used to determine the need for statins?) is apparently simply an additional increase in risk for people that are already at high risk? Is that correct? But when looking not at particularly high risk populations, just more the general populations that might need statins, the increased risk is more like 50%? Correct?

It is pretty darn impressive that the benefits outweigh the risks, considering all the misery diabetes can cause(just had a friend in his 60s who died a miserable death from it, but he also refused to do what was needed diet or meds for many years). Especially since those problems include a very significantly(2X-4X) increase in deaths fom CV disease.(and don't forget higher risk for amputations and blindness and many other problems, like many cancers and dementia) . But apparently the benefits do outweigh the risk. It appears we can increase the risk of diabetes a good bit and still end up better off after doing that. Definitely impressive indeed!

But taking statins along with their increased risk for diabetes(and for higher blood glucose leading to higher blood insulin I suppose?) for some possible slight improvement in my PC risk or outcome? Not me! (Many may well differ with me on that) I already have enough trouble staying away from diabetes due to my love of pancakes, bread, pasta and desserts! ( I guess there was a reason for the old name of sugar diabetes )
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