Headlines

As reported by the Danbury News-Times, January 4, 2006.

Study Says Statins Fail to Lower Cancer Risk

Best use for miracle drug is reducing cholesterol

By Robert Miller

Statins are still miracle drugs. They're just not miraculous across the board.
The cholesterol-lowering drugs have played a major part in reducing the incidence of heart attacks in the United States. If anything, cardiologists wish more people would take them.

But hopes oncologists could use them to prevent cancer — a claim put forward by some initial studies — may not be valid, at least not based on the evidence at hand.

A team of researchers at the University of Connecticut's School of Pharmacy and School of Medicine combined 21 major studies on statins, involving about 73,000 patients.

Combing through all the data in these studies, the team was unable to find any link between statin use and cancer incidence or mortality. The Journal of the American Medical Association published the team's findings today. "When we started this, we were hoping statins would make a difference,'' said Michael White, a pharmacist at UConn and a member of the team. "But we were looking at a humongous patient population and we weren't able to show any correlation.''

Dr. John Pezzimenti, chief of oncology at the Praxair Cancer Center at Danbury Hospital, said the study probably won't be the last word on the subject, since other researchers are exploring the use of statins to treat cancer. But, he said, it may help limit the use of the drugs by people taking them on a hunch.

"I have never prescribed statins for any of my cancer patients,'' he said.

Statins — sold under such trade names as Lipitor, Zocor, Pravachol and Vytorin —are used to lower LDL cholesterol, the so called 'bad' cholesterol. They are the top-selling class of prescription drugs in the United States, accounting for $15.5 billion in sales in 2004.

The reason they are so widely prescribed is simple. By and large, they work.

"They're a godsend,'' said Dr. Peter Schulman, associate professor of cardiology at the University of Connecticut School of Medicine in Farmington.

"There's our No. 1 therapy for people with heart disease or for people with a moderate risk of developing heart disease,'' said Dr. Andrew Keller,chief of cardiology at Danbury Hospital. "It's the only proven therapy to treat high cholesterol.''

Schulman said before the arrival of statins, doctors could tell their patients to exercise more and go on a low-fat diet to reduce cholesterol. "But they really don't work that well,'' he said of the lifestyle changes.

But with statins, he said, doctors can greatly reduce the risk of a second heart attack.

"I've been doing this for 25 years,'' he said. "When I first started, if a patient had a big heart attack, you knew you'd see that patient again within five years for a second attack. Today, because of statins, we have a reasonable expectation we won't see that patient again.''

Schulman said other studies show statins actually reduce the incidence of first heart attacks, as well.

"They reduce heart attacks, they reduce the incidence of strokes and peripheral vascular disease,'' he said. "They've proven to be of great value to diabetics, because they have a higher risk of heart disease.''

In recent years there has been speculation, and a few studies, to suggest that the drugs might also prevent tumors. One study from Israel, published in the New England Journal of Medicine in May, reported that statins could reduce the risk of some forms of cancer by as much as 50 percent.

To investigate these claims, the UConn team looked at 21 studies concerning statins. All of them, White said, were double blind studies, in which half the patients took statins and half, a placebo.

The UConn meta-analysis showed no correlation between statins and a reduction in either cancer rates or cancer deaths. White also said the team looked at particular types of cancer — breast, colon, lung, prostate — and again found no correlation between the drugs and cancer rates.

What this study may do, White said, is to confine statin use to those who need the drugs to treat high cholesterol. He said doctors, wanting to provide cutting-edge treatment to their patients, may have been prescribing these drugs as cancer-fighters.

If so, the new information is valuable. For as Pezzimenti of Danbury Hospital said, statins are medications. And like all medications, they have side effects.

"They can cause liver disease and muscle soreness,'' he said. "We also don't know the long-term impact of all these people being on statins. That's really a big question.''

At the same time, Pezzimenti said, he has seen animal studies that showed huge doses of statins — more than a human patient could tolerate — greatly reduced pancreatic tumors, which are still one of the deadliest and hardest forms of cancer to treat.

"I think this is still a work in progress,'' he said.