Platz conducted this investigation working with the massive, long-term Health Professionals Follow-up Study, in which 34,989 men have been followed for many years. As the study began, none of the men had prostate cancer. They answered a host of questions, reported all the medications they were taking, and updated this information every two years; investigators also reviewed their medical and pathology records to confirm their prostate cancer diagnosis. From 1990 to 2002, 2,579 of these men developed prostate cancer; 316 of them had advanced disease.
Platz’s study revealed that men who took statin drugs not only were protected against advanced prostate cancer, but that “the longer the men used a statin, the lower their risk of getting advanced and high-grade disease,” Platz says. Men who took a statin drug for less than five years had a 40-percent lower risk of developing advanced prostate cancer, and men who used a statin for at least five years had a 70-percent lower risk. This work was published in December 2006 in the Journal of the National Cancer Institute.
Why statins? Platz first started looking at these heart-disease drugs because she liked what they do: They have properties that fight inflammation and reduce the likelihood of metastasis, and promote a cellular process called apoptosis, or programmed cell death. (Basically, cells are supposed to die; cancer cells show immortal tendencies, and don’t die when they should. This results in uncontrolled growth.) “Statins have exactly the characteristics you would want to find in a drug to prevent and treat cancer,” she notes. Her findings were later confirmed in four other studies.
Platz loves the idea that it might be possible to improve a man’s prognosis simply by giving him a statin drug or other means of keeping cholesterol low.
Next, in a groundbreaking study of nearly 1,400 men, Platz and colleagues made another discovery: Low cholesterol itself — whether it was lowered by a statin, or was just a natural blessing — was good news. Men with cholesterol levels under about 190 had a 40-percent lower risk than other men of being diagnosed with high-grade and possibly advanced prostate cancer. Their findings were published in the International Journal of Cancer.
In further work, Platz, along with Misop Han, Patrick Walsh and a doctoral student, Alison Mondul, is hoping to answer further questions — investigating, for example, whether statins can influence the pathologic characteristics of prostate cancer in men undergoing radical prostatectomy, and whether these drugs can reduce a man’s risk of cancer recurrence after surgery. Platz expects results later this year.
“I am excited about this research,” she notes, “because it holds the promise of directly affecting the care of men at high risk for prostate cancer that may be aggressive or even fatal; men with the disease who are at high risk for recurrence after primary treatment; and men whose cancer recurs after treatment.”
Platz loves the idea that it might be possible to improve a man’s prognosis simply by giving him a statin drug or other means of keeping cholesterol low. If her collaborative work continues to be successful, the next steps likely include clinical trials to investigate the ability of statin drugs to prevent or treat prostate cancer. “Prostate cancer has been resistant to discoveries that are translatable into clinical interventions for prevention or treatment,” she says. “So, it is fortunate that a commonly prescribed treatment for cardiovascular disease — statin drugs — and its well-recognized target — cholesterol — have emerged possibly as top candidates.”