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Statin Plus Metformin Prolongs Survival of High-Risk Prostate Cancer Patients

Aggressive prostate cancer (Gleason score of 8 or higher) requires aggressive treatment to prevent recurrence. A statin plus metformin might be helpful.

Men diagnosed with aggressive prostate cancer may benefit from two unexpected medications: a statin plus metformin. The study was published in Cancer Medicine (Feb. 8, 2020). It tracked 12,700 men diagnosed with high-risk prostate cancer. These men had Gleason scores of 8 or higher. That means they were at greater risk of cancer recurrence, metastatic disease and death than men with lower Gleason scores.

The investigators note in their introduction:

“Identifying or developing additional therapies with low toxicity and cost is important to improve longevity and quality of life of men diagnosed with high‐risk PCa [prostate cancer].”

Can Prostate Cancer Be Delayed with a Statin Plus Metformin?

The evidence has been accumulating for years that both metformin alone and statins alone have some ability to help control prostate cancer. Here are just a few of the articles from the medical literature:

“Review of recent evidence in support of a role for statins in the prevention of prostate cancer,” (Current Opinion in Urology, May, 2008). 

“Statin use in relation to prostate cancer outcomes in a population‐based patient cohort study.” (Prostate, Aug. 2013).

“Metformin use and all‐cause and prostate cancer‐specific mortality among men with diabetes.” (J Clin. Oncol., Sept. 1, 2013).

“The current evidence on statin use and prostate cancer prevention: are we there yet?” (Nature Reviews. Urology, Feb. 2017).

“Metformin and prostate cancer: a new role for an old drug,” (Current Urology Reports, June, 2017)

New Research Confirms: Statin Plus Metformin Improves Survival

The investigators specifically examined the use of cholesterol-lowering statins or a statin plus metformin in men with aggressive prostate cancer. The men taking metformin were taking this diabetes drug to help control their blood sugar levels.

Men taking statins alone had longer survival statistics than men not taking statins. If they were taking both statins and metformin, survival data were even better.

The authors concluded that:

“We found that both statin alone and a combination of metformin and statin was significantly associated with reduced all‐cause and PCa [prostate cancer] mortality.”

Men who began taking both a statin plus metformin after their diagnosis of prostate cancer had the greatest benefit, a 54% reduction in prostate cancer mortality, even though the follow-up time was relatively short.

Which Statins Were Most Protective?

Not all statins may be created equal when it comes prostate cancer protection. The authors found that atorvastatin (Lipitor), pravastatin (Pravachol) or rosuvastatin (Crestor) seemed beneficial. Lovastatin (Mevacor) did not appear to afford protection.

Prostate Cancer Kills a LOT of Men!

Prostate cancer kills over 30,000 men each year. Some experts like to say that most men will die with prostate cancer, not from prostate cancer. That’s because many older men will have some microscopic signs of cancer by the time they reach their 70s or 80s. But it is often less aggressive. That means they are more likely to die of a heart attack, stroke or accident without even realizing that they had early signs of prostate cancer.

Men who have aggressive prostate cancer aren’t so fortunate. Once the cancer reachers the bones it can be a challenging journey. Treatment often revolves around shutting down testosterone production. That can also have a number of serious adverse effects. That’s why it is always best to try to reduce the risk of aggressive prostate cancer from getting even more aggressive.

The authors of the latest research concluded that:

“Our data demonstrated that statin alone is associated with reduced all‐cause and PCa mortality, and combination of metformin and statin holds great promise for reducing all‐cause or PCa mortality among patients with high‐risk PCa, particularly in post‐diagnostic settings.”

Men who began taking both a statin and metformin after their diagnosis of prostate cancer had the greatest benefit, a 54% reduction in prostate cancer mortality, even though the follow-up time was relatively short.

One Prostate Cancer Expert Ahead of the Curve:

Charles “Snuffy” Myers, MD, was founder and director of the American Institute for Diseases of the Prostate. He is a medical oncologist with prior experience in clinical pharmacology at the National Cancer Institute and as the director of the Cancer Center of the University of Virginia.

Throughout his long and distinguished career Dr. Myers’ goal has been comprehensive management of prostate cancer. He has been recommending a statin plus metformin for many years to reduce the risk of prostate cancer recurrence in high-risk cancer patients. You can listen to a free podcast with Dr. Myers at this link:

Show 1039: How to Reduce Your Risk from Breast or Prostate Cancer

Download the free mp3 file or click on the arrow inside the green circle under Dr. Susan Love’s photo to listen to the streaming audio.

Share your own experience with prostate cancer in the comment section below. 

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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Citations
  • Tan, X-L, et al, "Individual and joint effects of metformin and statins on mortality among patients with high‐risk prostate cancer," Cancer Medicine, Feb. 8, 2020, https://doi.org/10.1002/cam4.2862
  • Hamilton, R. J. and Freedland, S. J., "Review of recent evidence in support of a role for statins in the prevention of prostate cancer," Current Opinion. Urology, May, 2008, doi: 10.1097/MOU.0b013e3282f9b3cc.
  • Margel, D., et al, "Metformin use and all-cause and prostate cancer-specific mortality among men with diabetes," Journal of Clinical Oncology, Sept. 1, 2013, doi: 10.1200/JCO.2012.46.7043.
  • Liu, Q., et al, "Metformin Inhibits Prostate Cancer Progression by Targeting Tumor-Associated Inflammatory Infiltration," Clinical Cancer Research, Nov. 15, 2018, doi: 10.1158/1078-0432.CCR-18-0420
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