Heart disease drugs may fight prostate cancer

May 2022

A team of international researchers have found that heart disease and diabetes drugs may improve prostate cancer survival rates.

MEN who take tablets for heart disease and type 2 diabetes may be more likely to survive prostate cancer if they get it, a new study shows. 

Statins, which help to reduce high cholesterol (a major heart attack risk) and metformin, a drug used to lower blood sugar levels in adults with type 2 diabetes, both appeared to improve survival rates and reduce the chances of tumours re-growing once they have been treated. 

The findings, by an international team of scientists from leading cancer institutions in the UK, Australia, US, Switzerland and Spain, are important because a huge proportion of men over 50 – the age from which the risk of prostate cancer rises – are also on the cholesterol and diabetes drugs. 

In the UK, for example, an estimated 8 million people are prescribed statins, at least half of them men. In the US, 35 million men and women take them. 

Meanwhile, metformin is one of the main weapons against type 2 diabetes and the NHS issues more than 20 million prescriptions a year for the drug. 

Some previous studies have already hinted that the drugs may be useful in preventing prostate cancer. 

One, for example, published in European Urology in 2014, found men on metformin tablets were 16 per cent less likely to develop a tumour. 

But other studies have questioned their effectiveness. 

Indeed, a 2007 study suggested men on statins had a slightly higher chance of prostate cancer over the following 15 years than men who took a placebo (a dummy drug that looks the same). 

For the new research the experts, which included those from the Institute of Cancer Research in the UK, Duke University in the US and the Institute of Oncology in Switzerland, tracked thousands of men taking part in drug trials for abiraterone acetate, a hormonal drug used to treat prostate cancer that has spread to other parts of the body. 

Researchers looked to see which of the men were also on metformin, statins or a combination of the two, and then compared recurrence rates – when the cancer returns after initial successful treatment – and overall survival for several years afterwards.

The results, published in the latest European Journal of Cancer, showed men on metformin were roughly half as likely to see their cancer return as those not on the diabetes pill. 

Meanwhile, those on statins were roughly 20 per cent less likely to die prematurely from prostate cancer than others not on the lipid-lowering tablets. 

It’s not exactly clear how the two types of drugs combat prostate cancer. 

But statins have an anti-inflammatory effect – and inflammation is one of the hallmarks of cancer. 

Metformin, it’s thought, may help by blocking certain proteins that play a key role in the proliferation of prostate cancer cells. 

Scientists stressed the drugs appeared to be most effective when they were combined with abiraterone acetate – suggesting giving them all together is the most powerful remedy. 

In a report on the findings researchers said: ‘Metformin and statins are associated with a prolonged overall survival.’ 

A separate UK study on the use of metformin as an early treatment for prostate cancer – before men undergo surgery to remove the prostate – is due for completionn shortly. 

Half the men are getting the diabetes medicines and the rest a placebo. 

If the results are positive, it’s possible metformin could be used as a treatment in early-stage prostate cancer, or even as a preventive in men who are overweight and have high blood sugar – who are at higher risk of developing a tumour.

Source https://www.ejcancer.com/article/S0959-8049(22)00205-2/fulltext copy