Nigel Hawkes, Health Editor
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Lowering cholesterol with statins may slightly increase the risk of cancer, a study suggests.
It is not clear whether the cancer cases are caused by the drugs, or are a consequence of the low levels of “bad” LDL cholesterol produced by taking them.
The result, which amounts to one extra case of cancer for every 1,000 patients treated, surprised the researchers who discovered it. They were looking for new evidence on the known side-effects of statins on the liver and muscle wasting.
“This analysis doesn’t implicate the statin in increasing the risk of cancer,” said the study leader, Professor Richard Karas, of Tufts University School of Medicine, in Boston. “The demonstrated benefits of statins in lowering the risk of heart disease remain clear. However, certain aspects of lowering LDL with statins remain controversial and merit further research.”
The team reviewed the results of 13 previous trials, involving more than 41,000 patients and all published before November 2005. They detected higher rates of cancer among the patients whose use of statins achieved the lowest levels of LDL cholesterol.
This may be important because recent statin trials have shown that a more aggressive lowering of LDL produces greater benefits to the heart. There are moves to lower the cholesterol targets aimed at by GPs, on the assumption that doing so will do no harm. But there have been suggestions that there may be a greater risk of side-effects if a more aggressive statin treatment is used.
The researchers, who published their findings in the Journal of the American College of Cardiology, found that the degree of damage to the liver increased with greater statin doses, but that there was no such effect in muscle wastage. They said the best strategy may be to combine statins at moderate doses with other drugs.
As for cancer, conclusions are difficult to draw. No single form of cancer predominated, so if there is a side-effect of having a very low level of LDL, it would have to apply to all types of cancer. And previous statin trials have not shown any direct effect on cancer risk. But those trials did not compare cancer risk with the degree of lowering of LDL cholesterol.
John LaRosa, of the State University of New York, cast doubt on the findings. If they were caused by a lowering of cholesterol, the effect must have been very rapid, as the trials lasted five years or less. Other explanations, he said, were chance, or simply that people who would otherwise have died of heart disease were living longer, and dying of cancer.
June Davison, cardiac nurse for the British Heart Foundation, said: “We have known about the association between low cholesterol levels and cancer for some time now. While this [research] highlights an association between low levels of LDL and cancer, this is not the same as saying that low LDL or statin use increases the risk of cancer. There is overwhelming evidence that lowering LDL cholesterol through statins saves lives by preventing heart attacks and strokes. These findings do not change the message that the benefits of taking statins greatly outweigh any potential risks. People should not stop taking statin treatment on the basis of this research.”
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My Husband had a cholesterol level of 7. He was prescribed simvastatin 18 months ago 40mg. Previously he had managed to reduce his cholesterol to around 6 by diet but it kept creeping up again. Heart disease was a hereditory factor in his family.Firstly after taking simvastain his sex drive dipped a little, he suffered constipation and had slight pain in the groin and hip area. He went to the Doctor who could find nothing wrong and eventually reduced his statin to 20mg. All these ailments disappeared but unfortunately he has now been diagnosed with prostate cancer. I believe that simvastatin is responsible for this diagnosis.
Carol , London, United Kingdom
It is possible to lower your Total Cholesterol and LDL with diet and exercise.
I have just done that (TC was 9.02 LDL =7.87 Hdl 2.07 CHO:HDL ratio 4.4) My Total now is 6.7 HDL 1.6 LDL 4.2 TC :HDL 4.2)
supplements used were H factors, Supergar garlic and TMG all from Higher Nature (highernature.co.uk) these were formulated by Patrick Holford in line with his book The H Factor (h for homocysteine is far more indicative of heart disease). I was probably deficient in B vitamins due to mainly veg diet and Goats milk (depletes B12) Havong seen the side effects of Zocor on my mother after angina and then a triple heart bypass at 81 put me right off!!
I suggest reading The cholesterol myth (patrickholford's website and also checking out what doctors don't tell you www.wddty.co.uk for safer ways to cope with this
final comment from the last consultant was "I am am surprised at the fall in LDL from 7.9 to 4.2 on lifestyle measures"
My own GP does not believe in statins!
Jennie T, London,
I have heard from various sources that eating grapefruit exacerbates the effects of statins, so therefore people on statins should not eat grapefruit. Does this mean then that grapefruit could lower cholesterol? It would be a way of avoiding statins.
L. Farrington, Whitstable, UK
My father-in-law died of bowel cancer in jan this year aged 59. His problems started when he was prescribed statins and he always believed that there was a link between his cancer and the statins.
Catriona Lovell, Milton Keynes,
one of the results of having cancer is having a lower cholesterol level due to increased metabolism and weight loss. cholesterol does not pick up toxins from the body and does not eliminate them. cholesterol instead is the basic material for a variety of hormones and steroids.
Tisch, Hilders,
Some commentators are smugly assuming that just diet/lifestyle is to blame for high Chol. When you're diagnosed with heriditary high chol with a level of 13.6 you get a different view point! , and I am a fitness pro of many years standing. I wish mine was 6 or 7 without help!
val smith, nottm, uk
I can confirm what starling from Lancaster is saying. I am one of those patients who have to take stains even thou I was always very careful to keep fit and exercise regularly. My cholesterol levels where always high due to genetic reasons. My liver apperently produces more cholesterol then it should on an every day level, so i have to take stains everyday. Well its not good to hear that (even thou if on a very low percentage) stains increace risk of cancer.
Vincent Pavia, Gozo, MALTA
Few people naturally have a cholesterol level high enough to jeopardize their health. Those without heart disease, or the potential of it, need their cholesterol for many reasons. It keeps us flexible, it also is plays a part in skin elasticity (and artery flexibility), plus, our sexual hormones are produced in our cholesterol. Therefore the American obsession with lowering cholesterol might explain its ubiquitous need for Viagra. Many people diagnosed with dementia miraculously regain their memories when taken off statins.
One of cholesterolsâ main functions is to protect the body from toxins . It binds to the toxins to take them from the body before toxic damage occurs. Cholesterol has been proven, in studies outside the U.S., to be cancer protective, probably because cholesterol protects the body from the toxins that can cause cancer. It would stand to reason that lowering this cancer protective element would raise the chance of one getting cancer. As this article suggests.
Dian Freeman, Morristown, NJ, USA
Statins have never been licenced for treatment in known cancer and cancer was an exclusion in the initial trials ,all that has been found is a side effect known to the drug companiies initially.As for the risk at the lowe end of treament now being advocated Statins will save one life in 400 over ten years ,if you increase your risk of cancer by more than that you have a nil gain,a painful cancer death substituted for a quick heart attack.
and the side effects of the statins as well!
Graham Edlin, london, uk
Did the study control for anything significant like diet or exercise? It may be that participants who have greater success with statins become less concerned about the effects of their lifestyles--while others, having less success with the drug, adopt healthier lifestyles to compensate.
Lisa, New York, NY
"There is a view that lowering of LDL cholesterol, if that is neccessary, can be achieved by a balanced diet and exercise."
Nope, not if it's genetic. My uncle, for instance, who is very fit, eats lots of home-grown fruit and veg, and can't stand chips, had a stroke anyway. My entire family on my mum's side was basically born with high cholesterol. And it's just our luck that the same is the case with my partner's family (my father in law has just been diagnosed with very cholesterol, even though he's one of the healthiest living guys on the planet).
starling, Lancaster,
You have to die of something.
Rance, Lex,
I'd rather die of a heart attack quickly than waste away slowly with cancer. Why do we have to treat every piffling little thing? People all have weaknesses and tendencies to disease, that is nature. Why bother curing one thing when you just get something else instead? I would rather they stopped wasting money on cholesterol research and focused money on cancer, Parkinsons, etc that are long term illnesses that affect all ages, not something like cholesterol that might just give me another 5 years before I conk out from something else.
Helen, Reading, uk
Taking statins saved the lives of some people. Some of those people who were saved will go on to develop cancer. Had they not been saved they would not have survived to develop cancer. The question is whether the cancer rates amongst statin survivors are higher than those in the remainder of the population. And if there is a difference in cancer rates, how significant it is. If the difference in cancer rates is statistically significant, could it be that there is something about people who have high cholesterol that makes their chances of developing cancer different from the remainder of the population. I think that these are complicated questions and I wonder if they were addressed in the academic paper referred to in this article.
Gerard, London, UK
"While this highlights an association between low levels of LDL and cancer, this is not the same as saying that low LDL or statin use increases the risk of cancer"
How true: a (very) weak association does not prove causation. It's just a pity the same standard is not applied when the subject not a pill they want to force on - as when they invented passive smoking
Mike Bibby, St Albans, England -not EU
Charles from London - I doubt that the researchers are stupid enough to have fallen into that trap. (Though I guess it's possible).
I expect they have looked at the patients who survived and found a correlation between LDL levels & cancer rates within that group. Under your hypothesis, there should be no such correlation - just a higher cancer rate for the survivors than for those who died.
In fact, you don't need to ignore those who died at all, you just need to factor in the time for which they were exposed to the risk of cancer (i.e. alive).
Ed W, London,
Introducing any drug into the human body will always carry some risk. Careful and wise monitoring presents an enormous challenge to all concerned. I have been interested in adverse-event reports that raise some possible linkage between statins and ALS.
Gail Thomas, Washington, DC,
You can't win. The bottom line is start taking care of yourself through diet and lifestyle. If you have had a bad start like a smoking and drinking mum when you were in her womb and not breastfed there is nothing much you can do except try not to repeat the mistakes. Solids should not be introduced to babies without teeth (obviously) which is about 6-7 months as it increases their allergy risks. No doubt breastfeeding is far superior to the bottle but for some mums it is not convenient. Start giving your children fresh and healthy foods right from the start and give them water instead of sweet drinks. We will find that it is easier to eat healthily if it is the norm. Most people are not too bothered with healthy eating when they can just go to the doctors and be put on cholestrol lowering pills. Doing things the natural way is always better than popping pills. Of course it would be better for the pharmaceutical industry if everyone has to take some kind of pills. Milk is bad.
Virginia, Brisbane, Australia
Statins increase the overall incidence of death, due the reduction in CoQ10 production in the liver, which is a precursor to ATP, needed for cell energy. In more unbiased studies, 70% of patients taking statins who had no previous incidence of heart trouble developed diastolic disfunction wiithin 24 weeks. Other recent evidence indicates that full strength statins can deplete the brain of enough cholesterol to produce memory loss or even Alzheimer's (its used by your synapses). Still more unbiased research indicates cholesterol is not even in the top 10 causes of congestive heart failure. Also, if your over 70, your life expectancy actually goes up with your cholesterol level.
Inflammation is what should be worried about, and healthy eating is really the only way to fix it without side effects.
Tod Gordon, West Caldwell,
I am a low risk with regard to heart attack but was prescibed statins to reduce a high chloresterol level. This 10 mg dose brought the chloresterol level down to 5.5 which does not satisfy the text book levels and the dose was increased to 20 mg. Again the chloresterol level remained at 5.5 and now i am on a 40 mg dose ie four times the original dose.
I am far from convinced that this is reasonable, am I not being put at greater risk to liver, muscle and now cancer problems just to alter the statistics to fit an arbitary low chloresterol level?
A. Robson, Newcastle upon Tyne, Tyne and Wear
Although research, incomplete as it is may seem my be confusing to readers, it should be regarded as part of drug 'history' and should be merely borne in mind in relation to continuing new research as and if, it emerges.
All research is two sided. But its better to be mildly confused that totally ignorant.
TOM MCPARLAND, LONDON, UK
This is nothing new - it has long been known that low cholesterol is actually a rpoblem being assoicated with cancer, stroke, alzheimers and other diseases.
http://www.second-opinions.co.uk/cholesterol_myth_4.html
Of course it is not politically correct to say that and there is a huge amoutn of money being made by Big Pharma in prescribing statins.
Chris , Edinburgh,
It would be useful to know if there is a natural, non-damaging alternative to take alongside a low fat, reduced red meat diet.
The only natural rememdy I know of is garlic - anyone know more than this?
Molly, Lincoln, Lincs
Iv'e taken Zocor (Lipex in NZL) 40mg for 3 years since I was aged 40 as a precautionary measure (my other 'risk factors' other than high Chol were low). My Cholestorol dropped over a year from 8.6 to under 5.0. Good/Bad ratio improved from 15.4% to 38%.
In 2006, out of a group of 4 of my immediate workmates, the other 3 had MI's, & one died. I have never had an MI and I was the oldest of the 4 of us. The unfortunate workmate that died had a Chol level of 10, which had been reduced by using 40mg Lipex, but I understand (post facto) he had gone off his med's for the 3 months prior to the event, as he had'nt "found time" to get repeat prescriptions.
I'm considering increasing to either 50 or 60mg's to lower my LDL further in line with UK guidelines, but I would be interested in the mortality statistics in those that have been on statins that then cease treatment (PS: - I have no intention of stopping taking the meds).
Tim, London , England
There is a view that lowering of LDL cholesterol, if that is neccessary, can be achieved by a balanced diet and exercise. An Ockhams Razor view of holistic health maintenance would suggest that this simple approach, which avoids the expense of medication, might be considered as an alternative to the possibility of additional risk, not yet fully evaluated, however small.
Overeating (which might in some places now be considered an epidemic) might respond to non-medical remedy, including the raising of the level of general happiness by a balanced and less stressful lifestyle.
dr venables preller, Warminster, UK
Total rubbish.
What you're basically saying is that people who lived longer, got cancer.
They would have got cancer anyway, but we'd never have known because they would have already died of a heart attack, and or would be on a ridiculous antioxidant rich diet post event.
The only way the research would have been meaningful, was if some cancers were predominant.
Charles, London,
Until there is long term usage, which may or may not confirm these findings, surely the aggressive use of statins should now be discouraged.
David Elliott, Hull,
I was put on a daily dose of Lipitor whilst living in Adelaide. Over a period of a year the side effects - aching joints, debilitation of muscle strength, poor sleep patters and agonising bursitis - became so bad that on returning to South Africa I weaned myself off the drug and started taking policosanol instead.. Six months down the track no side effects and I am fitter than ever. A pharmacist neighbour similarly has stopped using Lipitor and is taking 3 grams of vitamin C instead as he believes this large dose also reduces blood cholesterol.
Bill Richards, Cape Town, South Africa