Statins are cholesterol-lowering drugs that some integrativein cancer care, a patient-centered approach combining the best of conventional care, self care, and evidence-informed complementary care in an integrated plan oncologists use off-label to improve survival, although statins can have serious side effects.
How do experts use statins?
Integrative experts provide recommendations for statins in treating people with cancer. Learn more about the approaches and meanings of recommendations ›
Published protocols, programs, and approaches
These protocolsa package of therapies combining and preferably integrating various therapies and practices into a cohesive design for care, programs, and approaches by leaders in integrative cancer care use or recommend statins.
We do not recommend specific integrative protocols or programs but provide information for you to evaluate with your healthcare team.
Keith Block, MD
Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Care. New York: Bantam Dell. 2009.
The integrative Block Program has recommendations to people who are at different places along the cancer continuum:
- Those who’ve been recently diagnosed
- Those in treatment
- Those who’ve concluded treatment and need to remain vigilant to prevent recurrence
Use of statins for inflammation:
“A 2007 trial suggested that a statin may overcome drug resistance in multiple myeloma. So if a patient has multiple myeloma and is out of options, I would certainly consider as one option prescribing a statin for her alongside her drug protocol, in hopes of overcoming resistance and initiating a response.” (p. 522.)
Raymond Chang, MD, FACP
Chang R. Beyond the Magic Bullet: The Anti-Cancer Cocktail. New York: Square One Publishers. 2012.
This book describes a “new therapy based on the knowledge that certain off-label drugs, nutrients, and therapies are each somewhat effective against cancer.” Dr. Chang combines approaches for added benefit.
Uses of statins:
- As an adjuvanttreatment applied after initial treatment for cancer, especially to suppress secondary tumor formation treatment for liver cancer
- As part of a combined treatment for preventing cancer occurrence as well as recurrence, especially for breast, colon, lung, and prostate cancer
“Based on the large volume of research, the benefits of statin use appear to outweigh the potential risks. Still, patients should discuss statin use with a healthcare professional and take the drug only as directed.“ (p. 105)
Neil McKinney, BSc, ND
McKinney N. Naturopathic Oncology, Fourth Edition. Victoria, BC, Canada: Liaison Press. 2020.
This book includes descriptions and uses of many natural and complementary protocols for cancer in general and for specific cancers. It also includes information on integrative support during conventional cancer treatment.
Statins are associated with increased survival in epithelial ovarian cancers. The statin drugs appear to slow the spread of aggressive forms of prostate cancer and to radiosensitize tumors. Red rice yeast extract contains a naturally occurring form of the statin drug lovastatin.
Other expert assessments
Henninger and Fritz
“Off-label use of statins or novel Rac1 inhibitors might represent a promising pharmacological approach to gain control over chronic cardiotoxicity by interfering with key mechanisms of anthracycline-induced cardiomyocyte cell death.”1Henninger C, Fritz G. Statins in anthracycline-induced cardiotoxicity: Rac and Rho, and the heartbreakers. Cell Death and Disease. 2017 Jan 19;8(1):e2564.
Wang, Wakelee, Aragaki, Tang, Kurian, Manson, and Stefanick
“Studies seem to suggest that statins may be protective and are not likely to be harmful in the setting of cancer, suggesting that cancer patients who already take statins should not have this medication discontinued.”2Wang A, Wakelee HA et al. Protective effects of statins in cancer: should they be prescribed for high-risk patients? Current Atherosclerosis Reports. 2016 Dec;18(12):72.
Dosing
Dosing of statins in conventional use varies depending on the particular statin prescribed.
The most effective dosing of statins for use in cancer treatment has not yet been established by randomized control clinical trials. No single statin agent and dose has yet been recommended for cancer prevention in the general population.3May MB, Glode A. Novel uses for lipid-lowering agents. Journal of the Advanced Practitioner in Oncology. 2016 Mar;7(2):181-187.
Because most human studies have been observational of people already on statins for lowering cholesterol and other conditions, conventional doses were observed in those studies. Some lab and animal studies suggest that higher doses may be needed for anticancer effects.4Licarete E, Sesarman A, Banciu M. Exploitation of pleiotropic actions of statins by using tumour-targeted delivery systems. Journal of Microencapsulation. 2015;32(7):619-31. However, higher doses are also likely to be accompanied by higher toxicity when given systemically.
These reviews discuss doses of specific statin drugs used in cancer prevention and/or treatment studies:
- Pisanti S, Picardi P, Ciaglia E, D’Alessandro A, Bifulco M. Novel prospects of statins as therapeutic agents in cancer. Pharmacological Research. 2014 Oct;88:84-98.
- Micallef D, Micallef S, Schembri-Wismayer P, Calleja-Agius J. Novel applications of COX-2 inhibitors, metformin, and statins for the primary chemoprevention of breast cancer. Journal of the Turkish German Gynecological Association. 2016 Dec 1;17(4):214-223. p. 221.
Commentary
Regarding concern for cognitive dysfunction with statin use, Gary Oberlender, MD, a geriatrician and consultant in geriatric care, states: “Though the connection between statins and cognitive dysfunction has not been ‘proven,’ that does not prove a lack of connection. The studies published have been too short and not well performed, in my view. However, there is abundant anecdotal evidence, including my own [clinical] experience, that strongly suggests that some, but certainly not all, people who take statins experience brain fog or other ill-defined cognitive symptoms. I think it has to do with too low LDL levels. In any event, I routinely recommend stopping statin drugs in persons experiencing cognitive symptoms, but only after a discussion with their primary care provider. I am not aware of evidence linking statin use with improved cognitive performance, though statins may reduce the risk of vascular dementia.”5Oberlender G. Email communication with Laura Pole. November 19, 2018.
Integrative oncologist and retired CancerChoices advisor Dwight McKee, MD, among others:6McKee D; Lecture: Off label pharmaceutical ‘cocktails’ for cancer treatment. Presentation at A4M Integrative Cancer Therapies, Module 6. June 6-8, 2013. Used with permission of Dwight McKee and Raymond Chang. Slides are available on request. Because most of the statins have patents that are expired or near expiration, there is a lack of incentive on the part of drug companies to conduct large-scale clinical trials using these agents against cancer, so it is not clear that we will gain much more useful clinical insight in the near future, but strong reasons to consider adding statins to most cancer preventative or treatment cocktails unless side-effects are an issue in an individual patient.
Notwithstanding occasional contradictory reports of statins increasing the risk of cancer, given the safety (simvastatin is available as an OTC in the UK) and low cost of statins, plus the wide array of studies and accumulating data showing a protective effect of statins against cancer development and recurrence, statins should be seriously considered as part of a cocktailed approach for primary and secondary cancer prevention (especially for colon, breast, lung and prostate—where the data are strongest).
Statins should also be seriously considered as a cornerstone ingredient to combine synergistically with other compounds such as gamma tocotrienols, Cox-2 inhibitors, bisphosphonates, etc. for added effects in cancer treatment. Not all statins are the same however, and some (lipophilic statins such as simvastatin) may work better against certain cancers than others (hydrophilic statins such as pravastatin). Dosage may be important as well.”
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References