Statin drugs may impact PSA levels – even in men with prostate cancer

Breaking Bad

Men, I have some horrible advice for you today.

That is – the advice is from someone else, and I’m giving you a heads-up: It’s truly awful.

Most importantly, your doctor needs to know it’s awful too.

Muddy waters

Just when it seems I’m as fed up as I can possibly get with cholesterol-lowering statin drugs, a new study reveals yet another reason to steadfastly avoid Lipitor, Zocor, Crestor and all the rest of the dangerous brand names in this drug class.

According to a press release from Detroit’s Henry Ford Hospital, it now appears that statin use artificially skews PSA levels.

As if the PSA picture weren’t already muddy enough.

In many e-Alerts I’ve discussed the PSA dilemma. PSA (prostate specific antigen) is often secreted by the prostate gland in greater abundance when prostate cancer is present. And although PSA is not an entirely reliable marker for prostate cancer, an upward progression of PSA levels over time is a red flag. The key phrase here: “over time.” PSA levels can fluctuate, so a high level on a single PSA test should be cause for further monitoring, but not cause for alarm, and certainly not cause for a biopsy.

At a recent meeting of the American Urological Association, a team from Henry Ford shared their findings in a study in which PSA levels were recorded in nearly 4,000 prostate cancer patients. More than 25 percent of the patients were also statin users.

Analysis showed that PSA levels were “significantly lower” among the prostate cancer patients who were taking statins. In other words, this already unreliable prostate cancer marker is made even more unreliable when statins are used.

But that’s not the way the lead author of the study saw it. In the Henry Ford press release, Piyush K. Agarwal, M.D., made this observation: “The implication is that we may need to lower our PSA threshold for performing a biopsy in patients on statins.”

LOWER the threshold? I’ve got two words for Dr. Agarwal: No! Way! (Repeat emphatically as many times as necessary.)

Not for the squeamish

In case you’re wondering, men, Dr. Agarwal’s advice is the advice you and your doctors should completely reject.

Why? Because a biopsy is serious business.

In a prostate biopsy a needle is inserted into the gland and a slice is extracted. About 10 slices are usually taken. Anesthesia is used during the procedure, of course, but pain lingers after the anesthesia wears off. Other side effects include blood in the urine, difficulty urinating, and infection of the prostate.

Alternative healthcare pioneer William Campbell Douglass, II, M.D., refers to the traditional use of PSA tests and their follow up biopsies as “the mainstream’s slash-and-burn approach to prostate cancer.”

And Dr. Agarwal suggests we nudge statin users a little closer to slash-and-burn?

No! Way!

I guess we can Thank Dr. Agarwal and his colleagues for one thing: They’ve given us another reason to avoid statin use.

Source: “Prostate Cancer Patients’ PSA Levels Altered By Statins” Medical News Today, 4/30/09,