Chronic Use of NSAIDs and/or Statins Does Not Affect PSA or PSA Velocity in Men at High Risk for Prostate Cancer

Abstract

Background Prostate specific antigen (PSA) and PSA velocity (PSAV, rate of PSA change over time) are biomarkers for diagnosis and prognosis of prostate cancer (PCa). Men who are at high risk for PCa also have associated co-morbidities for which they are taking NSAIDs and statins for long periods; therefore it is important to understand the effect of these medications on markers used to assess PCa risk. Methods Using a population of 699 men, multiple linear regressions were used to investigate the associations between PSA and concomitant medications; and mixed effects models were used to investigate these associations with PSAV. Results After adjusting for selenium use, age, race, body mass index, and pack-years of smoking; aspirin, other NSAIDs, or statins did not demonstrate statistically significant associations with PSA (p = 0.79, 0.68, and 0.79 respectively) or PSAV (p = 0.23, 0.43, and 0.84 respectively). Results were not altered upon stratifying the sample between men who developed PCa during the course of the study and those who did not. Conclusions Results from this study indicate that chronic use of aspirin, other NSAIDs, or statins did not impact PSA levels or PSAV in men at high risk for PCa. Larger prospective studies designed to investigate these relationships are needed to confirm this result. Impact Long-term use of NSAIDs or statins in men at high risk for PCa may not interfere with the diagnosis or prognosis of this disease, and supports appropriate use of these medications with regard to PCa risk.

Obesity and Cancer: 27-Hydroxycholesterol, the Missing Link

“…High plasma cholesterol levels are linked to the increased risk of prostate cancer in multiple epidemiologic studies [ 50 , 51 , 84 , 85 ]. However, statins that inhibit cellular cholesterol biosynthesis, thereby lower plasma cholesterol, were unable to improve prognosis in prostate cancer patients, suggesting that cholesterol itself might not be the critical factor in prostate cancer development [ 86 , 87 ]. As a major cholesterol metabolite, 27HC has attracted the attention of prostate cancer investigators over the past decade, and it was demonstrated to stimulate the proliferation of RWPE-1 normal prostate epithelial cells in an ER- and androgen receptor (AR)-dependent manner [ 88 ].…”

Adjuvant Low-dose Statin Use after Radical Prostatectomy: The PRO-STAT Randomized Clinical Trial

“…4 However, the serial changes in PSA level did not differ between men receiving atorvastatin and those receiving placebo in this study, a finding consistent with the results of another longitudinal study. 25 Given the long clinical course of prostate cancer, it is difficult to directly compare the effect of statin use on PSA levels following local treatment for other clinical stages, especially in the PSA screening setting. Further studies are needed to determine if statin use affects PSA levels in other stages of the disease course.…”

Decreased biochemical progression in patients with castration‑resistant prostate cancer using a novel mefenamic acid anti‑inflammatory therapy: A randomized controlled trial

“…Hence, sustained use of nonsteroidal anti-inflammatory drugs (NSAIDs) have been proposed as a mechanism that may retard PCa disease progression by decreasing the inflammatory response in PCa cells (25). Observational studies have revealed that NSAIDs are associated with a lower risk of developing PCa (25) and a lower risk of progression to high-grade PCa (26,27), resulting in different NSAIDs being postulated for the treatment of PCa. Clinical trials have been performed with certain NSAIDs (celecoxib, ibuprofen and indomethacin) (5,28), with unsatisfactory results, upon analyzing endpoints such as PSA levels, tumor size or overall survival time (29,30).…”