Statins, aspirin may hide prostate cancer

Most men learn that they have prostate cancer after a blood test shows elevated prostate-specific antigen (PSA) levels, prompting a biopsy. A high or rising PSA can also signal the return of cancer following surgery or radiation therapy. Drugs that artificially lower PSA levels could, at least in theory, obscure elevations that offer early warnings of a problem.

One recent study linked the use of cholesterol-lowering drugs called statins to reduced PSA levels. Researchers looked at PSA levels among 1,214 military veterans before and after they started taking a statin. With statins, the median decline in PSA was 4.1%, and changes in PSA were strongly associated with the statin dose and changes in LDL cholesterol, the “bad” cholesterol.

In another study, presented at a meeting of the American Association for Cancer Research last fall, Vanderbilt University researchers reported that participants in the Nashville Men’s Health Study who regularly took aspirin had PSA levels that were 9% lower on average than those in men who didn’t take aspirin. (Data from this trial have not yet been published in a scientific or medical journal.)

The changes in PSA in these studies weren’t large. But researchers expressed concern that the drugs could mask fluctuations in PSA that might interfere with the detection of prostate cancer. Another tantalizing possibility is that statins and aspirin fight prostate cancer. But it would take some very large, very long trials to determine if that is the reason for the decrease in PSA.

Given these findings, make sure to tell your urologist if you are taking statins, aspirin, or both. Also, track changes in your PSA over time to help ensure you aren’t harboring prostate cancer.

SOURCE: Hamilton RJ, Goldberg KC, Platz EA, Freedland SJ. The Influence of Statin Medications on Prostate-Specific Antigen Levels. Journal of the National Cancer Institute 2008;100:1511–18. PMID: 18957682

Originally published September 2010; last reviewed March 16, 2011.