Can a cholesterol drug really help fight advanced prostate cancer?
Yes, according to a new analysis, statins — the widely used cholesterol-lowering medications — may help some men with advanced prostate cancer live longer when paired with apalutamide and standard hormone therapy. The finding, published in the European Medical Journal, looked at data from more than 2,100 men enrolled in two major clinical trials, SPARTAN and TITAN. The researchers report that statin users had notably higher survival rates than non-users, but with an important caveat: statins were linked to an increased risk of heart-related problems, particularly among men with pre-existing heart disease.
What the study looked at
The analysis drew on two trials that studied different forms of advanced prostate cancer. Participants all received standard hormone therapy, and some were treated with apalutamide, a drug that blocks testosterone’s ability to fuel cancer growth. The researchers then compared outcomes between men who were taking statins (either before or during cancer treatment) and those who were not.
Key findings for survival
The results were striking for survival when apalutamide was part of the regimen. In the TITAN trial, statin users experienced a roughly 14% higher three-year survival rate, while in the SPARTAN trial the improvement was about 8%. In short, adding a statin to the combination of apalutamide and hormone therapy could extend life for men with metastatic or castration-resistant prostate cancer. Importantly, the benefit appeared in the groups receiving apalutamide, whereas the placebo groups did not show the same advantage.
Heart risks and the trade-off
There is a catch. The study found that statin use was associated with more serious cardiac events (grade 3 or higher) compared with non-use. This added risk underscores the reality that many men with advanced prostate cancer are older and may already have heart disease or other cardiovascular risk factors. The researchers emphasized the need for careful cardiovascular assessment both before starting statins and during treatment.
Why might statins help cancer patients?
Statins are best known for lowering cholesterol, but they may also exert anti-cancer effects. Scientists hypothesize several mechanisms: reducing systemic inflammation, slowing cancer cell growth, and possibly improving the effectiveness of hormone-suppressing therapies like apalutamide. While the exact biology isn’t settled, these potential anti-cancer actions help explain why some patients might benefit from statins beyond cholesterol control.
What this means for men with prostate cancer
The study’s authors and other oncologists say the findings could influence treatment planning, especially in men with advanced disease who are already on apalutamide and hormone therapy. Practical guidance from doctors typically includes:
- Discussing the potential benefits and risks of adding a statin with a healthcare team, taking into account heart health history and existing cardiovascular risk factors.
- Implementing regular monitoring for both heart health and cancer status if a statin is incorporated into the treatment plan.
- Recognizing that a statin isn’t suitable for every patient—some men may experience meaningful survival benefits, while others may face avoidable heart risks.
What patients should do next
If you’re a man with advanced prostate cancer in the United States, talk with your oncologist about whether a statin could be a safe and effective addition to your therapy. Your doctor will review your heart health, cholesterol levels, and overall medical history, and discuss a plan for monitoring and managing potential risks.
Bottom line
Statins may offer a survival advantage for some men with advanced prostate cancer when used alongside apalutamide and hormone therapy. However, the increased risk of heart problems means decisions must be personalized, with careful heart health assessment and ongoing monitoring. As research continues, clinicians aim to balance longer cancer control with cardiovascular safety to tailor treatment to each patient’s unique needs.
