Statins, NSAIDS improve all-cause mortality in prostate cancer patients

NEW YORK (Reuters Health) - Statins and nonsteroidal anti-inflammatory drugs (NSAIDs) are linked with lower all-cause mortality in prostate cancer patients, researchers report in an article published online February 11th by BJU International.

The suggestion that statins and NSAIDs are associated with lower overall mortality "is well known in the primary care community but warrants reinforcing with cancer specialists," lead author Dr. Matthew S. Katz told Reuters Health by email. "Further study should look to how cancer specialists and primary care physicians can work together to improve each man's overall health."

Dr. Katz, who is a partner in Radiation Oncology Associates, Manchester, New Hampshire, and colleagues used data from the CaPSURE registry to analyze the impact of these common medications on mortality after radical prostatectomy or radiotherapy.

In 7042 men with prostate cancer, statin use was associated with a 65% reduction in all-cause mortality after radical prostatectomy and 41% reduction after radiotherapy, the authors report. NSAIDs reduced all-cause mortality by 53% after prostatectomy and by 61% after radiotherapy.

Prostate cancer caused 21% (81/389) of deaths after radical prostatectomy and 20% (98/487) after radiotherapy. Cardiovascular causes accounted for 21% (81/389 (21%) of deaths after prostatectomy and 30% (146/487) after radiotherapy.

Other than statin and NSAID use, independent predictors of all-cause mortality after radical prostatectomy included a high frequency of office visits, older age, cardiovascular disease at diagnosis, earlier year of diagnosis, and high pT stage.

Independent predictors of all-cause mortality after radiotherapy included a high frequency of office visits, diabetes, high biopsy Gleason grade, and smoking.

Prostate specific antigen level at diagnosis and androgen deprivation therapy were not associated with all-cause mortality.

"The results are relevant for men with prostate cancer who choose surgery or radiation, but the focus of this study is more to highlight the importance of post-treatment survival and cancer survivorship," Dr. Katz said. "It demonstrates that non-cancer mortality can be lessened even in a cohort of cancer patients."

"If prostate cancer patients are willing to undergo one of two equally effective treatments, radiation and surgery, then it's an opportunity for doctors to educate them on the importance of addressing comorbid health conditions so they can get the most out of their cancer treatment," Dr. Katz concluded.

BJU Int 2010.

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