Do Cholesterol Statin Drugs Cause Breast Cancer?

Statin Cholesterol Drugs and Invasive Breast Cancer

What does breast cancer have to do with cholesterol? There are many potential mechanisms by which cholesterol boosts breast cancer growth. For example, our bodies make estrogen, which is correlated with an increased risk of breast cancer, out of cholesterol. We also package cholesterol into LDL, which, as you can see in my video Cholesterol Feeds Breast Cancer Cells, appeared to increase cancer proliferation and decrease patient survival.

Cholesterol is a major component of “lipid rafts.” Compared to their normal counterparts, cancer cells have higher levels of these cholesterol-rich lipid rafts in their plasma membrane, which may be important for cancer cell survival and may serve in human cancer development in terms of tumor migration and invasion. Elevated levels of cholesterol-rich lipid rafts have been found in breast cancer cells, and the hypothesis is that reducing blood cholesterol levels “may disrupt lipid raft formation and thereby inhibit breast cancer development.” This suggests cholesterol targeting may be used as a cancer therapy.

Controlled laboratory experiments have shown that phytosterols in seeds and nuts at dietary relevant levels appear to inhibit the growth of several types of tumor cells including breast cancer cells, including both estrogen-receptor negative and estrogen-receptor positive cancer. The therapeutic implications are that “plant-based diets rich in phytosterols may offer protection against the development of breast cancer.” Of course, you can’t make a lot of money on pumpkin seeds, so researchers looked to cholesterol-lowering statin drugs (this study is highlighted in my video, Statin Cholesterol Drugs and Invasive Breast Cancer).

Some petri dish work looked promising, but population studies have shown mixed results. Some studies showed that women on statins had decreased breast cancer risk, some showed increased risk, and most showed no association. These were all relatively short-term studies, though. “Long-term” statin use was defined as mostly just three to five years, but breast cancer can take decades to grow. The one study that looked at ten or more years of statin use only included 62 cases.

Given the increase in statin use over the past few decades, and the fact that they’re commonly prescribed to be taken every day for the rest of women’s lives, the studies published to date only had limited ability to evaluate the impact of long durations of use. We better figure this out: about one in four women over 45 in this country are on these drugs.

But that all changed with the publication of a study in 2013 including thousands of breast cancer cases. Long term statin users—women taking statins for ten years or more—had more than double the risk of both major types of breast cancer: invasive ductal carcinoma and invasive lobular carcinoma. Once women do get breast cancer, though, recent studies in Finland and the UK suggest statin use may improve survival.

The number one killer of women is heart disease, not breast cancer, so we still do need to bring down cholesterol levels. Might there be a way to get the benefits of cholesterol reduction without the risks? Plant-based diets have been shown to lower LDL-cholesterol by over 30%, within just a couple weeks, equivalent to most of the standard cholesterol lowering statin drugs and without any breast cancer risk.

As drugs go, statins are remarkably safe, but they can still present rare but serious side effects in both men and women (Statin Muscle Toxicity).

How can we lower cholesterol without drugs? It’s Purely a Question of Diet. We can lower our cholesterol by lowering our intake of three things: Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero. Where are trans fats found? Trans Fat in Meat and Dairy. Where is cholesterol found? Predominantly eggs: Eggs and Cholesterol: Patently False and Misleading Claims. There are also some foods particularly adept at lowering cholesterol levels:

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Ana C. / Flickr

  • elsie blanche

    Off topic, but what does the science say about sprouted greens, like like sprouted sunflower greens? So many people online and in the health community rave about the therapeutic and nutritional value of eating sprout-greens, as well as sprouted raw beans, and seeds, but is this actually accurate and documented by science or just assumptions, maybe even wrong? I see a sunflower sprout as something that should probably be left in the ground, for it wants and is designed to grow up to be a big sunflower, no? Wouldn’t the baby sprout contain some anti-nutrients to deter (humans!) from stopping its’ lifecycle to grow up to be a 5 foot flowering, beautiful plant?

    • Joseph Gonzales R.D.

      We have so many videos on sprouting! For more information on raw foods I’d suggest Brenda Davis’s book, “Becoming Raw” – perhaps the most referenced book on rw foods. She did a guest post about paleo diets, too.

  • guest

    Does this imply that if a woman who hasn’t been on statins develops breast cancer, putting her on statins will increase her chances of survival? In other words, are statins the next breast-cancer drug?

  • Sandra
    A study presented at the American Society of Clinical Oncologists meeting this year said that statins lower the risk of cancer death in some types of cancer. The study says statins don’t affect cancer incidence.

    • Joseph Gonzales R.D.

      Hi Sandra. I can’t seem to open your link. Do you mind resending? Perhaps we need to update some information, but it seems there is concern of taking statins, as it’s associated with an increased risk of breast cancer.

  • merrly

    It doesn’t help that breast cancer and heart disease (and most dis-eases) are such sensitive and personal topics for many and I have found it difficult to suggest a healthier diet (even with referring to blogs like this and medical sites) when a pill can ‘do it all’. Thank you for all the knowledge you share, as it encourages me to stay open-minded and true to my stance.

  • Psych MD
    • Joseph Gonzales R.D.

      Yikes! Is there not a better cost-effective way to help the public reduce heart disease risk? Semi rhetorical question. Thanks for the link very interesting.

    • dorange

      A friend of mine was diagnosed with ALS last year. One of possible causes of the disease inhis case: 10 year use of statins. The neurologist took him off the medication immediately.

  • Marty from Freo

    I’m confused about dietary cholesterol. You appear to imply here and in other places that dietary cholestrol should be avoided as it causes an increase in serum cholesterol, yet even T.Collin Campbell acknowloges that this is not the case. My understanding is that animal protein causes the body to over-produce cholesterol. Maybe it doesn’t matter as animal proteins come with lots of cholesterol and sat fat anyway, so the health recommendations would be the same? I would appreciate some clarification on this. Thanks for the great work!

    • Joseph Gonzales R.D.

      Hi Marty. Let me try to help. Saturated fat boosts cholesterol much more than dietary cholesterol, but dietary cholesterol still raises blood cholesterol slightly. This British Medical Journal blog explains more. Dr. Greger commented at the end stating “Indeed the Institute of Medicine did not set a tolerable upper intake limit for cholesterol “because any intake level above 0% of energy increased LDL cholesterol concentration.”[1] So the optimal intake may indeed by zero, as heart disease remains the leading killer in both the UK and US. [1] Trumbo PR, Shimakawa T. Tolerable upper intake levels for trans fat, saturated fat, and cholesterol. Nutr Rev. 2011;69(5):270-8.” His video on Optimal Cholesterol Levels may also help. Animal protein can be detrimental to health in excess, but I am uncertain its effects on cholesterol. I would agree with your statement that “Maybe it doesn’t matter as animal proteins come with lots of cholesterol and sat fat anyway.”

  • MikeOnRaw

    Is it cholesterol itself that promotes cancer, or is it “excess” cholesterol? I’m curious because our bodies create cholesterol as needed. So is it just the excess that we may get from our diet that is a problem or any cholesterol that’s a problem?

  • walterbyrd

    But that woman in the commercial seems so happy. She acts like she won the lottery when she finds out that she is “down with Crestor” then she dances down the street, high fiving everybody on her way. Her friends congratulate her on the great news.

    I have normal cholesterol, and I’m never *that* happy.

    • Fred

      These are what I call the “dancing fat*sses”…their drugs make them happy…usual corporate swill. I have Ch of 145 and I’m concerned about it being too low. From what I read the elderly live longer with higher Ch…the real issue being OXIDIZED Ch…not blood levels.

      • Jim Felder

        Actually Fred, this is a case of reverse causation. Illness and lowers ones cholesterol. So low cholesterol isn’t the cause of disease in the elderly, but rather a symptom of disease. Thus it would be incorrect to conclude that higher cholesterol improves health.

  • Wegan

    I wonder how many are taking statins when their cholesterol is high due to an iodine deficiency.

  • Rodrigo Cardoso

    Another translation accomplished in Portuguese –

  • Anna Thesia

    Wow, I’d sure like to see that 30% drop in cholesterol….I’ve been vegan x 3 years, and my levels are still higher than the usual recommended levels.

    • Jim Felder

      You might try to track your total fat intake. It is still possible to eat a high fat diet without eating animals. Plant based sources of fat are definitely lower in saturated fat than animal sources, but they still do have saturated fat. Try to make a focused push to not eat high fat foods or use free oils in cooking and dressings for several weeks and see if your cholesterol numbers don’t drop.

  • Jason

    Dr. Greger says that statins are remarkably safe, considering that they are drugs, and mentions the proviso that occasionally they cause muscle pain. What about diabetes? I’ve read a couple studies indicating that those taking statins have anywhere from 50% to more than double the rate of contracting diabetes as those not taking statins (those taking low dose statins had less diabetes).

  • A good friend of mine still has cholesterol slightly over 200 despte being a vegan for 10+ years, exercising regularly, and maintaining a healthy weight. Five months ago, he set out to eat really clean: no outside meals, nothing fried, no added salt, only a handful of nuts a day, no junk food, no family history of high cholesterol – but his cholesterol still didn’t go down. This is especially bad as he is a vegan activist. No one is impressed when they ask about his cholesterol level. Thanks for your insights.

    • dorange

      My cholesterol went down when I stopped eating saturated fat and drinking fruit juices. This happened even before I went on a WFPB approach. However, I believe there’s more to high cholesterol than diet – has he had his thyroid checked?

  • A good friend of mine still has cholesterol
    slightly over 200 despite being a vegan for 10+ years, exercising regularly, and
    maintaining a healthy weight. Five months ago, he set out to eat really clean:
    no outside meals, nothing fried, no added salt, only a handful of nuts a day,
    no junk food, no family history of high cholesterol – but his cholesterol still
    didn’t go down. This is especially bad as he is a vegan activist. It’s not a good advertisement for being vegan when his cholesterol level is far above 150. Thanks for your insights.

  • Richard

    I think there’s a problem here. If a magic pill shows a doubling of breast cancer after long term use, and dissolves SOME people’s muscles and causes SOME people diabetes, AND there’s very little studies during long term use, then COMMON SENSE says it’s not “remarkably safe” as stated above. This time, I think Dr Greger may be mistaken in saying so. Is it possible that breast cancer risk and the dissolving of muscles is so unique that some other horrific result isn’t caused by statins that has yet to be discovered? If there’s no bad evidence discovered for strawberries, it’s very safe to take them despite some remote possibility of a future danger being discovered. But for a magic drug that lowers cholestrol even if you sit on your couch and watch TV? Especially one that has shown some serious side effects. I don’t know about “remarkably safe”.