Statin Cholesterol Drugs & Invasive Breast Cancer

Statin Cholesterol Drugs & Invasive Breast Cancer
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Reducing cholesterol levels may inhibit breast cancer development, but the long-term use of cholesterol-lowering statin drugs is associated with more than double the risk of both types of breast cancer: invasive ductal carcinoma and invasive lobular carcinoma.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

What does breast cancer do with cholesterol? Here are some of the potential mechanisms by which cholesterol boosts breast cancer growth. Cholesterol is what our body makes estrogen out of. It’s packaged into LDL, which we saw appeared to increase proliferation of breast cancer cells, decrease patient survival, and it’s a major component of lipid rafts.

“[C]ompared with their normal counterparts, cancer cells have higher levels of cholesterol-rich lipid rafts in the[ir] plasma membrane[s], which may be important…[for] cancer cell survival”—as well as serve in human cancer development in terms of tumor migration and invasion.

Elevated levels of these cholesterol-rich lipid rafts have been found in breast cancer cells, and the thought is that by “[r]educing [blood] cholesterol levels may disrupt lipid raft formation and thereby inhibit…breast cancer development.” This suggests cholesterol targeting may be useful 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”—both estrogen-receptor negative and estrogen-receptor positive cancer.

The “[t]herapeutic 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 at cholesterol-lowering statin drugs.

“Evaluating the safety of statin therapy for women is particularly difficult; however, little research has explicitly proceeded from a gender-based perspective.” 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. But these were all relatively short-term studies. So-called “long-term” statin use was defined as mostly just like three to five years. 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 your life, “the studies published to date have had limited ability to evaluate the impact of long durations of…use.” And we better figure this out. About one in four women over 45 in this country are on these drugs. But, that was the only data we had—until now.

Thousands of breast cancer cases included, and “long-term statin users”—women taking statins for ten years or more, “had more than double the risk of both types” of breast cancer: invasive ductal carcinoma and invasive lobular carcinoma.

Now, the #1 killer of women is heart disease, not breast cancer, so, we still need to bring down cholesterol levels. But might there be a way to get the benefits 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—without potential side effects, such as increased breast cancer risk.

Please consider volunteering to help out on the site.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

What does breast cancer do with cholesterol? Here are some of the potential mechanisms by which cholesterol boosts breast cancer growth. Cholesterol is what our body makes estrogen out of. It’s packaged into LDL, which we saw appeared to increase proliferation of breast cancer cells, decrease patient survival, and it’s a major component of lipid rafts.

“[C]ompared with their normal counterparts, cancer cells have higher levels of cholesterol-rich lipid rafts in the[ir] plasma membrane[s], which may be important…[for] cancer cell survival”—as well as serve in human cancer development in terms of tumor migration and invasion.

Elevated levels of these cholesterol-rich lipid rafts have been found in breast cancer cells, and the thought is that by “[r]educing [blood] cholesterol levels may disrupt lipid raft formation and thereby inhibit…breast cancer development.” This suggests cholesterol targeting may be useful 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”—both estrogen-receptor negative and estrogen-receptor positive cancer.

The “[t]herapeutic 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 at cholesterol-lowering statin drugs.

“Evaluating the safety of statin therapy for women is particularly difficult; however, little research has explicitly proceeded from a gender-based perspective.” 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. But these were all relatively short-term studies. So-called “long-term” statin use was defined as mostly just like three to five years. 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 your life, “the studies published to date have had limited ability to evaluate the impact of long durations of…use.” And we better figure this out. About one in four women over 45 in this country are on these drugs. But, that was the only data we had—until now.

Thousands of breast cancer cases included, and “long-term statin users”—women taking statins for ten years or more, “had more than double the risk of both types” of breast cancer: invasive ductal carcinoma and invasive lobular carcinoma.

Now, the #1 killer of women is heart disease, not breast cancer, so, we still need to bring down cholesterol levels. But might there be a way to get the benefits 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—without potential side effects, such as increased breast cancer risk.

Please consider volunteering to help out on the site.

Doctor's Note

If you missed the “prequel” video, you might be confused about the role cholesterol plays in breast cancer risk; see Cholesterol Feeds Breast Cancer Cells.

Alhough as drugs go, statins are remarkably safe, they can present rare but serious side effects in both men and women; see Statin Muscle Toxicity.

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

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35 responses to “Statin Cholesterol Drugs & Invasive Breast Cancer

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  1. Is eating raw corn-on-the-cob harmful? I see that corn is a grain, and grains I suppose are to be cooked in order to deal with anti-nutrients/natural toxins, but raw corn on the cob is so easy and delicious to eat, but I am wondering if it is harmful unless cooked. Sort of like how there are things in certain beans and other grains that will cause harm to humans unless the beans are cooked, neutralizing a few things). As far as digestion goes, I do fine with raw corn.

  2. Thank you for the video, a topical issue indeed. What would you recommend if a strictly vegan, fruit-and-veg based diet and regular exercise are not enough to bring the blood cholesterol down to desired levels? I.e. girls/women living with inherited familial hypercholesterolemia?

  3. Statins are potent drugs, with potentially dangerous side effects, and should – as every other pharmaceutical drug – be used with caution. Too many people are on statins – the only thing they will experience are side effects -and some deadly – and no benefit.

  4. I am skeptical that statins actually promote cancer in the long-term. We do have some long-term follow-up of randomized trials, such as the Heart Protection Study and the West of Scotland Coronary Prevention Study, which show no increased risk of malignancy with these lifesaving drugs. The individual patient data meta-analyses by the Cholesterol Treatment Trialists Collaboration also indicate no increased risk for cancer, and possible protection. Therefore to indict these drugs based on observational studies, which are heavily prone to selection bias (i.e. higher risk women are put on statins in the first place) and residual confounding (i.e. covariates that are not measured and cannot be adjusted for) – is likely a spurious fallacy.

    1. The cited study only adjusted for year and age when diagnosed, residence, and history of hormone replacement therapy. Other known risk factors, common to both cardiovascular disease and breast cancer (like obesity, diet, and exercise) weren’t considered.

      It’s possible we’re seeing the effects of a common cause for both diagnosable invasive breast cancer, and 10 years use of statins by age 55-74. This website offers a lot of suspects.

  5. “more than double the risk of both types of breast cancer” … Doc, when you think of it and it’s convenient, in these kind of reports would you also mention the absolute risk measures along with relative?

    1. The cited paper, a retrospective case-control study, because of its design, couldn’t report the absolute risks for its population. The lifetime risk (by age 90) for invasive breast cancer incidence from this 1993 study was 12.1%. According to Wikipedia, Invasive ductal carcinoma accounts for 55% of invasive breast cancer, while invasive lobular accounts for 5-10%. So lifetime risks for these two types could be around 6.7% and 0.6-1.2% respectively. Before the statins, at least.

  6. Rosewing, Some farmers are genetically engineering sweet corn to not only create their own pesticide in the gut of the consumer, but to also be resistant to Roundup. This means that the crop won’t die, but the chronic effects to people and animals are another story.
    Don’t eat sweet corn unless it is certified organic. Then, only sparingly.

    1. Becca, farmers do not have the resources to genetically engineer crops. Large corporations such as Monsanto and DuPont do. So-called Bt modified corn does form toxins in the guts of target pests. However, due to the lower pH of the human gut, these toxins are not formed in humans. Bacillus thuringiensis (Bt) has long been used to protect certain crops instead of synthetic pesticides. Although I remain skeptical of GM crops, the alarm you have sounded about Bt modified corn is most likely unfounded.

      Finally a question – what evidence can you provide that certified organic corn should be eaten only sparingly?

      1. I stand corrected. Poor wording on my post. Of course, farmers are not genetically modifying crops. But, many are using genetically engineered seeds from Monsanto, Dupont, Syngenta, Bayer, Dow and others to change the dna of seeds so that the corporations can sell more of their highly toxic herbicides with LESS regulation and government oversight to kill superweeds which has popped up from constant spraying. And, now, because of more superweeds, the corporations are genetically engineering the seeds in triplicate so that the seeds can basically drink 3 different weed killers and not die.
        However, the runoff from the fields is highly toxic, poisoning fish and livestock/wildlife that drink the waters, the drift from the fields is in the air and is cleansed from the clouds and sky when it precipitates –it’s raining pesticides containing 100% Round-up, 2,4-D and other pesticides, and may be contaminating organic backyards and fields. And remember, that organic livestock, while not intentionally fed GMO corn and soy, may be getting it in organic feed, UNLESS they are pastured and graze on grasses (inc. alfalfa) that is not yet contaminated. But, wildlife and livestock still drink unpurified waters. Hence, this is a good reason to eat vegan!
        Monsanto is coming out with genetically engineered sweet corn this year, which is why I recommend eating certified organic corn sparingly. One never knows when the corn or soy you are eating is contaminated, as I learned when I consumed a small amount of certified organic soymilk on my cereal and received my first super bad case of indigestion. It was not used by the farmer, but was contaminating their field, compliments of Monsanto. The effects to me was the same.

  7. This 2014 cochrane review summarizing the results of 18 randomized control trials on statin use concluded that statins are effective in primary prevention of cardiovascular disease and do not increase risk of “serious adverse effects” such as cancer.

  8. Cholesterol has important function in the body, does it not? isn’t it a precursor to many hormones and other important functions? and reducing dietary cholesterol would not significantly benefit, even if our cells manufacture it? why isn’t cholesterol seen as a protective agent rather then concluding that at the site of the problem there is cholesterol in tumor cells, in the arteries and so on?

  9. In the garden of eden study, they were eating a seriously plant based diet with over 100g of fiber a day to reduce it that much. Less plant based but still plant based with more grains showed less effect.

  10. IF: 1. A “magic pill” can do such wonders for cholestrol” and
    2. Is associated with increased risk of breast cancer and
    3. Causes various other side effects including 3% risk of diabetes, then
    WHAT ELSE HAS YET DO GO WRONG TAKING THIS PILL LONG TERM? Doctors in five years may say, “Don’t take statins” but continue to prescribe whatever they have been told is safe at that time. U.S. mortality rates are equal to that of Columbia, Costa Rica. It will get worse. Doctors should not wait until a negative effect is PROVEN; they should cautiously await real proof of a BENEFIT if the benefit is too extraordinary and accompanies too many dangers to consider real. On the other hand, berries, amla, mushrooms, ginseng, and other things that can reduce risk should be absolutely included unless there’s something scarier than bad flavor as a side affect. Doctors used to say that cigarettes were safe. In fact, many doctors PRESCRIBED cigarettes.

  11. I have read on the web that plain Niacin (nicotinic acid) is the best and cheapest way to reduce cholesterol.
    I’ve searched nutritionfacts.org website for any mention of niacin / nicotinic acid and Dr Gregor has apparently not addressed it.
    I’d like to ask that this theory be answered or addressed in Ask the Doctor or even in a video, but it’s impossible to submit a question.
    So hopefully other’s can chime in to support an answer to this theory that Niacin (and the Niacin Flush) is better than a statin drug?

  12. I read on the web that Niacin (nicotinic acid) is the cheapest way to reduce cholesterol.
    I’ve searched nutritionfacts.org website for any mention of niacin and Dr Gregor has apparently not addressed it.
    I’d like to ask that this be answered or addressed but it’s impossible to submit a question.
    So hopefully other’s can support an answer to the theory that Niacin is better than a statin drug?

    1. I agree – its very annoying that questions cannot be directly submitted. I don’t even know if anyone bothers to read these posts to pick up on issues of concern. they probably use a program to ferret out profanities and such. As for the niacin. I was doing the same thing for awhile. Slow release. It didn’t really help and then I read of some studies that said there was no significant effect on cholesterol.

      1. Alison: I am a layperson, volunteer moderator for NutritionFacts. One of my tasks is to preview every post submitted on this site. (Well most of them. With the new wordpress comment system, it’s not as thorough.) If I see a question, regardless of which page the question is on, I forward it to our volunteer “medical moderators”, people who are RDs, doctors, nurses, etc. We get more questions than our volunteers can answer, but every question is put into the pile to get a fair shot at getting an answer.

        FYI: I saw your question about cholesterol and Lipitor and immediately forwarded it to the medical moderators. While I can’t offer any guarantees, I hope you get your answer.

      2. Hi Slow release niacin is NOT the product referred to.
        Slow release niacin is NOT beneficial – it is the Niacin Flush that is beneficial in high doses (IF this is actually true) Slow release Niacin has Warnings regarding potential liver damage.
        The value (potentially) is the Niacin Flush.  Research and read about it.  Stay away from slow release.
        The flush is something you can get used to and it’s proof it’s opening blood vessels as you turn red like a lobster.
        DB

        1. Thanks for the information…Interesting. though I no longer take niacin.
          I’m still trying to figure out why I can’t keep my cholesterol down with out a statin, even with the vegan diet

          1. Alison1951: “I’m still trying to figure out why I can’t keep my cholesterol down without a statin, even with the vegan diet.” You may already know this part: Our bodies make cholesterol in response to the food we eat. Our bodies make too much cholesterol when we eat certain foods (mainly animal products). With that in mind, I wanted to share my pet theory with you in regards to your question. I’m not an expert. This is just my speculation, not based on specific studies.

            It’s my belief that after decades of your body getting used to producing so much cholesterol, it can’t easily stop. I don’t understand the mechanism by which statins work, but it’s my understanding that it is an artificial forcing process. In other words, it’s not actually fixing your body. Statins just have a way to force your body to have less cholesterol in it.

            *If* all that’s true then I have two conclusions: 1) It’s not surprising that people’s cholesterol would creep back up after dropping statins, 2) Not all may be lost. It took decades to get your body to the point it is at now. It may take some time to get your body to start producing less cholesterol in response to a diet of low fat, whole plant foods, including lots of greens. (Esseslstyn’s diet)

            I have a friend who went vegan and it took 3 years before her doctor said that her cholesterol numbers dropped enough to no longer recommend statins. My guess is that her numbers are still too high, just not high enough to recommend statins. So, it may take another 3 years or who knows how long before her numbers actually get to safe levels. Or maybe her body is permanently broken? I have no idea if we know whether or not all people can fix a non-genetic cholesterol problem that’s been going on for years strictly with diet. (FYI: The genetic problems are pretty rare is my understanding.) In your case, maybe instead of just dropping statins, you could veerrrrrry slooowwwwly cut back a little at a time over the course of a year or two of continued healthy eating and see how that goes??? I’m not a doctor, so I don’t know if this is a good idea or not. Just thinking out loud.

            Also, please note the following Ask The Doctor page which has ideas on what to do about cholesterol numbers that just do not want to drop. http://nutritionfacts.org/questions/what-can-i-do-to-lower-my-cholesterol-it-seems-ive-tried-everything/

            What do you think? Does this help?

            1. You have given me some good information to consider. Thank you.
              And perhaps this is a common enough problem, and important enough, that Dr Gregor will address it in his daily blog or a DVD. THAT I would buy.

  13. I was on 20mg of generic Lipitor and eating vegan. My cholesterol numbers were best ever! total was 153, LDL was 66 and HDL was 75 and Trig were 59. So I told my Dr I wanted to go off the statin and see if the numbers would remain low. I was shocked to see my cholesterol back to 250, LDL 147 and HDL 83 and Trig 100. I am back on the Statin. My Dr says its my genes – body just naturally produces too much cholesterol. Now I don’t know what to think. I fasted correctly but is it possible that some of the chocolate I had the previous week (Valentines day) effected my numbers despite the fast? Is it true that my body may be predisposed to produce too much cholesterol? I haven’t seen ANY mention of that by others or Dr Gregor. I would really like to hear more about this. I am very concerned. Especially since my liver numbers are slightly elevated.

  14. I was on 20mg of generic Lipitor and eating vegan. My cholesterol numbers were best ever! total was 153, LDL was 66 and HDL was 75 and Trig were 59. So I told my Dr I wanted to go off the statin and see if the numbers would remain low. I was shocked to see my cholesterol back to 250, LDL 147 and HDL 83 and Trig 100. I am back on the Statin. My Dr says its my genes – body just naturally produces too much cholesterol. Now I don’t know what to think. I fasted correctly but is it possible that some of the chocolate I had the previous week (Valentines day) effected my numbers despite the fast? Is it true that my body may be predisposed to produce too much cholesterol? I haven’t seen ANY mention of that by others or Dr Gregor. I would really like to hear more about this. I am very concerned. Especially since my liver numbers are slightly elevated.

    1. Hi, Carol! Fortunately, most cases of high cholesterol can be treated with a whole food, plant-based diet. There are rare genetic conditions that give people high cholesterol no matter what they eat, but such genetic defects occur in no more than 1 in 200 people. The primary reason certain health conditions tend to run in families may be that diets tend to run in families. Even for those of us who do have certain genetic predispositions, a healthy diet and lifestyle can actually change you on a genetic level, up-regulating disease-preventing genes, and down-regulating disease-promoting genes. I would recommend checking out the cholesterol topics page, which will provide you with lots of information and links you may find helpful. You may find this article useful as well: https://nutritionfacts.org/questions/what-can-i-do-to-lower-my-cholesterol-it-seems-ive-tried-everything/.

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