So, what should an oncology nurse do when a patient asks if they should be on a statin? “My answer is that I would not start a statin in a patient for the purposes of cancer treatment or prevention outside of a clinical trial. If a patient has a medically indicated reason to be on a statin, and they are tolerating it well, then I would keep them on the statin during treatment,” said Dr Lehman. 

He said if the patient is a cancer survivor or is posttreatment and has medical indications for a statin, he would start a statin after discussion with their primary care physician. These agents are generally well tolerated, but they have potential adverse events. He said clinicians owe it to their patients to treat their cancer based on mature prospective clinical trials. “This ensures that when we treat patients, the care team and the patient can be confident that we are giving them more benefit than risk,” explained Dr Lehman. 


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IMPLICATIONS FOR NURSES

The researchers draw an analogy between statins and aspirin. They point out how aspirin is combined with caffeine to improve efficacy, and suggest a possible benefit of using statins in a similar fashion. Michael Fradley, MD, director of USF-Moffitt Cancer Center Cardio-Oncology Program, Tampa, Florida,  said he thinks the idea is promising but it is too soon to know which statins would be effective and for which tumor type.

“We recognize that statins have many beneficial effects separate from lower[ing] cholesterol, including anti-inflammatory properties. There are some data suggesting cancer patients on statins may have mortality benefits, however this is quite preliminary. We need large prospective studies to more fully evaluate this question,” Dr Fradley stated.

He said oncology nurses should tell their patients that statins may have some benefits from an anticancer standpoint. However, at this time he does not recommend starting statins for this purpose. “However, if the patient is already taking a statin or needs to start the statin for an appropriate medical reason, then there may be an additional antitumor benefit. We will hopefully be able to answer this question more completely in the future based on data from several ongoing clinical trials,” said Dr Fradley.


John Schieszer is a medical writer based in Seattle, Washington. 


Reference

Papanagnou P, Stivarou T, Papageorgiou I, Papadopoulos GE, Pappas A. Marketed drugs used for the management of hypercholesterolemia as anticancer armament. Onco Targets Ther. 2017;10:4393-4411.