Hello, Kevin! Thanks for posting this.
Kevin Mackie wrote:I smell some crap science here, Bill.
I believe the study was properly couched both by the scientists and by the reporter who wrote the article.
Kevin Mackie wrote:wht's the point of even publishing anything like this?
This type of science is done in the early stages of investigation when you don't have a lot of money to research an idea, but feel either from first principles (understanding of basic science) or from observation (years of clinical experience) that there's a possible pattern.
The gold standard to investigate this type of question is to set up a randomized, double-blinded, controlled trial involving a lot of healthy men either taking a statin or a placebo over a long time. This means that healthy men may have to experience the potential side effects of a statin, and men who end up with cholesterol issues may have to forgo taking life-saving medicine. It would be a long, expensive study with potential issues.
You could do what these researchers did and do a quick look-see. They matched 380 men who died of prostate cancer with 380 men who didn't - as best they could. There's a process for doing that, but it isn't perfect
. I do it in my line of work when doing "the perfect study" isn't possible. A look-see with major caveats is sometimes better than no look at all.
They found differences in the rate of statin use in the two groups with this kind of study. So great... you get a statistically significant finding. Attributing causality however is difficult. But it may generate just enough interest to do better, more expensive studies.
As a footnote to this... Penicillin was discovered when some scientist left his dirty lab dishes in the sink, and they got all gross and moldy. He noted that bacteria weren't growing around the (penicillium) mold, and the rest is history. Good science often has humble beginnings combined with great observation and pattern recognition skills.
Kevin Mackie wrote:Could it be that those who take statins ALSO get regular checkups and are more concerned with maintaining their health?
That depends on how well or poorly the propensity matching was done. It *is* possible...
It's also worth noting that after decades of doing PSA exams, we've found that we can't reduce the rate of deaths from prostate cancer with the screening tool. Great... So, Kevin, what could these men be getting with their "regular checkups" that the men without them weren't getting? With the recent PSA finding, I'm at a loss. This would weigh more heavily in favor of there being an intrinsic link to the taking of statins. We're not talking causality yet, but we are beginning to get interested.
Layer on the basic science, and we might begin to paint a mechanism. They discussed how cholesterol is used by cancer cells in the article. If you have a mechanism, then you begin to create believability. And you subsequently can begin to attack the scientific problem in a more rigorous fashion. You might even be able to produce an even better effect at another point in the sequence of biochemical steps.
I'll finish my post with a few paragraphs from the article. This puts it all in great perspective.
Researchers agreed that until there's clearer evidence for benefit, men with healthy hearts shouldn't seek out statin prescriptions for the purpose of lowering their prostate cancer risks.
But Freedland said that other strategies for lowering cholesterol, such as eating better and exercising regularly, are ways almost everyone can lower their disease risks in the meantime.