Do Cholesterol-Lowering Drugs Cause Cancer?

Updated September 18, 2013

“Carcinogenicity of lipid-lowering drugs” by Thomas Newman in the January 3rd, 1996 issue of the Journal of the American Medical Association tabulated rodent data on the cancer causing effects of cholesterol-lowering medications from the 1994 Physician’s Desk Reference, and other sources (275:55). They found two popular classes of drugs (fibrates and statins) cause cancer in rodents, in most cases at levels close to those prescribed to humans at maximum doses. Evidence from humans was inconclusive because of inconsistent results and insufficient duration of follow-up. The authors concluded, “In the meantime, the results of experiments in animals and humans suggest that lipid-lowering drug treatment, especially with the fibrates and statins, should be avoided except in patients at high short-term risk of coronary heart disease.” The commonly prescribed fibrate is Lopid (gemfibrozil), and the statins include Mevacor (lovastatin), Zocor (simvastatin), Lescol (fluvastatin), and Pravachol (pravastatin). Even though another popular cholesterol-lowering drug, Questran (cholestyramine) did not encourage cancer alone, it did enhance the effects of other cancer-causing chemicals.

Comments

The “war on cholesterol” began with the introduction of powerful, albeit highly profitable, cholesterol lowering statins in the mid 1980’s. A market for these medications had to be created by educating the public and doctors about the dangers of high cholesterol. Over the past decade there has been a 10-fold increase in the use of these drugs, with 26 million prescriptions written in 1992 in the United States. These medications are effective, especially the statins, for lowering cholesterol, and the statins have been shown to save lives in people with and without heart disease (Lancet 344:1383; N Engl J Med 333:1301, 1995). The benefits of gemfibrozil are questionable because results have shown a trend toward an increase in death and heart disease (Ann Med 25:41, 1993).

Almost all substances known to cause cancer in humans also cause cancer in mice and rats. Therefore, the findings in this study should bring great concern to doctors prescribing, and patients taking these drugs. The ultimate question is does the benefit from the prevention of heart disease outweigh the risk of cancer and other side effects from the drugs. There is great debate about this, yet insufficient information to come to solid conclusions.

Clearly, you should take the safest, most effective routes first. A low-fat, no-cholesterol diet must be the foundation for your cholesterol-lowering program. If you need extra help turn first to the “natural” cholesterol-lowering medications; like garlic, oat bran, vitamin C, and vitamin E (dry form). Next try a natural herb, gugulipid. Activated charcoal has been found to be as effective as Questran, with fewer side effects. (A thorough discussion on the use of these “natural” agents is found in The McDougall Program for a Healthy Heart, Dutton 1996)

If these self-administered, over-the-counter, relatively-nontoxic, low-cost agents fail to reduce your levels sufficiently, then use doctor-prescribed medications. Colestid (colestipol) and Questran (cholestyramine) bind cholesterol in the intestine and remove it; they never enter the body; therefore they may be your first choice. The next step might be niacin (vitamin B3)–however, the side effects can be very troublesome. The last step I recommend is the statins.

I have used the statins for years for my patients who I feel have a very high risk of suffering a tragedy like a heart attack or death soon. My father and father-in-law are two of these people. I have no plans on recommending they change their present treatments. They also follow the McDougall diet strictly, and take Colestid. A complete discussion of these medications with their effects and recommended dosages is found in The McDougall Program for a Healthy Heart (Dutton 1996). An ideal cholesterol level is 150 mg/dl or less.

John McDougall, MD