Thursday, July 26, 2007

Cancer risk: Will the statin fad now come to an end?

The British government recently decided that statins should be given even to healthy people if their serum cholesterol is high. Will they now back down? One hopes that they will. Amusing that the report below says that the cancer risk is low so don't worry. Similar risks elsewhere -- e.g. with HRT -- have led to loud cries for the medication concerned to be withdrawn from use. So we have another example of a "scientific" recommendation that is agenda-driven rather than fact driven. As it happens, the recommendation attached to this research is right. It is just a pity that similar recommendations are not routinely offered for low probability risks. They often are not. Note however that there are substantial other reasons not to take statins: Muscle-wasting anybody?

Lowering cholesterol with statins may slightly increase the risk of cancer, a study suggests. It is not clear whether the cancer cases are caused by the drugs, or are a consequence of the low levels of "bad" LDL cholesterol produced by taking them. The result, which amounts to one extra case of cancer for every 1,000 patients treated, surprised the researchers who discovered it. They were looking for new evidence on the known side-effects of statins on the liver and muscle wasting.

"This analysis doesn't implicate the statin in increasing the risk of cancer," said the study leader, Professor Richard Karas, of Tufts University School of Medicine, in Boston. "The demonstrated benefits of statins in lowering the risk of heart disease remain clear. However, certain aspects of lowering LDL with statins remain controversial and merit further research." The team reviewed the results of 13 previous trials, involving more than 41,000 patients and all published before November 2005. They detected higher rates of cancer among the patients whose use of statins achieved the lowest levels of LDL cholesterol.

This may be important because recent statin trials have shown that a more aggressive lowering of LDL produces greater benefits to the heart. There are moves to lower the cholesterol targets aimed at by GPs, on the assumption that doing so will do no harm. But there have been suggestions that there may be a greater risk of side-effects if a more aggressive statin treatment is used.

The researchers, who published their findings in the Journal of the American College of Cardiology, found that the degree of damage to the liver increased with greater statin doses, but that there was no such effect in muscle wastage. They said the best strategy may be to combine statins at moderate doses with other drugs.

As for cancer, conclusions are difficult to draw. No single form of cancer predominated, so if there is a side-effect of having a very low level of LDL, it would have to apply to all types of cancer. And previous statin trials have not shown any direct effect on cancer risk. But those trials did not compare cancer risk with the degree of lowering of LDL cholesterol.

John LaRosa, of the State University of New York, cast doubt on the findings. If they were caused by a lowering of cholesterol, the effect must have been very rapid, as the trials lasted five years or less. Other explanations, he said, were chance, or simply that people who would otherwise have died of heart disease were living longer, and dying of cancer.

June Davison, cardiac nurse for the British Heart Foundation, said: "We have known about the association between low cholesterol levels and cancer for some time now. While this [research] highlights an association between low levels of LDL and cancer, this is not the same as saying that low LDL or statin use increases the risk of cancer. There is overwhelming evidence that lowering LDL cholesterol through statins saves lives by preventing heart attacks and strokes. These findings do not change the message that the benefits of taking statins greatly outweigh any potential risks. People should not stop taking statin treatment on the basis of this research."


Hope for new drug to control Alzheimer's

SCIENTISTS have developed a chemical compound hailed as the "holy grail" of Alzheimer's research that could stop the disease and enable sufferers to improve memory and learning ability. The man-made chemical created by Scottish researchers was able to prevent the death of brain cells and slow the progression of the disease in rats. It is hoped it will lead to drugs, particularly for early stage Alzheimer's and dementia.

Researchers at the University of St Andrews and scientists in America succeed in blocking the build-up of a toxic protein called amyloid in nerve cells, which kills the cells and collects in clumps called senile plaques. "We have shown that it is possible to reverse some of the signs associated with Alzheimer's disease," said lead researcher Frank Gunn-Moore.



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.


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