There have been a number of studies that have suggested that some common medications will alter prostate-specific antigen (PSA) levels.
Researchers from Stanford University School of Medicine, Stanford, CA., investigated the impact of individual and combinations of common medications thought to impact PSA in a large cross-sectional study of the United States population.
The study included men > /= 40 years old without prostate cancer from the 2003 to 2004 and 2005 to 2006 cycles of the National Health and Nutrition Examination Survey (NHANES). Men with recent prostate manipulation, prostatitis, and those on hormone therapy were excluded.
The researchers weighted and performed a multivariate linear regression to determine the effect on PSA measurements of the 10 most commonly prescribed medication classes. They adjusted for potential confounders including demographics, clinical characteristics, physical examination, laboratory studies, and duration of medication use.
In total, 1,864 men met inclusion criteria. They found that:
1- Nonsteroidal anti-inflammatory drug (NSAID; P = .03), statin (P = .01), and thiazide diuretic (P = .025) intake was inversely related to PSA levels.
2- Five years of NSAID, statin, and thiazide diuretic use was associated with PSA levels lower by 6%, 13%, and 26%, respectively.
3- The combination of statins and thiazide diuretics showed the greatest reduction in PSA levels: 36% after 5 years.
4- Concurrent calcium channel blocker use minimizes or negates the inverse relationship of statin use and PSA level.
They concluded that men using NSAIDs, statins, and thiazide diuretics have reduced PSA levels by clinically relevant amounts. The impact of regularly consuming these common medications on prostate cancer screening is unknown.
These findings might have additional implications for men post treatment and for men battling known advanced disease.
None of the subjects in the study were diagnosed with prostate cancer. However, if these commonly used drugs have a similar effect on men with prostate cancer they can be artificially masking recurrences as well as interfering with our ability to monitor advanced prostate cancer treatments.
Anyone taking these drugs needs to discuss this possibility with their doctor.
Reference: J Clin Oncol. 2010 Aug 2. Epub ahead of print.
doi: 10.1200/JCO.2009.27.9406 ; Chang SL, Harshman LC, Presti JC Jr
Joel T Nowak, M.A., M.S.W.
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