Simvastatin and Cancer Risk

Content provided by the Faculty of the Harvard Medical School

Simvastatin and Cancer Risk

Question:

I have been taking 20 mg of simvastatin for some time. I have read that this type of drug increases the risk of cancer. What is your advice on taking this medication?

Answer

A new study examined the possibility that a cholesterol medicine that combines the drugs ezetimibe and simvastatin (a pill marketed by the brand name Vytorin) might slightly raise the risk of dying from cancer. The New England Journal of Medicine published the study on September 25.

The study included 1,873 people. Half received Vytorin and half received a placebo (sugar pill). The main purpose of the study was to see if taking Vytorin improved heart health. It did not. But researchers were even more dismayed by an unexpected finding.

The group taking Vytorin had more prostate cancers, cancers in the digestive tract, skin cancers, and other cancers than the group taking the placebo. There were 39 deaths from cancer in the Vytorin group, compared with only 23 deaths among the people taking the placebo. Previous studies seemed to rule out the link between statin drugs, such as simvastatin, and cancer. Therefore, suspicion fell on ezetimibe, the other drug in Vytorin.

One additional study suggested a slightly increased cancer risk from ezetimibe. That study did not involve the drug simvastatin.

The cancer concerns for ezetimibe are minor. Nevertheless, there are growing worries that ezetimibe may do more harm than good in the end. Doctors have not seen a clear benefit from using ezetimibe or combination pills such as Vytorin to lower cholesterol.

Simvastatin, like other statins, has been shown to have a clear benefit to heart health when it is used alone (not packaged in combination with ezetimibe). Doctors are not concerned about simvastatin being a cause of cancer.

My advice would be to continue your simvastatin, if you and your doctor have decided that you need this medicine to improve your cholesterol.

Mary Pickett, M.D., is a lecturer for Harvard Medical School and an assistant professor of medicine at Oregon Health & Science University in Portland, OR. At OHSU, she practices general internal medicine and teaches medical residents and students.

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Last updated:	July 20, 2009

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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