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World Journal of Urology
Published in: World Journal of Urology 1/2022

01-01-2022 | Prostate Cancer | Topic Paper

The role of metformin, statins and diet in men on active surveillance for prostate cancer

Authors: Raj Tiwari, Neil Fleshner

Published in: World Journal of Urology | Issue 1/2022

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Abstract

Purpose of review

A sound scientific basis has been emerging on the anti-neoplastic role of metformin, statins and dietary interventions. However, evidence in prostate cancer patients remains mixed owing to an absence of completed randomized trials. This overview examines the rationale for metformin, statins and dietary intervention for secondary prevention in men on active surveillance by summarizing current evidence base and biological mechanisms in influencing cancer progression and mortality.

Methods

A comprehensive literature search was performed to identify studies that evaluated the role of metformin, statins and diet in the secondary prevention of prostate cancer as well as those that described the anti-cancer mechanisms of these agents. The search included Pubmed, MEDLINE, EMBASE and Cochrane library from inception till August 2021.

Results

A total of 14 trials on metformin, 21 trials on statins and 13 trials on dietary measures were evaluated. Majority were observational population-based cohort studies or meta-analysis of them. Three ongoing prospective randomized controlled trials were also reported. Overall, mixed results were obtained.

Conclusions

The role of metformin and statins remains promising with several trials showing reduced rates of progression and cancer specific mortality. Combination therapy strategies have also been evaluated in more advanced patients showing synergism. Dietary interventions especially fruits, vegetables and fish intake has shown some benefit albeit with mixed results for others like legumes, red meat, coffee and multivitamins. Several ongoing randomized trials will provide stronger evidence in the future for secondary prevention.
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Metadata
Title
The role of metformin, statins and diet in men on active surveillance for prostate cancer
Authors
Raj Tiwari
Neil Fleshner
Publication date
01-01-2022
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 1/2022
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-021-03858-4

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