Low cholesterol, cancer and infections

December 2011

Bad statin news aren´t welcome

In many western countries more and more get cancer although at the same time more and more people stop smoking, one of the most cancer-provoking factors. We (the members of THINCS) think that the reason is the increasing use of cholesterol lowering drugs. Those who promote such treatment argue that no analysis of the statin trials have shown any association and some even claim that the statins protect against cancer.

There are many ways to cover up the fact that lowering cholesterol may lead to cancer, but there are also numerous observations that point to low cholesterol as the villain.

But how can low cholesterol lead to cancer? This is a good question, and there is an answer. Because the liporoteins partake in the immune defense system, and because many cancers are caused by virus or bacteria.

Together with two members of THINCS, Kilmer McCully, the discoverer of the association between homocysteine and atherosclerosis, and Paul Rosch, President of the American Institute of Stress, I have tried to present the facts around this issue. The paper has finally been published in Quarterly Journal of Medicine Before that, we sent the paper to six different medical journals (not at the same time of course), all of which rejected it. Here are their arguments

Archives of Internal Medicine:
I regret to inform you that its priority rating is not sufficiently high to warrant our considering it further for publication. Based on our initial review, we will not be sending the paper for additional outside editorial review.

CA: A Cancer Journal for Clinicians:
Thank you for submitting your proposal for an article on “Low cholesterol, cancer and the role of lipoproteins” to CA: A Cancer Journal for Clinicians. It is our editorial policy to concentrate on articles that address cancer more broadly (treatment modalities used for many cancer types, current treatment of common types of cancer, public health issues relevant to several cancer types, etc.). For these reasons, we cannot consider your article for publication in CA. However, you may want to consider submitting your article to CANCER, another peer-reviewed American Cancer Society journal, which publishes more focused papers such as the one you have described

Cancer:
Thank you for your recent manuscript submission of “Low cholesterol, cancer and the role of lipoproteins” (CNCR-11-2485) to Cancer. Your paper has undergone initial review. I am sorry to report that it was not deemed to be of broad enough interest to our readership to merit further evaluation.

JAMA:
Thank you for your inquiry. However, JAMA is not able to consider your manuscript for publication.

Journal of the National Cancer Institute:

I am sorry that we shall not be able to use the above-titled manuscript. After careful evaluation, the Editorial Board did not accord it a priority sufficient for further consideration.

Scandinavian Cardiovascular Journal:
Thank you for submitting the manuscript # SCAR-2011-0151 entitled “Low cholesterol, cancer and the crucial role of lipoproteins” to the Scandinavian Cardiovascular Journal. The questions raised are important, indeed, and deserve a thorough analysis and discussion. Admittedly not being an expert on this field, my impression is that the present manuscript is polemic in style, and biased. This view was shared by one leading cancer epidemiologist; he/she finds the present selection and interpretation of the literature superficial and subjective. Hence I choose not to forward your manuscript to our reviewers.

Read our paper yourself and tell me if the paper is not “of broad enough interest” or if it is “polemic in style” or if “its priority rating is not sufficiently high”

What I have told you here is no exception. Many of our members including myself can tell you about how difficult it is to publish papers that goes counter to conventional wisdom. On one of our websites you can find many examples of rejected papers and comments.

Statin treatment and infections

Several researchers have claimed that statin treatment prevents infections. Recently a Dutch group published an analysis of the statin trials where the authors had reported the number of infections. Not unexpectedly they didn´t find any difference between the statin groups and the controls (those who got an ineffective placebo pill).

In an editorial in the same issue of British Medical Journal, where the Dutch report was published, Beatrice Golomb commented the study. It was certainly not expected either because, as she wrote, a number of relevant factors may distort the results. One of them is the fact that among 632 statin trials, only eleven reported the number of infections, and ”most authors declined to provide the omitted information when approached”. “The best evidence, she concluded, “is that statins should not be used to forestall infection or its consequences.”

There is even evidence of the opposite. As mentioned, and as Golomb also pointed out, low cholesterol is a risk factor for infection, and as we have a plausible mechanism to propose, we send a letter to British Medical Journal, now published as a Rapid Response.

Most Rapid Responses are available on the web ony. If you sympathize with our letter, you are most welcome to vote (on the right hand side of the letter). Many positive votes may possibly increase its chance to become published in the paper version as well.