In his "Consultations & Comments" response to a reader’scomments about statins and cancer risk in elderly patients(CONSULTANT, October 2003, page 1389), Dr David Nashnotes that the increased number of deaths from cancer thatoccurred in the second year of the Pravastatin in Elderly Individualsat Risk of Vascular Disease (PROSPER) study canprobably be attributed to disease that was already present beforethe start of the trial.
In his "Consultations & Comments" response to a reader'scomments about statins and cancer risk in elderly patients(CONSULTANT, October 2003, page 1389), Dr David Nashnotes that the increased number of deaths from cancer thatoccurred in the second year of the Pravastatin in Elderly Individualsat Risk of Vascular Disease (PROSPER) study canprobably be attributed to disease that was already present beforethe start of the trial. Let us assume he is correct. Yet,might pravastatin, by lowering levels of cholesterol--which isused to repair tissues--have increased the growth of thesecancers?-- Steven Horvitz, DO
 Moorestown, NJ
Cholesterol is used in the building of tissues--as are a host of other ingredients. This in noway implies a causal relationship between thelowering of cholesterol levels and the growthof cancer. Realistically, smoking, obesity, andgenetics play much more defined roles--yet many physiciansand patients pay little more than lip service to preventivecare that targets these risk factors.Statins will improve the lives of many who use themproperly. However, they need not be prescribed if either thephysician or the patient has reservations about their use.-- David T. Nash, MD
 Clinical Professor of Medicine
 State University of New York Health Science Center
 Syracuse