Just about every cancer is a nightmare, largely because of the uncertainty, and the rigours of treatment.

Still, overall, more people are surviving that magic five years, depending on cancer type.

Pancreatic cancer, however, remains stubbornly resistant to becoming a good news story. The five-year survival rate stands at about 13 per cent.

Which is woeful, but actually much better than it used to be. Thirty years ago, the survival rate was less than four per cent.

Most pancreatic cancers are driven by cell mutations in what’s known as the KRAS gene. For these, there are no treatments available.

And because pancreatic tumours entangle themselves into surrounding blood vessels and tissue, surgical removal is difficult.

So where’s the hope?

On the face of it, the best hope probably lies in prevention, which means finding an agent that is actively protective against the disease.

Scientists believe that statins, the cheap drugs that helps keep your cholesterol in a healthy range, may be that agent.

Twenty years ago, in a study involving half a million US veterans,  statins were associated with a 52 per cent “reduced incidence of pancreatic cancer after controlling for aspirin use, smoking, age and diabetes”.

Subsequent studies have had similar findings.

In 2022, a systematic review and meta analysis involving 2.7 million patients, found that “overall statins use is significantly associated with a reduction in risk of pancreatic cancer”.

It’s a fascinating idea, but how can the concept be converted into a clinical reality? What is it that statins do to protect against cancer?

A potential breakthrough

For years, it has been understood that some cancers, including pancreatic cancer, are caused by chronic inflammation. It has also been long accepted that statins have anti-inflammatory properties.

If this inflammation can be switched off, pancreatic cancer won’t develop.

For about a decade, according to a report at Healthline, researchers from Massachusetts General Hospital and Harvard Medical School have been trying to establish the mechanism that triggers this cancer-causing chronic inflammation.

Eventually they discovered that interleukin 33 (IL-33), which plays critical roles in certain immune responses, is the “initiator of this cancer-causing chronic inflammation”.

Even better, the researchers “appear to have found a way to suppress that inflammation response through the use of pitavastatin, a generic statin medication”.

How they made this discovery

According to the Medical News Today:

• The researchers utilised mice, human tissue samples, and cell lines
• They induced chronic inflammation in mice on the skin and in the pancreas
• They found that IL-33 was highly expressed in the inflamed skin and pancreas
• They then tested the use of pitavastatin to block IL-33 expression
• While looking at human tissue samples, they further confirmed that IL-33 signalling is active when the pancreas is inflamed and in cases of pancreatic cancer
• Finally, electronic health records from more than 200 million people confirmed that those taking pitavastatin were at a decreased risk for chronic pancreatitis and pancreatic cancer.

These findings are promising, and exciting, but very new. We’re a long way from translating these findings to offering pitavastatin as a cancer prophylactic.

Meanwhile, observational studies “have found significantly lower rates of breast cancer among statin users”.

Other research has suggested that statins “could cut the risk of aggressive prostate cancer”.

However, none of these associations have been rigorously determined in clinical trials. Hopefully in good time they will be.