Can statins, aspirin and metformin help to prevent prostate cancer? Can polypill delay cancer progression? Leading cancer expert explains pharmacological prevention of prostate cancer. Dr. Anton Titov, MD. There is some medical literature about primary cancer prevention. It is called SAM strategy. Statins, Aspirin and Metformin. Dr. Mark Emberton, MD. Yes! Statins, aspirin, metformin are not just for prostate cancer prevention, but also for colorectal cancers. What can you say about using potentially those medicines in primary cancer prevention? I think this Statins, aspirin, metformin are of a great interest for cancer prevention. These are the constituents of the PolyPill. PolyPill was proposed to prolong all our lives. I think there's something probably in all those agents. Can we show that individually they will affect cancer survival and outcome? I think it is another issue. Metformin is really interesting one. There are many clinical trials being done with metformin at present. We have to see if we can change the natural history of prostate cancer. So men prior to radical prostatectomy, for instance, are being given metformin. Men on active surveillance of prostate cancer have been given metformin. Dr. Mark Emberton, MD. We are involved in the trial of active surveillance and aspirin. We have to see if we can reduce prostate cancer progression rates. All stories lead the back to MRI. I think with prostate MRI we're going for the first time to have the opportunity to assess Statins, aspirin, metformin. Because we've got a test that can show us small changes in prostate cancer volume. So in other words, instead of waiting for prostate cancer to progress. There are lots of reasons why prostate cancer might progress. There are lots of reasons why people might die. We can look at fewer men with prostate cancer, but watch lesions over time. we can randomize prostate cancer patients to aspirin or metformin or statins. Or we can give a polypill approach. We can compare with placebo. And I think we will be able to define over maybe a period of year or two, prostate cancer progressors from non-progressors. Also we can look at the prostate biopsy tissue to see how these pills are affecting the genetic expression within the tumors. Dr. Anton Titov, MD. Of course, it's a controversial topic. But one theory says that people are living significantly longer. So you should do some extreme dietary intervention, like calorie restriction or alternate-day diet or intermittent fasting at extreme level. Otherwise, it's very hard to avoid chemo-prevention and chemo-intervention with medicines: statins, aspirin and metformin. So you can avoid getting multiple cancers. Dr. Mark Emberton, MD. Correct, correct!