Cholesterol Again

Q: My 28-year-old sister has breast cancer. Our mom died of ovarian cancer, and the doctor wants to test my sister’s genes. He mentioned that her high cholesterol needs to be controlled for best results with the cancer. I’m 33, and all four of us siblings have high cholesterol. What’s the link between cholesterol and cancer?

A: We’re sorry to hear about your sister’s diagnosis and encourage you and all your siblings—female and male—to get evaluated since your doctor suspects a hereditary cancer. Based on the history you provided, we also strongly recommend that you do some Internet-based research from trusted, accountable sources such as the Centers for Disease Control and Prevention,* and we remind you that prevention is more effective than any type of treatment available today. Early risk reduction and disease detection often produce greater survival, lower treatment complexity, and less cost.

Cholesterol biology is complicated. Our bodies naturally make as much cholesterol as is needed, but we can also get it when we eat foods of animal origin. For years correlations between high cholesterol in the blood and the likelihood of certain cancers have been reported. In some kinds of cancer—such as breast, prostate, testicular, and colorectal—lowering cholesterol levels seems to reduce the risk of getting and dying from these cancers. On the other hand, bladder and lung cancers do not appear to be associated with cho- lesterol levels, and the use of cholesterol-lowering drugs (statins) may increase the risk compared to the benefit. Specifically, increased dietary choles- terol is associated with an increased risk of breast cancer, and that’s probably what prompted the comment by your sister’s doctor. Some studies also estimate that for every 300 milligrams of cholesterol in the daily diet (about a two-egg omelet per day), the risk of pancreatic cancer increases by 24 percent, endometrial cancer by 18 percent, and throat cancer by about 25 percent.

In 2018 researchers at the University of California, Los Angeles, showed how cholesterol promotes tumor growth. In 2019 a scientific review concluded that both a high-fat, high-cholesterol diet and having elevated levels of blood cholesterol can affect cancer development because cholesterol handling is reprogrammed in cancer cells. In 2021 researchers at Duke University demonstrated the way breast cancer cells use cholesterol to fuel the mechanisms that make them impervious to the natural cell stress as they migrate (metastasize). Metastatic breast cancer is difficult to treat, so preventing the spread is preferable. Lowering cholesterol by lifestyle and, if necessary, with medications will interfere with breast cancer metas- tasis and be better for the affected person. Current cholesterol-lowering strategies include physical exercise, adequate sleep, stress reduction, and improved diets low in animal prod- ucts (saturated fat and cholesterol) and high in legumes, seeds, avocados, olives, and especially nuts such as pecans, walnuts, and almonds.

We encourage you and your siblings to find a health-care team that’s knowledgeable about lifestyle-based, wholistic risk reduction and follow their rational plan. Thank God for His evidence-based pathway to optimal health and wholeness even in our brokenness!

* https://www.cdc.gov/cancer/breast/young_women/bringyour- brave/hereditary_breast_cancer/index.htm

Peter N. Landless, a board-certified nuclear cardiologist, is director of Adventist Health Ministries at the General Conference. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.