Cholesterol . . . Again?

Q: Years ago numerous health talks highlighted cholesterol. Nowadays I don’t hear much about it. Is cholesterol still relevant?

A: Cholesterol became a household word during the 1980s and 1990s because of its association will atherosclerosis and disease of the heart, brain, and other blood vessels. Cholesterol travels through the body in the blood packaged in high-density lipoprotein (HDL) or low-density lipoprotein particles (LDL), known as “good” and “bad” cholesterol respectively. People with high cholesterol have about twice the risk of heart disease as people with lower levels; and yes, heart disease and stroke are still leading causes of death around the world. So the relevance of adopting healthful-living practices to reduce cholesterol to appropriate levels is far from over. And we also now know that cholesterol is a player in the deadly processes involving risk, progression, survival, and prognosis of cancer. 

Cholesterol is necessary for making vitamin D, estrogen, testosterone, and other steroid hormones and is vital for sperm development, immune-system defense, and the health of our nervous system. While all our cells contain cholesterol, cancer cells tend to have higher levels of cholesterol than normal, healthy cells; and alteration in the level of cholesterol in the blood is a common occurrence in a wide variety of cancers. We don’t know whether the cholesterol “causes” cancer or if the cancer “causes” the cholesterol to accumulate in the cells, but we have some clues that have come from research conducted in the past few decades. 

Cholesterol stored in cancer cells may function as a reservoir for rapid cell division and makes breakaway cells more likely to produce new colonies away from the parent tumor (i.e., metastasis). In a manner of speaking, cholesterol is “hijacked” in the malignant process for the development, 

survival, progression, and metastasis of cancerous cells. In most cases tissue from tumors shows an increase in the uptake receptors for LDL cholesterol, which may then serve as a pipeline for new cholesterol to support rapid growth in the cancer cells. So could it be that a lifestyle that promotes high levels of LDL, or “bad” cholesterol, may also be fueling the development of cancers and cancer metastasis? 

It’s now known that alteration of the way cholesterol is handled in cancer cells can hamper or facilitate the response to anti-cancer therapies. Increased cholesterol levels are associated with higher cancer incidence, and cholesterol-lowering drugs (e.g., statins) may reduce the risk of dying from certain cancers, such as breast, prostate, and colorectal. Yet some cancers aren’t affected by blood cholesterol levels, and cholesterol-lowering drugs themselves may increase cancer risk. So just looking for medication to “fix” the cholesterol may not be the answer. 

There’s robust evidence that a healthful lifestyle using a plant-based diet of whole foods, adequate exercise, rest, stress management, and trust in God makes a lot of sense in reducing the risk of cancer as well as other leading threats to our health.