Cholesterol and Cancer, in the Balance

Cholesterol metabolites can promote or suppress breast cancer, raising questions about how therapies might disrupt this balance. Mammalian cells synthesize cholesterol through a series of 21 enzymatic steps, generating numerous metabolites that are involved in the control of physiological and developmental processes. Cholesterol itself is the precursor of steroid hormones and sterols, the latter of which can be further modified into molecules that induce specific biological responses. Epidemiological studies have investigated the role of cholesterol in breast cancer risk, with contradictory findings. Recent studies, however, linking cholesterol metabolism to breast cancer may provide some insights. Certain cholesterol metabolites can promote (1, 2) or suppress (3) breast cancer. This raises the important question of how to regulate or inhibit the cholesterol metabolic pathway, and at which steps, in a therapeutic approach to cancer.