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Prostate Cancer, Nutrition, and Dietary Supplements (PDQ®)

Health Professional Version
Last Modified: 05/01/2012

Introduction

This complementary and alternative medicine (CAM) information summary provides an overview of the use of various foods and dietary supplements for reducing the risk of developing prostate cancer or for treating prostate cancer. This summary includes history of research on different foods and dietary supplements, reviews of laboratory and animal studies, and results of clinical trials. Each type of dietary supplement and food will have a dedicated section in the summary and new topics will be added over time.

Prostate cancer is the most common noncutaneous cancer affecting men in the United States. From 2004 to 2008, the median age of diagnosis of prostate cancer was 67, and the incidence rate was 156 cases per 100,000 men per year.[1]

Many studies suggest that CAM use is common among prostate cancer patients, and the use of vitamins, supplements, and specific foods is frequently reported by these patients. For example, the Prostate CAncer Therapy Selection (PCATS) study was a prospective study investigating men’s decision-making processes about treatment following a diagnosis of local stage prostate cancer. As part of this study, patients completed surveys regarding CAM use, and more than half of the respondents reported using one or more CAM therapies, with mind-body modalities and biologically based treatments being the most commonly used.[2]

International studies have reported similar findings. A Swedish study published in 2011 found that, overall, participants with prostate cancer were more likely to have used supplements than were healthy population-based control subjects. Supplement use was even more common among the patients with the healthiest dietary patterns (e.g., high consumption of fatty fish and vegetables).[3] In a Canadian study, CAM use was reported among 39% of recently diagnosed prostate cancer patients, and the most commonly used forms of CAM were herbals, vitamins, and minerals. Within those categories, saw palmetto, vitamin E, and selenium were the most popular. The two most popular reasons for choosing CAM were to boost the immune system and to prevent recurrence.[4] According to another Canadian study, approximately 30% of survey respondents with prostate cancer reported using CAM treatments. In that study, vitamin E, saw palmetto, and lycopene were the most commonly used.[5] A British study published in 2008 indicated that 25% of prostate cancer patients used CAM, with the most frequently reported interventions being low-fat diets, vitamins, and lycopene. The majority of CAM users in this study cited improving quality of life and boosting the immune system as the main reasons they used CAM.[6]

Vitamin and supplement use has also been documented in men at risk of developing prostate cancer. One study examined vitamin and supplement use in men with a family history of prostate cancer. At the time of the survey, almost 60% of the men were using vitamins or supplements. One third of the men were using vitamins and supplements that were specifically marketed for prostate health or chemoprevention (e.g., selenium, green tea, and saw palmetto).[7] A 2004 study examined herbal and vitamin supplement use in men attending a prostate cancer screening clinic. Men attending the screening clinic completed questionnaires about supplement use. Of the respondents, analysis revealed that 70% used multivitamins, and 21% reported using herbal supplements.[8]

A meta-analysis published in 2008 reviewed studies reporting vitamin and mineral supplement use among cancer survivors. The results showed that, among prostate cancer survivors, vitamin or mineral use ranged from 26% to 35%.[9]

Although many prostate cancer patients use CAM treatments, they do not all disclose their CAM use to treating physicians. According to results from the PCATS study, 43% of patients discussed their CAM use with a healthcare professional.[2] In two separate studies, 58% of respondents told their doctors about their CAM usage.[4,6]

How do prostate cancer patients decide whether to use CAM or not? A qualitative study published in 2005 described results from interviews with prostate cancer patients who were CAM users or nonusers. The study identified differences in thinking patterns between the two groups and suggested that no specific theme led patients to CAM, rather a combination of ideas directed them. For example, the perception of CAM being harmless was associated with the belief that conventional medicine resulted in many negative side effects.[10] Results of a 2003 qualitative study suggest that decision making by prostate cancer patients about CAM treatments depends on both fixed (e.g., medical history) and flexible (e.g., a need to feel in control) decision factors.[11]

References

  1. National Cancer Institute.: SEER Stat Fact Sheets: Prostate. Bethesda, MD: National Cancer Institute, 2011. Available online 1. Last accessed December 14, 2011. 

  2. McDermott CL, Blough DK, Fedorenko CR, et al.: Complementary and alternative medicine use among newly diagnosed prostate cancer patients. Support Care Cancer 20 (1): 65-73, 2012.  [PUBMED Abstract]

  3. Westerlund A, Steineck G, Bälter K, et al.: Dietary supplement use patterns in men with prostate cancer: the Cancer Prostate Sweden study. Ann Oncol 22 (4): 967-72, 2011.  [PUBMED Abstract]

  4. Eng J, Ramsum D, Verhoef M, et al.: A population-based survey of complementary and alternative medicine use in men recently diagnosed with prostate cancer. Integr Cancer Ther 2 (3): 212-6, 2003.  [PUBMED Abstract]

  5. Boon H, Westlake K, Stewart M, et al.: Use of complementary/alternative medicine by men diagnosed with prostate cancer: prevalence and characteristics. Urology 62 (5): 849-53, 2003.  [PUBMED Abstract]

  6. Wilkinson S, Farrelly S, Low J, et al.: The use of complementary therapy by men with prostate cancer in the UK. Eur J Cancer Care (Engl) 17 (5): 492-9, 2008.  [PUBMED Abstract]

  7. Bauer CM, Ishak MB, Johnson EK, et al.: Prevalence and Correlates of Vitamin and Supplement Usage Among Men With a Family History of Prostate Cancer. Integr Cancer Ther : , 2011.  [PUBMED Abstract]

  8. Barqawi A, Gamito E, O'Donnell C, et al.: Herbal and vitamin supplement use in a prostate cancer screening population. Urology 63 (2): 288-92, 2004.  [PUBMED Abstract]

  9. Velicer CM, Ulrich CM: Vitamin and mineral supplement use among US adults after cancer diagnosis: a systematic review. J Clin Oncol 26 (4): 665-73, 2008.  [PUBMED Abstract]

  10. Singh H, Maskarinec G, Shumay DM: Understanding the motivation for conventional and complementary/alternative medicine use among men with prostate cancer. Integr Cancer Ther 4 (2): 187-94, 2005.  [PUBMED Abstract]

  11. Boon H, Brown JB, Gavin A, et al.: Men with prostate cancer: making decisions about complementary/alternative medicine. Med Decis Making 23 (6): 471-9, 2003 Nov-Dec.  [PUBMED Abstract]





Glossary Terms

analysis (uh-NA-lih-sis)
A process in which anything complex is separated into simple or less complex parts.
animal study (A-nih-mul STUH-dee)
A laboratory experiment using animals to study the development and progression of diseases. Animal studies also test how safe and effective new treatments are before they are tested in people.
biological (BY-oh-LAH-jih-kul)
Pertaining to biology or to life and living things. In medicine, refers to a substance made from a living organism or its products. Biologicals may be used to prevent, diagnose, treat or relieve of symptoms of a disease. For example, antibodies, interleukins, and vaccines are biologicals. Biological also refers to parents and children who are related by blood.
chemoprevention (KEE-moh-pree-VEN-shun)
The use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or recurrence of, cancer.
clinical trial (KLIH-nih-kul TRY-ul)
A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.
complementary and alternative medicine (KOM-pleh-MEN-tuh-ree... all-TER-nuh-tiv MEH-dih-sin)
Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices generally are not considered standard medical approaches. Standard treatments go through a long and careful research process to prove they are safe and effective, but less is known about most types of CAM. CAM may include dietary supplements, megadose vitamins, herbal preparations, special teas, acupuncture, massage therapy, magnet therapy, spiritual healing, and meditation. Also called CAM.
control group (kun-TROLE groop)
In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works.
conventional medicine (kun-VEN-shuh-nul MEH-dih-sin)
A system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery. Also called allopathic medicine, biomedicine, mainstream medicine, orthodox medicine, and Western medicine.
diagnosis (DY-ug-NOH-sis)
The process of identifying a disease, such as cancer, from its signs and symptoms.
diet (DY-et)
The things a person eats and drinks.
dietary supplement (DY-uh-TAYR-ee SUH-pleh-ment)
A product that is added to the diet. A dietary supplement is taken by mouth, and usually contains one or more dietary ingredient (such as vitamin, mineral, herb, amino acid, and enzyme). Also called nutritional supplement.
family history (FA-mih-lee HIH-stuh-ree)
A record of the relationships among family members along with their medical histories. This includes current and past illnesses. A family history may show a pattern of certain diseases in a family. Also called family medical history.
herbal (ER-bul)
Having to do with plants.
immune system (ih-MYOON SIS-tem)
The complex group of organs and cells that defends the body against infections and other diseases.
incidence (IN-sih-dents)
The number of new cases of a disease diagnosed each year.
lycopene (LY-kuh-peen)
A red pigment found in tomatoes and some fruits. It is an antioxidant and may help prevent some types of cancer.
median (MEE-dee-un)
A statistics term. The middle value in a set of measurements.
meta-analysis (meh-tuh-uh-NA-lih-sis)
A process that analyzes data from different studies done about the same subject. The results of a meta-analysis are usually stronger than the results of any study by itself.
mineral (MIH-neh-rul)
In medicine, a mineral is a nutrient that is needed in small amounts to keep the body healthy. Mineral nutrients include the elements calcium, magnesium, and iron.
prospective (pruh-SPEK-tiv)
In medicine, a study or clinical trial in which participants are identified and then followed forward in time.
prostate cancer (PROS-tayt KAN-ser)
Cancer that forms in tissues of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum). Prostate cancer usually occurs in older men.
quality of life (KWAH-lih-tee ... life)
The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.
recurrence (ree-KER-ents)
Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrent cancer.
saw palmetto (...pawl-MEH-toh)
A shrub that is a member of the palm tree family. An extract made from the berries of this shrub has been studied in the treatment of certain urinary and prostate disorders. The scientific name is Serenoa repens.
selenium (seh-LEE-nee-um)
A mineral that is needed by the body to stay healthy. It is being studied in the prevention and treatment of some types of cancer. Selenium is a type of antioxidant.
side effect (side eh-FEKT)
A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.
stage (stayj)
The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
survivor (ser-VY-ver)
One who remains alive and continues to function during and after overcoming a serious hardship or life-threatening disease. In cancer, a person is considered to be a survivor from the time of diagnosis until the end of life.
vitamin (VY-tuh-min)
A nutrient that the body needs in small amounts to function and stay healthy. Sources of vitamins are plant and animal food products and dietary supplements. Some vitamins are made in the human body from food products. Vitamins are either fat-soluble (can dissolve in fats and oils) or water-soluble (can dissolve in water). Excess fat-soluble vitamins are stored in the body’s fatty tissue, but excess water-soluble vitamins are removed in the urine. Examples are vitamin A, vitamin C, and vitamin E.
vitamin E (VY-tuh-min ...)
A nutrient that the body needs in small amounts to stay healthy and work the way it should. It is fat-soluble (can dissolve in fats and oils) and is found in seeds, nuts, leafy green vegetables, and vegetable oils. Vitamin E boosts the immune system and helps keep blood clots from forming. It also helps prevent cell damage caused by free radicals (highly reactive chemicals). Vitamin E is being studied in the prevention and treatment of some types of cancer. It is a type of antioxidant. Also called alpha-tocopherol.

Table of Links

1http://seer.cancer.gov/statfacts/html/prost.html#prevalence