March 12, 2014 Oakland, CA. Dennis R. Hill M.D. Medical Director of the HDR Prostate Brachytherapy Center and Radiation Oncologist at the Alta Bates Summit Medical Center in Oakland, CA continues his series on prostate cancer treatment options.
March 12, 2014 Oakland, CA- A new report (1) updating the previously reported Selenium and Vitamin E Cancer Prevention Trial (SELECT), was published online February 22, 2014 in the Journal of the National Cancer Institute. This analysis included an examination of whether the baseline selenium level had any impact on the development of prostate cancer.
The SELECT trial began in 2001 as a placebo-controlled trial in which more than 35,000 men were randomized to high-dose vitamin E (400 IU/day) and/or selenium (200 µg/day) supplements. The study was funded by the National Cancer Institute.
The original report (2) concluded that men receive no preventive benefit from either selenium or vitamin E supplements; in fact, for certain men, these supplements actually increased the risk for prostate cancer. The supplements were stopped in 2008 for that reason after average of five years but the study continued.
In this new study, the investigators reviewed the previously measured concentration of selenium in the toenails of 1,739 men diagnosed with prostate cancer during the SELECT trial and compared them with 3,117 men who were not.
They found that men with high selenium levels at baseline who took selenium supplements increased their risk for high-grade cancer by 91%. In other words, the levels of selenium in these men became toxic with supplementation.
The investigators also report that vitamin E increased prostate cancer risk in men, but only in those with low selenium levels at baseline. In the men with low levels of selenium randomized to receive vitamin E alone the risk for high-grade cancer increased by 111%.
The authors write that this study “suggests that effects of supplementation are dependent upon the nutrient status of the target population, such that supplementation of populations with adequate nutrient status, leading to supra physiological exposure, has either no effect or increases cancer risk.”
Dr. Hill says “Although many people think that dietary supplements ‘can’t hurt and might help” this report is consistent with the medical literature on supplements and cancer. If you are healthy, additional supplements are of no benefit.”
If prostate cancer is proven on biopsy, treatment options are active surveillance or interventional treatment such as radical surgery, external beam radiation, permanent seed implant or High Dose Rate Brachytherapy. In low risk disease the cure rate is excellent with any of the treatment methods. However, High Dose Rate Brachytherapy has a very low complication rate compared to the other modalities. There are essentially no rectal complications, no incontinence and a low percentage of erectile dysfunction.
About Dennis R. Hill MD
Dr. Hill is a board certified radiation oncologist doing High Dose Rate brachytherapy exclusively since 2004 and has published scholarly articles on the subject. His office is located at: Dennis R. Hill MD, 3012 Summit Street, Suite 2675, Oakland, CA 94609 510-869-8875. His email is firstname.lastname@example.org and his website is hdrprostatebrachytherapy.com
- Frankel PH, Parker RS, Madsen FC, Whanger PD. Baseline selenium and prostate cancer risk: comments and open questions. J Natl Cancer Inst. Natl Cancer Inst. 2014 Feb 22. [Epub ahead of print]
- Lippman SM, Klein EA, Goodman PJ, et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2009;301:39-51.