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Vitamins Don't Cut Prostate Cancer Risk

Large trial casts doubt on earlier studies

December 11, 2008

• Study Links Prostate Cancer to Single Rogue Cell • PSA Testing May Be Unnecessary for Some Older Men • Compound Can Identify Prostate Cancer • Improved PSA Tests May Better Determine Prostate Cancer Risk • Vitamins Don't Cut Prostate Cancer Risk • Aspirin May Lower PSA Levels in Men • FDA Approves New Overactive Bladder Drug • New Prostate Surgical Techniques Often "Over-Promoted" • Feds Approve Drug for Enlarged Prostate • New Prostate Cancer Treatment Shows Promise • Broccoli Reduces Prostate Cancer Risk, Study Finds • Celebrex-Lipitor Combo May Halt Prostate Cancer • Exercise May Speed Prostate Tumor Growth • Soy Compound May Halt Spread of Prostate Cancer • Obesity Linked to Higher Prostate Cancer Mortality • Red Wine May Fight Prostate Cancer • Enlarged Prostate Doesn't Mean Cancer • Hopkins Researchers Claim Better Blood Test for Prostate Cancer • Severe Form of Enlarged Prostate Disease Discovered • Tomato-Broccoli Combo Can Help Shrink Prostate Cancers • Weight Gain Increases Risk of Dying from Prostate Cancer • Smoking Linked to Complications in Prostate Cancer Treatment • Newer Approach Urged in Screening for Aggressive Prostate Cancer • Aspirin May Prevent or Delay Enlarged Prostate • Hopkins Researchers Find Better Blood Test for Prostate Cancer • Prostate Radiation May Cause Problems Later • New Test Detects Prostate Cancer Spread Earlier • Castration May Be Advised in Advanced Prostate Cancer • Radiation Therapy May Be Best for Younger Prostate Cancer Patients • Study Recommends More Prostate Biopsies • Delayed Surgery May Be OK for Some Prostate Cancer Patients • Study: PSA Test Doesn't Improve Prostate Cancer Survival Rate • Prostate Cancer Genes Identified • Annual Prostate Cancer Screening Test Appears to Save Lives • FDA Panel Rejects Prostate Cancer Pill • PSA Test Still Useful, Hopkins Study Finds • No "Normal" PSA Level: Study • New Prostate Cancer Test Shows Promise • Lifestyle and Diet May Stop or Reverse Prostate Cancer Progression

In perhaps the largest cancer chemoprevention trial ever conducted, researchers have found that taking vitamin E or selenium, alone or in combination, was not associated with a lower risk of prostate cancer or other cancers.

The study is being published the January 7 issue of JAMA. But, because of public health implications, it was released early online.

While the number of prostate cancer deaths in the United States has declined in recent years, this cancer remains one of the most common malignancies in U.S. men, with approximately 186,000 new cases and 29,000 deaths estimated for 2008. An effective prevention strategy for prostate cancer would have substantial public health benefits.

Previous studies have indicated the potential of selenium and vitamin E for preventing prostate cancer but the latest trial casts doubt on those findings.

Researchers from the University of Texas M. D. Anderson Cancer Center, Houston, and the Cleveland Clinic Lerner College of Medicine, Cleveland, conducted the Selenium and Vitamin E Cancer Prevention Trial (SELECT) to examine the effects of selenium and vitamin E, alone or in combination, on the risk of prostate cancer and other health outcomes in relatively healthy men.

The trial included 35,533 men, age 50 years or older for black men and age 55 years or older for other men at the start of the study, from the U.S. The men were randomly assigned to receive one of four interventions between August 2001 and June 2004 for a planned minimum follow-up of 7 years: selenium (200 μg/day); vitamin E (400 IU/day), selenium + vitamin E, or placebo.

On September 15, 2008, the independent data and safety monitoring committee recommended the discontinuation of study supplements because the alternative hypothesis of no evidence of benefit from either study agent was convincingly demonstrated and there was no possibility of a benefit to the planned degree with additional follow-up.

The researchers found that there were no statistically significant differences in the absolute numbers (or 5-year incidence rates) of prostate cancer diagnoses between the four groups: placebo, 416 cases; selenium, 432 cases; vitamin E, 473 cases; and selenium + vitamin E, 437 cases.

There were nonsignificant increased risks of prostate cancer in the vitamin E group and type 2 diabetes mellitus in the selenium group, but not in the selenium + vitamin E group.

"In conclusion, SELECT has definitively demonstrated that selenium, vitamin E, or selenium + vitamin E (at the tested doses and formulations) did not prevent prostate cancer in the generally healthy, heterogeneous population of men in SELECT," the authors write. "These data underscore the prudence that is needed in considering recommendations to use agents for the prevention or control of disease in the absence of convincing clinical trial results. These findings also compel the medical research community to continue the search for new, effective agents for prostate cancer prevention."

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