Six common myths about prostate cancer

Published on August 23, 2012 at 4:08 AM · 1 Comment

When it comes to prostate cancer, there's a lot of confusion about how to prevent it, find it early and the best way - or even whether - to treat it. Below are six common prostate cancer myths along with research-based information from scientists at Fred Hutchinson Cancer Research Center to help men separate fact from fiction.

Myth 1 - Eating tomato-based products such as ketchup and red pasta sauce prevents prostate cancer. "The vast majority of studies show no association," said Alan Kristal, Dr.Ph., associate director of the Hutchinson Center's Cancer Prevention Program and a national expert in prostate cancer prevention. Kristal and colleagues last year published results of the largest study to date that aimed to determine whether foods that contain lycopene - the nutrient that puts the red in tomatoes - actually protect against prostate cancer.

After examining blood levels of lycopene in nearly 3,500 men nationwide they found no association. "Scientists and the public should understand that early studies supporting an association of dietary lycopene with reduced prostate cancer risk have not been replicated in studies using serum biomarkers of lycopene intake," the authors reported in Cancer Epidemiology, Biomarkers & Prevention. "Recommendations of professional societies to the public should be modified to reflect the likelihood that increasing lycopene intake will not affect prostate cancer risk."

Myth 2 - High testosterone levels increase the risk of prostate cancer. "This is a lovely hypothesis based on a very simplistic understanding of testosterone metabolism and its effect on prostate cancer. It is simply wrong," Kristal said. Unlike estrogen and breast cancer, where there is a very strong relationship, testosterone levels have no association with prostate cancer risk, he said. A study published in 2008 in the Journal of the National Cancer Institute, which combined data from 18 large studies, found no association between blood testosterone concentration and prostate cancer risk, and more recent studies have confirmed this conclusion.

Myth 3 - Fish oil (omega-3 fatty acids) decrease prostate cancer risk. "This sounds reasonable, based on an association of inflammation with prostate cancer and the anti-inflammatory effects of omega-3 fatty acids," Kristal said. However, two large, well-designed studies - including one led by Kristal that was published last year in the American Journal of Epidemiology - have shown that high blood levels of omega-3 fatty acids increase the odds of developing high-risk prostate cancer.

Analyzing data from a nationwide study of nearly 3,500 men, they found that those with the highest blood percentages of docosahexaenoic acid, or DHA, an inflammation-lowering omega-3 fatty acid commonly found in fatty fish, have two-and-a-half times the risk of developing aggressive, high-grade prostate cancer compared to men with the lowest DHA levels. "This very sobering finding suggests that our understanding of the effects of omega-3 fatty acids is incomplete," Kristal said.

Myth 4 - Dietary supplements can prevent prostate cancer. Several large, randomized trials that have looked at the impact of dietary supplements on the risk of various cancers, including prostate, have shown either no effect or, much more troubling, they have shown significantly increased risk. "The more we look at the effects of taking supplements, the more hazardous they appear when it comes to cancer risk," Kristal said. For example, the Selenium and Vitamin E Cancer Prevention Trial (SELECT), the largest prostate cancer prevention study to date, was stopped early because it found neither selenium nor vitamin E supplements alone or combined reduced the risk of prostate cancer. A SELECT follow-up study published last year in JAMA found that vitamin E actually increased the risk of prostate cancer among healthy men. The Hutchinson Center oversaw statistical analysis for the study, which involved nearly 35,000 men in the U.S., Canada and Puerto Rico.

Myth 5 - We don't know which prostate cancers detected by PSA (prostate-specific antigen) screening need to be treated and which ones can be left alone. "Actually, we have a very good sense of which cancers have a very low risk of progression and which ones are highly likely to spread if left untreated," said biostatistician Ruth Etzioni, Ph.D., a member of the Hutchinson Center's Public Health Sciences Division.

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Comments
  1. Auburn Auburn United States says:

    The SELECT study demonstrated only that a synthetic form of one of the eight forms of vitamin E and a form of selenium different than the form of selenium that had previously shown significant reduction of prostate cancer showed no reduction in the SELECT study.

    SELECT is a phase III randomized, placebo-controlled trial of selenium (200 microg/day from L-selenomethionine) and/or vitamin E (400 IU/day of all-rac--tocopheryl acetate) supplementation for a planned minimum of 7 years (maximum of 12 years) for prostate cancer prevention.

    The panel of investigators reconsidered the possibility of using the yeast form of selenium because results with yeast would compare directly with the results of the NPC study, which provided the major rationale for selenium in SELECT. Therefore, in July and October 2000, an expanded panel of selenium experts reexamined the decision to use selenomethionine and reevaluated the issue of whether high-selenium yeast may be a preferable source of  selenium. However, after reviewing new evidence that indicated substantial batch-to-batch variations in both the presence and relative levels of specific organoselenium compounds in samples of NPC yeast the panel reaffirmed the original decision to use selenomethionine at 200 microg/day.

    Compared with the selenium formulation considerations, the decision to use vitamin E in the form of all rac--tocopheryl acetate was made relatively easily, given both its activity in the ATBC Study and its absorption and metabolism in humans. Supplements made from naturally occurring RRR--tocopherol that have approximately twice the biologic activity of synthetic forms exist, but because there have been no controlled trials of this form in disease prevention, RRR--tocopherol was excluded as a potential choice for SELECT.

    (See Designing the Selenium and Vitamin E Cancer Prevention Trial (SELECT) JNCI Journal of the National Cancer Institute 2005 97(2):94-102; doi:10.1093/jnci/dji009 )

    Yes, you read correctly.  The committee EXCLUDED  the forms of vitamin E and selenium previously shown to be effective.  The medical expert’s remarks were incomplete and misleading.  Not an uncommon experience with media reports on supplements.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News-Medical.Net.
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