Vitamin D And Risk Of Prostate Cancer
Valerie Clinard, PharmDCampbell University College of Pharmacy & Health SciencesCo-Director, Campbell University Drug Information CenterBuies Creek, North Carolina
Campbell University College of Pharmacy & Health SciencesFuquay Varina, North Carolina
US Pharm. 2013 38:8-11.
ABSTRACT: Prostate cancer is the most common cancer in men and the second most common cause ofdeath from cancer among white, African American, American Indian/NativeAlaskan, and Hispanic men. The epidemiology of prostate cancer is notfully understood however, several risk factors have been documented,including increasing age, family history, and race. Vitamin D also hasbeen suggested as a risk factor. Dietary vitamin D intake, serum vitaminD levels, and sunlight exposure have been investigated to determinewhether vitamin D is associated with an increased or decreased risk ofprostate cancer. Epidemiologic studies evaluating the correlationbetween risk of prostate cancer and vitamin D levels are conflicting.
Excluding nonmelanoma skin cancer, prostate cancer is the most common cancer in men, regardless of race or ethnicity.1It is the second most common cause of death from cancer among white,African American, American Indian/Native Alaskan, and Hispanic men. In2008, a total of 214,633 men were diagnosed with prostate cancer in theUnited States, and 28,471 men died from the disease.
Questions And Answers About Selenium
Selenium is a mineral that is essential to humans in tiny amounts. Selenium is needed for many body functions, including reproduction and immunity. Food sources of selenium include meat, vegetables, and nuts. The amount of selenium found in the food depends on the amount of selenium in the soil where the food grows. Selenium is stored in the thyroid gland, liver, pancreas, pituitary gland, and kidneys.
Selenium may play a role in many diseases, including cancer. Results of the large National Cancer Institute-sponsored Selenium and Vitamin E Cancer Prevention Trial suggest that men with prostate cancer should not take selenium supplements.
Selenium may be eaten in food or taken in dietary supplements.
- Vitamin E and selenium.
- Two placebos.
Early results of SELECT reported in 2009 found no difference in the rate of developing prostate cancer among the 4 groups. In the selenium alone group, there was a slight increase in the rate of diabetes mellitus. Even though this change was not clearly shown to be due to the supplement, the men in the study were advised to stop taking the study supplements.
A study of 1,434 men in SELECT suggested that changes in certain genes which control the way selenium is used by the body may have an effect on the risk of developing prostate cancer.
Purpose Of This Summary
This PDQ cancer information summary has current information about the use of nutrition and dietary supplements for reducing the risk of developing prostate cancer or for treating prostate cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
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Vitamin D Sunlight And Prostate Cancer Risk
Charles Y. F. Young
1Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
2Departments of Urology, Biochemistry and Molecular Biology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
Prostate cancer is the second common cancer in men worldwide. The prevention of prostate cancer remains a challenge to researchers and clinicians. Here, we review the relationship of vitamin D and sunlight to prostate cancer risk. Ultraviolet radiation of the sunlight is the main stimulator for vitamin D production in humans. Vitamin D’s antiprostate cancer activities may be involved in the actions through the pathways mediated by vitamin D metabolites, vitamin D metabolizing enzymes, vitamin D receptor , and VDR-regulated genes. Although laboratory studies including the use of animal models have shown that vitamin D has antiprostate cancer properties, whether it can effectively prevent the development and/or progression of prostate cancer in humans remains to be inconclusive and an intensively studied subject. This review will provide up-to-date information regarding the recent outcomes of laboratory and epidemiology studies on the effects of vitamin D on prostate cancer prevention.
2. Vitamin D Metabolism
3. Action of VDR in Prostate Cancer Cells
4. Sunlight Exposure and Prostate Cancer
5. Circulating Vitamin D and Prostate Cancer Risk
7. Concluding Remarks
To Learn More About Cam
National Center for Complementary and Integrative Health
The National Center for Complementary and Integrative Health at the National Institutes of Health facilitates research and evaluation of complementary and alternative practices, and provides information about a variety of approaches to health professionals and the public.
- NCCIH Clearinghouse
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How Was Your Health Before Vitamin D
I had a concern about a diagnosis for prostate cancer in 2010. I went through all the specialists they all wanted to fix me. But I decided that I wanted to go into vigilant watching by having a PSA test done every 3 months.
In 2011, another biopsy was done and came up positive. At that point I decided to start taking much more vitamin D than was recommended at the time 10,000 IU/day. About half of my doctors thought I was crazy and that it was going to be toxic. Most of the health people at the time were recommending 1,000 2,000 IU/day.
In 2012 I had another biopsy. It came up completely negative. I met with my oncologist, I asked what happened? He told me to wait for another year 2013 It was completely negative. The oncologist wouldnt go on record, but he said that high levels of D can starve tumors. He is now recommending vitamin D to all of his patients, because he saw my success.
I no longer have any symptoms. My PSA is still elevated, but I feel much better and no one can find any prostate cancer.
Overview Of Cam Use In Prostate Cancer
- Men who have prostate cancer are more likely to take dietary supplements and eat certain foods than men who do not have prostate cancer.
- Men who have prostate cancer and who have healthy eating habits are more likely to take dietary supplements.
- Men who have prostate cancer use CAM treatments to help boost the immune system, improve quality of life, and lower the risk of the cancer coming back, but only half of them tell their doctors about their use of CAM.
Studies of CAM use to lower prostate cancer risk or to prevent it from coming back have shown the following:
- A study of men with a family history of prostate cancer found that over half used vitamins or other dietary supplements for prostate health or to prevent cancer.
- A study of men at a prostate cancer screening clinic found that over half took multivitamins and some took herbal supplements.
- A study of prostate cancer survivors found that up to one-third took vitamins or minerals.
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Are Vitamin D And Prostate Health Related
Half of all men over age 50 will be diagnosed with benign prostatic hyperplasia. This statistic rises to nearly 90% in men over age 80. While an enlarged prostate due to BPH can be related to age, it may be even more intricately linked to hormonal and vitamin imbalances in the body.
In fact, numerous studies in recent years may have found a strong link between BPH and vitamin D. A majority of men are deficient in vitamin D, especially as they get older. Studies show this deficiency increases the risk for male sexual health problems among other concerns like cancers, heart disease, and depression.
Lets first take a look at BPH and vitamin D separately, and then use information about both to understand the correlation between the two.
Prostate Cancer And Genome Damage
There is a strong link between the prevalence of markers of genome damage and cancer risk. Studies have shown that prevalence of chromosomal aberrations is 2.2-fold to 2.4-fold higher in cancer patients than in non-cancer controls, and that micronuclei formation, a marker for chromosomal instability, was associated with increased cancer incidence in a study of 6718 individuals. There is also evidence to link telomeres to cancer risk. Telomeres are repetitive TTAGGG DNA sequences that maintain genomic stability by protecting the ends of chromosomes they shorten in length over time in normal somatic tissues due to incomplete replication of the telomere. Telomere shortening is accelerated by oxidative stress, inflammation and cell proliferation and has been linked with induction of cell senescence which guards against survival of genomically abnormal cells. Evidence from prospective studies show positive associations between telomere length and various cancers, including that for low-grade and localised PC disease, possibly due to abnormal telomerase expression and telomere elongation, which enables the survival of genomically unstable cells, their unrestricted growth and their evolution into cancer. There is evidence to show that some micronutrients are essential to prevent genome damage but the specific impact of vitamin D is only just starting to be explored.
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Dietary Vitamin D And Risk Of Prostate Cancer
The association between dietary vitamin D intake and prostate cancer risk has been examined in several epidemiologic studies.3Results of these studies are negative or conflicting however, limiteddata indicate a possible link. One study concluded that men in the U.S.have a 10-fold greater risk of developing prostate cancer compared withmen in Japan.10 The increased risk has been linked to thedifference in diet between American and Japanese men. Japanese men have ahigher consumption of fatty fish, and thus an increased amount ofvitamin D and omega-3 fatty acids. Omega-3 fatty acids dissociatevitamin D metabolites from binding proteins, thereby increasing activelevels of these metabolites in the blood.3 In another study, Ahn et al noted a reduced risk of prostate cancer with greater intake of supplemental vitamin D.11A 40% risk reduction occurred in patients receiving more than 600 IU ofsupplemental vitamin D versus those not receiving it. However, dietaryintake of vitamin D was not associated with adecreased or increased risk of prostate cancer.11
Vitamin D And Prostate Cancer: Results From Dr Hollis
Hollis and colleagues ran an intervention study at the Medical University of South Carolina on 52 men who had been diagnosed with stage 1 prostate cancer. They purposely did not conduct an RCT as they wished to give everyone in the study vitamin D. They used a dose of 4,000 IU/day of vitamin D for one full year while the participants were on a wait and see approach with their cancer.
The overall result was that almost 60% had a reduction in tumors as opposed to doing nothing . Of the 52 men, 15 went from a Gleason score of 6 to a Gleason score of 0 .
In considering differences by race, the chart below, shows that while African Americans started with a vitamin D level of about half the value of Caucasians, after a year of taking 4,000 IU/day both race groups reached roughly the same vitamin D level .
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Multivitamins And Prostate Cancer
I was sitting with apatient the other day, who came in for advice about his prostate cancer. We had already covered the rather long listof cancer-specific supplements he takes. Last on his list was a question about the multivitamin I had suggested afew years back and whether I still thought it his best choice. His question caused me to pause. A pause so long that it felt like when yourcomputer screen freezes and you need to force quit whatever you were doing. I didnt know what to tell him.
Im no longer sure whetherprostate cancer patients should take a multivitamin.
A year ago, in an articleon prostate cancer, I wrote, Taking a multivitamin is safe and probablyuseful. At the time, I cited thePhysicians Health Study randomized trial of regular multivitamin use thatreported a modest but significant reduction in total cancer incidence inmen. The men with a history of prior cancer had a 27% reduction in total cancerduring the study. Yet there had been significant effect on risk of prostatecancer.1
I am no longer sure that mythinking was accurate. Research resultson nutrition and prostate cancer tend to be erratic and often conflict from onestudy to the next. In one study anutrient appears helpful and another the same substance seems harmful. Whats good one day is bad the next.
How do we translate thatinto patient instructions? If youve hadprostate surgery be careful, but if you were treated by radiation, go ahead,eat all the folate you want?
Questions And Answers About Soy
The soybean plant has been grown in Asia for food for hundreds of years. The soybean can be made into products, such as soy milk, miso, tofu, soy flour, and oil.
Isoflavones are phytoestrogens that attach to estrogen receptors found in prostate cancercells. Genistein may affect some processes inside prostate cancer cells that are involved in the growth and spread of cancer.
Soy may be eaten in food or taken in dietary supplements.
See the Laboratory/Animal/Preclinical Studies section of the health professional version of Prostate Cancer, Nutrition, and Dietary Supplements for information on laboratory and animal studies done using soy.
Population studies and clinical trials have been done to find out if soy can prevent or treat prostate cancer. The results of these studies have been mixed. Some studies have shown a lower risk of prostate cancer or a change in prostate-specific antigen level, and others have not. The results may be mixed because the number of men participating in the studies is small and different types and doses of soy products were given for varying lengths of time.
Combined population studies
Questions And Answers About Green Tea
Tea comes from the Camellia sinensis plant. The way tea leaves are processed determines whether green tea, black tea, or oolong tea is made. Green tea leaves are steamed and dried.
The health benefits studied in green tea are thought to be from compounds called polyphenols. Polyphenols are a group of plant chemicals that include catechins . Catechins make up most of the polyphenols in green tea.
Catechins in green tea can vary widely, depending on the source of the tea leaves and the way they are processed. This makes it hard to identify most of the chemical factors linked to the health benefits of green tea.
People usually drink green tea or take it as a dietary supplement.
See the Laboratory/Animal/Preclinical Studies section of the health professional version of Prostate Cancer, Nutrition, and Dietary Supplements for information on laboratory and animal studies done using green tea.
Clinical Trial Study Design
The open-label study enrolled 52 eligible subjects. Forty-eight subjects completed the study and were included in the safety analysis these subjects had complete PSA laboratory results for inclusion in the evaluation of changes in PSA. Forty-four subjects had both baseline and repeat biopsy to compare the number of positive cores and Gleason score with baseline, after completing vitamin D3 supplementation. All subjects had study visits every 2 months for 1 yr to measure serum levels of 25D, PSA, phosphorus, and PTH, plus complete blood count, basic metabolic panel, and urinary calcium to creatinine ratio . In addition, circulating levels of vitamin D3 and 1,252D were measured at baseline and exit in 19 subjects for whom extra serum samples were available.
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Questions And Answers About Vitamin D
Vitamin D has many actions in the body, including the following:
See the Laboratory/Animal/Preclinical Studies section of the health professional version of Prostate Cancer, Nutrition, and Dietary Supplements for information on laboratory and animal studies done using vitamin D.
Population studies and clinical trials have been done to study the effects of vitamin D on prostate cancer. The results of these studies have been mixed. Some studies have shown a link between Vitamin D levels and prostate cancer, and others have not. There is not enough evidence to know whether giving vitamin D can prevent prostate cancer.