Prostate Cancer: Prevention: Difference between revisions

Line 33:

** '''FDA concluded that 5-ARIs did not have a favourable risk-benefit profile for the chemoprevention of prostate cancer'''

*** FDA assessment: for every 150-200 men treated with a 5-ARI, 1 additional man would be diagnosed with high-grade prostate cancer to avert 3-4 low-grade cancers.

*'''SELECT (2009) (Selenium and Vitamin E Cancer Prevention Trial)'''

* SELECT (2009) (Selenium and Vitamin E Cancer Prevention Trial)

** Objective: determine whether selenium, vitamin E, or combination thereof could reduce risk of prostate cancer

** Population: 35,533 men with normal DRE, PSA ≤ 4 ng/ml and normal blood pressure

** Randomized to 4 treatment arms: Selenium + placebo

** Randomized to 4 treatment arms:

** Vitamin E + placebo

***Selenium + placebo

** Selenium + vitamin E

*** Vitamin E + placebo

** Placebo + placebo

*** Selenium + vitamin E

** Primary end point: biopsy-confirmed prostate cancer Indications for biopsy not dictated by protocol

*** Placebo + placebo

** Results: Study planned for 12 years. Independent data and safety monitoring committee recommended discontinuation of the study because data convincingly demonstrated no effect

** Primary end point: biopsy-confirmed prostate cancer

** Follow-up study showed that dietary supplementation with Vitamin E increased risk of prostate cancer

***Indications for biopsy not dictated by protocol

** Results:

***Study planned for 12 years. '''Independent data and safety monitoring committee recommended discontinuation of the study because data convincingly demonstrated no effect'''

*** '''Follow-up study showed that dietary supplementation with Vitamin E increased risk of prostate cancer'''

** Lippman, Scott M., 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 301.1 (2009): 39-51.

*RCT in men with HGPIN found that daily selenium, vitamin E, and soy vs. placebo did not reduce the risk of prostate cancer

* RCT in men with HGPIN found that daily selenium, vitamin E, and soy vs. placebo did not reduce the risk of prostate cancer

* RCT in 60 men with HGPIN found that green tea catechin reduced the risk of prostate cancer RCT in 1,467 men with HGPIN found daily toremifene did not reduce the risk of prostate cancer at 3 years

* Lycopene

** A red-orange carotenoid found primarily in tomatoes and tomato-derived products including tomato sauce, tomato paste, and ketchup, and other red fruits and vegetables.

** In an in vivo model in which male rats were treated with N-methyl-N-nitrosourea and testosterone to induce prostate cancer, a protective effect was observed for both calorie restriction and tomato powder but not pure lycopene. This observation suggests that tomato products contain compounds in addition to lycopene that modify prostate carcinogenesis and that reduced caloric consumption and a diet rich in tomato-based foods may be more beneficial than taking oral lycopene supplements in reducing the risk of prostate cancer.

** Meta-analysis of 3 RCTs found no association of lycopene on prostate cancer risk

@@ Line 33: / Line 33: @@
 ** '''FDA concluded that 5-ARIs did not have a favourable risk-benefit profile for the chemoprevention of prostate cancer'''
 *** FDA assessment: for every 150-200 men treated with a 5-ARI, 1 additional man would be diagnosed with high-grade prostate cancer to avert 3-4 low-grade cancers.
+*'''SELECT (2009) (Selenium and Vitamin E Cancer Prevention Trial)'''
-* SELECT (2009) (Selenium and Vitamin E Cancer Prevention Trial)
 ** Objective: determine whether selenium, vitamin E, or combination thereof could reduce risk of prostate cancer
 ** Population: 35,533 men with normal DRE, PSA ≤ 4 ng/ml and normal blood pressure
-** Randomized to 4 treatment arms: Selenium + placebo
+** Randomized to 4 treatment arms:
-** Vitamin E + placebo
+***Selenium + placebo
-** Selenium + vitamin E
+*** Vitamin E + placebo
-** Placebo + placebo
+*** Selenium + vitamin E
-** Primary end point: biopsy-confirmed prostate cancer Indications for biopsy not dictated by protocol
+*** Placebo + placebo
-** Results: Study planned for 12 years. Independent data and safety monitoring committee recommended discontinuation of the study because data convincingly demonstrated no effect
+** Primary end point: biopsy-confirmed prostate cancer
-** Follow-up study showed that dietary supplementation with Vitamin E increased risk of prostate cancer
+***Indications for biopsy not dictated by protocol
+** Results:
+***Study planned for 12 years. '''Independent data and safety monitoring committee recommended discontinuation of the study because data convincingly demonstrated no effect'''
+*** '''Follow-up study showed that dietary supplementation with Vitamin E increased risk of prostate cancer'''
 ** Lippman, Scott M., 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 301.1 (2009): 39-51.
+*RCT in men with HGPIN found that daily selenium, vitamin E, and soy vs. placebo did not reduce the risk of prostate cancer
-* RCT in men with HGPIN found that daily selenium, vitamin E, and soy vs. placebo did not reduce the risk of prostate cancer
 * RCT in 60 men with HGPIN found that green tea catechin reduced the risk of prostate cancer RCT in 1,467 men with HGPIN found daily toremifene did not reduce the risk of prostate cancer at 3 years
 * Lycopene
 ** A red-orange carotenoid found primarily in tomatoes and tomato-derived products including tomato sauce, tomato paste, and ketchup, and other red fruits and vegetables.
 ** In an in vivo model in which male rats were treated with N-methyl-N-nitrosourea and testosterone to induce prostate cancer, a protective effect was observed for both calorie restriction and tomato powder but not pure lycopene. This observation suggests that tomato products contain compounds in addition to lycopene that modify prostate carcinogenesis and that reduced caloric consumption and a diet rich in tomato-based foods may be more beneficial than taking oral lycopene supplements in reducing the risk of prostate cancer.
 ** Meta-analysis of 3 RCTs found no association of lycopene on prostate cancer risk