Study Fails to Find Selenium Levels Linked to Less Prostate Cancer: In a nested case-control study within the screening arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, serum selenium in prospectively collected samples was compared between 724 incident prostate cancer case subjects and 879 control subjects, frequency-matched for age, time since initial screen, and year of blood draw. The men were followed for up to 8 y. Overall, serum selenium was not associated with prostate cancer risk (P for trend = 0.70). Serum selenium and risk of prostate cancer-a nested case-control study. Peters U, et al. Fred Hutchinson Cancer Research Center, Seattle. . Am J Clin Nutr 2007 Jan;85(1):209-17.

Selenium Appears Helpful in Reducing Prostate Cancer: In a meta-analysis of the 16 best studies (eleven cohort studies and five case-control studies), the pooled relative risk of prostate cancer for any intake of selenium was 0.72 for cohort studies and 0.74 for case-control studies. The pooled relative risk of moderate intake was 0.74 for cohort studies and 0.74 for case-control studies. A dose-response trend was observed when we stratified the studies by disease severity. Intake of selenium in the prevention of prostate cancer: a systematic review and meta-analysis. Etminan M et al. Montreal, Canada. . Cancer Causes Control 2005 Nov;16(9):1125-31. Ed: The 32,000 man SELECT study will answer the question with results in 2013.

Higher Selenium May Slow Cancer Progression: Using plasma samples obtained 13 years earlier, in a nested case-control study of 586 men diagnosed with prostate cancer and 577 control subjects, pre-diagnostic plasma selenium levels were inversely associated with risk of advanced prostate cancer (5th versus 1st quintile OR = 0.52; P = .05), even among men diagnosed after 1990 (OR = 0.39). The inverse association with prostate cancer risk was observed only for case subjects with elevated baseline PSA levels (PSA >4 ng/mL, 5th versus 1st quintile OR = 0.49; P = .002). Higher levels of selenium may slow prostate cancer tumor progression. Ongoing randomized trials of selenium supplements may help to further evaluate this issue. A prospective study of plasma selenium levels and prostate cancer risk Li H, Stampfer MJ, Giovannucci EL, et al. Harvard  J Natl Cancer Inst 2004;96:696-703.

Prostate Cancer Lower with High Selenium: 58,279 Dutch men followed for 6.3 years found prostate cancer rates were progressively lower with increasing selenium in toenail cuttings. Incidence rate ratios in increasing selenium quintiles were 1.00 (ref), 1.05, 0.69, 0.75, and 0.69, respectively (P-trend=0.008). This association persisted after exclusion of cases diagnosed during early follow-up. The inverse association was more pronounced in ex-smokers than current smokers, and unclear in never-smokers. Analysis of effect modification by intake of antioxidant vitamins C, E, and the carotenoids alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, and lutein/zeaxanthin showed a strong, significant interaction with beta-cryptoxanthin, and to a lesser extent with vitamin C. Toenail selenium levels and the subsequent risk of prostate cancer: a prospective cohort study. van den Brandt PA, Zeegers MP, Bode P, Goldbohm RA. Cancer Epidemiol Biomarkers Prev. 2003 Sep;12(9):866-71

Prevents Prostate Cancer & Overall Cancer In DB: 976 patients with basal or squamous skin cancer were treated in a DB PC study with 200 mg/day of selenium. There were no effects on skin cancer but a 63% decrease in prostate cancer incidence (13 vs. 35 cases RR 0.37) and an overall decreased cancer incidence, lung and colon cancer, and mortality. Clark, U Arizona, Br J Urol 5/98;81:730

No Association Dietary Selenium or Vitamin E and Prostate Cancer but Supplemental E helped Smokers in DB: A DB PC study of 29,000 smokers treated for 6 years with 50 mg/day of vitamin E with a 9 year follow-up. There was no benefit from beta-carotene supplementation. The highest quartile in vitamin E intake had less prostate cancer (RR 0.52). Hartmann, NCI, Cancer Epid Biomarkers Prevention 4/98;7:335

Supplement Helped Those at Lower Risk: In the 8-year SU.VI.MAX DB PC study of 5,141 men, those given a supplementation with nutritional doses of vitamin C, vitamin E, beta-carotene, selenium and zinc daily had a 12% (nonsignificant) reduction in prostate cancer rate associated with the supplementation. However, the effect differed significantly between men with normal baseline PSA (< 3 mug/L) and those with elevated PSA (p = 0.009). Among men with normal PSA, there was a marked 48% reduction in the rate of prostate cancer for men receiving the supplements. In men with elevated PSA at baseline, the supplementation was associated with a 54% increased incidence of prostate cancer of borderline statistical significance. The supplementation had no effect on PSA or IGF levels. Antioxidant vitamin and mineral supplementation and prostate cancer prevention in the SU.VI.MAX trial. Meyer F, Galan P, et al. Laval University, Quebec, Canada. Int J Cancer. 2005 Aug 20;116(2):182-6.

Prostate Cancer Victims Low Selenium: 212 cases vs. 233 controls. Serum selenium was inversely associated with risk of prostate cancer, comparing highest to lowest quartiles, OR = 0.71. Natl Cancern Inst. Serum selenium and risk of prostate cancer in U.S. blacks and whites. Vogt TM, Ziegler RG, Graubard BI, Swanson CA, Greenberg RS, Schoenberg JB, Swanson GM, Hayes RB, Mayne ST. Int J Cancer 2003 Feb 20;103(5):664-70

Prostate Cancer Victims Low Selenium: Cases from Baltimore Longitudinal Aging study 52 pt compared 96 controls. RR 2^nd quartile 0.15, 3^rd 0.21, 4^th 0.24. Lowest quartile 4-5 times the risk. Plasma selenium level before diagnosis and the risk of prostate cancer development. Brooks JD, Metter EJ, Chan DW, Sokoll LJ, Landis P, Nelson WG, Muller D, Andres R, Carter HB. J Urol 2001 Dec;166(6):2034-8

Selenium Good for Dog Prostate: Dietary selenium supplementation decreases DNA damage and increases epithelial cell apoptosis within the aging canine prostate. J Natl Cancer Inst 2003 Feb 5;95(3):237-41

Lycopene, Selenium Lower in Men with Benign Prostatic Hypertrophy Symptoms: 2,497 men over age 59 in the Third National Health and Nutrition Examination Survey compared men with nocturia, hesitancy, incomplete emptying, and weak stream, but who had never undergone noncancer prostate surgery to controls. Serum concentrations of vitamin E (P = 0.03), lycopene (P = 0.06), and selenium (P = 0.03) were lower in men with symptoms compared with controls. Association between serum concentrations of micronutrients and lower urinary tract symptoms in older men in the Third National Health and Nutrition Examination Survey. Rohrmann S, Smit E, et al. Johns Hopkins. Urology. 2004 Sep;64(3):504-9.

Thomas E. Radecki, M.D., J.D.

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