Selenium and Prostate Cancer Prevention: Insights from the Selenium and Vitamin E Cancer Prevention Trial (SELECT)

Cancer Prevention Fellowship Program, Nutritional Science Research Group, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Dr, Rockville, MD 20850, USA. .
Nutrients (Impact Factor: 3.27). 04/2013; 5(4):1122-48. DOI: 10.3390/nu5041122
Source: PubMed


The Selenium and Vitamin E Cancer Prevention Trial (SELECT) was conducted to assess the efficacy of selenium and vitamin E alone, and in combination, on the incidence of prostate cancer. This randomized, double-blind, placebo-controlled, 2 × 2 factorial design clinical trial found that neither selenium nor vitamin E reduced the incidence of prostate cancer after seven years and that vitamin E was associated with a 17% increased risk of prostate cancer compared to placebo. The null result was surprising given the strong preclinical and clinical evidence suggesting chemopreventive activity of selenium. Potential explanations for the null findings include the agent formulation and dose, the characteristics of the cohort, and the study design. It is likely that only specific subpopulations may benefit from selenium supplementation; therefore, future studies should consider the baseline selenium status of the participants, age of the cohort, and genotype of specific selenoproteins, among other characteristics, in order to determine the activity of selenium in cancer prevention.

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    • "Worryingly, an elevated risk with vitamin E was found [65]. A possible explanation for these null findings include the agent formulation and dose, the baseline characteristics of the cohort and the study design, which suggests that it is likely that only specific subpopulations may benefit from selenium supplementation [66]. Furthermore, a recent phase III studies of selenium vs placebo in patients with HGPIN found no benefit in the prevention of progression to prostate cancer and suggested higher intake might increase the risk of cancer [67]. "
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    ABSTRACT: Prostate cancer is the second most common cause of cancer worldwide after lung cancer. There is increasing evidence that diet and lifestyle plays a crucial role in prostate cancer biology and tumourigenesis. Prostate cancer itself represents a good model of cancer in which to look for chemopreventive agents due to the high disease prevalence, slowly progressive nature, and long latency period. Dietary agents have gained considerable attention, often receiving much publicity in the media. To review the key evidence available for potential chemopreventive nutrients. The methodology for this review involved a PubMed search from 1990 to 2013 using the key-words “diet and prostate cancer”, “nutrition and prostate cancer”, “dietary factors and prostate cancer”, “prostate cancer epidemiology”, “prostate cancer prevention”, “prostate cancer progression”. Red meat, dietary fat and milk intake should be minimised as they appear to increase the risk of prostate cancer. Fruit and vegetables and polyphenols may be preventive in prostate cancer, but further studies are needed to draw more solid conclusions and to clarify their role in patients with an established diagnosis of prostate cancer. Selenium and vitamin supplements cannot be advocated for the prevention of prostate cancer and indeed higher doses may be associated with a worse prognosis. There is no specific evidence regarding benefits of probiotics or prebiotics in prostate cancer. From the wealth of evidence available, many recommendations can be made although more randomised control trials are required. These need to be carefully designed due to the many confounding factors and heterogeneity of the population.
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    • "Another example is that vitamin E had been recommended as a way to slow the progress of Alzheimer's disease (Sano et al., 1997). However, vitamin E not only has no proven effectiveness but also increases the risk of cancer in men (Nicastro and Dunn, 2013). A recent study of older Iowa women showed that taking any nutritional supplement was risky. "
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