National Cancer Institute


Posted Date: Jan 26, 2016

Expert-reviewed information summary about the use of nutrition and dietary supplements for reducing the risk of developing prostate cancer or for treating prostate cancer.

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.

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Cancer Complementary and Alternative Medicine Editorial Board.

Prostate Cancer, Nutrition, & Supplements

Prostate Cancer, Nutrition, and Dietary Supplements

Introduction

Men in the United States get prostate cancer more than any other type of cancer except skin cancer. It is found mainly in older men. In the United States, about one out of five men will be diagnosed with prostate cancer. Most men diagnosed with prostate cancer do not die of it.

Complementary and alternative medicine (CAM) is a form of treatment used in addition to (complementary) or instead of (alternative) standard treatments. CAM treatments generally are not considered standard medical approaches. Standard treatments go through a long and careful research process to prove they are safe and effective, but less is known about most types of CAM.

CAM use among prostate cancer patients is reported to be common. CAM treatments used by prostate cancer patients include certain foods, dietary supplements, herbs, vitamins, and minerals.

This PDQ CAM summary gives general information about using foods and dietary supplements to lower the risk of developing prostate cancer or for treating prostate cancer, its symptoms, or side effects of disease treatment. In addition, this summary has sections for several specific foods or dietary supplements:

More topics will be added over time. These sections include the following information for each food or dietary supplement:

Overview of CAM Use in Prostate Cancer

Studies of CAM use to treat prostate cancer have shown the following:

Studies of CAM use to lower the risk of developing prostate cancer or to prevent it from coming back have shown the following:

Studies of why prostate cancer patients do or don't decide to use CAM show that their choice is based on many factors, including their medical history, their beliefs about the safety and side effects of CAM compared to standard treatments, and their need to feel in control of their treatment.

Questions and Answers About Calcium

Current Clinical Trials

Check the list of NCI-supported cancer clinical trials for CAM clinical trials on calcium carbonate for prostate cancer and calcium citrate for prostate cancer that are actively enrolling patients.

General information about clinical trials is also available from the NCI website.

Questions and Answers About Green Tea

Current Clinical Trials

Check the list of NCI-supported cancer clinical trials for CAM clinical trials on green tea for prostate cancer and green tea extract for prostate cancer that are actively enrolling patients.

General information about clinical trials is also available from the NCI website.

Questions and Answers About Lycopene

Current Clinical Trials

Check the list of NCI-supported cancer clinical trials for CAM clinical trials on lycopene for prostate cancer that are actively enrolling patients.

General information about clinical trials is also available from the NCI website.

Questions and Answers About Modified Citrus Pectin

Current Clinical Trials

Check the list of NCI-supported cancer clinical trials for CAM clinical trials on modified citrus pectin for prostate cancer that are actively enrolling patients.

General information about clinical trials is also available from the NCI website.

Questions and Answers About Pomegranate

Current Clinical Trials

Check the list of NCI-supported cancer clinical trials for CAM clinical trials on pomegranate-extract pill for prostate cancer, pomegranate juice for prostate cancer, and pomegranate liquid extract for prostate cancer that are actively enrolling patients.

General information about clinical trials is also available from the NCI website.

Questions and Answers About Selenium

Current Clinical Trials

Check the list of NCI-supported cancer clinical trials for CAM clinical trials on selenium for prostate cancer that are actively enrolling patients.

General information about clinical trials is also available from the NCI website.

Questions and Answers About Soy

Current Clinical Trials

Check the list of NCI-supported cancer clinical trials for CAM clinical trials on soy isoflavones for prostate cancer and soy protein isolate for prostate cancer that are actively enrolling patients.

General information about clinical trials is also available from the NCI website.

Questions and Answers About Vitamin D

Current Clinical Trials

Check the list of NCI-supported cancer clinical trials for CAM clinical trials on vitamin D for prostate cancer that are actively enrolling patients.

General information about clinical trials is also available from the NCI website.

Questions and Answers About Vitamin E

Current Clinical Trials

Check the list of NCI-supported cancer clinical trials for CAM clinical trials on vitamin E for prostate cancer that are actively enrolling patients.

General information about clinical trials is also available from the NCI website.

Combination Therapies

Pomegranate, Green Tea, Broccoli, and Turmeric

Polyphenols are compounds found in many plants and give some flowers, fruits, and vegetables their color. Polyphenols have antioxidant activity that helps protect cells from damage caused by free radicals.

A food supplement high in polyphenols was studied in a group of men who had prostate cancer that had not spread. This supplement contained a combination of the following:

These ingredients were raw, dry, plant-based powders that were not standardized (a standardized herbal supplement has one or more active ingredients measured in a specific amount, so that the product is the same from batch to batch).

In a randomized clinical trial, 199 men were given either the food supplement or a placebo for 6 months. Before the study began, slightly less than half of the men had rising prostate-specific antigen (PSA) levels after being treated with local therapy, and slightly more than half of the men were on active surveillance (not yet treated). In the group that took the supplement, median PSA levels rose much less than in the group that took the placebo. The food supplement was well tolerated and there were no marked differences reported in adverse effects between supplement and placebo groups. However, patients in the supplement group were more likely to have gastrointestinal symptoms (i.e., more gas and loose bowels).

Questions and Answers About Zyflamend

Other Prostate Health Supplements

Overview

Many widely available dietary supplements are marketed to support prostate health. African Cherry (pygeum africanum) and beta-sitosterol are two related supplements that have been studied as possible prostate cancer treatments.

African Cherry / P. africanum

African cherry or Pygeum africanum is a tree that grows in tropical climates. It is found in a number of African countries including Kenya, Madagascar, Uganda, and Nigeria. Bark from the P. africanum tree was used by African tribes to relieve urinary symptoms and stomach pain. In the 18th century, European travelers learned from South African tribes that P. africanum could treat bladder discomfort and “old man’s disease” (enlarged prostate).

Since 1969, bark extracts from P. africanum have been available as prescription drugs in Europe and have been widely used to treat benign prostatic hyperplasia (BPH). The bark contains a number of compounds including fatty acids and phytosterols (e.g., beta-sitosterol). The bark is processed and purified as an extract.

Laboratory studies and animal studies have shown that two substances in bark extract from P. africanum are active in blocking cells from taking up androgen. The antiandrogen activity found in P. africanum is at a markedly lower concentration than the antiandrogen activity found in flutamide (an anticancer drug).

Beta-Sitosterol

Beta-sitosterol is a member of the phytosterol family of phyto chemicals and is widely found in plant life in different amounts. It is found in African cherry (Pygeum africanum), saw palmetto (Serenoa repens), and various nuts, beans, and seeds. It is one of several phytosterols (plant sterols) that have a chemical structure similar to cholesterol. Phytosterols, including beta-sitosterol, limit the amount of cholesterol that can be absorbed from the diet and they are being studied for their potential to protect against cardiovascular disease. Beta-sitosterol is very poorly absorbed by the body.

Studies suggest that phytosterols may have anticancer activity, but their exact actions are unknown. Phytosterols may affect immune and hormonal systems or may directly target cell cycles and cause cell death in tumors.

Laboratory studies have shown that high concentrations of beta-sitosterol markedly slow the growth of human prostate cancer cells and cause cancer cell death.

About This PDQ Summary

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

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.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Cancer Complementary and Alternative Medicine Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Clinical trials are listed in PDQ and can be found online at NCI's website. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).

Permission to Use This Summary

PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

The best way to cite this PDQ summary is:

National Cancer Institute: PDQ® Prostate Cancer, Nutrition, and Dietary Supplements. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/about-cancer/treatment/cam/patient/prostate-supplements-pdq. Accessed <MM/DD/YYYY>.

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Disclaimer

The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

Contact Us

More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.

General CAM Information

Complementary and alternative medicine (CAM)—also referred to as integrative medicine—includes a broad range of healing philosophies, approaches, and therapies. A therapy is generally called complementary when it is used in addition to conventional treatments; it is often called alternative when it is used instead of conventional treatment. (Conventional treatments are those that are widely accepted and practiced by the mainstream medical community.) Depending on how they are used, some therapies can be considered either complementary or alternative. Complementary and alternative therapies are used in an effort to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease.

Unlike conventional treatments for cancer, complementary and alternative therapies are often not covered by insurance companies. Patients should check with their insurance provider to find out about coverage for complementary and alternative therapies.

Cancer patients considering complementary and alternative therapies should discuss this decision with their doctor, nurse, or pharmacist as they would any therapeutic approach, because some complementary and alternative therapies may interfere with their standard treatment or may be harmful when used with conventional treatment.

Evaluation of CAM Approaches

It is important that the same rigorous scientific evaluation used to assess conventional approaches be used to evaluate CAM therapies. The National Cancer Institute and the National Center for Complementary and Integrative Health (NCCIH) are sponsoring a number of clinical trials (research studies) at medical centers to evaluate CAM therapies for cancer.

Conventional approaches to cancer treatment have generally been studied for safety and effectiveness through a rigorous scientific process that includes clinical trials with large numbers of patients. Less is known about the safety and effectiveness of complementary and alternative methods. Few CAM therapies have undergone rigorous evaluation. A small number of CAM therapies originally considered to be purely alternative approaches are finding a place in cancer treatment—not as cures, but as complementary therapies that may help patients feel better and recover faster. One example is acupuncture. According to a panel of experts at a National Institutes of Health (NIH) in November 1997, acupuncture has been found to be effective in the management of chemotherapy-associated nausea and vomiting and in controlling pain associated with surgery. In contrast, some approaches, such as the use of laetrile, have been studied and found ineffective or potentially harmful.

The NCI Best Case Series Program which was started in 1991, is one way CAM approaches that are being used in practice are being investigated. The program is overseen by the NCI’s Office of Cancer Complementary and Alternative Medicine (OCCAM). Health care professionals who offer alternative cancer therapies submit their patients’ medical records and related materials to OCCAM. OCCAM conducts a critical review of the materials and develops follow-up research strategies for approaches deemed to warrant NCI-initiated research.

Questions to Ask Your Health Care Provider About CAM

When considering complementary and alternative therapies, patients should ask their health care provider the following questions:

To Learn More About CAM

National Center for Complementary and Integrative Health (NCCIH)

The National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH) facilitates research and evaluation of complementary and alternative practices, and provides information about a variety of approaches to health professionals and the public.

CAM on PubMed

NCCIH and the NIH National Library of Medicine (NLM) jointly developed CAM on PubMed, a free and easy-to-use search tool for finding CAM-related journal citations. As a subset of the NLM's PubMed bibliographic database, CAM on PubMed features more than 230,000 references and abstracts for CAM-related articles from scientific journals. This database also provides links to the websites of over 1,800 journals, allowing users to view full-text articles. (A subscription or other fee may be required to access full-text articles.)

Office of Cancer Complementary and Alternative Medicine

The NCI Office of Cancer Complementary and Alternative Medicine (OCCAM) coordinates the activities of the NCI in the area of complementary and alternative medicine (CAM). OCCAM supports CAM cancer research and provides information about cancer-related CAM to health providers and the general public via the NCI website.

National Cancer Institute (NCI) Cancer Information Service

U.S. residents may call the NCI Cancer Information Service toll free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 am to 8:00 pm. A trained Cancer Information Specialist is available to answer your questions.

Food and Drug Administration

The Food and Drug Administration (FDA) regulates drugs and medical devices to ensure that they are safe and effective.

Federal Trade Commission

The Federal Trade Commission (FTC) enforces consumer protection laws. Publications available from the FTC include:

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