"The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease."
- Thomas Edison
Vitamin E and selenium help prevent prostate cancer.
There are two selenium articles on this page.
Title: Decreased incidence of prostate cancer with selenium supplementation: results of a double-blind cancer prevention trial.
Source: British Journal of Urology. 81(5):730-4, 1998 May.
OBJECTIVE: To test if supplemental dietary selenium is associated with changes in the incidence of prostate cancer.
PATIENTS AND METHOD: A total of 974 men with a history of either a basal cell or squamous cell carcinoma were randomized to either a daily supplement of 200 microg of selenium or a placebo. Patients were treated for a mean of 4.5 years and followed for a mean of 6.5 years. RESULTS: Selenium treatment was associated with a significant (63%) reduction in the secondary endpoint of prostate cancer incidence during 1983-93. There were 13 prostate cancer cases in the selenium-treated group and 35 cases in the placebo group (relative risk, RR=0.37, P=0.002). Restricting the analysis to the 843 patients with initially normal levels of prostate-specific antigen (< or = 4 ng/mL), only four cases were diagnosed in the selenium-treated group and 16 cases were diagnosed in the placebo group after a 2 year treatment lag, (RR=0.26 P=0.009). There were significant health benefits also for the other secondary endpoints of total cancer mortality, and the incidence of total, lung and colorectal cancer. There was no significant change in incidence for the primary endpoints of basal and squamous cell carcinoma of the skin. In light of these results, the 'blinded' phase of this trial was stopped early.
CONCLUSIONS: Although selenium shows no protective effects against the primary endpoint of squamous and basal cell carcinomas of the skin, the selenium-treated group had substantial reductions in the incidence of prostate cancer, and total cancer incidence and mortality that demand further evaluation in well-controlled prevention trials.
P53, Where Are You?
Health Sciences Institute e-Alert
June 26, 2003
Don't tell those purple pill people, but it's selenium time again.
This has almost become an e-Alert tradition: every two or three months I find a new study that reminds us just how important it is to get adequate amounts of selenium in our diets.
In previous e-Alerts I told you how selenium helps fight autoimmune disorders, increase insulin efficiency, and curb the mutation of viruses. More importantly, selenium has been shown to reduce both the risk and mortality for prostate, liver and colorectal cancers.
Now another cancer can be added to that list: esophageal cancer - a disease closely associated with chronic heartburn and acid reflux.
The selenium millennium
When acid reflux causes digestive acids in the stomach to be regurgitated into the esophagus, damage to the lower esophagus often results in an abnormal healing process that causes the wrong type of cells to grow in the damaged area. This condition is known as Barrett's esophagus. Painful acid reflux and heartburn symptoms may recede, but the new cell growth substantially increases the risk of esophageal cancer.
Knowing that elevated selenium levels may reduce the risk of other cancers, researchers at the Fred Hutchinson Cancer Research Center collaborated with a team at the University of Washington School of Medicine to study the relationship of selenium blood levels in Barrett's patients. The Seattle Barrett's Esophagus Program provided 399 subjects for the test - all diagnosed with Barrett's. In addition to the analysis of blood samples and medical history, esophageal tissue specimens were collected and examined for DNA content.
Results showed a clear association between high selenium levels and a reduced risk that those with Barrett's would develop esophageal cancer. More specifically, elevated selenium in the blood was associated with a significantly better chance that an important tumor-suppressing gene called p53 would be activated. (Just last year an Indiana University School of Medicine study showed striking evidence that selenium intake triggers activity of the p53 gene.)
These results are particularly significant because therapies have not yet been developed that would protect Barrett's patients from esophageal cancer - a fast-growing cancer that is frequently fatal.
No fear of effective doses
All commentary about selenium inevitably comes with a warning about overdoing selenium intake, and the commentary I found for this study was no exception. In a Fred Hutchinson Cancer Research Center press release, the authors of the study warn that "megadosing" with selenium supplements is not recommended. And we would agree with that, but I would add this note: a toxic dose of selenium is hard to come by.
The U.S. RDA for selenium if 55 mcg, and the average diet probably falls short of that amount. I say "probably" because the selenium content of fruits and vegetables depends on the selenium content of the soil they're grown in. In the U.S., selenium is most highly concentrated in the soil of six western states: North and South Dakota, Utah, Colorado, Montana and Wyoming. Anyone who lives in these states and eats large amounts of fruits and vegetables daily might be at slight risk of getting too much selenium, but only if they're also taking a high dosage selenium supplement as well.
Dr. Martin L. Smith, the author of the Indiana University study on the tumor-suppressing p53 gene, noted that in order to reap the cancer preventive qualities of selenium, daily intake should be around 200 mcg. This is well over the RDA, of course, but you would have to get more than 2,500 mcg of selenium per day for an extended period to receive a toxic amount, so the chances of getting a dangerous dose are extremely slim.
Besides fruit and vegetables, bread, fish, and meat all contain selenium. The real selenium powerhouse, however, is the Brazil nut, weighing in at 840 mcg of selenium per ounce.
Not a minute too early
The authors of the Fred Hutchinson research state that it's too early to recommend selenium supplements for Barrett's patients, but I disagree. Supplements in moderate doses will not do any harm in the average person and the list of selenium's benefits is long and impressive. So Barrett's patients, as well as anyone with chronic heartburn or acid reflux, would almost certainly be giving themselves an important preventive benefit with a daily selenium supplement.
For further prevention of Barrett's esophagus, those who are experiencing gastro-esophageal problems should talk to their doctors. For chronic cases, however, you want to avoid any over-the-counter antacids or prescription medications, which neutralize stomach acids. Those acids are there for a reason - we need them to digest food!
Anyone searching for a safe, effective, and inexpensive way to treat acid reflux and heartburn need look no further than the e-Alert "Fire Down Below" (12/23/02), in which HSI Panelist Allan Spreen, M.D., outlined a simple regimen that uses readily available acidophilus and digestive enzymes. Dr. Spreen's protocol, when combined with a daily selenium supplement, makes for an effective plan that just might prevent the chain of events that leads to esophageal cancer.
..and another thing
I'm sure you probably heard the reports this week about the newest setback for the combined hormone replacement therapy (HRT) of estrogen-progestin. The Women's Health Initiative study was stopped short one year ago when it became clear that estrogen-progestin increased the risk of breast cancer, heart attack, and strokes. But research using the data from that study goes on, and the latest findings are nothing less than a disaster.
Examining records of more than 16,000 women, researchers concluded that combined HRT tends to make breast cancer tumors more aggressive and harder to detect, reducing the chances for successful treatment.
If this were an ocean liner, the lifeboats would already be a mile away from the ship.
A spokesman for Wyeth Pharmaceuticals (the makers of Prempro, the brand name for estrogen-progestin) told the Associated Press that hormone therapy remains "an appropriate therapy when used at the lowest possible dose for the shortest possible time."
Is that an absolute gem of drug company double-speak? That's about as close as you can get to saying, "Stop using it." Which may be the best advice for the 3 million U.S. women who still are.
To Your Good Health,
Health Sciences Institute
"Serum Selenium Levels in Relation to Markers of Neoplastic Progression Among Persons With Barrett's Esophagus" Journal of the National Cancer Institute, Vol. 95, No. 10, 750-757, 5/21/03, jncicancerspectrum.oupjournals.org
"Selenium May Inhibit Progression Toward Barrett's-Related Esophageal Cancer" Fred Huctchinson Cancer Research Center, press release, 5/20/03, eurekalert.org
"What is Barrett's Esophagus?" Johns Hopkins Pathology, pathology2.jhu.edu
"HRT Linked to Aggressive Tumors" Associated Press, 6/24/03, msnbc.com
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