Prevalence and patterns of self‐initiated nutritional supplementation in men at high risk of prostate cancer
Authors: Uzzo R.G. , Brown J.G. , Horwitz E.M. , Hanlon A. , Mazzoni S. , Konski A. , Greenberg R.E. , Pollack A. , Kolenko V. , Watkins‐Bruner D. 
Published: May 2004

Authors from Philadelphia have studied the prevalence and patterns of self‐initiated herbal and vitamin supplementation among men at high risk of developing prostate cancer. They found that many patients at risk take measures to try and reduce this risk, even if the items that they take have not necessarily been shown to be effective.

Another group of authors from Chicago evaluated the effect of seminal vesical invasion on survival in prostate cancer, and in particular attempted to validate Kattan's nomogram in this pathological subgroup. The authors from Vancouver attempted to identify sexual information resource preferences of patients before and after definitive treatment for early‐stage prostate cancer with either radical prostatectomy or brachytherapy. They strongly advocate the need for physicians to offer patients access to such information.

A group of authors from Brisbane investigated the effects of pharmacological treatments as apposed to clinical monitoring on quality of life in patients with non‐localised prostate cancer, and found that the adverse effects on quality of life are important in deciding the timing of androgen suppression.

OBJECTIVE

To define the prevalence and patterns of self‐initiated herbal and vitamin supplementation among men at high risk of developing prostate cancer, as there is increasing public awareness of prostate cancer screening, risk‐factor assessment and prevention, leading to increasing interest in the use and systematic study of nutritional therapies for prostate cancer prevention.

SUBJECTS AND METHODS

Since 1996 our institution has prospectively maintained a prostate cancer‐risk registry through its Prostate Cancer Risk Assessment Program (PRAP). Eligibility includes African‐American men, any man with at least one first‐degree relative or two or more second‐degree relatives with prostate cancer, or men who tested positively for the BRCA1 gene mutation. A 420‐item self‐administered questionnaire was completed and included the use of nutritional supplements and complementary therapies. We divided men into groups who used supplements to lessen their cancer risk and those who did not. The prevalence and patterns of use were evaluated and the two groups then compared for differences in demographic, socio‐economic and risk‐perception variables.

RESULTS

In all, 345 high‐risk men were enrolled in the PRAP over a 5‐year period. Data on the use of dietary or herbal supplements were available on 333 men (97%), of whom over half (170) reported taking one or more supplements to prevent prostate cancer. Supplement use was divided into eight categories, including vitamins, minerals, extracts from fruits/seeds, organic compounds, flowers/bulbs, leaves/bark, roots, or animal products. Most commonly used for self‐initiated chemoprevention were vitamins (95%), minerals (28%), and fruit/seed extracts (18%). More than a quarter of men (27%) took three or more agents. Men taking proactive preventative measures were statistically more likely to be Caucasian and aged > 60 years (P < 0.05). African‐Americans were less likely to self‐initiate preventative steps. Men taking supplements tended to return more often for follow‐up and participate in PRAP longer, while those not taking supplements tended to earn less and report less self‐perceived risk.

CONCLUSIONS

A significant proportion of men at risk of developing prostate cancer initiate measures they perceive to reduce their risk. Although the chemopreventative efficacy of many of these supplements remains unsubstantiated, they are widely perceived by the public to reduce the risk of developing prostate cancer. These data provide an insight into patient perceptions and misconceptions of chemopreventative strategies, and may help to refine recruitment efforts in multi‐institutional prostate cancer prevention trials.