As many of you are probably aware, earlier this week, Secretary of State Colin L. Powell underwent successful surgery for prostate cancer.
He joined a long list of distinguished individuals, including Arnold Palmer, Mayor Rudolph Guilliani, Yankee manager Joe Torre, General Norman Schwarzkopf, Michael Milken, and the list goes on and on.
This latest “casualty” gives me an ideal excuse to get back on my soapbox. When I first entered the medical field almost thirty years ago, I was under the mistaken belief that both our government and academic medicine in general were extremely conservative, and ultimately concerned about the well-being of our citizens. However, nothing could be further from the truth. Apparently, our government and academic institutions are currently planning to risk the lives of over 2 million men.
How can this be?
Well, it all has to do with a current study that is being funded by the National Cancer Institute for prostate cancer. It is called the Selenium and Vitamin E Chemoprevention Trial (SELECT). It will involve over 32,000 men nationwide, with an expected duration of twelve years. It is estimated that approximately 220,000 men every year in this country will develop prostate cancer, with about 30,000 of them dying each year from the disease. If you multiply 220,000 by twelve years, the number comes out to more than 2.5 million individuals that are potentially being put at risk over the study’s duration.
There is certainly a valid argument to be made that in a situation where one is unsure about the safety and potential benefits of a particular treatment that a stringent double-blinded study is in order. However, I would argue that selenium as a treatment of prostate cancer has proven its validity.
I had previously commented on many occasions about a landmark 1996 double-blinded study published in JAMA. In this study, which involved over 1,300 individuals and went on for several years, it was indicated that those treated with 200 mcg of selenomethionine had a 63% reduction in the incidence of prostate cancer, as compared to a placebo group which did not take this special form of selenium.
This study was further validated by a study published in 1998 in the Journal of the National Cancer Institute involving over 30,000 physicians. It was found that those physicians with the highest selenium blood levels had an approximately two-thirds reduction in the incidence of the most malignant forms of prostate cancer. In another study published in a cancer journal only about three months ago, 58,000 men between the ages of 55 and 69 were evaluated in the Netherlands Cohort Study.
In September 1986, the members of the study completed a questionnaire on risk factors for cancer and provided toenail clippings for determination of baseline selenium levels. After approximately six years of follow-up, it was revealed that those men with the highest selenium levels had a reduction of prostate cancer by over 30% in a relatively short period of time. This association was even more definite in ex-smokers. The authors of this study again confirmed the hypothesis that higher selenium intake may reduce the risk of prostate cancer.
Your options in this matter seem rather clear. On one hand, you can take a small amount of additional selenium for less than four cents per day, which is considered to be safe. And, three independent and very large studies have shown that this results in significantly reducing prostate cancer. On the other hand, you can patiently wait until when the results of the study are available. This is such a double standard. If this was a drug with or without side effects, and one that potentially reduced the risk of prostate cancer by 60%, this product would be fast-tracked through the FDA, and every single man would be taking it — even if the cost was 100 times higher than selenium.
However, because it is an inexpensive nutrient (an essential nutrient for life), instead of a new, blockbuster billion dollar drug, academia and the FDA are not willing to make any definitive statement until this monumental study is completed more than a decade from now.
Furthermore, drug companies want nothing to do with it because they cannot patent it, monopolize it, charge you a 10 – 100X mark-up, and make billions of dollars per year.
I think the choice is pretty easy. I, for one, choose to take the selenium on a daily basis. Suppose for some unexplained reason, selenium has no benefit for prostate cancer — a result which I truly doubt. Nothing has been lost, and there are many other benefits. On the other hand, if it turns out that the results show positive effects, which I am certain it will, imagine the literally tens of thousands of men each year who had died needlessly, waiting for academia and the FDA to give it its final blessing.
Another wonderful nutrient with studies showing benefit for the prostate is lycopene, a carotenoid. A carotenoid is the yellow to red pigments that are found in plants and animals that colors tomatoes red. Lycomato is the standardized brand used in most clinical studies, at a dosage of 15 – 30 mg per day.
As always, this blog tries to provide meaningful, actionable information. Look for supplements with the superior form of selenium, selenomethionine. This is the best type of selenium and as you can see from the studies, is a supplement you should likely be taking.
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