Prostate cancer: Dr Philippa Kaye discusses symptoms
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Despite the billions invested into research, a cure for cancer remains out of reach. This illustrates the enormity of the challenge: cancerous cells are fiendishly difficult to stop. However, progress is afoot in understanding what drives the development of the deadly disease and some of these factors can be modified.
Research has uncovered many lifestyle factors that raise the risk of cancer but one that raises a few eyebrows is vitamin E supplementation.
Vitamin E helps maintain healthy skin and eyes, and strengthen the body’s natural defence against illness and infection (the immune system).
Most people should get all the vitamin E they need through their diet and growing evidence suggests this is a much safer approach.
Studies done in the 80s and 90s suggested that vitamin E and selenium each somehow provided protection against prostate cancer.
The Selenium and Vitamin E Cancer Prevention Trial (SELECT) was started in 2001 to investigate the findings further.
The 36,000 healthy, middle-aged volunteers were divided into four groups.
Each man took two pills a day: 400 international units (IU) of vitamin E plus 200 micrograms of selenium; vitamin E plus a placebo; selenium plus a placebo; or two placebos. Neither the men nor their doctors knew who was taking what.
Although SELECT was supposed to last until 2011, it was stopped three years early because neither vitamin E nor selenium were showing any benefit — and there were vague warning signs they might be doing some harm.
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A 2014 report in the Journal of the National Cancer Institute provided further clarification.
A team of researchers from across the US looked specifically at almost 5,000 of the SELECT volunteers who sent in toenail clippings when they joined the trial.
Toenail clippings are a great way to measure how much selenium is in a man’s (or woman’s) body.
The study showed that taking vitamin E alone raised the risk of developing high-grade prostate cancer, but only in men who started the study with low selenium levels.
It also showed:
- Taking selenium, either alone or in combination with vitamin E, increased the risk of high-grade prostate cancer in men who started the study with high selenium levels, but not in those with low selenium levels.
- Among men who didn’t take either vitamin E or selenium, those who started the study with high selenium levels were no more likely to have developed prostate cancer than men who started it with low selenium levels. (This means the culprit is added selenium from supplements, not selenium from food.
What the experts say
“I counsel all of my patients to absolutely avoid any dietary supplements that contain selenium or vitamin E—including multivitamins,” said prostate cancer expert Doctor Marc Garnick, a clinical professor of medicine at Harvard Medical School, an oncologist at Beth Israel Deaconess Medical Center, and editor in chief of Harvard’s Annual Report on Prostate Diseases.
Writing in Harvard Health, the doc said: “The new data are very troubling, and emphasise that supplements can cause real and tangible harm.
“Any claims of benefits from dietary supplements must be ignored unless large, controlled, and well-conducted investigations confirm such benefits—which I believe will be a very rare occurrence.”
Prostate cancer – signs to spot
The NHS explains: “Prostate cancer does not usually cause any symptoms until the cancer has grown large enough to put pressure on the tube that carries urine from the bladder out of the penis (urethra).”
Symptoms of prostate cancer can include:
- Needing to pee more frequently, often during the night
- Needing to rush to the toilet
- Difficulty in starting to pee (hesitancy)
- Straining or taking a long time while peeing
- Weak flow
- Feeling that your bladder has not emptied fully
- Blood in urine or blood in semen.
These symptoms do not always mean you have prostate cancer.
“Many men’s prostates get larger as they get older because of a non-cancerous condition called benign prostate enlargement,” notes the NHS.
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