Measures to prevent prostate cancer (PC) must be a routine part of the counsel that general practitioners and internists give their patients. Selenium intake of at least 200 mcg a day should be a consideration in the prevention of PC. Low plasma selenium is associated with a four- to fivefold increased risk of PC. In addition, levels of plasma selenium also decrease with age, resulting in middle-aged to older men being at a higher risk for low selenium levels.
A large-scale study of almost 11,000 men in Maryland showed that the protective effects of high selenium levels, and similarly that of the alpha-tocopherol isomer of vitamin E, were only observed when the concentrations of the gamma tocopherol isomer of vitamin E were also high. In this study, the risk of PC declined with increasing concentrations of alpha-tocopherol, with the highest concentration associated with a 68% PC risk reduction. For gamma-tocopherol, men with levels in the highest fifth of the distribution had a fivefold greater reduction in the risk of developing PC than men in the lowest fifth (p = .002). The observed interaction between alpha-tocopherol, gamma-tocopherol, and selenium suggested that combined alpha- and gamma-tocopherol supplements, used in conjunction with selenium, should be considered in future PC prevention trials.
A report by Chan et al. (1999) showed significant benefit only to smokers or those recently quitting smoking in a study involving 47,780 U.S. male health professionals who received at least 100 IU of supplemental alpha-tocopherol. In this population, the risk of metastatic or fatal PC was reduced 56%. In the nonsmoking population, there were no beneficial findings of statistical significance.
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