Higher serum folate levels linked with reduced biochemical recurrence following prostatectomy
Friday, July 26, 2013. The May-June 2013 issue of the International Brazilian Journal of Urology published the discovery of U.S. researchers of a lower risk of biochemical recurrence following radical prostatectomy among men with higher levels of the B vitamin folate. Biochemical recurrence is defined as a rise in serum prostate specific antigen (PSA) levels after surgery or radiation treatment for prostate cancer, which can indicate a return of the disease.
The study included 135 African American and Caucasian men who had undergone radical prostatectomy between 1991 and 2009 at Veteran Affairs Medical Centers. The men were followed for a median of 36 months, during which 31% developed biochemical recurrence. Folate levels measured prior to surgery ranged from 1.5 to 20.0 nanograms per milliliter (ng/mL), with a median preoperative level of 11.6 ng/mL, and were higher among Caucasians and those with lower preoperative PSA levels. Lead author Daniel Moreira, MD, explained that while the researchers did not use cut-off points for serum folate values, higher levels of folate were independently associated with a lower risk of biochemical recurrence, i.e., the higher the level of folate, the lower the risk of recurrence.
In their introduction to the article, Dr Moreira and his colleagues remark that humans need folate to synthesize and repair DNA, and that when this process is impaired, the risk of cancer is increased. They note that a deficiency in folate has been associated with the development of pancreatic, cervical and colon cancer, however, the role of the vitamin in prostate cancer has been the subject of controversy. "To date, no studies have examined the role of folate in prostate cancer recurrence after primary treatment," they note.
"While the source of the folate in the serum in this study is unknown (i.e., diet vs. supplement), these findings if confirmed in future prospective studies, suggest a potential role of folic acid supplementation or increased intake of folate rich foods to reduce the risk of recurrence," the authors conclude. "However, further studies are required to determine whether folate supplementation or diet modification to increase folate intake can reduce prostate cancer progression."