Can selenium therapy prevent prostate cancer in men with HG-PIN?
Posted Jun 13 2010 12:00am
We know from the results of the SELECT study that selenium therapy does not prevent prostate cancer in men in general. However, a smaller and separate trial has been studying whether selenium may be able to prevent prostate cancer in men with a biopsy-based diagnosis of high-grade prostatic epithelial neoplasia (HG-PIN), which is a particular risk factor for prostate cancer. Data from this study were presented at the annual meeting of the American Urological Association at the end of May, and the actual presentation is available on line .
The results of this trial (S9917) carried out by the Southwest Oncology Group were presented by Marshall on behalf of the research group.
Criteria for inclusion in this trial were relatively strict. Men had to be >40 years of age, have had a negative digital rectal examination, be diagnosed with HG-PIN (but no sign of prostate cancer), have a PSA < 10 ng/ml, and could not have been recently treated with selenium or with any 5α-reductase inhibitor (e.g., finasteride).
The basic structure of this randomized, double-blind, multi-center trial was that men who met the criteria for inclusion in the trial were randomized to receive either 200 μg of selenium daily for 3 years or a placebo (a sugar pill). After 3 years, all patients were given a further biopsy. The results were reported by Marshall as follows:
The trial enrolled 423 patients, of whom 212 received selenium and 211 received a placebo.
The patients enrolled in the trial “tended to be rather obese” and more than 45 percent of the patients in each arm of the study had a body mass index (BMI) > 29.
Among the patients who actually received a follow-up biopsy at 3 years according to the study protocol:
Adverse effects noted as a result of selenium therapy were minimal
Marshall concluded that:
Treatment with 200 μg of selenium (given as selenomethionine) is not effective in the prevention of prostate cancer in men previously diagnosed with HG-PIN.
Well-biopsied men with a diagnosis of HG-PIN have at least a 35 percent risk for prostate cancer after 3 years of follow-up.
We know from the results of the SELECT study that selenium therapy does not prevent prostate cancer in men in general. However, a smaller and separate trial has been studying whether selenium may be able to prevent prostate cancer in men with a biopsy-based diagnosis of high-grade prostatic epithelial neoplasia (HG-PIN), which is a particular risk factor for prostate cancer. Data from this study were presented at the annual meeting of the American Urological Association at the end of May, and the actual presentation is available on line .
The results of this trial (S9917) carried out by the Southwest Oncology Group were presented by Marshall on behalf of the research group.
Criteria for inclusion in this trial were relatively strict. Men had to be >40 years of age, have had a negative digital rectal examination, be diagnosed with HG-PIN (but no sign of prostate cancer), have a PSA < 10 ng/ml, and could not have been recently treated with selenium or with any 5α-reductase inhibitor (e.g., finasteride).
The basic structure of this randomized, double-blind, multi-center trial was that men who met the criteria for inclusion in the trial were randomized to receive either 200 μg of selenium daily for 3 years or a placebo (a sugar pill). After 3 years, all patients were given a further biopsy. The results were reported by Marshall as follows:
Marshall concluded that: