, Volume 3, Issue 4, pp 160-168
Date: 01 Dec 2005

Prescription versus herbal medications for prostate cancer prevention: Why history cannot be allowed to repeat itself in your clinical practice

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It is obvious that herbal dietary supplements have enjoyed a great deal of popularity and sales throughout the past decade and, in the area of prostate cancer prevention, this is especially the case. However, the lack of currently available evidence to indicate their effectiveness truly is a potential problem. In addition, the quality control, safety, and regulatory issues abound. However, regardless of this, one only needs to point toward the history of specific supplements for the prevention and treatment of cancer throughout the past 30 years to realize that there indeed is reason for concern. Beta-carotene supplements, shark cartilage, PC-SPES, vitamin C, and zinc are just a few examples of why clinicians cannot let history repeat itself. In other words, until the results of large randomized trials are published, the best course of action may be promoting no action at all. Lifestyle changes, supplements, and prescription medications that promote overall heart health for patients who qualify seem to make the most sense at this time because even in the worst-case scenario, patients still benefit. Most of the herbal medications that seem promising (eg, flaxseed) have been studied mostly using the dietary, not the supplement form, and this has to be emphasized to patients. The herbal prostate health supplements such as saw palmetto, pygeum, stinging nettle, and others have no adequate clinical data to suggest any impact on cancer prevention. However, their use by individuals at screening sites increases the probability that history may unfortunately repeat itself.