Skip to main content

Chemoprevention of prostate cancer: What can be recommended to patients?

Abstract

Prostate cancer is third to lung and colon cancer as the cause of cancer-related deaths in American men. It is estimated that there will have been more than 28,000 deaths and 186,000 new cases in 2008 that will impose a significant burden on national health care costs. Chemoprevention aims to reduce both incidence and mortality through the use of agents to prevent, reverse, or delay the carcinogenic process. This study provides clinicians with information on some chemoprevention agents that have been considered to reduce prostate cancer risks, including 5-α-reductase inhibitors; statins (a class of compounds used to reduce cholesterol); NSAIDs; selenium; vitamins E and D; lycopene; allium vegetables (garlic, scallions, onions, chives, and leeks); soy/isoflavones; and green tea polyphenols. The evidence to support prostate cancer risk reduction benefits for each chemoprevention agent based on a review of the literature is provided.

This is a preview of subscription content, access via your institution.

References and Recommended Reading

  1. Huggins C, Hodges CV: Studies on prostatic cancer I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. Cancer Res 1941, 1:293–297.

    CAS  Google Scholar 

  2. Bologna M, Muzi P, Biordi L, et al.: Finasteride dosedependently reduces the proliferation rate of the LnCap human prostatic cancer cell line in vitro. Urology 1995, 45:282–290.

    PubMed  Article  CAS  Google Scholar 

  3. Tsukamoto S, Akaza H, Onozawa M, et al.: A five-alpha reductase inhibitor or an antiandrogen prevents the progression of microscopic prostate carcinoma to macroscopic carcinoma in rats. Cancer 1998, 82:531–537.

    PubMed  Article  CAS  Google Scholar 

  4. Thorpe JF, Jain S, Marczylo TH, et al.: A review of phase III clinical trials of prostate cancer chemoprevention. Ann R Coll Surg Engl 2007, 89:207–211.

    PubMed  Article  CAS  Google Scholar 

  5. Andriole G, Bostwick D, Brawley O, et al.: Chemoprevention of prostate cancer in men at high risk: rationale and design of the reduction by dutasteride of prostate cancer events (REDUCE) trial. J Urol 2004, 172(4 Pt 1):1314–1317.

    Article  Google Scholar 

  6. Dale KM, Coleman CI, Henyan NN, et al.: Statins and cancer risk: a meta-analysis. JAMA 2006, 295:74–80.

    PubMed  Article  CAS  Google Scholar 

  7. Platz EA, Leitzmann MF, Visvanathan K, et al.: Statin drugs and risk of advanced prostate cancer. J Natl Cancer Inst 2006, 98:1819–1825.

    PubMed  Article  CAS  Google Scholar 

  8. Jacobs EJ, Rodriguez C, Bain EB, et al.: Cholesterol-lowering drugs and advanced prostate cancer incidence in a large US cohort. Cancer Epidemiol Biomarkers Prev 2007, 16:2213–2217.

    PubMed  Article  CAS  Google Scholar 

  9. Murtola T, Tammela TL, Lahtela J, Auvinen A: Cholesterol-lowering drugs and prostate cancer risk: a population-based case-control study. Cancer Epidemiol Biomarkers Prev 2007, 16:2226–2232.

    PubMed  Article  CAS  Google Scholar 

  10. Colli JL, Amling CL: Exploring causes for declining prostate cancer mortality rates in the United States. Urol Oncol 2008, 26:627–633.

    PubMed  Article  Google Scholar 

  11. Colli JL, Amling CL: High cholesterol levels are associated with reduced prostate cancer mortality rates during periods of high but not low statin use in the United States. Urol Oncol 2008 Feb 1 (Epub ahead of print).

  12. Schaffner CP: Prostatic cholesterol metabolism: regulation and alteration. Prog Clin Biol Res 1981, 75A:279–324.

    PubMed  CAS  Google Scholar 

  13. Rosenson RS: Current overview of statin-induced myopathy. Am J Med 2004, 116:408–416.

    PubMed  Article  CAS  Google Scholar 

  14. Habel LA, Zhao W, Stanford JL: Daily aspirin use and prostate cancer risk in a large multiracial cohort in the US. Cancer Causes Control 2002, 13:427–434.

    PubMed  Article  Google Scholar 

  15. Leitzmann MF, Stampfer MJ, Ma J, et al.: Aspirin use in relation to risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 2002, 11:1108–1111.

    PubMed  CAS  Google Scholar 

  16. Perron L, Bairati I, Moore L, Meyer F: Dosage, duration and timing of nonsteroidal antiinflammatory drug use and risk of prostate cancer. Int J Cancer 2003, 106:409–415.

    PubMed  Article  CAS  Google Scholar 

  17. García Rodríguez LA, González-Pérez A: Inverse association between nonsteroidal anti-inflammatory drugs and prostate cancer. Cancer Epidemiol Biomarkers Prev 2004, 13:649–653.

    PubMed  Google Scholar 

  18. Jacobs EJ, Rodriguez C, Mondul AM, et al.: A large cohort study of aspirin and other nonsteroidal anti-inflammatory drugs and prostate cancer incidence. J Natl Cancer Inst 2005, 97:975–980.

    PubMed  Article  Google Scholar 

  19. Singer EA, Palapattu GS, van Wijngaarden E: Prostatespecific antigen levels in relation to consumption of nonsteroidal anti-inflammatory drugs and acetaminophen: results from the 2001–2002 National Health and Nutrition Examination Survey. Cancer 2008, 113:2053–2057.

    PubMed  Article  Google Scholar 

  20. Penson DF, Chan JM: Prostate cancer. In Urologic Diseases in America. Edited by Litwin MS, Saigal CS. Washington, DC: US Government Publishing Office; 2007:71–122; NIH publication 07-5512.

    Google Scholar 

  21. Brawley OW: The potential for prostate cancer chemoprevention. Rev Urol 2002, 4(Suppl 5):S11–S17.

    PubMed  Google Scholar 

  22. van den Brandt PA, Zeegers MPA, Bode P, Goldbohm RA: Toenail selenium levels and the subsequent risk of prostate cancer: a prospective cohort study. Cancer Epidemiol Biomarkers Prev 2003, 12:866–871.

    PubMed  Google Scholar 

  23. Yoshizawa K, Willett WC, Morris SJ, et al.: Study of prediagnostic selenium level in toenails and the risk of advanced prostate cancer. J Natl Cancer Inst 1998, 90:1219–1224.

    PubMed  Article  CAS  Google Scholar 

  24. Helzlsouer KJ, Huang HY, Alberg AJ, et al.: Association between alpha-tocopherol, gamma-tocopherol, selenium, and subsequent prostate cancer. J Natl Cancer Inst 2000, 92:2018–2023.

    PubMed  Article  CAS  Google Scholar 

  25. Nomura AM, Lee J, Stemmermann GN, Combs GF Jr: Serum selenium and subsequent risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 2000, 9:883–887.

    PubMed  CAS  Google Scholar 

  26. Duffield-Lillico AJ, Dalkin BL, Reid ME, et al.: Selenium supplementation, baseline plasma selenium status and incidence of prostate cancer: an analysis of the complete treatment period of the Nutritional Prevention of Cancer Trial. BJU Int 2003, 91:608–612.

    PubMed  Article  CAS  Google Scholar 

  27. Klein EA, Thompson IM, Lippman SM, et al.: SELECT: the selenium and vitamin E cancer prevention trial. Urol Oncol 2003, 21:59–65.

    PubMed  Article  CAS  Google Scholar 

  28. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. N Engl J Med 1994, 330:1029–1035.

  29. Colli JL, Grant WB: Solar ultraviolet B radiation compared with prostate cancer incidence and mortality rates in United States. Urology 2008, 71:531–535.

    PubMed  Article  Google Scholar 

  30. Grant WB: An estimate of premature cancer mortality in the U.S. due to inadequate doses of solar ultraviolet-B radiation. Cancer 2002, 94:1867–1875.

    PubMed  Article  Google Scholar 

  31. Giovannucci E: The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer Causes Control 2005, 16:83–95.

    PubMed  Article  Google Scholar 

  32. Li H, Stampfer MJ, Hollis JB, et al.: A prospective study of plasma vitamin D metabolites, vitamin D receptor polymorphisms, and prostate cancer. PLoS Med 2007, 4:e103.

    PubMed  Article  Google Scholar 

  33. Mills PK, Beeson WL, Phillips RL, Fraser GE: Cohort study of diet, lifestyle, and prostate cancer in Adventist men. Cancer 1989, 64:598–604.

    PubMed  Article  CAS  Google Scholar 

  34. Giovannucci E, Ascherio A, Rimm EB, et al.: Intake of carotenoids and retinol in relation to risk of prostate cancer. J Natl Cancer Inst 1995, 87:1767–1776.

    PubMed  Article  CAS  Google Scholar 

  35. Giovannucci E, Rimm EB, Liu Y, et al.: A prospective study of tomato products, lycopene, and prostate cancer risk. J Natl Cancer Inst 2002, 94:391–398.

    PubMed  Article  CAS  Google Scholar 

  36. Kirsh VA, Mayne ST, Peters U, et al.: A prospective study of lycopene and tomato product intake and risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 2006, 15:92–98.

    PubMed  Article  CAS  Google Scholar 

  37. Peters U, Leitzmann MF, Chatterjee N, et al.: Serum lycopene, other carotenoids, and prostate cancer risk: a nested case-control study in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Epidemiol Biomarkers Prev 2007, 16:962–968.

    PubMed  Article  CAS  Google Scholar 

  38. Key TJ, Appleby PN, Allen NE, et al.: Plasma carotenoids, retinol, and tocopherols and the risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition study. Am J Clin Nutr 2007, 86:672–681.

    PubMed  CAS  Google Scholar 

  39. Kavanaugh CJ, Trumbo PR, Ellwood KC: The U.S. Food and Drug Administration’s evidence-based review for qualified health claims: tomatoes, lycopene, and cancer. J Natl Cancer Inst 2007, 99:1074–1085.

    PubMed  Article  CAS  Google Scholar 

  40. Hsing AW, Chokkalingam AP, Gao YT, et al.: Allium vegetables and risk of prostate cancer: a population based study. J Natl Cancer Inst 2002, 94:1648–1651.

    PubMed  Article  CAS  Google Scholar 

  41. Hodge AM, English DR, McCredie MR, et al.: Foods nutrition and prostate cancer. Cancer Causes Control 2004, 15:11–20.

    PubMed  Article  Google Scholar 

  42. Galeone C, Pelucchi C, Levi F, et al.: Onion and garlic use and human cancer. Am J Clin Nutr 2006, 84:1027–1032.

    PubMed  CAS  Google Scholar 

  43. Colli JL, Colli A: International comparisons of prostate cancer mortality rates with dietary practices and sunlight levels. Urol Oncol 2006, 24:184–194.

    PubMed  Article  Google Scholar 

  44. Morton MS, Arisaka O, Miyake N, et al.: Phytoestrogen concentrations in serum from Japanese men and women over forty years of age. J Nutr 2002, 132:3168–3171.

    PubMed  CAS  Google Scholar 

  45. Kurahashi N, Iwasaki M, Sasazuki S, et al.: Soy product and isoflavone consumption in relation to prostate cancer in Japanese men. Cancer Epidemiol Biomarkers Prev 2007, 16:538–545.

    PubMed  Article  CAS  Google Scholar 

  46. Balk E, Chung M, Chew P, et al.: Effects of soy on health outcomes. Summary, evidence report/technology assessment (no 126). Rockville, MD: Agency for Healthcare Research and Quality; 2005: AHRQ publication 05-E024-1.

    Google Scholar 

  47. Kurahashi N, Sasazuki S, Iwasaki M, et al.: Green tea consumption and prostate cancer risk in Japanese men: a prospective study. Am J Epidemiol 2008, 167:71–77.

    PubMed  Article  Google Scholar 

  48. Kikuchi N, Ohmori K, Shimazu T, et al.: No association between green tea and prostate cancer risk in Japanese men: the Ohsaki Cohort Study. Br J Cancer 2006, 95:371–373.

    PubMed  Article  CAS  Google Scholar 

  49. Jian L, Lee AH, Binns CW: Tea and lycopene protect against prostate cancer. Asia Pac J Clin Nutr 2007, 16(Suppl 1):453–457.

    PubMed  CAS  Google Scholar 

  50. Jian L, Xie LP, Lee AH, Binns CW: Protective effect of green tea against prostate cancer: a case-control study in southeast China. Int J Cancer 2004, 108:130–135.

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Janet L. Colli.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Colli, J.L., Amling, C.L. Chemoprevention of prostate cancer: What can be recommended to patients?. Curr prostate rep 7, 47–53 (2009). https://doi.org/10.1007/s11918-009-0008-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11918-009-0008-8

Keywords

  • Prostate Cancer
  • Lycopene
  • Prostate Cancer Risk
  • Advanced Prostate Cancer
  • Chemoprevention Agent