Posted: September 9, 2013

To summarize the state of the art of the role of nutrition in prostate cancer prevention:  in the early 1990’s a group of dermatologists discovered by accident that supplemental selenium cut the incidence of prostate cancer by 50%. (they had tried to show an effect against skin cancer and failed).  This pilot study involving only about 1000 men started a flurry of research which has shown conflicting results.   Until recently the SELECT trial, looking at selenium and vitamin E supplements, provided the best data and showed no protective effect from selenium pills.  Now comes a study published in the Journal of the National Cancer Institute (click here for abstract;  Dr. Stark can provide the full article if you request it — see box on right to ask him) .  In the Netherlands a huge study involving over 58000 men was conducted.  Toenail clipping selenium levels were measured.  Why toenails instead of blood??  Blood selenium levels can vary from day to day but toenail clipping levels are more stable and constant over time, and reflect long-term selenium blood levels.  What the investigators found was that men with higher toenail selenium levels were much less likely to develop clinically significant prostate cancer.   The authors focused on advanced-stage cancer rather than all cases, possibly because PSA screening is much less common in Europe, so a higher percentage of cases when discovered are advanced.  The authors further postulate that the reason for the discrepant findings versus the SELECT trial is that diets in the USA are much higher in selenium because US soil has much more selenium in it than European soil; hence our produce has higher selenium content.  For whatever reason this vital anti-oxidant continues to play a role in the debate over cancer prevention.  Dr. Stark weighs in, “When the original dermatology study came out in the early 90’s I along with thousands of physicians and some of my friends (over whom I seemed to have influence) started taking selenium pills.  I found it difficult to raise my selenium level with them probably (with benefit of hindsight) because my level was high-normal to begin with.   After SELECT was published I stopped taking them.   If you live in Europe the data suggest you should take supplemental selenium, probably as seleno-methionine, the biologically potent stuff; if you live in the US you are probably wasting your time.  This may not be the end of the story;  stay tuned. “