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Does Vitamin E ..

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Prostate cancer is the third most common cause of death from cancer in men of all ages and is also the most common cause of death from cancer in men over the age of 75.1 There have been reports of vitamin E and selenium being options in cancer prevention.2, 3 Vitamin E has reported uses in Alzheimer’s disease, macular degeneration, cardiovascular disease, and prostate cancer risk reduction.4 Selenium has many reported uses with cancer prevention amongst them.5 The original SELECT trial was stopped prematurely and the authors concluded vitamin E and selenium, alone or in combination, did not prevent prostate cancer in healthy men. The trial found a non-significant increase in the incidence of prostate cancer in men supplementing with vitamin E and a non-significant increase in diabetes mellitus associated with selenium.6

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Klein and colleagues performed a follow up report to The Selenium and Vitamin E Cancer Prevention Trial (SELECT) to examine the effects of supplementation on the prevention of prostate cancer over a longer period of time. This trial analyzed the effect of selenium, vitamin E, vitamin E and selenium, or placebo on prostate cancer prevention. The participants included black men 50 years or older and men of other races 55 years and older, and they had a digital rectal exam not suspicious for cancer and prostate specific antigen of 4.0 ng/ml or less.7

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According to the most current data as of July 5, 2011 there has been an additional 54,464 person-years of follow-up with 521 additional cases of prostate cancers diagnosed since the initial report. Of these diagnoses 113 have been in the placebo group, 147 in the vitamin E group, 143 in the selenium group, and 118 in the combination group. The rate of cancer was higher in the groups receiving supplementation of either selenium, vitamin E, or both compared to the placebo group, but only the vitamin E group was statistically significant (HR 1.17, 99% CI 1.004-1.36, p=0.008).7

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In this follow-up of SELECT participants, it revealed healthy men with an average risk of developing prostate cancer and taking a common formulation of vitamin E, 400 IU/day, while undergoing screening have a significant 17% increase in the risk of developing prostate cancer.7 Over 50% of men over the age of 60 are taking at least 400IU of vitamin E daily even though the daily recommended dose is 22.4 IU.8 Therefore, at this time the use of vitamin E over the recommended daily allowance can not be advised for men due to the lack of evidence supporting its use in preventing prostate cancer and other disease states.

1. Prostate Cancer. (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001418/). Last Accessed October 25, 2011.
2. Mondul AM, Rager HC, Kopp W, et al. Supplementation with {alpha}-Tocopherol or {beta}-Carotene Reduces Serum Concentrations of Vascular Endothelial Growth Factor-D, but not -A or -C, in Male Smokers. J Nutr. 2011;141(11):2030-4.   [PubMed: 21956960]

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