Friday, February 14, 2014

Prostate cancer in Vitamin E's Points of View

The widespread of prostate cancer, once considered as a disease of aging male, now has become major concerns of governments and scientific community in South East Asian with tendency to effect even younger age population. Epidemiological studies, linking vitamin E in reduced risk of prostate cancer have produced conflict results. It may be due to age related, smoking habit, gene mutation, types of tocopherol, etc.

Prostate cancer is defined as a condition in which the cells of prostate has become cancerous, causing abnormal cell growth with possibility of spreading to the distant parts of the body. Most prostate cancers are slow growing and enlarged prostate and prostate cancer may be detected during physical (rectum) exams.

The conflict results
The Selenium and Vitamin E Cancer Prevention Trial (SELECT) showed an adverse effect of dietary supplement with vitamin E significantly increased the risk of prostate cancer among healthy men through illustration  per 1000 person-years.(1)or prevented the development of prostate cancer in the population of relatively healthy men(2). In the study of  combination used of vitamin C and E of total of 14,641 male physicians in the United States initially aged 50 years or older, including 1307 men with a history of prior cancer at randomization, also suggested that neither vitamin E nor C supplementation reduced the risk of prostate or total cancer(3). Positively, on prostate cancer (PCa), in N-methyl-N-nitrosourea (MNU)-induced epithelial dysplasia in the rat ventral prostate (VP), animals fed a control+γ-tocopherol (CT+γT)  significantly attenuated the adverse effects of MNU in the VP through the deceased epithelial dysplasia, along with the cell proliferation index, GST-pi and Cox-2 immunoexpression(3). Some researchers insisted that different forms of vitamin E exert different effects on prostate cancer, with alpha-tocopherol potentially increasing and gamma-tocopherol potentially decreasing risk of the disease(5).



The serum of tocopherol
In the study of the effects of Serum α-tocopherol and γ-tocopherol in prostate cancer patient showed  that  higher serum α-tocopherol was associated with significantly lower prostate cancer risk and by contrast, risk was non-significantly elevated among men with higher γ-tocopherol concentrations(12).
Some researchers suggested that higher prediagnostic serum concentrations of alpha-tocopherol, but not dietary vitamin E, was associated with lower risk of developing prostate cancer, particularly advanced prostate cancer(13). But in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study, showed that risk of prostate cancer reduced with high serum tocopherols and  higher circulating concentrations of the major vitamin E fractions, alpha-tocopherol and gamma-tocopherol(14) and higher alpha-tocopherol (and not beta-carotene or retinol) status increases overall prostate cancer survival(15).



The benefits
Study of 8-wk-old male TRAMP mice were fed 0.1% γ-TmT or a control diet for 16 weeks, Nuclear factor-erythroid 2-related factor 2 (Nrf2), showed that γ-tocopherol-rich mixture of tocopherols (γ-TmT) inhibited CpG methylation (promoters of genes can lead to their silencing, a feature found in a number of human cancers ) in the Nrf2 promoter in the prostate of transgenic adenocarcinoma of the mouse prostate (TRAMP) and in TRAMP-C1 cells(6). In prostate cancer, combination use of NAG-1 and Vitamin E succinate (VES), showed the enhancement of VES in >3-fold increase in the half-life of NAG-1 mRNA through transcriptional/post-transcriptional mechanism in a p38 kinase-dependent manner(7). On prostate cancer in male smokers. long-term supplementation with alpha-tocopherol substantially reduced prostate cancer incidence and mortality(8). In the study of  the incidence of prostate cancer risk associations of alpha-tocopherol, gamma-tocopherol, and selenium, indicated that risk of prostate cancer declined, but not linearly, with increasing concentrations of alpha-tocopherol; gamma-tocopherol, men in the highest fifth of the distribution had a fivefold reduction in the risk of developing prostate cancer than men in the lowest fifth(9).
Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study of 29,133 Finnish male smokers aged 50-69 years, showed a decreased risk of prostate cancer with oral administration of daily α-tocopherol (50 mg) for a median of 6.1 years and lower prostate cancer mortality(10). Other suggestion of inhibitory prostate cancer activities of δ-T and γ-T (than α-T) may be as a result of  due trapping of reactive nitrogen species and their capacity to generate side-chain degradation products(11).



Taking altogether, most researchers agreed that intake of alpha-tocopherol  may be beneficiary in reduced risk and treatment of prostate cancer accompany of diet,  life style change(16)(17)(18). Over doses of vitamin E supplement can cause symptoms of blurred vision, weakness, dizziness, nausea, diarrhea, etc., please make sure you follow the guideline of the Institute of Medicine of the National Academies.

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References
(1) Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT) by Klein EA, Thompson IM Jr, Tangen CM, Crowley JJ, Lucia MS, Goodman PJ, Minasian LM, Ford LG, Parnes HL, Gaziano JM, Karp DD, Lieber MM, Walther PJ, Klotz L, Parsons JK, Chin JL, Darke AK, Lippman SM, Goodman GE, Meyskens FL Jr, Baker LH(PubMed)
(2) Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT) byLippman SM, Klein EA, Goodman PJ, Lucia MS, Thompson IM, Ford LG, Parnes HL, Minasian LM, Gaziano JM, Hartline JA, Parsons JK, Bearden JD 3rd, Crawford ED, Goodman GE, Claudio J, Winquist E, Cook ED, Karp DD, Walther P, Lieber MM, Kristal AR, Darke AK, Arnold KB, Ganz PA, Santella RM, Albanes D, Taylor PR, Probstfield JL, Jagpal TJ, Crowley JJ, Meyskens FL Jr, Baker LH, Coltman CA Jr.(PubMed)
(3) Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians' Health Study II randomized controlled trial by Gaziano JM, Glynn RJ, Christen WG, Kurth T, Belanger C, MacFadyen J, Bubes V, Manson JE, Sesso HD, Buring JE(PubMed)
(4) Protective effect of γ-tocopherol-enriched diet on N-methyl-N-nitrosourea-induced epithelial dysplasia in rat ventral prostate by Sanches LD, Santos SA, Carvalho JR, Jeronimo GD, Favaro WJ, Reis MD, Felisbino SL, Justulin LA Jr(PubMed)
(5) Dietary antioxidants and prostate cancer: a review by Vance TM, Su J, Fontham ET, Koo SI, Chun OK.(PubMed)
(6) A γ-tocopherol-rich mixture of tocopherols maintains Nrf2 expression in prostate tumors of TRAMP mice via epigenetic inhibition of CpG methylation by Huang Y, Khor TO, Shu L, Saw CL, Wu TY, Suh N, Yang CS, Kong AN(PubMed)
(7) Vitamin E succinate induces NAG-1 expression in a p38 kinase-dependent mechanism by Shim M, Eling TE (PubMed)
(8) long-term supplementation with alpha-tocopherol substantially reduced prostate cancer incidence and mortality by Heinonen OP1, Albanes D, Virtamo J, Taylor PR, Huttunen JK, Hartman AM, Haapakoski J, Malila N, Rautalahti M, Ripatti S, Mäenpää H, Teerenhovi L, Koss L, Virolainen M, Edwards BK.(PubMed)
(9) Association between alpha-tocopherol, gamma-tocopherol, selenium, and subsequent prostate cancer by Helzlsouer KJ, Huang HY, Alberg AJ, Hoffman S, Burke A, Norkus EP, Morris JS, Comstock GW(PubMed)
(10) Effects of α-tocopherol and β-carotene supplementation on cancer incidence and mortality: 18-Year postintervention follow-up of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study by Virtamo J, Taylor PR, Kontto J, Männistö S, Utriainen M, Weinstein SJ, Huttunen J, Albanes D.(PubMed)
(11) Cancer prevention by different forms of tocopherols by Yang CS, Suh N(PubMed)
(12) Serum α-tocopherol and γ-tocopherol concentrations and prostate cancer risk in the PLCO Screening Trial: a nested case-control study by Weinstein SJ, Peters U, Ahn J, Friesen MD, Riboli E, Hayes RB, Albanes D(PubMed)
(13) Serum and dietary vitamin E in relation to prostate cancer risk by Weinstein SJ, Wright ME, Lawson KA, Snyder K, Männistö S, Taylor PR, Virtamo J, Albanes D.(PubMed)
(14) Serum alpha-tocopherol and gamma-tocopherol in relation to prostate cancer risk in a prospective study by Weinstein SJ, Wright ME, Pietinen P, King I, Tan C, Taylor PR, Virtamo J, Albanes D(PubMed)
(15) Associations between alpha-tocopherol, beta-carotene, and retinol and prostate cancer survival by Watters JL, Gail MH, Weinstein SJ, Virtamo J, Albanes D(PubMed)
(16) Mediterranean Diet and Prostate Cancer Risk and Mortality in the Health Professionals Follow-up Study by Kenfield SA, Dupre N, Richman EL, Stampfer MJ, Chan JM, Giovannucci EL.(PubMed)
(17)  A prospective study of demographics, diet, and prostate cancer among men of Japanese ancestry in Hawaii by Severson RK, Nomura AM, Grove JS, Stemmermann GN.(PubMed)
(18) Alcohol consumption, smoking, and other risk factors and prostate cancer in a large health plan cohort in California (United States) by Hiatt RA, Armstrong MA, Klatsky AL, Sidney S.(PubMed)




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