Prostate Cancer Supplement Recommendations

Multiple nutritional supplements have been associated with reduced cancer occurrence and/or cancer progression. The list below contains those with the greatest evidence-base and benefit, though it is not necessary that they all be included.

Vitamin D

  • Vitamin D levels are associated with risk of dying from prostate cancer. In a trial of men given 4000 IU per day for 1 year, vitamin D levels increased from 33ng/mL to 66ng/mL, over half had a decrease in the number of positive cores or Gleason score on biopsy.[1]
  • Suggested dose is that sufficient to raise vitamin D blood levels to >40 ng/mL, which may require 5000 IU per day or more.[2]

Lycopene

  • This tomato-based antioxidant has been shown to inhibit cell proliferation via several pathways.[3],[4],[5] Pasta sauce containing 30mg per day increased cancer cell death in patients prior to prostatectomy.[6]
  • Suggested dose: 30 mg per day.

Green tea extract

  • Catechins, antioxidants found in green tea, particularly ECEG (epigallocatechin-3-gallate), have been shown to increase prostate cancer cell death by at least two mechanisms.[7]
  • Suggested dose: 1g EGCG and mixed catechins per day.[8],[9]

Curcumin

  • The pharmacologically active component of the spice turmeric, curcumin inhibits tumor growth by multiple mechanisms. [10]
  • Suggested dose: 1-2g per day of Meriva® or Longvida® curcumin.[11],[12]

Resveratrol

  • Found in red wine and grapes, this antioxidant has inhibited prostate cancer cell growth and metastasis.[13] It also appears to improve the effectiveness of radiotherapy.[14]
  • Suggested dose: 100-200mg per day.

Omega-3 fatty acids

  • Omega-3 fatty acids have been shown to reduce the risk of prostate cancer, and higher intakes have been associated with greater survival.[15] Several grams of DHA/EPA have been used in clinical trials.[16] Additionally, GLA, another omega-3 found in Evening Primrose oil, helps to maintain balance in the fatty acids and enhances the anti-inflammatory effect.[17],[18]
  • Suggested dose: 200-400mg, three times per day.

Milk thistle

  • Silymarin and silibinin from milk thistle have anti-proliferative and anti-metastatic properties.
  • Suggested dose: At least 500mg silymarin per day.[19],[20]

Diindolylmethane (DIM)

  • A number of extracts from cruciferous vegetables (such as broccoli, cauliflower, cabbage, etc.), particularly diindolylmethane (DIM), may explain the benefit of these vegetables on cancer progression, as it has been shown to inhibit multiple mechanisms of cancer growth.[21],[22]
  • Suggested dose: 250mg per day.

Quercetin

  • This antioxidant found primarily in onions has been shown to inhibit invasion and metastasis of prostate cancer cells.[23]
  • Suggested dose: 200-400mg, three times per day.

Grape seed extract and/or pycnogenol

  • In a large cohort of over 35,000 men, use of grape seed extract supplements was associated with a 41% reduced risk of prostate cancer.[24] It is thought to influence hormonal and inflammatory pathways.[25]
  • Suggested dose: 100-200mg per day.

Melatonin

  • A hormone, supplemental melatonin intake has improved survival in a number of cancers, and may enhance conventional therapy effectiveness.[26]
  • Suggested dose: at least 3mg at night, preferably time-released.

Vitamin E

  • Various components of vitamin E have shown anti-cancer properties. Although alpha-tocopherol is often used in clinical trials, when given alone it may deplete other important components of vitamin E.[27],[28]
  • Suggested dose: 200-400 IU per day of mixed tocopherols and tocotrienols.

Vitamin K2

  • Vitamin K-2 (MK-7) has the longest half-life, meaning it is the most stable, of all forms of vitamin K. Shown to improve bone and cardiovascular health, higher intakes of this form have also been associated with reduced cancer incidence & fatality, and may improve effectiveness of other therapies.[29],[30],[31]
  • Suggested dose: 100 mcg vitamin K-2 (MK-7).

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[1] Marshall DT, Savage SJ, Garrett-Mayer E, et al. Vitamin D3 supplementation at 4000 international units per day for one year results in a decrease of positive cores at repeat biopsy in subjects with low-risk prostate cancer under active surveillance. J Clin Endocrinol Metab. 2012 Jul;97(7):2315-24.

[2] Garland CF, French CB, Baggerly LL, et al. Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention. Anticancer Res. 2011 Feb;31(2):607-11.

[3] Yang CM, Lu YL, Chen HY, et al. Lycopene and the LXRα agonist T0901317 synergistically inhibit the proliferation of androgen-independent prostate cancer cells via the PPARγ-LXRα-ABCA1 pathway. J Nutr Biochem. 2012 Sep;23(9):1155-62.

[4] Teodoro AJ, Oliveira FL, Martins NB, et al. Effect of lycopene on cell viability and cell cycle progression in human cancer cell lines. Cancer Cell Int. 2012 Aug 6;12(1):36.

[5] Giovannucci E. Commentary: Serum lycopene and prostate cancer progression: a re-consideration of findings from the prostate cancer prevention trial. Cancer Causes Control. 2011 Jul;22(7):1055-9.

[6] Kim HS, Bowen P, Chen L, et al. 2003 Effects of tomato sauce consumption on apoptotic cell death in prostate benign hyperplasia and carcinoma. Nutrition and Cancer 47 40– 47.

[7] Gupta K, Thakur VS, Bhaskaran N, et al. Green tea polyphenols induce p53-dependent and p53-independent apoptosis in prostate cancer cells through two distinct mechanisms. PLoS One. 2012;7(12):e52572.

[8] McLarty J, Bigelow RL, Smith M, et al. Tea polyphenols decrease serum levels of prostate-specific antigen, hepatocyte growth factor, and vascular endothelial growth factor in prostate cancer patients and inhibit production of hepatocyte growth factor and vascular endothelial growth factor in vitro. Cancer Prev Res (Phila). 2009 Jul;2(7):673-82.

[9] Bettuzzi S, Brausi M, Rizzi F, et al. Chemoprevention of human prostate cancer by oral administration of green tea catechins in volunteers with high-grade prostate intraepithelial neoplasia: a preliminary report from a one-year proof-of-principle study. Cancer Res. 2006 Jan 15;66(2):1234-40.

[10] Killian PH, Kronski E, Michalik KM, et al. Curcumin inhibits prostate cancer metastasis in vivo by targeting the inflammatory cytokines CXCL1 and -2. Carcinogenesis. 2012 Dec;33(12):2507-19.

[11] Marczylo TH, Verschoyle RD, Cooke DN, et al. Comparison of systemic availability of curcumin with that of curcumin formulated with phosphatidylcholine. Cancer Chemother Pharmacol. 2007 Jul;60(2):171-7

[12] DiSilvestro RA1, Joseph E, Zhao S, Bomser J. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. Nutr J. 2012 Sep 26;11:79. doi: 10.1186/1475-2891-11-79.

[13] Sheth S, Jajoo S, Kaur T, et al. Resveratrol reduces prostate cancer growth and metastasis by inhibiting the Akt/MicroRNA-21 pathway. PLoS One. 2012;7(12):e51655.

[14] Fang Y, DeMarco VG, Nicholl MB. Resveratrol enhances radiation sensitivity in prostate cancer by inhibiting cell proliferation and promoting cell senescence and apoptosis. Cancer Sci. 2012 Jun;103(6):1090-8.

[15] Epstein MM, Kasperzyk JL, Mucci LA, et al. Dietary fatty acid intake and prostate cancer survival in Örebro County, Sweden. Am J Epidemiol. 2012 Aug 1;176(3):240-52.

[16] Aronson WJ, Kobayashi N, Barnard RJ et al. Phase II prospective randomized trial of a low-fat diet with fish oil supplementation in men undergoing radical prostatectomy. Cancer Prev Res (Phila). 2011 Dec;4(12):2062-71.

[17] Xu Y, Qian SY1. Anti-cancer activities of ω-6 polyunsaturated fatty acids. Biomed J. 2014 May-Jun;37(3):112-9.

[18] Biomed J. 2014 May-Jun;37(3):112-9. Gamma linolenic acid with tamoxifen as primary therapy in breast cancer. Int J Cancer. 2000 Mar 1;85(5):643-8.

[19] Vidlar A, Vostalova J, Ulrichova J, et al. The safety and efficacy of a silymarin and selenium combination in men after radical prostatectomy – a six month placebo-controlled double-blind clinical trial. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010 Sep;154(3):239-44.

[20] Flaig TW, Glodé M, Gustafson D, et al. A study of high-dose oral silybin-phytosome followed by prostatectomy in patients with localized prostate cancer. Prostate. 2010 Jun 1;70(8):848-55.

[21] Beaver LM, Yu TW, et al. 3,3′-Diindolylmethane, but not indole-3-carbinol, inhibits histone deacetylase activity in prostate cancer cells. Toxicol Appl Pharmacol. 2012 Sep 15;263(3):345-51.

[22] Wang TT, Schoene NW, Milner JA et al. Broccoli-derived phytochemicals indole-3-carbinol and 3,3′-diindolylmethane exerts concentration-dependent pleiotropic effects on prostate cancer cells: comparison with other cancer preventive phytochemicals. Mol Carcinog. 2012 Mar;51(3):244-56.

[23] Senthilkumar K, Arunkumar R et al. Quercetin inhibits invasion, migration and signalling molecules involved in cell survival and proliferation of prostate cancer cell line (PC-3). Cell Biochem Funct. 2011 Mar;29(2):87-95.

[24] Brasky TM, Kristal AR, Navarro SL, et al. Specialty supplements and prostate cancer risk in the VITamins and Lifestyle (VITAL) cohort. Nutr Cancer. 2011;63(4):573-82.

[25] Park SY, Lee YH, Choi KC et al. Grape seed extract regulates androgen receptor-mediated transcription in prostate cancer cells through potent anti-histone acetyltransferase activity. J Med Food. 2011 Jan-Feb;14(1-2):9-16

[26] Cutando A, López-Valverde A, et al. Role of melatonin in cancer treatment. Anticancer Res. 2012 Jul;32(7):2747-53.

[27] Ju J, Picinich SC, Yang Z, et al. Cancer-preventive activities of tocopherols and tocotrienols. Carcinogenesis. 2010 Apr;31(4):533-42.

[28] Yang CS, Suh N, Kong AN. Does vitamin E prevent or promote cancer? Cancer Prev Res (Phila). 2012 May;5(5):701-5

[29] Nimptsch K, Rohrmann S, Kaaks R, et al. Dietary vitamin K intake in relation to cancer incidence and mortality: results from the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg). Am J Clin Nutr. 2010 May;91(5):1348-58.

[30] Nimptsch K, Rohrmann S, Linseisen J. Dietary intake of vitamin K and risk of prostate cancer in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg). Am J Clin Nutr. 2008 Apr;87(4):985-92.

[31] Zhang H, Ozaki I, Hamajima H, et al. Vitamin K2 augments 5-fluorouracil-induced growth inhibition of human hepatocellular carcinoma cells by inhibiting NF-κB activation. Oncol Rep. 2011 Jan;25(1):159-66.

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