Originally published 3/12/2015
If you’re a guy and you eat breads, grains, meat, poultry, fish and eggs, you are probably getting all the selenium your body needs. Selenium, a trace element that supports several bodily wellness functions, occurs naturally in many foods. The average American male who consumes a balanced diet is getting all the selenium he needs.
At the time we published the blog below, the SELECT study had gathered enough evidence that adding selenium supplements to a diet that already provided adequate levels was overkill—and actually increased the risk for prostate cancer (PCa). The only newer information comes from a 2018 journal article that consists of a review of previous studies.[i]
The majority of previous research that supported a protective role for selenium predated the SELECT study’s conclusions by as much as 10 years.
It is our position, which is in agreement with the SELECT findings, that selenium supplements for men whose diet leaves them with low levels of this mineral will have no effect on their PCa risk. However, for men whose nutrition provides totally adequate levels, our recommendation is to avoid packaged or manufactured supplements—and STOP taking them if you already do so.
There is a wealth of information on the potential of natural and alternative ways to prevent and perhaps even control prostate cancer – at least in its early stages when patients are candidates for active surveillance. I have previously written on such topics as
I am always interested in promoting healthy lifestyle choices, especially when there is ever-increasing evidence that the things that support overall well-being (exercise, healthy foods, stress management, etc.) also support prostate health. For at least two decades, there has been particular interest in the value of antioxidants to prevent aging and disease, so it’s easy to wonder what value they would have with regard to prostate cancer (PCa).
One of those antioxidants, selenium, came to public attention almost 2 decades ago as a preventative agent against PCa. Selenium is a mineral found in the soil, water, and some foods. Most people get all the selenium they need, which is only a very small amount, through normal eating. However, there’s an irrational line of thought that goes, “If a little is good, a lot will be even better.” Thus, supplement manufacturers produced over-the-counter selenium supplements to the delight of consumers.
How did selenium become associated with preventing PCa? A few studies at the turn of the new millennium found that men who took selenium appeared to have a lower incidence of developing PCa (this later turned out to be true for men whose selenium levels were lower than normal). In 2001 the SELECT trial (Selenium and Vitamin E Cancer Prevention Trial) began enrolling men, and by 2004 over 35,000 men in the U.S., Canada and Puerto Rico were on board. There was much hope that Selenium and/or Vitamin E could be demonstrated to prevent prostate cancer. Sadly, within 5 years it was clear that neither substance alone, or together, had any preventive merits. In 2008, participants were advised to stop taking both substances. Further analysis demonstrated that men who began the trial with high levels of selenium actually doubled their risk of developing high-grade prostate cancer.
A very recent study from several respected academic medical centers suggests that men with nonmetastatic PCa who take selenium supplements, especially at higher doses, may actually increase their risk of biochemical recurrence, and even death from prostate cancer.[ii] Although the mechanism by which this occurs is not yet known, caution is urged.
The Sperling Prostate Center applauds the awareness of and commitment to holistic health by our patients, and by men everywhere. Remember to do your due diligence before self-prescribing selenium or any other supplement, research the internet, and check with your doctor.
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.
References
[i] Sayehmiri K, Azami M, Mohammadi Y, Soleymani A, Tardeh Z. The association between Selenium and Prostate
Cancer: a Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev. 2018 Jun 25;19(6):1431-1437.
[ii] Kenfield SA, Van Blarigan EL, DuPre N et al. Selenium supplementation and prostate cancer mortality. J Natl Cancer Inst. 2014 Dec 12;107(1):360.
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
