Protect Your Prostate with Vitamin E

Protect Your Prostate with Vitamin E
Several forms of this versatile vitamin can
cut the risk of prostate cancer in half
By Dr. Edward R. Rosick

t’s becoming harder than ever to differentiate between real science and “junk” science these days. With the proliferation of health-related sites on the Internet and the seemingly endless amounts of money being poured into advertising by multinational pharmaceutical corporations, we’re besieged 24/7 with medical information. Yet how can you determine whether what you see, hear, or read is valid or bogus?

Even if you’re not a physician or someone trained in the medical sciences, there are some basic steps you can take to protect yourself against fraudulent medical information. First, check the source. Is it credible? Do you really think a pharmaceutical company will tell you that their product isn’t all that safe or that it’s significantly more expensive, yet no more efficacious, then a natural supplement that can be used for the same purpose?

Next, look at the report’s literature references to see if they seem legitimate and relevant. If the report doesn’t have any references, and especially if it makes grandiose claims (“Our product is guaranteed to cure cancer, diabetes, and impotence!”), then run, don’t walk, from that product and that manufacturer.

Finally, use your common sense: if the report claims something that sounds fishy, then it probably does stink.

Vitamin E Has Been Getting a Bum Rap

There has been a spate of negative reports lately concerning vitamin E, and that’s a shame.1 Not only do the reports contain skewed and misleading statistics, but they’re also being reported by the mainstream media as evidence that supplements are harmful. Yet there are dozens of scientifically valid studies (none of which were cited by the recent articles questioning the use of vitamin E) showing that supplemental vitamin E can be helpful in preventing some potentially deadly health problems, including cancer.


“We propose that . . . gamma-
tocopherol may contribute
significantly to human health in ways
that have not yet been recognized.”


The recent reports on vitamin E failed, e.g., to take into account the different forms of this important antioxidant. Vitamin E exists in eight chemically similar forms (four tocopherols and four tocotrienols), each of which is surely important in its own way. Alpha-tocopherol is the most potent form of vitamin E and has been the subject of more studies than any other, yet recent research has shown that gamma-tocopherol is also important, especially when it comes to preventing cancer, notably cancer of the prostate.*


*The prostate gland, a walnut-sized object located between the bladder and the rectum, secretes seminal fluid, which nourishes and carries the semen during orgasm. It also converts the male sex hormone testosterone into a more powerful form called dihydrotestosterone.


Prostate Cancer Is a Major Killer of Men

Over 200,000 men will be diagnosed with prostate cancer this year in the USA, and 37,000 will die from it. Certain common lifestyle choices, such as cigarette smoking and a diet high in fatty foods, are thought to contribute to the development and continued high prevalence of prostate cancer in this country.

Although prostate cancer can be cured if caught early, most cases are quite advanced by the time a diagnosis is made, because the disease has practically no symptoms in its early stages. In the later stages, symptoms such as frequent urination, pain or burning during urination, and blood in the urine can occur. By the time a man notices these problems, the cancer has probably spread beyond the prostate gland, making it much more difficult, if not impossible, to treat.

An Enlarged Prostate Does Not Necessarily Mean Prostate Cancer

Another problem posed by prostate cancer is that it’s often confused with benign prostatic hyperplasia, or BPH (the H can also stand for hypertrophy).* In BPH, the prostate, for reasons not yet known, starts to grow larger. As the name of the disorder implies, however, the enlargement is not malignant. This condition can start affecting men in their 40s, although it’s more commonly seen in men in their 50s or older. It becomes increasingly prevalent with age and is virtually universal in men in their 90s.


*Hyperplasia refers to an increase in the number of prostate cells; hypertrophy refers to an increase in the size of the existing cells. Whichever it is in a given case, the result is an abnormal enlargement of the prostate.


Although the symptoms of BPH are often similar to those of prostate cancer, most researchers believe that BPH and prostate cancer are not linked. In BPH, the inner cells of the prostate gland seem to be the ones that grow larger in number or size, whereas in prostate cancer, it appears that it’s the cells in the outer portion of the gland that start proliferating in an unregulated fashion.

Large-Scale Human Studies Show Benefits of Both Alpha and Gamma Forms

One of the first large-scale studies to show the impact that vitamin E can have on prostate cancer was the Finnish Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study, which involved 29,133 male smokers, aged 50–69.2 The study was originally designed to see if these compounds could help prevent lung cancer, but neither of them did. In analyzing the data, however, the researchers found that daily supplementation with 50 mg of alpha-tocopherol decreased the incidence of prostate cancer by 32% and reduced the mortality from that cancer by 41%.


“Our study . . . strongly supports
the notion that vitamin E forms
may be useful as anticancer agents.”


Although alpha-tocopherol has been the most widely studied form of vitamin E, other research has examined the importance of gamma-tocopherol in our diet. In one such study, by the renowned University of California at Berkeley biochemist Bruce Ames and his colleagues, the authors concluded:3

Results from recent epidemiologic studies suggest a potential protective effect of gamma-tocopherol against cardiovascular disease and prostate cancer. … We propose that although alpha-tocopherol is certainly a very important, if not the most important, component of vitamin E, gamma-tocopherol may contribute significantly to human health in ways that have not yet been recognized.

Does Estrogen Cause Prostate Cancer?

A growing number of doctors and researchers believe that estrogen and its metabolites (products of metabolic reactions), such as 16-alpha-hydroxyestrone, may be a significant factor in the development of prostate cancer. This idea is based in part on our knowledge of the ways in which the levels and activities of sex hormones change as we age. Testosterone levels are highest in young men, e.g., and prostate cancer is virtually never seen in their ranks. It’s only older men, who have lower levels of testosterone and higher levels of estrogen and its metabolites, for whom prostate cancer is a significant threat.

A recent article in the World Journal of Urology summed up the estrogen/prostate cancer question succinctly: “Estrogenic stimulation through estrogen receptor-alpha in a milieu of decreasing androgens [mainly testosterone] contributes significantly to the genesis of benign prostatic hyperplasia, prostate dysplasia, and prostate cancer.”1

[For more information on the role of estrogen in health and disease, see “Defeating Out-of-Control Cell Growth” (September 2000), “Achieving a Healthy Sex-Hormone Ratio” (October 2000), and “Fighting Prostate Cancer with Broccoli Compounds” (September 2003).]

  1. Steiner MS, Raghow S. Antiestrogens and selective estrogen receptor modulators reduce prostate cancer risk. World J Urol 2003;21(1):31-6.


Dr. Bruce Ames
Another study, conducted at The Johns Hopkins University School of Hygiene and Public Health, examined the association between different forms of vitamin E—including alpha-tocopherol and gamma-tocopherol—and the development of prostate cancer in 10,456 men.4 Blood levels of both alpha- and gamma-tocopherol were found to be lower in men who developed prostate cancer then in men who did not, leading the authors to conclude, “The risk of prostate cancer was lower among men with higher concentrations of alpha-tocopherol, gamma-tocopherol, and selenium.” (The mineral selenium is an important antioxidant in its own right and has been shown, in the form of the organic compound selenomethionine, to be a potent inhibitor of prostate cancer cells.5)

Laboratory Study Favors Gamma Over Alpha

Studies showing the power of vitamin E to help prevent prostate cancer continue to be published. An in vitro (“in glass,” meaning in the laboratory) study by Dr. Ames and his colleagues in 2004 examined the effects of gamma-tocopherol, both alone and in combination with other forms of vitamin E, in inducing cell death in human prostate cancer cells and lung cancer cells, using normal prostate epithelial cells as controls.6 They found that gamma-tocopherol alone and in combination with other forms of vitamin E inhibited the proliferation of the prostate cancer cells, while not affecting the growth or health of normal prostate epithelial cells.

The researchers also tested alpha-tocopherol alone and found that it did not inhibit growth or induce death in prostate cancer cells. However, combining gamma-tocopherol with alpha-tocopherol, beta-tocopherol, or gamma-tocotrienol caused synergistic effects in terms of prostate-cancer-cell inhibition. From these promising results, the authors concluded, “Our study, together with in vitro and epidemiological studies, strongly supports the notion that vitamin E forms may be useful as anticancer agents.”

ATBC Follow-Up Trial Shows Strong Effects with Alpha and Gamma

Recently, American and Finnish scientists conducted a follow-up study to the ATBC Study in order to assess the effectiveness not just of alpha-tocopherol but also of gamma-tocopherol in preventing prostate cancer.7 The researchers looked at the baseline serum concentrations of both alpha- and gamma-tocopherol in 100 of the men from the original study who had developed prostate cancer, and in 200 healthy control subjects.

The results showed that the men in the highest tertile (highest one-third of the group) with respect to circulating blood levels of alpha-tocopherol had a 51% lower risk for prostate cancer than the men in the lowest tertile. For gamma-tocopherol, the risk reduction was similarly large: 43%. The protective effect of vitamin E was strongest in those men who had supplemented with alpha-tocopherol during the original ATBC Study. Furthermore, there was no evidence that the use of alpha-tocopherol had diminished the effectiveness of gamma-tocopherol, as had been suggested by the results of some other studies; indeed, it may have done the opposite, in the authors’ judgment.

Alpha or Gamma—Which Is Better?

Astute reader that you are, you may now be saying to yourself, “Wait a minute—on the one hand, we see evidence that both alpha-tocopherol and gamma-tocopherol are useful for preventing prostate cancer, but on the other hand, there’s evidence suggesting that only gamma-tocopherol may be useful in treating prostate cancer. What gives?”

What gives is the scientific process. The truth is that, right now, we can be reasonably certain that vitamin E does, in fact, help prevent prostate cancer. The follow-up to the ATBC Study showed that both the alpha and gamma forms of tocopherol cut the risk for prostate cancer roughly in half. By contrast, the 2004 paper coauthored by Dr. Ames (an in vitro study) shows inhibition of cancer-cell proliferation by gamma-tocopherol but not by alpha-tocopherol.

Overall, Gamma Is Probably Better

Thus, superficially, at least, it appears that alpha-tocopherol may be effective for prevention but not therapy, whereas gamma-tocopherol may be effective for both. Or not—it all depends on the weight one gives to the various lines of evidence, and that depends in part on the different kinds of evidence in question. As a rule, greater weight should be given to clinical results—assuming they come from a solid, gold-standard study—than to in vitro results, which can sometimes be highly misleading. Nonetheless, any conclusions drawn by such a distinguished scientist as Bruce Ames must be taken very seriously.

So what’s the bottom line? While the overall weight of evidence now seems to favor gamma-tocopherol over alpha-tocopherol with regard to prostate cancer, there is certainly enough evidence to suggest that both forms of vitamin E are useful in maintaining good health and preventing prostate cancer.

To See the Big Picture, Look at All Sides

Despite recent media reports that supplemental vitamin E may be harmful to your health, there is much evidence to the contrary. Dozens of scientific studies have demonstrated the value of vitamin E for maintaining good health, and the research reviewed in this article suggests strongly that supplemental vitamin E can help protect men against prostate cancer. Our health is our most precious asset, and it behooves each of us to look carefully at all sides of every issue.

References

  1. Miller ER, Pastor-Barriuso R, Dalal D, et al. Meta-analysis: high-dose vitamin E supplementation may increase all-cause mortality. Ann Int Med 2005;142(1):1-11.
  2. Heinonen OP, Albanes D, Virtamo J, et al. Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. J Natl Cancer Inst 1998;90(6):440-6.
  3. Jiang Q, Christen S, Shigenaga MK, Ames BN. Gamma-tocopherol, the major form of vitamin E in the US diet, deserves more attention. Am J Clin Nutr 2001;74:714-22.
  4. Helzlsouer KJ, Huang HY, Alberg AJ, et al. Association between alpha-tocopherol, gamma-tocopherol, selenium, and subsequent prostate cancer. J Natl Cancer Inst 2000;92(24):2018-23.
  5. Redman C. Inhibitory effect of selenomethionine on the growth of three selected human tumor cell lines. Cancer Lett 1998;125(1-2):103-10.
  6. Jiang Q, Wong J, Fyrst H, Saba JD, Ames BN. Gamma-tocopherol or combinations of vitamin E forms induce cell death in human prostate cancer cells by interrupting sphingolipid synthesis. PNAS 2004;101(51):17825-30.
  7. Weinstein SJ, Wright ME, Pietinen P, King I, Tan C, Taylor PR, Virtamo J, Albanes D. Serum alpha-tocopherol and gamma-tocopherol in relation to prostate cancer risk in a prospective study. J Natl Cancer Inst 2005;97(5):396-8.


Dr. Rosick is an attending physician and clinical assistant professor of medicine at Pennsylvania State University, where he specializes in preventive and alternative medicine. He also holds a master’s degree in healthcare administration.

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