October 2019
PCRI's Executive Director, Mark Scholz, MD, gives a survey of the supplements most relevant to prostate cancer and aging men in general.
1:05 Vitamin D and vitamin B12 levels are somewhat commonly low in middle-aged and aging men (around 10-20% of men in Southern California and perhaps more in places with less sun exposure). The effects of low vitamin D or B12 levels develop slowly and subtly and can include tiredness, nerve problems, memory problems, and issues with the bones. A physician can check vitamin D and B12 levels, and if either of these levels are low, then men should take supplements to restore levels to a normal range. Some men like to take these supplements even if their levels are in the normal range, but there is no benefit.
2:11 Men who are on hormonal therapy for prostate cancer rapidly lose calcium from their bones. Therefore, they should be taking vitamin D, perhaps a pharmaceutical agent like Prolia or Boniva, and small doses of calcium (perhaps 500 milligrams) at bedtime. Bone metabolism occurs during sleep, so it is important to take calcium before bedtime.
2:55 Large amounts of calcium and other minerals (e.g. copper, selenium, zinc) have been shown to stimulate cancer cell growth for the same reasons that they stimulate healthy cell growth. Some men believe that these supplements will strengthen the immune system, but the problem with cancer is not a weak immune system, but rather an immune system that is unable to detect that anything is wrong
4:12 Statins are commonly prescribed to reduce the risk of heart attacks and strokes, and they also appear to have an inhibitory effect on prostate cancer. They can, however, deplete Coenzyme Q10 levels, and so men taking statins should be supplementing their diets with 50-200 milligrams of Coenzyme Q10 to restore normal levels for as long as they are taking statins.
4:47 Some men take Tumeric and Zyflamend to reduce their PSAs. However, the reduction of PSA that they achieve is less likely to be related to cancer and more likely related to their anti-inflammatory properties since many men in this age range harbor chronic inflammation in their prostates. This same effect can be achieved with other anti-inflammatories like Advil, Aleve, and Celebrex.
5:42 Some men take Arginine to restore erectile function. It is not typically recommended since pharmaceutical agents (e.g. Levitra, Viagra, and Cialis) are so effective; however, Arginine is cheaper and it does seem to work for some men.
6:03 Some men take supplements like saw palmetto and stinging nettle to alleviate the symptoms of an enlarged prostate (also known as Benign Prostatic Hypertrophy or BPH) and these supplements do seem to have an effect in some men, but less so than the pharmaceutical agents that are more commonly used by physicians.
6:37 Multivitamins have the same issue with mineral supplements in that they can stimulate prostate cancer growth by providing substrates that the cancer cells need to reproduce. If a man does not have vitamin deficiencies, then routine multivitamins are not recommended.
7:03 Supplements are similar to pharmaceutical agents in that they should have a specific, directed purpose. You should use them one at a time, closely monitor your progress for 30-60 days, and evaluate your progress at the end of that period. Physicians tend to prefer pharmaceutical agents since supplements have mild effects; however, they also have mild side effects and it is reasonable to experiment with supplements if you are closely monitoring your progress.
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