Adequate screening has proven extremely effective in catching this slow-growing cancer in its earliest stages when treatment is theoretically most likely to improve survival.
While prostate cancer detection and treatment aren’t perfect, knowledge and technology have given physicians a new sense of confidence that thousands of deaths can potentially be avoided. Most health groups recommend annual digital rectal exams and PSA blood tests beginning at age 50, but earlier for African-Americans and others who have a family history of the disease. For a long time, doctors have sounded the alarm about the importance of screening, but now they’re including prevention, conducting the largest-ever prostate-cancer-prevention clinical trial in history.
The name of the trial is SELECT, and it’s looking to enroll 32,000 men of all ethnicities from the United States, Canada and Puerto Rico. The study will try to answer a simple question: can selenium and vitamin E be effective in preventing prostate cancer in men? Researchers are looking at these two nutrients because they are antioxidants, which means they’re able to neutralize dangerous toxins known as “free radicals” that might otherwise damage the genetic material contained within cells and possibly lead to cancer. Another reason is because during two large studies that were looking at preventing skin and lung cancer, it was found incidentally that there was a reduction in prostate cancer.
The design of the SELECT study is quite simple. Men are given two unmarked pills to take daily. The pills can be selenium and vitamin E, two placebos or a combination of placebo and vitamin E or placebo and selenium. Volunteers also have the option of taking a multivitamin that contains neither selenium nor vitamin E. Men who join the trial will not need to change their diet in any way, but they must stop taking those supplements that might contain vitamin E or selenium, as those are the nutrients under study.
The trial started enrolling participants more than a year ago, and according to Dr. Elise Cook, a physician and director of minority recruitment at the M.D. Anderson Cancer Center in Houston, patients are signing up much faster than researchers had anticipated. They expected to enroll men over a five-year period, but it might only take three or four years if the study continues to fill up as rapidly as it has over the past. “One of the major concerns is getting enough African-American men in the study,” Cook says. “Right now, approximately 11 percent of the volunteers are African-Americans, but we’d like 20 percent.”
This 20 percent target isn’t just a number that researchers pulled from the sky. This number, in fact, accurately reflects the proportion of prostate cancer patients who are also African-American. In fact, African-Americans have the highest incidence (that is, new cases per a sample size of the population) of prostate cancer in the world, for reasons that still are unclear but currently under study. Getting more African-Americans involved is important as researchers want to make sure the results are reflective of the entire disease population and not just a part of it.
Cook stresses that the trial is still open and there are more than 400 sites in North America where men of all ethnicities can still enroll. There are, however, criteria that must be met before you can enroll: 1) you must be age 55 or older, but 50 or older if you’re African-American; 2) have never had prostate cancer and have not had any other cancer, except nonmelanoma skin cancer in the last five years; 3) are in general good health. This trial will take several years before researchers have collected enough data to determine if vitamin E or selenium have any preventive effects against prostate cancer, but even if researchers find there aren’t any cancer-preventing benefits, there’s still no harm in adding these important antioxidants to your diet. They can be found in vegetable oils, nuts, dark green leafy vegetables, dried beans, whole grains, organ meats (e.g., liver and kidney), seafood, eggs and avocados.
To find out more about the SELECT trial and the participating centers where you might register, in the United States and Puerto Rico, call the National Cancer Institute’s Cancer Information Service at 800-422-6237. The number for callers with TTY equipment is 800-332-8615. In Canada, call the Canadian Cancer Society’s Cancer Information Service at 888-939-3333. If you have access to the Internet, check out http://cancer.gov/select.
