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  • Review Article
  • Published:

Future directions in the prevention of prostate cancer

Nature Reviews Clinical Oncology volume 11, pages 49–60 (2014)Cite this article

Subjects

Key Points

  • Chemoprevention has been increasingly explored to mitigate the global burden of prostate cancer and the overtreatment of indolent disease that has arisen in the prostate-specific antigen (PSA) screening era

  • Preclinical and epidemiological evidence suggested that selenium and α-tocopherol (vitamin E) might reduce the risk of prostate cancer

  • A large trial found vitamin E to significantly increase the risk of prostate cancer and selenium to have no effect on risk

  • The strongest evidence supports the use of 5α-reductase inhibitors for prostate cancer prevention, with recent data showing that the risk reduction with these agents is 30%

Abstract

The high global incidence of prostate cancer has led to a focus on chemoprevention strategies to reduce the public health impact of the disease. Early studies indicating that selenium and vitamin E might protect against prostate cancer encouraged large-scale studies that produced mixed clinical results. Next-generation prostate cancer prevention trials validated the impact of 5α-reductase inhibitors in hormone-responsive prostate cancer, and these results were confirmed in follow-up studies. Other interventions on the horizon, involving both dietary and pharmacological agents, hold some promise but require further investigation to validate their efficacy. In this Review, we discuss the clinical and preclinical evidence for dietary and pharmacological prevention of prostate cancer and give an overview of future opportunities for chemoprevention.

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Figure 1: Prostate cancer progression.

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Acknowledgements

The authors are supported by grants from the NCI (R01CA96994, P30CA054174 and UO1CA86402).

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  1. Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, Mail Code 8026, 7979 Wurzbach, Suite 627, Zeller Building, San Antonio, 78229, TX, USA

    Ian M. Thompson Jr, April B. Cabang & Michael J. Wargovich

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All the authors researched data for the article, made a substantial contribution to the discussion of its content, wrote the manuscript and edited it prior to submission.

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Thompson, I., Cabang, A. & Wargovich, M. Future directions in the prevention of prostate cancer. Nat Rev Clin Oncol 11, 49–60 (2014). https://doi.org/10.1038/nrclinonc.2013.211

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