Cancer prevention: one man’s opinion

In an editorial commentary on OncologySTAT, Schwartzenberg discusses where we stand on the issue of vitamins, micronutrients, and cancer prevention in general after the negative result of the SELECT trial, but his views are also applicable to prostate cancer in particular.

After briefly reviewing the results of other, earlier cancer prevention studies, including data from the Physicians Health Study and the Women’s Health Study in the USA, Dr. Schwartzenberg argues that the theory behind the SELECT trial was reasonable. He notes that the mechanisms were in place to carry out the trial with relative ease. And he also offers a whole series of possible reasons for the negative result of this trial.

Perhaps most importantly, he goes on to comment on four potential lessons to be learned from the result of this and prior prevention trials. We quote these potential lessons in their entirety:

  • “[W]e should not be so arrogant as to believe we know the answers before doing the studies.”
  • “[W]hile vitamins and other micronutrients are critically important for maintaining good health, it does not necessarily follow that use of supplements by nutritionally repleted individuals has beneficial effects on either cancer or cardiovascular disease.”
  • “[D]espite compelling in vitro evidence, an intervention may simply not work in vivo.”
  • “[I]n view of our admittedly incomplete knowledge at this point, the best advice may be what we learned at our mother’s knee: Eat your fruits and vegetables! This may be the most effective way to derive benefit from antioxidants.”

It is enticing to believe in simple solutions to what are often complex problems. For decades now, starting with Linus Pauling, people have attempted to provide data to support hypotheses that supplemental doses of vitamins and micronutrients at various strengths could significantly impact everything from the common cold to cancer. The actual data from prospective, well-structured, randomized, controlled clinical trials, however, have consistently failed to provide evidence for any of these theories using any vitamin or micronutrient.

Dr. Schwartzenberg’s “lessons” cut to the heart of this issue.

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