Purpose of review
The number one cause of death in the United States and in most countries around the world is cardiovascular disease. The number one or two cause of death in prostate cancer patients is also cardiovascular disease. These observations do not serve to belittle the impact of prostate cancer, but serve as a reminder that the ultimate goal of dietary supplement recommendations is to reduce the burden of both of these major causes of death, especially after definitive prostate therapy. Several supplements should be discussed with a patient following definitive prostate cancer therapy.
On the basis of observational studies, a general cheap multivitamin that provides the recommended daily values of folic acid, B6, B12 and vitamin D may reduce the risk of a variety of chronic diseases. Selenium supplements at 200 μg/day should be reserved only for men with a deficient level of plasma selenium, but healthy dietary sources should be recommended for most men. Low-dose vitamin E supplements may be adequate for current or recent smokers but not non-smokers. All men should be encouraged to consume healthy dietary sources of vitamin E, regardless of smoking status. Low-dose daily aspirin may be the best over the counter product to utilize as a preventive agent; this statement is made on the basis of the numerous clinical studies that support its use for individuals that qualify after consulting with their physician or a specialist to evaluate current cardiovascular risk. In addition, fish oil supplements have gained acceptance as a possible therapy in high-risk cardiovascular patients.
The potential future role in prostate cancer should be of interest, and preliminary data is noteworthy. Regardless, all of these supplements have indirect evidence for effects in prostate cancer, but it seems that only a minority of men overall qualify for them currently, with the exception of a low-dose aspirin or multivitamin.