Abstract
The quest for dietary patterns and supplements efficient in down-regulating prostate-specific antigen (PSA) concentrations among men with prostate cancer (PCa) or increased PCa risk has been long. Several antioxidants, including lycopene, selenium, curcumin, coenzyme Q10, phytoestrogens (including isoflavones and flavonoids), green tea catechins, cernitin, vitamins (C, E, D) and multivitamins, medicinal mushrooms (Ganoderma lucidum), fruit extracts (saw palmetto, cranberries, pomegranate), walnuts and fatty acids, as well as combined supplementations of all, have been examined in randomized controlled trials (RCTs) in humans, on the primary, secondary, and tertiary PCa prevention level. Despite the plethora of trials and the variety of examined interventions, the evidence supporting the efficacy of most dietary factors appears inadequate to recommend their use.
Highlights
Prostate-specific antigen (PSA) consists of a glycoprotein excreted by both healthy and cancerous cells, with the latter indicating an increased risk for prostate cancer (PCa)
At 6 mo, a reduction in prostate-specific antigen (PSA) was noted in both arms, but at 2 yrs, it was higher in the lycopene arm
When patients with high-grade prostatic intraepithelial neoplasia (HGPIN) and/or atypical small acinar proliferation (ASAP) were recruited (Table 5), daily green tea catechins (GTCs) supplementation for a year decreased serum PSA concentrations compared with placebo, in two trials [110,112], but failed to induce any notable change according to one randomized controlled trials (RCTs) [111]
Summary
Prostate-specific antigen (PSA) consists of a glycoprotein excreted by both healthy and cancerous cells, with the latter indicating an increased risk for prostate cancer (PCa). Since the antigen is not PCa-specific and can be affected by various factors, caution is required before relying on its diagnostic accuracy It has been suggested than one in seven men undergoing PSA screening will demonstrate increased concentrations [2,7,8]. Research has shown that both BPH and PCa patients often resort to dietary manipulations, complementary and alternative medicine (CAM), and/or nutritional supplements to lower PCa risk, through the reduction of PSA concentrations [20,21,22,23]. PCa and/or BPH is scattered [24] To fill this gap, the present review aimed to gather all evidence on the effects of diet and dietary supplements on PSA concentrations among men with PCa and BPH, to aid the formulation of recommendations regarding their use. Evidence from the higher steps of the evidence-based pyramid, being randomized controlled trials (RCTs) and meta-analyses were deployed to evaluate the effectiveness of nutritional factors in down-regulating PSA concentrations
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