title: Heart healthy equals prostate healthy and statins, aspirin, and/or metformin (S.A.M.) are the ideal recommendations for prostate cancer prevention.
abstract: Cardiovascular disease (CVD) has been the number one cause of death in the U.S. for 114 of the last 115 years. Lifestyle factors that promote CVD also appear to increase prostate cancer risk and those that reduce CVD risk also appear to reduce the risk of prostate cancer. The largest randomized trials utilizing dietary supplements or pharmacologic agents for prostate cancer prevention (Selenium and Vitamin E Cancer Prevention Trial [SELECT]) have also shed light on the problems and future solutions in this area. Dietary supplements that have not been found to be CVD protective, such as selenium and Vitamin E have not been found to be prostate protective. In addition, over exposure to specific anti-oxidants in nutritionally replete populations may be encouraging cancer growth. Future trials of dietary supplements to prevent prostate cancer could be problematic because by the time a definitive trial is initiated the participants will no longer be "deficient" in the nutrient being tested, which arguably occurred in the SELECT trial. It is also interesting that statins, aspirin, and/or metformin (S.A.M.) are 3 generic, low-cost, heart healthy agents derived from natural sources with separate mechanism of actions, which all appear to have the best benefit to risk ratio compared to any other agent available for prostate cancer prevention, especially aggressive disease, or as an ancillary agent (s) to conventional cancer treatment. It is time to focus on the forest over the trees and recommend proven CVD protective measures for men concerned about their risk of prostate cancer.
authors: Department of Urology, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
authors: Mark A
authors: MA
authors: Moyad
authors: Nicholas J
authors: NJ
authors: Vogelzang
mesh_terms: D001241:Aspirin / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011471:Prostatic Neoplasms / Q000517:prevention & control*; D014481:United States
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D010975:Platelet Aggregation Inhibitors; D008687:Metformin; D001241:Aspirin
references: Ann Oncol. 2012 Jun;23(6):1403-15
references: 22517822
references: Cancer Epidemiol Biomarkers Prev. 2009 Aug;18(8):2202-6
references: 19661078
references: Pharmacotherapy. 2010 Mar;30(3):254-64
references: 20180609
references: Urol Clin North Am. 2011 Aug;38(3):243-59
references: 21798387
references: JAMA. 2008 Nov 12;300(18):2123-33
references: 18997197
references: JAMA. 2006 Nov 15;296(19):2343-50
references: 17105797
references: Sports Med. 2004;34(6):363-9
references: 15157121
references: Ann Intern Med. 2005 Apr 19;142(8):611-9
references: 15838067
references: Cancer Causes Control. 2010 Aug;21(8):1297-303
references: 20383574
references: MMWR Morb Mortal Wkly Rep. 2012 Nov 9;61(44):889-94
references: 23134971
references: Circulation. 2004 Jun 29;109(25):3244-55
references: 15198946
references: Arch Intern Med. 2008 Feb 25;168(4):404-10
references: 18299496
references: Ann Intern Med. 2012 Nov 6;157(9):601-10
references: 23128859
references: Circulation. 2010 Feb 23;121(7):948-54
references: 20177011
references: J Clin Oncol. 2011 Feb 1;29(4):355-61
references: 21041707
references: Cancer Prev Res (Phila). 2011 Apr;4(4):544-51
references: 21325564
references: Diabetes Technol Ther. 2012 Jun;14 Suppl 1:S51-8
references: 22650225
references: Urol Clin North Am. 2011 Aug;38(3):325-31
references: 21798395
references: MMWR Morb Mortal Wkly Rep. 2012 Sep 7;61:697-702
references: 22951451
references: Am J Clin Nutr. 1999 Sep;70(3 Suppl):532S-538S
references: 10479227
references: JAMA. 2009 Jan 7;301(1):52-62
references: 19066368
references: N Engl J Med. 2010 Apr 1;362(13):1192-202
references: 20357281
references: Ann Intern Med. 2003 Jan 7;138(1):24-32
references: 12513041
references: Br J Surg. 2012 May;99(5):693-8
references: 22302466
references: J Natl Cancer Inst. 2003 Jul 2;95(13):1004-7
references: 12837837
references: JAMA. 2005 Dec 21;294(23):2996-3002
references: 16414947
references: Br J Cancer. 2004 Jan 12;90(1):93-9
references: 14710213
references: Lancet. 2011 Jan 1;377(9759):31-41
references: 21144578
references: BJU Int. 2010 Feb;105(4):456-9
references: 19930174
references: N Engl J Med. 1994 Apr 14;330(15):1029-35
references: 8127329
references: Ann Oncol. 2011 Dec;22(12):2556-60
references: 21421541
references: Cancer Epidemiol Biomarkers Prev. 2009 Nov;18(11):2807-13
references: 19887582
references: Urol Oncol. 2004 Nov-Dec;22(6):466-71
references: 15610863
references: JAMA. 2012 Oct 3;308(13):1333-9
references: 23032549
references: JAMA. 2012 Nov 7;308(17):1751-60
references: 23117775
references: Am J Clin Nutr. 2006 Jul;84(1):18-28
references: 16825677
references: N Engl J Med. 2009 Mar 26;360(13):1310-9
references: 19297565
references: MMWR Morb Mortal Wkly Rep. 2011 Feb 4;60(4):103-8
references: 21293325
references: N Engl J Med. 2011 Jul 14;365(2):97-9
references: 21675880
references: N Engl J Med. 2003 Jul 17;349(3):297-9
references: 12824458
references: Int J Chron Obstruct Pulmon Dis. 2011;6:259-67
references: 21814462
references: Arch Intern Med. 2010 Oct 11;170(18):1622-31
references: 20937919
references: Nutr Rev. 2012 Aug;70(8):472-81
references: 22835140
references: Circulation. 2012 Jan 3;125(1):e2-e220
references: 22179539
references: Cancer Causes Control. 2005 Aug;16(6):643-50
references: 16049802
references: BMJ. 2012;344:e2697
references: 22531797
references: JAMA. 2005 Mar 16;293(11):1338-47
references: 15769967
references: BMJ Open. 2012 Jan 12;2(1):e000653
references: 22240654
references: Cancer Epidemiol Biomarkers Prev. 2012 Apr;21(4):576-81
references: 22315364
references: Urol Clin North Am. 2012 Feb;39(1):89-107
references: 22118348
references: World J Urol. 2012 Apr;30(2):167-79
references: 22198724
references: Natl Health Stat Report. 2009 Jul 30;(18):1-14
references: 19771719
references: JAMA. 2003 Jul 23;290(4):476-85
references: 12876090
references: Ann Intern Med. 2011 Dec 20;155(12):827-38
references: 22184690
references: Med Princ Pract. 2011;20(2):103-11
references: 21252562
references: Arch Intern Med. 2012 Sep 24;172(17):1306-12
references: 22868691
references: Rejuvenation Res. 2012 Apr;15(2):184-8
references: 22533429
references: J Natl Cancer Inst. 2009 Sep 16;101(18):1272-9
references: 19700655
references: Osteoporos Int. 2012 Feb;23(2):675-86
references: 21625888
references: Nat Rev Urol. 2012 Feb 09;9(2):59
references: 22318289
references: Ann Intern Med. 2007 Aug 21;147(4):217-23
references: 17620655
references: J Clin Oncol. 2010 Sep 10;28(26):4081-5
references: 20697066
references: Asian J Androl. 2012 Nov;14(6):830-41
references: 23001440
references: Circulation. 2011 Feb 1;123(4):e18-e209
references: 21160056
references: Urol Clin North Am. 2011 Aug;38(3):359-67
references: 21798398
references: Ann Intern Med. 2005 Feb 15;142(4):233-9
references: 15710956
references: Cancer Prev Res (Phila). 2011 Apr;4(4):486-501
references: 21233290
references: Am J Clin Nutr. 2008 Apr;87(4):1087S-91S
references: 18400739
references: Maturitas. 2009 Oct 20;64(2):67-79
references: 19720479
references: Cancer Epidemiol Biomarkers Prev. 2002 Jul;11(7):630-9
references: 12101110
references: BJU Int. 2008 Mar;101 Suppl 3:17-21
references: 18307681
references: Cardiorenal Med. 2011;1(2):87-95
references: 22294985
references: Eur Urol. 2012 Mar;61(3):560-70
references: 22119157
references: J Am Coll Nutr. 2009 Aug;28 Suppl:500S-516S
references: 20234038
references: Arch Intern Med. 2004 Nov 22;164(21):2335-42
references: 15557412
references: Cancer Epidemiol Biomarkers Prev. 2011 Jun;20(6):1089-97
references: 21467238
references: J Natl Cancer Inst. 2007 May 16;99(10):754-64
references: 17505071
references: Eur Urol. 2012 Mar;61(3):623-4
references: 22289976
references: Clin Med Res. 2012 Aug;10(3):97-105
references: 22537761
references: Prostate Cancer Prostatic Dis. 2012 Dec;15(4):346-52
references: 22614062
references: Asia Pac J Public Health. 2003;15 Suppl:S3-9
references: 18924533
references: Public Health. 2011 Dec;125(12):821-31
references: 22019360
references: JAMA. 2011 Jun 22;305(24):2548-55
references: 21693743
references: Am J Public Health. 2010 Apr;100(4):693-701
references: 19608952
references: JAMA. 2011 Oct 12;306(14):1549-56
references: 21990298
references: J Natl Cancer Inst. 2003 Oct 1;95(19):1477-81
references: 14519754
references: Arch Intern Med. 2004 Jul 26;164(14):1552-6
references: 15277288
references: Sports Med. 1997 May;23(5):271-8
references: 9181665
references: Arch Intern Med. 2008 Feb 11;168(3):284-90
references: 18268169
references: J Clin Oncol. 2011 Feb 20;29(6):726-32
references: 21205749
references: N Engl J Med. 2010 Apr 1;362(13):1237-8
references: 20357287
references: BJU Int. 2012 May;109(10):1495-502
references: 21933330
references: Ann Intern Med. 2005 Jan 4;142(1):37-46
references: 15537682
references: JAMA. 2010 May 12;303(18):1815-22
references: 20460620
references: Endocr Relat Cancer. 2012 Oct;19(5):F47-62
references: 22514110
references: N Engl J Med. 2003 Jul 17;349(3):215-24
references: 12824459
references: BMJ Open. 2012 May 11;2(3):null
references: 22581797
references: Curr Opin Lipidol. 2008 Feb;19(1):43-9
references: 18196986
references: Cancer Sci. 2010 May;101(5):1073-9
references: 20345478
references: Urol Oncol. 2004 Nov-Dec;22(6):472-7
references: 15610864
references: JAMA. 2012 Nov 14;308(18):1871-80
references: 23162860
references: Int J Clin Pract. 2010 Mar;64(4):465-74
references: 20456193
references: J Korean Med Sci. 2012 Sep;27(9):1079-84
references: 22969256
references: Eur J Nutr. 2013 Mar;52(2):513-25
references: 22538929
references: Cancer Epidemiol Biomarkers Prev. 2010 Jun;19(6):1632-42
references: 20501771
references: Curr Opin Urol. 2013 Jan;23(1):2-4
references: 23159990
references: JAMA. 1996 Dec 25;276(24):1957-63
references: 8971064
references: Urol Nurs. 2003 Dec;23(6):439-41
references: 14725161
references: Curr Vasc Pharmacol. 2010 May;8(3):327-37
references: 19485923
references: Am J Epidemiol. 2008 Apr 15;167(8):925-34
references: 18263602
references: JAMA. 2011 Apr 6;305(13):1348-9
references: 21467288
references: J Plant Physiol. 2005 Jul;162(7):790-6
references: 16008106
references: Cancer. 2008 Mar 1;112(5):1058-65
references: 18186497
references: N Engl J Med. 2002 Feb 7;346(6):393-403
references: 11832527
references: Circulation. 2010 Jan 5;121(1):143-50
references: 20026779
references: JAMA. 2012 Nov 7;308(17):1725-6
references: 23117755
references: JAMA. 2012 Mar 28;307(12):1273-83
references: 22427615
references: MMWR Morb Mortal Wkly Rep. 2012 Nov 16;61(45):918-21
references: 23151951
references: JAMA. 2012 Sep 12;308(10):1024-33
references: 22968891
references: Br J Cancer. 2012 Jun 26;107(1):207-14
references: 22722313
references: JAMA. 2005 Jul 6;294(1):56-65
references: 15998891
references: Eur J Cancer. 2010 Sep;46(13):2369-80
references: 20656475
references: Cancer Causes Control. 2009 Dec;20(10):1799-810
references: 19562492
references: Nat Clin Pract Urol. 2008 Jul;5(7):376-87
references: 18542103
references: BioDrugs. 2006;20(5):271-3
references: 17025373
references: J Cardiovasc Risk. 1996 Feb;3(1):42-7
references: 8783029
references: J Obes. 2012;2012:107989
references: 22655173
references: N Engl J Med. 2008 Nov 20;359(21):2195-207
references: 18997196
references: Lancet. 2000 Dec 9;356(9246):1955-64
references: 11130523
references: JAMA. 2009 Jan 7;301(1):39-51
references: 19066370
references: Int J Cancer. 2005 Aug 20;116(2):182-6
references: 15800922
references: Lancet. 2012 Jun 16;379(9833):2243-51
references: 22683134
references: Can J Urol. 2011 Oct;18(5):5875-83
references: 22018148
references: Urology. 2012 Jun;79(6):1197-205
references: 22446342
references: Immun Ageing. 2012 Apr 23;9(1):10
references: 22524271
references: Lancet. 2009 Nov 14;374(9702):1677-86
references: 19878986
references: Lancet. 2012 Mar 31;379(9822):1256-68
references: 22381456
references: JAMA. 2004 Sep 22;292(12):1433-9
references: 15383513
references: Ann Oncol. 2012 Jul;23(7):1665-71
references: 22228452
references: BMJ Open. 2012 Jul 13;2(4):null
references: 22798258
references: BJU Int. 2003 May;91(7):608-12
references: 12699469
references: Nihon Koshu Eisei Zasshi. 2007 Oct;54(10):695-703
references: 18041227
references: Am J Epidemiol. 2006 Apr 15;163(8):694-9
references: 16495471
references: Asian J Androl. 2012 Mar;14(2):243-4
references: 22198632
references: Am J Clin Nutr. 2010 Oct;92(4):841-8
references: 20720256
references: Circulation. 2002 Sep 24;106(13):1602-5
references: 12270848