The information provided in this article is for the sole purpose of providing educationin and is not intended to diagnose, treat, cure or mitigate any disease. If you have a medical condition, please consult a health professional.

Monday

Association between fish oil (Omega-3 fatty acids) and prostate cancer

Prostate Cancer is a type of cancer that develops in the  prostate gland of the male reproductive system  (ACS, 2010) .  The occurrence of prostate cancer varies  widely across the world, suggesting that a major role is played by lifestyles  and dietary factors. Areas such as Europe and the United States experience more  frequent cases, while other areas such as South and East Asia have less  frequent cases. Prostate cancer commonly occurs in men over 50 years (ACS, 2010) .  Scientists have not been able to have a complete understanding of the causes of  prostate cancer. However the primary risk factors have been established to be  age, family history and obesity (ACS, 2010) .

A study was conducted by Brasky et al. to investigate the  role of serum phospholipid fatty acids and prostate cancer risk ( 2011) .  The study was based on the knowledge that inflammation may play a major role in  the development and progression of cancer. The study therefore, examined the  association between inflammation that is related to phospholipid fatty acids  and the prevalence of prostate cancer in a nested case-control analysis of  participants (Brasky, Till, White, &  Neuhouser, 2011) . The  findings of the study established no association between low-grade prostate  cancer risk and fatty acids. However, docosahexaenoic acid was found to be  positvely associated with high grade disease  (Brasky, Till, White, & Neuhouser, 2011) .  These findings suggested a complex relationship between fatty acids and  prostate cancer risk (Brasky, Till, White, &  Neuhouser, 2011) .

Recent studies have indicated that there might be an  association between fish oil and the development of prostate cancer. Fish oil  oils are made up of the omega-3 fatty acids; eicosapentaenoic acid (EPA), and  docosahexaenoic acid (DHA) (Swansom, Block,  & Mouse, 2012) . A  number of studies have associated EPA and DHA to various health benefits,  including anti-cancer effects. Various studies have reported conflicting  accounts on whether fish oil has positive effect, negative effect or no effect  on the development of prostate cancer (Swansom,  Block, & Mouse, 2012) .   Laboratory investigations have indicated  that n-3 fatty acids inhibit and n-6 fatty acids stimulate prostate tumor  growth, but it still remains unclear if the dietary intake of these fatty acids  affects the risk of prostate cancer in human beings (Leitzmann, et al., 2004)  However, not all epidemiologic  studies  support these findings (Chavarro, Stampfer, Li, Campos, Kurth, & Ma, 2007).
prostate cancer
prostate cancer

A comprehensive assessment of the association between  fish consumption and prostate cancer was conducted by Szmanski et al (2010) .  The study analyzed the association of fish intake and prostate cancer by  focusing on the incidence of the prostate cancer and prostate-cancer-specific  mortality, and included a subgroup analyses that was based on race, fish type,  method of fish preparation, and occurrence of high-grade and high-stage cancer (Szmanski, Wheeler, & Mucci, 2010) .  The analysis did not establish any association between fish consumption and any  subsequent significant reduction in the incidence of prostate cancer (Szymanski, Wheeler, & Mucci, 2010) .   The researchers were unable to perform a  meta-analysis for the high grade prostate cancer disease.  The study however established an association between  fish consumption and significant (63%) reduction in prostate cancer-specific  mortality (Szymanski, Wheeler, & Mucci,  2010) .  It was concluded that that, even though there was no strong evidence to show a  protective association between fish consumption and prostate cancer incidence,  fish consumption was linked to a significant reduction in prostate  cancer-specific mortality (Szymanski, Wheeler,  & Mucci, 2010) .

A study conducted by Leitzmann et al. prospectively  evaluated the association between the intake of alpha-linolenic (ALA; 18:3n-3),  eicosapentaenoic (EPA; 20:5n-3), docosahexaenoic (DHA; 22; 6n-3), linoleic (LA;  18:2n-6), and arachidonic (AA; 20:4n-6) acids and the risk of developing  prostate cancer (2004) .  The researchers studied 2965 total cases of prostate cancer in the follow-up,  and up to 448 of these were identified to be advanced cases of prostate cancer (Leitzmann, et al., 2004) .  The intake of ALA was not found to be associated with the risk of prostate  cancer. In contrast, however, multivariate relative risks of 2.02 (95% CI:  1.35, 3.03) and 1.53 (0.88, 2.66, p=ns) were established when extreme quintiles  of ALA from non-animal sources and ALA from meat and dairy sources,  respectively (Leitzmann, et al., 2004) .  The study did not find any association between the intake of linoleic and  arachidonic acid, and the risk of prostate cancer (Leitzmann, et al., 2004) .   The researchers concluded that an increased  dietary intake of ALA may result into an increased risk of the advanced form of  prostate cancer. However, the intake of EPA and DHA may result in a reduced  risk of total and advanced prostate cancer  (Leitzmann, et al., 2004) .
 
A prospective study was conducted by Chavarro et al. to examine  the association between polyunsaturated fatty acid levels in blood and the risk  of prostate cancer (2007) .  Blood samples drawn from 14,916 healthy men  were used as control during the study. The blood fatty acid level was then  evaluated in 476 men diagnosed with prostate cancer during a 13-year follow-up  period, and matched with the controls (Chavarro,  Stampfer, Li, Campos, Kurth, & Ma, 2007) .  An analysis conducted using conditional logistic regression showed that the  whole blood levels of all long-chain n-3 fatty acids and of linoleic acid were  inversely related to the overall risk of prostate cancer (Chavarro, Stampfer, Li, Campos, Kurth, & Ma, 2007) .  The blood levels of gamma-linolenic and dihomo-gamma-linolenic acids and fatty  acids, which are associated with linoleic acid metabolism, were directly  associated with an increased risk of prostate cancer (Chavarro, Stampfer, Li, Campos, Kurth, & Ma, 2007) .   The study concluded that the higher  blood levels of long-chain n-3 fatty acids, mostly found in marine foods, and  linoleic acid, mainly sourced from non-hydrogenated vegetable oils, are linked to a reduced risk of cancer (Chavarro, Stampfer, Li, Campos, Kurth, & Ma, 2007) .

  A multi-ethnic case control study was conducted to  establish the risk of prostate cancer in association with circulating fatty  acids (Park, et al., 2009) .  The study aimed at investigating the conflicting findings on the contribution of  dietary fat, including specific fatty acids, in the pathogenesis of prostate  cancer.  The researchers examined the  association between the erythrocyte membrane fatty acid composition and  prostate cancer risk in a nested case-control study in multiethnic cohort that  included African Americans, Native Hawaiians, Japanese Americans, Latinos, and  Whites (Park, et al., 2009) .   The study utilized conditional logistic  regression to estimate the odd ratios and 95% confidence intervals with  adjustments in the case for multiple covariates  (Park, et al., 2009) .

The findings of the study showed that there was no  significant association between saturated, mono- and polyunsaturated fatty  acids, or for the specific n-3 and n-6 fatty acids, even when the analysis was  only conducted in the advanced or high grade prostate cancer (Park, et al., 2009) .   The ethnic-specific analysis showed that  there was a positive association with palmitic acid (supplied primarily by palm  oils, but is also found in high-saturated  animal fat foods such as meat, cheese, butter, and dairy products) in  Japanese Americans that was found to be significantly different from the null  findings from other groups.  The study  also identified an increased risk with n-3 fatty acids and the ratio of n-3/n-6  fatty acids in white people (Park, et al., 2009) .

Several other studies have shown that it is healthy to  consume fatty fish, particularly for the purpose of reducing cancer risk. A study  was conducted by Terry et al. to establish the relationship between fatty fish consumption  and prostate cancer risk in Swedish men (2001) .  The association was studied in a prospective cohort consisting of 6,272 Swedish  men. In the course of the 30-year follow-up, the study established that men who  did not consume any fish at all had two to three times higher occurrence of  prostate cancer as compared to those who ate higher or moderate amounts (Terry, Lichtenstein, Feychting, Ahlbom, & Wolk,  2001) .   The results of the study suggested that  fish consumption could decrease the risk of prostate cancer.  Similar associations have also been  established in studies that investigated the relationship between fish oil and  other types of cancers.

A study done by Zheng et al. investigated on the  relationship between the intake of marine n-3 polyunsaturated fatty acids and  the risk of breast cancer (Zheng, Hu, Zhao,  Yang, & Li, 2013) .  The study was carried out as a meta-analysis and systematic review of  prospective cohort studies.  In these  studies, relative risk and 95% confidence intervals for the occurrence of breast  cancer according to fish intake and n-3 PUFA intake were evaluated (Zheng, Hu, Zhao, Yang, & Li, 2013) .  The findings of the study indicated that  marine n-3 PUFA was associated with a 14% reduction in the risk of breast cancer (Zheng, Hu, Zhao,  Yang, & Li, 2013) .   The researchers concluded that higher  consumption of dietary marine n-3 PUFA was associated with a reduced risk of  breast cancer.

However, the widely acknowledged positive role that of  fish oils and fatty fish consumption in the reduction of prostate cancer risk  was thrown into question by the findings of a recent study. The study was led  by Theodore Brasky, and its findings were published in the Journal of the  National Cancer institute ( 2013) .  

The study investigated the blood levels  of omega-3 fatty acids in patients who were enrolled at the Selenium and  Vitamin E cancer Prevention Trial (SELECT) and evaluated more than 35,000 males  aged 50 years and above in the United States, Puerto Rico, and Canada (Brasky, et al., 2013) .  During the study, 834 men from the trial diagnosed with prostate cancer were  compared a group of 1,393 participants who were randomly drawn from the 35,000 participants (Simon, 2013) .   The findings of the study showed that  men with the highest levels of omega-3 had a paradoxical 43 percent higher risk of developing prostate  cancer, and a 71% chance of developing a high-grade prostate cancer (Simon, 2013) .

The study did not however collect diet  information on the men included in the study and, therefore, it’s not clear  whether the omega-3 fatty acids in their blood were as a result of dietary supplements or food consumption (Brasky, et al., 2013) .

  The results of the study have been rejected by many  researchers, and practitioners who see these findings as both scientifically  weak and irresponsible. This is primarily due to the large volume of scientific  evidence to the contrary that indicate the health benefits of marine omega-3  fatty acids.

  The suggested weaknesses of this analysis include: the  failure of the study to examine the exact relationship between the intake of  omega-3 fatty acids and prostate cancer; the basing of the conclusions of this  study on a minimal 0.2% difference in the levels of omega-3;  the lack of epidemiological data to support  the findings of the study, given the widespread consumption of fish across the world, the epidemiologic findings of lower prostate cancer risks in populations  consuming high levels of fatty fish in their diets; the use of plasma  measurements that did not reflect long term consumption of omega 3s, and which  could be influenced by a single meal; the failure to report on the serum levels  of EPA, DHA, DPAn-3; the lack of documentation to show rate of fish consumption  in the study group; the study was not designed to specifically evaluate omega  -3s intake, and was confounded with selenium and vitamin E, which are used in  treatment regimens and could contribute beneficial or deleterious effects; the  CPH model used did not show a statistically significant relationship between  EPA, DPA and DHA; the lead author in the study did not find similar findings in  a study conducted in 2011; the test cohort included a sample of both sick and  healthy individuals, and it is possible that the sickest participants in this  study were taking higher levels fish oil supplements, creating a selection  bias. (Advances in EPA & DHA Research, 2013) .

Summary
Numerous studies have reported on the health benefits of  fish oils. Omega -3s, EPA, and DHA have widely been reported to reduce the risk  of various health conditions and this is supported by findings of studies  conducted over several decades. This long-standing knowledge has been  challenged by the results of a recent study; Omega-3s and  Prostate Cancer Risk. There are however a number or questions  that about the study that challenges the credibility of the findings, and it is  best to discuss these results with your personal physician before discontinuing  a prescribed supplement regimen, or undertaking any new supplemental regimen.

        ACS. (2010, August 9). What Is Prostate Cancer?" Information and  Resources for Cancer: Breast, Colon, Prostate, Lung and Other Forms. Retrieved  July 23, 2013, from American Cancer Society :  http://www.cancer.org/cancer/prostatecancer/overviewguide/prostate-cance...
  ACS. (2010, August 9).
  ACS. (2010, August 9).
  Brasky, T. M., Till, C., White, E., &  Neuhouser, M. L. (2011). Serum phospholipid fatty Acids and the prostate cancer  Risk:Results from the Prostate cancer trial. Am J Epidemiol , 173(12)1429-1439.
  Brasky, T. M., Till,  C., White, E., & Neuhouser, M. L. (2011).
  Brasky, T. M., Till,  C., White, E., & Neuhouser, M. L. (2011).
  Brasky, T. M., Till,  C., White, E., & Neuhouser, M. L. (2011).
  Swansom, D., Block, R., & Mouse, S. (2012). Omega-3 Fatty Acids EPA and DHA: Health Benefits Throught Life. Adv. Nutr. , 3:1-7.
  Swansom, D., Block,  R., & Mouse, S. (2012).
  Leitzmann, M. F., Stampfer, M. J., Michaud, D.  S., Augustsson, K., Colditz, G. C., Willet, W. C., et al. (2004). Dietary intake of n-3 and n-6 fatty acids and the risk of prostate cancer. Am J Clin Nutr , 80(1):204-16.
  Chavarro, J. E., Stampfer, M. J., Li, H.,  Campos, H., Kurth, T., & Ma, J. (2007). A prospective study of polyunsaturated fatty acid levels in blood and  prostate cancer risk. CancerEpidemiolBiomarkersPrev , 16(7):1364-70.
  Szymanski, K. M., Wheeler, D. C., & Mucci,  L. (2010). Fish oil consumption and prostate cancer risk: a  review and meta-analysis. Am J  Clin Nutr , 92(5):1223-33.
 Szymanski, K. M., Wheeler, D. C.,  & Mucci, L. (2010).
  Szymanski, K. M.,  Wheeler, D. C., & Mucci, L. (2010).
  Szymanski, K. M.,  Wheeler, D. C., & Mucci, L. (2010).
  Szymanski, K. M.,  Wheeler, D. C., & Mucci, L. (2010).
  Leitzmann, M. F.,  Stampfer, M. J., Michaud, D. S., Augustsson, K., Colditz, G. C., Willet, W. C.,  et al. (2004).
  Leitzmann, M. F.,  Stampfer, M. J., Michaud, D. S., Augustsson, K., Colditz, G. C., Willet, W. C.,  et al. (2004).
  Leitzmann, M. F.,  Stampfer, M. J., Michaud, D. S., Augustsson, K., Colditz, G. C., Willet, W. C.,  et al. (2004).
  Leitzmann, M. F.,  Stampfer, M. J., Michaud, D. S., Augustsson, K., Colditz, G. C., Willet, W. C.,  et al. (2004).
  Leitzmann, M. F.,  Stampfer, M. J., Michaud, D. S., Augustsson, K., Colditz, G. C., Willet, W. C.,  et al. (2004).
 Chavarro, J. E., Stampfer, M. J., Li,  H., Campos, H., Kurth, T., & Ma, J. (2007).
  Chavarro, J. E.,  Stampfer, M. J., Li, H., Campos, H., Kurth, T., & Ma, J. (2007).
  Chavarro, J. E.,  Stampfer, M. J., Li, H., Campos, H., Kurth, T., & Ma, J. (2007).
  Chavarro, J. E.,  Stampfer, M. J., Li, H., Campos, H., Kurth, T., & Ma, J. (2007).
  Chavarro, J. E.,  Stampfer, M. J., Li, H., Campos, H., Kurth, T., & Ma, J. (2007).
  Park, S. Y., Wilkens, S. R., Henning, S. M.,  LeMarchand, L., Gao, K., Goodman, M. T., et al. (2009). Circulating fatty acids and prostate cancer risk in a nested case-control  study: the Multiethnic Cohort. Cancer  Causes Control , 20(2):211-23.
  Park, S. Y., Wilkens,  S. R., Henning, S. M., LeMarchand, L., Gao, K., Goodman, M. T., et al. (2009)
  Park, S. Y., Wilkens,  S. R., Henning, S. M., LeMarchand, L., Gao, K., Goodman, M. T., et al. (2009)
  Park, S. Y., Wilkens,  S. R., Henning, S. M., LeMarchand, L., Gao, K., Goodman, M. T., et al. (2009)
  Park, S. Y., Wilkens,  S. R., Henning, S. M., LeMarchand, L., Gao, K., Goodman, M. T., et al. (2009)
  Terry, P., Lichtenstein, P., Feychting, M.,  Ahlbom, A., & Wolk, A. (2001). Fatty fish consumption and risk of prostate cancer. Lancet , 357(9720):1764-6.
  Terry, P., Lichtenstein, P.,  Feychting, M., Ahlbom, A., & Wolk, A. (2001).
  Zheng, J.-S., Hu, X.-J., Zhao, Y.-M., Yang, J.,  & Li, D. (2013). Intake of fish and marine n-3 polyunsaturated fatty acids and risk of  breast cancer: meta-analysis of data from 21 independent prospective cohort  studies. BMJ , 346:3706.
  Zheng, J.-S., Hu,  X.-J., Zhao, Y.-M., Yang, J., & Li, D. (2013).
  Zheng, J.-S., Hu,  X.-J., Zhao, Y.-M., Yang, J., & Li, D. (2013).
  Brasky, T., Darke, K. A., Song, X., Tangen, C.  M., Goodman, P. J., Thompson, I. M., et al. (2013). Omega-3s and prostate cancer risk: Plasma phospholipid Fatty Acids and  Prostate Cancer Risk in the SELECT Trial. Journal of the National Cancer Institute .
  Brasky, T., Darke, K.  A., Song, X., Tangen, C. M., Goodman, P. J., Thompson, I. M., et al. (2013).
  Simon, S. (2013, July 17). Omega-3 Fatty Acids Linked to Increase in Prostate  Cancer Risk. Retrieved July 25,  2013, from American Cancer Society:  http://www.cancer.org/cancer/news/news/omega-3-fatty-acids-linked-to-inc...
  Simon, S. (2013, July  17).
  Brasky, T., Darke, K.  A., Song, X., Tangen, C. M., Goodman, P. J., Thompson, I. M., et al. (2013)
  Advances in EPA & DHA Research. (2013, July 11). Retrieved July 24, 2013, from Rapid  Review Alert:  http://us1.campaign-archive1.com/?u=4ae075406cd789efec4e9ff09&id=6f3dc7a...

0 komentar

Post a Comment