• Madeline Lewis •
• Originally published January 7, 2009 at 11:36 p.m., updated January 7, 2009 at 11:36 p.m.

SAN ANTONIO - Dr. Ian Thompson has an unusual professional aspiration.

"The ultimate goal is to put ourselves out of business," he said.

Thompson is the director of the genitourinary clinic at the Cancer Therapy & Research Center at The University of Texas Health Science Center in San Antonio. He studies how to prevent prostate cancer so that fewer men will struggle with the disease and have to seek cancer treatment with him and other urologists.

An average of 1,683 men in Texas died of prostate cancer every year between 2001 and 2005, according to the National Cancer Institute. About eight of these deaths occurred annually in Victoria County.

In December, The Journal of the American Medical Association published the results of a study that Thompson and 32 other doctors and scientists authored. "The Selenium and Vitamin E Prevention Trial," or SELECT, analyzed whether consuming vitamin E, selenium or both reduced the risk of developing prostate cancer. The study showed that they do not.

"The message to men is if they are interested in reducing the risk of prostate cancer, selenium and vitamin E do not work," Thompson said.

Sponsored by the National Cancer Institute, more than 35,000 men in Canada, the United States and Puerto Rico took part in the study. To participate, the men faced no maximum age restrictions, but they had to be relatively healthy. This meant they were likely to be alive in 10 years, Thompson said.

Between Aug. 2001 and October of this year, study subjects received one of four possible supplements: selenium, vitamin E, the two together or a placebo containing neither.

During that period of time, doctors monitored the patients for prostate cancer. Originally, SELECT was slatted to continue for at least another three years, but members of the study's oversight committee deemed the results so conclusive that they decided to end it early.

"They told me to close it because there is no difference and the additional years would will not change the outcome," Thompson said.

The study concluded that taking vitamin E, selenium or both did not cut down on the number of cases of prostate cancer. Indeed, it found a slight increase in incidences of prostate cancer among the men who took only vitamin E. However, the increase was so small that it was not statistically significant, Thompson said.

SELECT challenged a 1996 U.S. study and a 1998 Finnish study. The U.S. study indicated selenium reduced the risk of prostate cancer and the Finnish study that vitamin E lowered the risk.

Thompson thought these results might have been due to chance.

"They looked at all sorts of other things and if you look at all sorts of other things, one will be positive by chance," he said.

Neither study began as analysis between the supplement and prostate cancer. The U.S. study looked at a possible relationship between skin cancer and selenium and the Finnish study, a potential association between vitamin E and lung cancer.

"The early literature supported the fact that it may have been helpful in not only preventing prostate cancer, but also treating prostate cancer, " said Dr. Marshall Wiener, a Victoria urologist, about selenium.

For several years, Wiener suggested selenium to patients who asked how they could reduce their risk of getting prostate cancer. He never recommended vitamin E because research "has gone back and forth on it being helpful," he said.

After SELECT's results became public, Wiener stopped advising patients to take selenium for prostate health.

"For now, there doesn't seem to be any justification in recommending selenium in either the prevention or treatment of prostate cancer," he said.

Thompson recommends patients exercise, eat fruits and vegetables and take the drug, finasteride, if they want to better protect their prostates. Finasteride lowers the incidence of prostate cancer by at least 25 percent, he said.

• Dietary supplement company responds to SELECT studyPharmacies in Victoria sell several dietary supplements meant to maintain prostate health, including Schiff Nutrition Group's "Prostate Health."

  The product's container states:

  "Some scientific evidence suggests that consumption of selenium may reduce ...

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Dietary supplement company responds to SELECT studyPharmacies in Victoria sell several dietary supplements meant to maintain prostate health, including Schiff Nutrition Group's "Prostate Health."

The product's container states:

"Some scientific evidence suggests that consumption of selenium may reduce the risk of certain forms of cancer. However, FDA has determined that this evidence is limited and not conclusive."

Luke Bucci, vice president of research for Schiff, stands by the statement.

"That disclaimer still says it all," he said. "That data is still limited and still not conclusive so I don't think anything has changed with the results of the SELECT study."

Bucci said the study had two major flaws: It started with an older group of men - all of the participants were 50 or over - and followed them for too short a period of time.

"Prostate cancer is pretty much going to happen to all men if they live long enough," he said. "It may only be a few cells, but they are there, from the 50's, 60's and 70's. So pretty much, the people that already had it, already had it. Selenium prevents it. It doesn't stop it once it's started."

Later, he added:

"You have to make sure the selenium is there long enough to stop any cells from changing over and if that process has already started, which it has with this age group, you are just not going to see any difference."

Dr. Ian Thompson, director of the genitourinary clinic at the Cancer Therapy & Research Center at The University of Texas Health Science Center in San Antonio, responded that all men do not get prostate cancer.

"The risk increases with age, but that all men will get it is incorrect," he said.

Thompson added that a multi-decade study was not feasible both because of the financial expense and the difficulty of getting people to participate for such a long time.

"It would be really nice to have studies for that period of time," he said. "It really is not possible."

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