The use of dietary supplements to alleviate androgen deprivation therapy side effects during prostate cancer treatment. By Dueregger et al. 2014
Key sentence from the paper: “[M]ore clinical randomized studies in [prostate cancer] patients on ADT are highly warranted to support these findings.”
For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/25338271
Commentary: This paper is a fairly comprehensive review of the potential of dietary supplements in managing or reducing the metabolic and musculoskeletal side effects of ADT. The kinds of supplements reviewed in this article include: herbal compounds, phytoestrogens, selenium, fatty acids, calcium, vitamin D, and vitamin E. The authors support patients on ADT taking vitamin D and calcium, but do not suggest that other supplements are helpful; especially not selenium or vitamin E.
Perhaps the most interesting compound discussed in this article is black cohosh (Cimicifuga racemosa). This has been thought to be helpful for reducing hot flashes. The authors write “a randomized, placebo–controlled trial found no difference in the frequency of hot flashes but a significantly lower incidence of sweating in menopausal women with a history of breast cancer in the black cohosh group compared to placebo.” They acknowledge that such studies have not been undertaken with men on ADT. The authors make an intriguing observation about hot flash management in general and the power of placebos. They state, “that a significant placebo effect is consistently observed in investigations of hot flashes, with a placebo effect reportedly sufficient to reduce hot flashes by up to 75%.” That suggests that almost any compound that patient thinks might help with hot flashes, is likely to work to some extent. That being said, if the compound has no other toxicity or side effects associated with it, there is probably no harm to the patient to using it.
On the subject of hot flashes, one might suppose that a variety of phytoestrogens would also be helpful. The authors, however, cite a small, but well-designed study from 2011, which showed that “phytoestrogens failed to improve metabolic or inflammatory parameters of men with PCa during ADT.”
In sum, there is little evidence for the use of dietary supplements, other than calcium and Vit D in reducing ADT side effects.
Dueregger, A., Heidegger, I., Ofer, P., Perktold, B., Ramoner, R., Klocker, H., Eder, I.E., 2014. The use of dietary supplements to alleviate androgen deprivation therapy side effects during prostate cancer treatment. Nutrients. 6, 4491-519.