Advertisement

Men’s Health Supplement Use and Outcomes Among Men Receiving Definitive IMRT for Localized Prostate Cancer

      Purpose/Objective(s)

      Men’s health supplements (MHSs) are marketed to men for health benefits, particularly for “prostate health.” We evaluated the impact of MHSs on patient outcomes and toxicities among men undergoing definitive intensity modulated radiation therapy (IMRT) for localized prostate cancer.

      Materials/Methods

      We reviewed our prospectively collected institutional database of men undergoing IMRT for localized prostate cancer taking MHSs, defined as any medication marketed with any of the following terms: “men’s health,” “men’s formula,” or “prostate health,” excluding general multivitamins, minerals, or prescription meds. Each MHS was queried online to find the individual ingredient(s), if these could be identified. MHS use was defined as any use at the time of IMRT or during follow-up. Kaplan Meier analysis was performed to compare rates of freedom from biochemical failure (FFBF; nadir + 2 ng/mL), freedom from distant metastasis (FFDM), cancer-specific survival (CSS), and overall survival (OS). Competing risk regression and Cox models were used to estimate hazard ratios (HRs) adjusted for prostate-specific antigen (PSA), Gleason score, T stage, hormone use, age at start of RT, comorbidities, and smoking; difference in acute and late gastrointestinal and genitourinary toxicities (modified Radiation Therapy Oncology Group [RTOG] definitions) were also assessed.

      Results

      Between 2001 and 2012, 2301 men were treated with IMRT alone (median dose: 78 Gy); of these, 40% were low-, 36% intermediate-, and 24% high-risk, based on National Comprehensive Cancer Network criteria. MHS was reported in 232 men (10%); these men were less likely to have heart disease or diabetes (P<.05). MHSs contained a median of 3 identifiable ingredients (range, 0-30); the most common was saw palmetto (91%), followed by ingredients no different than standard multivitamins (5%), or no identifiable ingredients (4%). At a median follow-up time of 46 months (range 1–190 months), men taking an MHS had no difference compared to those not on MHSs in FFBF (among any risk group), CSS, or FFDM (Table). Differences in OS in men taking MHSs versus those not on MHSs were not significant after adjusting for risk covariates. RTOG acute and late toxicities were not different between the groups.
      Poster Viewing Abstracts 2492; TableOutcomes of patients on MHS treated with IMRT for prostate cancer.
      Kaplan Meier estimates, 5 years (%)Adjusted HRs from MVAs (95% CI)
      n (%)OSFFBFFFDMCSSOSFFBFFFDMCSS
      MHS stratification
      Not on MHS2069 (90)928996991111
      On MHS232 (10)97**93971000.6 (0.3 – 1.1)0.9 (0.6-1.4)0.8 (0.4 – 2.0)0.3 (0.0 – 2.6)
      NCCN risk group stratification
      Low911 (40)969799100
      Intermediate845 (36)91†87††96††99†
      High509 (24)89††79††90††97††
      Note: */** denotes significantly different (log-rank *P<.05; **P<.01) than men not on MHS †/†† denotes significantly different (log-rank †P<.05; ††P<.01) than NCCN low risk

      Conclusion

      MHS use is not associated with a change in cancer-related outcomes or toxicities in men receiving IMRT for prostate cancer.

      Comments

      Commenting Guidelines

      To submit a comment for a journal article, please use the space above and note the following:

      • We will review submitted comments as soon as possible, striving for within two business days.
      • This forum is intended for constructive dialogue. Comments that are commercial or promotional in nature, pertain to specific medical cases, are not relevant to the article for which they have been submitted, or are otherwise inappropriate will not be posted.
      • We require that commenters identify themselves with names and affiliations.
      • Comments must be in compliance with our Terms & Conditions.
      • Comments are not peer-reviewed.