Category: Cancer

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Selenium and Cancer Prevention – the Evidence

The evidence for the use of selenium supplementation in cancer prevention is still inconclusive. Rataan et al suggest that the fault may lie in the design of the existing studies. At least two factors have contributed to this lack of conclusive evidence:

  • the use of different compounds in the tests of selenium and cancer
  • the different blood selenium levels of the study participants at baseline
Cancer patients
Selenium supplementation of individuals with low dietary intakes of selenium may help prevent the development of certain types of cancer.

As an example, Rataan et al cite the differences between the Nutritional Prevention of Cancer (NPC) trial and the Selenium and Vitamin E Cancer Prevention Trial (SELECT). In the NPC study, the researchers used a selenium-enriched yeast supplement. This yeast formulation contained mostly selenomethionine but also contained several other selenium species including Se-methylselenocysteine. In the SELECT study, the researchers used a 100% selenomethionine supplement. It now seems clear that the chemopreventive effect of selenium that was seen in the NPC study but not seen in the SELECT study must have come from some selenium species other than selenomethionine. The most likely chemopreventive selenium species is the Se-methylselenocysteine [Rataan 2022; Marshall 2017]. read more

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Selenium May Reduce the Risk of Heart Disease and Some Cancers

Reduced risk of heart disease and reduced risk of some cancers. Increasing the daily intake of selenium among individuals with low selenium status may reduce the risk of cardiovascular disease and some cancers. The available data seem to show that most adults in the Nordic and Baltic countries, with the exception of adults in Finland, have low selenium intakes and low selenium status [Alexander & Olsen 2023].

Jan Alexander
Prof. Jan Alexander, MD, PhD, Norwegian Institute of Public Health in Oslo, says: There are various factors that influence cardiovascular disease mortality and cancer incidence: diet, lifestyle, genetics, inter alia. The impact of these factors varies from one Nordic country to the next.

Selenium is an essential trace element. The human body cannot synthesize it. It must come from the diet and supplements. Selenium is a vital component of selenoproteins that are critical to normal health and physiological functioning. This is the fundamental message from a 2023 selenium scoping review conducted for the Nordic Nutritional Recommendations 2023 [Alexander & Olsen 2023]. read more

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Selenium and Radiation Therapy for Cancer Patients

Cancer patients tend to have reduced serum selenium concentrations compared to healthy controls. Adjuvant selenium supplementation improves the protection of healthy tissue in tumor patients undergoing radiation therapy [Muecke 2018].

Cologne cathedral in Germany
15 years of experience with adjuvant selenium supplementation in radiation oncology in Germany has yielded a solid knowledge database. As a result,  some radiation oncologists measure the patient’s selenium levels during therapy and compensate in cases of selenium deficiency. Even so, it is important to remember that selenium status is  a relatively small piece in the bigger puzzle of therapeutic success in radiation oncology.

In a 2018 review of 15-years of experience with selenium supplementation in radiation oncology, Muecke et al [2018] reported on two randomized controlled trials. The researchers observed positive effects of the supplemental selenium and no adverse effects in the patients undergoing radiation therapy:

  • 81 patients with uterine cancer
  • 39 patients with head and neck tumors
Selenium Deficit in Cancer Patients

In the majority of the tumor patients (carcinomas of the uterus, head and neck, lungs, rectum or prostate) whom they examined, German researchers found a relative selenium deficit in whole blood or serum [Muecke 2018]. read more

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Selenium Supplementation and Chemotherapy in Cervical Cancer Patients

Selenium yeast supplementation administered concurrently with chemotherapy and radiation therapy effectively increased blood selenium levels in cervical cancer patients with inadequate selenium status. The selenium yeast supplementation was used as an adjuvant treatment to the standard chemotherapy and radiation therapy. It significantly decreased the hematologic toxicity of the chemoradiotherapy [Yang 2023].

Cancer and selenium
Each year, worldwide, half a million women are diagnosed with cervical cancer, and 300 000 die from the disease. In most cases, the human papilloma virus is the cause of the disease [Cohen 2019]. The trace element selenium has antiviral properties. Cell studies and mouse studies of cervical cancer have shown that different selenium species have anticancer effects in cervical cancer induced by human papilloma virus or by chemical carcinogens [Jablonska 2021].
In a randomized controlled trial, researchers randomly assigned 104 patients diagnosed with stage IIB cervical cancer receive 100 mcg selenium yeast tablets (n=50) or matching placebos twice daily (n=54) for five weeks [Yang 2023].

All patients in both groups received the standard treatment including pelvic external irradiation, concurrent five cycles of chemotherapy, and brachytherapy [Yang 2023]. read more

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Breast Cancer Recurrence and Selenoprotein P Autoimmunity

Breast cancer prognosis is especially poor in patients with low serum selenium and serum selenoprotein P concentrations. Now, researchers have discovered natural autoantibodies with antagonistic properties to selenoprotein P uptake in breast cancer patients and  in patients with thyroid disease [Demircan 2022; Sun 2022].

Autoimmunity
Autoimmunity is the production of antibodies against the tissues or substances of one’s own body, resulting in an autoimmune disease or hypersensitivity reaction. Autoantibodies to Selenoprotein P impair the transport of the essential trace element selenium in breast cancer patients and in Hashimoto’s thyroiditis patients.

Selenium is an essential trace element that has numerous biological functions in the body, most of which are carried out by selenium-containing selenoproteins. Among the more important selenoproteins are selenoprotein P, the main transporter of selenium in the blood, and glutathione peroxidase 3 (GPX3), an important antioxidant.

The human body does not synthesize selenium. Human cells are dependent upon selenium sources in the diet. Unfortunately, the selenium content in the soil and in food varies considerably from region to region in the world. For example, the plasma selenium concentrations in people living in much of Europe are generally below, often well below, 80–90 mcg/L whereas people living in North America generally have plasma selenium levels above 120 mcg/L [Alehagen 2022]. read more

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Selenium Exposure Studies

Selenium exposure in the diet and in supplements: in this review article, we summarize the key outcomes of the best selenium exposure studies.

Optimal Selenium Intake and Status

In his review of the available research literature, Professor Urban Alehagen, Linköping University, Sweden, concluded that a daily intake of 100–150 mcg of selenium per day is required.

This is the intake level that enables an optimal expression of the important selenoprotein P that transports selenium from the liver to peripheral tissues [Alehagen 2022].  For other selenoproteins to be optimized, i.e., to be fully expressed, Prof. Alehagen argues that selenium status of approximately 120 mcg/L when measured in red blood cells is necessary [Alehagen 2022]. read more

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Serum Selenium Levels Predict Breast Cancer Prognosis

Research done in southern Sweden shows that three blood biomarkers of selenium availability correlated inversely with mortality from breast cancer. The lower the three selenium biomarker levels, the higher the mortality [Demircan 2021].

Breast cancer awareness
Assessment of selenium status at the time of breast cancer diagnosis identifies patients at exceptionally high risk for a poor prognosis. They are breast cancer patients with low levels of selenium, selenoprotein P, and glutathione peroxidase in their blood.

The blood biomarkers are:

  • Total selenium
  • Selenoprotein P
  • Glutathione peroxidase 3

Breast cancer patients with blood concentrations of these three selenium biomarkers in the highest quintile had significantly better chances of survival compared with patients whose blood levels of these substances were in the lowest quintile [Demircan 2021].

Breast cancer patients with low selenium status according to these three biomarkers had the highest mortality risk with an overall survival probability of approximately 50% after 8 years. The difference in survival between the breast cancer patients in the lowest selenium quintile compared to breast cancer patients with at least one biomarker in the highest quintile was especially notable [Demircan 2021]. read more

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Serum Selenium Status and Cancer Risk

On its Selenium: Fact Sheet for Health Professionals website, the US Office of Dietary Supplements, an agency of the National Institutes of Health, writes that selenium might play a role in the prevention of cancer for the following reasons:

  • selenium’s role in DNA repair
  • selenium’s role in apoptosis
  • selenium’s role in the endocrine and immune systems
  • the antioxidant properties of certain selenoproteins
Cancer prevention ribbons
It is not possible to draw any conclusions regarding a causal link between selenium exposure/status and the prevention of cancer. However, numerous observational studies show an inverse relationship between serum selenium status and the risk of cancer.
Different Selenium Compounds Have Different Effects on Cancer

The evidence from scientific research into the effect of selenium on cancer prevention can be confusing. Two observations about selenium supplementation may help to explain the confusing results from existing selenium and cancer studies:

1. Different selenium containing compounds differ widely in their ability to prevent cancer. Study results may vary according to the form of the selenium supplement tested.

2. Selenium supplementation may be more effective at cancer prevention in study participants with low baseline selenium status (below 100 mcg/L) and less effective in study participants with high baseline selenium status (above 135 mcg/L). read more

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Selenium Supplementation and Prostate Cancer

New Zeland landscape
The New Zealand study results suggest that each of us needs to take personalized selenium supplement dosages based on our individual characteristics rather than have all of us take the same 200 microg/day tablet for prostate health benefits [Karunasinghe 2019].
Demographic, dietary, genetic, and life style factors influence the prostate health effects of selenium supplementation according to New Zealand researchers.

An inverse association between serum selenium concentrations and prostate-specific antigen levels was especially strong in the following sub-groups of study participants [Karunasinghe 2019]:

  • men below the age of 55 years
  • men who never smoked
  • men carrying the GPX1 rs1050450 T allele
  • men with dietary intakes above the recommended daily intake for zinc (11 mg)
  • men with dietary intakes below the recommended daily intake for vitamin B12 (15 mcg)

Moreover, the increase in serum selenium status and the resulting post-supplementation serum selenium status were significantly dependent upon baseline serum status [Karunasinghe 2019].

The overall gain in serum selenium levels from supplementation declined at a rate of 0.828 microg/L with each one microg/L increase in baseline serum selenium level [Karunasinghe 2019]. read more

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Selenium Intakes and the Risk of Cancer: Two Meta-Analyses

Blue ribbon for prostate cancer
Despite the billions of dollars spent in the war on cancer, cancer in its various forms continues to be a leading cause of death worldwide. Treatment is expensive. The prognosis is often poor. Even so, the World Health Organization estimates that perhaps one third of all cancer cases could be prevented with changes in behavioral and dietary patterns. An inverse linear association has been found between increased selenium intake and reduced risk of all cancers. As the selenium intake increased, the overall risk of cancer incidence decreased [Kuria 2020].
A 2020 meta-analysis of population-based prospective studies shows that selenium supplementation is protective against cancer; however, the beneficial effects of the selenium supplementation vary with the different types of cancer. The differences in the effect of selenium intakes on the risk of various cancer forms has been attributed to differences in the pathophysiology of cancer [Kuria 2020].

Briefly, the data from the meta-analysis show that selenium decreases the risk of cancer at the highest daily intake levels of the included studies.

This outcome is consistent with the outcomes of a previous study showing a protective effect of selenium at high doses compared to low doses [Cai 2016]. A 2018 meta-analysis used different methods to assess selenium exposure and showed a null association between selenium at high doses compared to low doses [Vinceti 2018]. read more