Medical News: Dietary Supplement Tied to Metastatic Prostate Cancer - in Primary Care, Alternative Medicine from MedPage Today

[Guest guest]

http://www.medpagetoday.com/PrimaryCare/AlternativeMedicine/tb/7960

Androgenic

steroid product sales have been exponentially increasing, in part, because

patients believe supplements to be safe and drug-free, Dr. Shariat and

colleagues wrote.

Thus,

physicians should routinely assess patients, particularly cancer patients, for

use of supplements, explain the risks, and monitor for possible interactions

and side effects, they added.

In

both cases the researchers reported to the FDA, the patients purchased the

product, via the Internet, for increased muscle mass or improved sexual

performance, or both.

The

labeled ingredients included 60 mg of a proprietary blend of six testosterone

precursors (androstenediones and androstenediols), 100 mg of the aromatase

inhibitor-like flavinoid chrysin, and 100 mg of elk velvet antler per serving.

After

10 to 11 months of use of the product, both patients developed prostate

problems.

One,

a 67-year-old white male, presented with a non-productive cough, frequent

urination, and loss of appetite with involuntary weight loss of more than 40 pounds.

Despite

two normal prostate cancer screenings over the prior two years, his total serum

prostate-specific antigen (tPSA) level had jumped to 74 ng/mL. In addition to

prostate cancer with a Gleason score of 6, he had developed metastatic disease

in both lungs and the right rib cage, upper lumbar spine, right sacrum, and

both pubic rami.

The

other patient, a 51-year-old African-American male had a spike in tPSA (21.7

ng/mL) at his yearly prostate cancer screening after starting on the product

despite normal screening results over the prior two years.

He

had developed prostate cancer with a Gleason score of 7, with extracapsular

extension, seminal vesicle involvement, pelvic lymph node enlargement, and

multiple small metastases in both lungs and two vertebrae.

Both

patients discontinued the supplement after diagnosis, but had widely metastatic

disease at last follow-up despite androgen blockade therapy and palliative

radiation therapy.

Neither

patient had androgen receptor gene mutations that have been associated with

aggressive disease, disease progression, and metastasis.