Prostate cancer prevention trial enrolls area men.

Byline: The Health Files by Tim Christie The Register-Guard

MOST MEN, if they live long enough, will develop prostate cancer. It may never cause them to be sick or be seen by a doctor, but autopsy studies have found more than 50 percent of men who live into their 80s will have at least a little cancer in their prostate when they die.

In younger men, prostate cancer can be a killer, though it's highly treatable when caught early.

"Most guys who know about prostate cancer know it might be in their future," said Dr. David Fryefield, medical director at Willamette Valley Cancer Center in Eugene.

But what if prostate cancer could be prevented through a dietary supplement? How many lives would be spared, and how many millions of dollars in treatment costs would be saved if scientists could reduce the incidence of prostate cancer?

That's what the scientists directing a massive clinical trial hope to find out during the next dozen years. The study will determine if two dietary supplements - Vitamin E and selenium - can prevent prostate cancer, either working alone or in tandem.

Willamette Valley Cancer Center is one of 400 sites in the United States, Canada and Puerto Rico enrolling patients in the trial. Healthy men 55 and older are eligible to participate. Black men can enroll at age 50, because they tend to get prostate cancer at a younger age.

The prostate is a doughnut-shaped gland surrounding the neck of the bladder and the urethra. It produces the milky liquid that carries the sperm in semen.

Mike BeBout, a Eugene locomotive engineer, is one of two men to enroll so far in the trial at Willamette Valley Cancer Center. BeBout's father died of prostate cancer when he was 86, and he knows that family history puts him at greater risk of developing prostate cancer. That, and the fact his wife, Donna, survived ovarian cancer, inspired him to participate in the trial. He's a regular blood donor and he liked the idea of contributing to science.

"It sounded like a fairly painless trial," he said.

Patients are screened for prostate cancer before enrolling by getting a digital rectal exam and a test that measures the levels of a protein called prostate-specific antigen, or PSA, in the blood.

Patients are put into one of four groups, and neither they nor the clinic site know which: One group will get Vitamin E and selenium pills; one will get Vitamin E and a placebo; one will get selenium and a placebo; and one will get a double placebo.

The Selenium and Vitamin E Cancer Prevention Trial, or SELECT for short, is sponsored by the National Cancer Institute and is coordinated by the Southwest Oncology Group in San Antonio, Texas. Study coordinators plan to enroll men for five years and conduct the trial for 12 years.

The idea for the trial developed after some unexpected results emerged from two earlier cancer prevention trials.

A 1996 study in Arizona of 1,000 men and women found that selenium did not prevent skin cancer in men. But researchers found that selenium decreased the incidence of prostate cancer in men by more than 60 percent.

A 1998 study in Finland tested whether Vitamin E and beta carotene would prevent lung cancer in 29,000 male smokers. The study found that neither substance prevented lung cancer - but men who took Vitamin E had 32 percent less prostate cancer than men who took the placebo. (The study also found that men who smoked and took beta carotene were morelikely to get lung cancer and die than men who didn't take it.)

Those two trials suggested that Vitamin E and selenium could help prevent prostate cancer, so scientists decided to design a trial to answer the question definitively.

Scientists don't know whether Vitamin E and selenium work in tandem or alone, said Dr. Eric Klein, the national study coordinator and a Cleveland urologic oncologist.

But they know Vitamin E and selenium are both antioxidants. Antioxidants gobble up toxins in the body called free radicals, which otherwise could damage cells and cause cancer.

"We think that's why they may work," Klein said. "The evidence suggests that either one could work alone."

Vitamin E is found in a wide range of foods, especially vegetables, vegetable oils, nuts and egg yolks. Selenium is a nonmetallic trace element found in water and food, especially seafood, meats and Brazil nuts.

If the trial finds that Vitamin E and selenium do in fact prevent prostate cancer, they could easily be added to the food supply, Klein said. Not only could the regimen save lives, but it could spare men the side effects, lost work time and expense of cancer treatment.

Prostate cancer is the second most common cancer to afflict American men, after skin cancer.

Since the trial opened last summer, about 8,300 men have enrolled, and the goal is to enroll 32,400 men during the next four years.

"As far as I know it's the largest cancer prevention trial that's ever been done," Klein said.

Tim Christie covers health and medical issues. Call 338-2572.

PROSTATE CANCER PREVENTION TRIAL

Willamette Valley Cancer Center in Eugene is one of 400 sites in North America participating in a prostate cancer prevention trial called SELECT. Healthy men at least 55 years old - and black men at least 50 years old - are eligible to participate. For more information:

Call Willamette Valley Cancer Center at 683-5001, Ext. 914.

On the Web, go to www.swog.org and click on "SELECT" under the "Visitors" heading.