Multivitamin Use May be Linked to Reduced Cancer Risk

This multivitamin was used in the randomized clinical research trial described below.

On NBC Nightly News (10/17, story 5, 1:50, Williams), NBC’s Chief Science Correspondent Robert Bazell said that for the clinical trial, “The Physicians Health Study,” researchers gave almost 15,000 male doctors  either a multivitamin or a placebo. Treatment with the multivitamin resulted in a small reduction in total cancer risk.

Bloomberg News (10/18, Flinn) reports, “The study’s authors couldn’t pinpoint any single reason for the reduction in cancer among those who took the supplements, though they speculated it may be due to the combination of several low-dose vitamins and minerals, where previous studies looked at the effect of high levels of individual nutrients.”

The Boston Globe (10/18, Kotz) “Daily Dose” blog reports, however, that according Dr. Albanes, “These are very encouraging results, but women weren’t included in this study, nor were younger men, nor those from a range of ethnicities.” Dr. Albanes added, “It’s one trial, and we’ve seen many cases where one trial doesn’t always give the final answer.

The AP (10/18, Marchione, Writer) reports that Dr. Ernest Hawk, formerly of the National Cancer Institute, said that “it’s a very mild effect and personally I’m not sure it’s significant enough to recommend to anyone,” but “at least this doesn’t suggest a harm.”

 Medical Commentary by Paul Goldfinger, MD, FACC

There have been many prior trials of multivitamins in the past, trying to prove a benefit in preventing chronic diseases, especially heart trouble and cancer. The National Institutes of Health’s most recent recommendations for good health do not include vitamins for protection. But, the fact is that 1/3-1/2 of the US population take vitamin supplements.

This trial is unique because it is a huge study over 14 years involving nearly 15,000 male physicians over the age of 50. The trial is considered kosher because of its size, long followup and the fact that it is randomized and placebo controlled. The multivitamin that was used was Pfizer’s Centrum Silver, which contains an array of vitamins and minerals.

The study did show a modest benefit with an 8% reduction in total cancer incidence, but the treatment did not result in any reduction in mortality. The most common cancer in the group was prostate, and that was not reduced by vitamins. Also, there is no answer here for women. Prior trials in women were inconclusive. Even the treated group here is a very special one consisting of mostly health minded, non-smoking doctors — not exactly reflecting the general population. This trial, the Physicians Health Study, is presented by the National Cancer Institute and the Brigham and Women’s Hospital in Boston.

The NIH will consider this result in planning for future recommendations, but so far they are not changing their guidelines. In the New York Times today, Dr. J. Michael Gaziano, a cardiologist from Boston, said that the benefit of the trial was “modest” but significant. He stressed that other measures are more important than taking vitamins, such as exercise, a nutritious diet and stopping smoking.

My own history over the years with vitamins has fluctuated with the tides of research trials that yielded conflicting results. My usual advice to patients was to skip the vitamin supplements unless they had a poor diet and needed nutritional augmentation. Certainly mega doses of vitamins, advocated by some, have no scientific support.

In the most recent (2011) edition of our book on preventing heart disease, this is what we say: “Vitamins used to be recommended as preventive therapy due to their anti-oxidant actions. In recent years, however, large trials have shown no benefit with vitamins, so these supplements can no longer be considered part of a prevention regimen. This conclusion does not apply to vitamins found in fruits and vegetables.”

But now, I think I’ll get some Centrum Silver. What the heck, it might help and it won’t hurt. Maybe I’ll change my mind with the next study.

3 thoughts on “Multivitamin Use May be Linked to Reduced Cancer Risk

  1. Paul – Thank you for the article and your coments. I have taken the Centrum Silver for a number of years and did not quit when I read in your book that you agreed with others that there was no advantage.

  2. Watchman: Thanks for having read our book. Lay people like yourself often self-medicate. So many people take multivitamins because they have faith that the supplements will keep them healthy. But such individuals often think that multivitamins are totally safe, and that is not always the case. Many people have gotten sick from over-the-counter remedies including vitamins. My advice is to tell your doctor about any OTC nutritional supplements or other treatments that you are taking.

    As for the advice in our book about vitamins, my practice (as is the case with most doctors) is to make recommendations that are based on scientific research. That’s called “evidence based medicine.” On the other hand, doctors sometimes have to make therapeutic decisions based on “the art of medicine,” i.e. based on their best judgement and experience.

    In our book, I spend a lot of time and space acquainting the readers about the research behind the decisions. I believe that patients are smart enough to understand such matters if they are explained clearly. It’s part of my philosophy about empowering patients to practice defensive medicine and to participate in the decisions being made about their care. (You probably have seen the two articles I posted regarding defensive medicine for patients) —Paul

    PS: “Prevention Does Work: A Guide to a Healthy Heart” is available in paperback at (search Paul Goldfinger, MD) or (search “Prevention Does Work”) or (search Paul Goldfinger, MD). The price is usually $12.95

  3. Dr. Paul…..thanks for the GREAT Blog. On the topic of Nutrition….Centrum is a Chemical (Synthetic) version of the real thing. If you are NOT to closed minded I refer you to Your Healt with Dr. Richard Becker D.O. on Dish chn.
    49 daily @ 2PM….(It’s Backed by research) also check out Dr. Sinatras book on Metabolic Cardiology…….Dr. Mike Croker, D.C. CCN (Retired)

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