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PostPosted: Thu Mar 08, 2007 9:14 pm 
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"There is evidence suggesting lack of cancer-preventive activity for beta-carotene when used as a supplement at high doses. There is inadequate evidence with regard to the cancer-preventive activity of beta-carotene at the usual dietary levels." (International Agency for Research on Cancer)

Notably, there is now data that implies that supplementation with beta-carotene will increase the risk of lung cancer in people who smoke. There is insufficient evidence for the efficacy of beta-carotene as a treatment for people who already have cancer.

Description / Source / Components
"Beta-carotene is a pro-vitamin which the body converts into vitamin A." (Ontario)

Beta-carotene is found in natural sources such as squash, peaches, mangoes, papayas, "yellow and dark green fruits and vegetables including carrots, apricots, cantaloupe, sweet potatoes, spinach, kale, broccoli and mustard greens . . . ." (Ontario)

"Beta-carotene traps free radicals, and a few studies in animals suggest that it may also reduce tumor development." (Menkes)

There is no daily recommended intake for beta-carotene.

Units conversion: 1 mg [milligrams] Beta-carotene = 1667 IU's = 1/6 RE (Retinol Equivalent)

Proponent / Advocate Claims - Use in Preventing Cancer
Proponents believe that beta-carotene helps to "neutralize free radicals, which are believed to lead to cancer." (Ontario)

"Observational epidemiological studies have consistently shown that a diet rich in beta-carotene-rich fruits and vegetables or high blood levels of beta-carotene are associated with a reduced risk of cancer at a number of common sites, such as lung and stomach." (van Poppel)

In the randomized clinical trial of micronutrient supplementation conducted in Linxian, China (a rural county with one of the world's highest rates of esophageal cancer), between March 1986 and May 1991, "significant lower total mortality rates were observed among persons receiving pills with beta-carotene, vitamin E, and selenium." (Blot 1993)

"Animal studies have indicated that beta-carotene can delay or prevent induction of sarcomas and skin cancer in mice exposed to carcinogens." (Smigel)

"The inhibitory effects of the newly-developed forms of beta-carotene -- water-soluble and liposomal - have been studied in rats and mice bearing tumors induced in 4 models of carcinogenesis. ... Water-soluble beta-carotene failed to influence the carcinogenesis in the mammary gland and esophagus in rats; however, it significantly inhibited carcinoma development in murine vagina and cervix uteri (47%). Liposomal beta-carotene significantly inhibited lung adenomas (46.4%) and mammary carcinomas (55.6%) in the urethane-treated mice." (Aleksandrov)

Sankaranarayanan and colleagues "conducted a double-blind placebo-controlled trial to evaluate the chemopreventive potential of either vitamin A alone or beta carotene alone in subjects with oral leukoplakia in Kerala, India. ... The complete regression rates were 10% in the placebo arm, 52% with vitamin A and 33% with beta-carotene. ... No major toxicities were observed." (Sankaranarayanan)

"Four studies in the USA, Canada, and Italy have shown that beta-carotene, as a single agent, completely or partially reduces oral leukoplakia in 44-71% of patients. Another study, in India, reported that 14% of patients responded completely to beta-carotene; the percentage with partial improvement was not given. ... The extent to which a reduction in oral leukoplakia will lead to a reduction in the incidence of oral cancer is unknown." (World Cancer Research Fund)

The relation between beta-carotene consumption at various times in life and breast cancer risk was assessed by conducting a case-control study within a population-based cohort of women screened for breast cancer in Sweden. ... "Women were at lower risk with increasing levels of reported intake of beta-carotene. This pattern of association between breast cancer and beta-carotene intake was similar at various times before screening. These findings indicate that although diets high in beta-carotene may be associated with lower breast cancer risk, there does not seem to be evidence of a critical time period during which such diets are more relevant." (Jumaan)

"In this Phase II study, we have explored the effect of per oral beta-carotene administration on CIN [cervical intraepithelial neoplasia] I and II. ... This study indicates that a large percentage of patients with CIN I and II will respond clinically to per oral beta-carotene supplementation." (Manetta)

"Numerous... studies have shown that a high intake of carotenoid rich fruit and vegetables is associated with a decreased risk of cancer." (van Poppel, 1996)

Professional Evaluation / Critique - Use in Preventing Cancer
"Three major studies, involving a total of 74,000 men and women, showed definitely that beta carotene supplements do not lower the risk of cancer or heart disease.

Among smokers in the studies, in fact, the beta-carotene supplements increased the incidence of serious diseases. Supplements do not produce the same beneficial results seen with vegetables and fruits, probably because of currently unknown interactions with other helpful ingredients." (Cassileth)

"Four large trials involving beta-carotene supplementation, notably within well-nourished populations, have provided no evidence of a protective effect against cancer; indeed, two have shown an increased risk of lung cancer and overall mortality." (World Cancer Research Fund)

A large study examining the effects of beta-carotene and alpha-tocopherol on prostate cancer revealed that "beta-carotene apparently increased the risk of clinically evident prostate cancer only in drinkers, and that the increase was dose related to alcohol intake. (Heinonen)" (Olson)

"Supplementation with alpha-tocopherol or beta-carotene for 5 years has no major impact on the occurrence of neoplastic changes of the stomach in older male smokers with atrophic gastritis." (Varis)

"Greenberg and Sporn followed 1805 patients who had had a recent nonmelanomatous skin cancer and were randomly selected to receive 50 mg [milligrams] of beta-carotene daily or placebo. With yearly evaluations to detect new skin cancers, no reduction in the number of new nonmelanomatous skin cancers was detected. (Greenberg)" (Spencer)

"Women with histopathologically confirmed cervical intraepithelial neoplasia (CIN) were followed at 3-month intervals in a randomized double-blinded trial to evaluate the efficacy of beta-carotene to cause regression of CIN. ... Supplementation of beta-carotene does not appear to have a detectable benefit in treatment of CIN." (Romney)

"Our results confirm other findings of a lack of any benefit from administration of large doses of synthetic beta-carotene." (de Klerk)

Proponent / Advocate Claims - Use in Treating Cancer
"Another important aspect of nutritional intervention involves adjuvant therapy with antioxidants including beta carotene. Most chemotherapies deliberately increase the oxidative stress in the cancerous tissue but cannot avoid concomitant increases in free radical damage in adjacent, normal tissue. There may therefore be an important role for antioxidants in preventing chemotherapy associated oxidative damage." (Bendich)

Toxicity / Risks
"While the risk of supplemental beta-carotene may be real, it seems to be confined to lung cancer in current heavy smokers, possibly heavier drinkers, and those who take high doses of beta-carotene. (Omenn), (Blot 1993,1994)" (Mayne)

According to one study, beta-carotene increased the risk of coronary heart disease. "Based on these findings, we recommend that patients with a previous myocardial infarction who smoke should not use this agent." (Rapola)

"Researchers are now urging caution for smokers taking beta-carotene." (McDonald)

"Obviously, further analysis is needed, but it is now appropriate, whenever supplementation of beta-carotene is being considered, to warn of the possible hazard from concomitant drinking of substantial amounts of alcohol." (Leo)

"The short-term toxic effects of beta-carotene are minor even at relatively high doses. Temporary hypercarotenemia [a yellowing of the skin due to high levels of carotene in the blood], especially of the palms of the hands and the soles of the feet, may develop in some people." (Kaegi)

"There are no known or described mechanisms of toxic effects of beta-carotene, no data from studies in animals suggesting beta-carotene toxicity, and no evidence of serious toxic effects of this substance in human." (Alpha-Tocopherol)

"Toxicity studies in animals have shown that carotene is not mutagenic, carcinogenic, or teratogenic; it does not cause hypervitaminosis A because the conversion of beta-carotene to vitamin A is dependent on the vitamin A status of the individual, which if adequate, limits the uptake of carotene and its conversion to vitamin A." (Helzlsouer)

A patient with chronic lymphocytic (T-cell) leukemia took high-dose oral beta-carotene, 300 mg [milligrams] per day in May 1993. "Follow-up laboratory tests showed a substantial fall in the lymphocyte count during the treatment." (Baranowitz)

Ninety 10,000 IU capsules cost approximately $6. (Ontario)

Aleksandrov VA, et al. [The inhibitory effect of water-soluble and liposomal beta-carotene on various models of carcinogenesis]. [Russian] Voprosy Onkolgii 1998;44:79-85.

Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta-carotene on the incidence of lung cancer and other cancers in male smokers. New England Journal of Medicine 1994 Apr 14;330(15):1029-1035.

Baranowitz SA. Treatment of cutaneous T-cell lymphoma with beta-carotene. New England Journal of Medicine 1994 June 23;330(25):1830.

Bendich A. Vitamin A, beta-carotene, and cancer (Meeting Abstract). Adjuvant Nutrition in Cancer Treatment Symposium, Tampa, Florida, September 27, 1997:A20.

Blot WJ, et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease specific mortality in the general population. Journal of the National Cancer Institute 1993 Sept 15;85(18):1483-1491.

Blot WJ, et al. Lung cancer and vitamin supplementation [letter]. N Engl J Med 1994;331:614.

Cassileth BR. Alternative medicine handbook: the complete reference guide to alternative and complementary therapies. New York: W.W.Norton & Co., 1998:68-9.

de Klerk NH, et al. Vitamin A and cancer prevention II: comparison of the effects of retinol and beta-carotene. Int J Cancer 1998;75:362-67.

Greenberg ER, Sporn MB. Antioxidant vitamins, cancer, and cardiovascular disease. N Engl J Med 1996;334:1145,1150,1189.

Heinonen OP, et al. Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. J Natl Cancer Inst 1998;90:440-6.

Helzlsouer KJ. Summary of the round table discussion on strategies for cancer prevention: diet, food, additives, supplements, and drugs. Cancer research 1994 Apr 1;54(suppl):2044s-2051s.

International Agency for Research on Cancer. World Health Organization. IARC handbook of cancer prevention: carotenoids. Lyon, France: IARC, 1998:278.

Jumaan AO, et al. Beta-carotene intake and risk of postmenopausal breast cancer. Epidemiology 1999;10:49-53.

Kaegi E, on behalf of the Task Force on Alternative Therapies of the Canadian Breast Cancer Research Initiative. Unconventional therapies to cancer: 5. Vitamins A, C, and E. Canadian Medical Association 1998; 158:1483-88.

Leo MA, Lieber CS. Re: Risk factors for lung cancer and for intervention effects in CARET, the beta-carotene and retinol efficacy trial. J Natl Cancer Inst 1997;89:1722.

McDonald A, et al. Complete book of vitamins and minerals. Publications International, Ltd., 1996;94.

Manetta A, et al. beta-Carotene treatment of cervical intraepithelial neoplasia: a phase II study. Cancer Epidemiol Biomarkers Prev 1996;5:929-32.

Mayne ST, et al. Beta-carotene and lung cancer promotion in heavy smokers - a plausible relationship? J Natl Cancer Inst 1996;88:1513-5.

Menkes MS, et al. Serum beta-carotene, vitamin A and E, selenium, and the risk of lung cancer. New England Journal of Medicine 1986 Nov 13;315(20):1250-1254.

Olson KB, Kenneth JP. Vitamins A and E: further clues for prostate cancer prevention. J Natl Cancer Inst 1998:90;414-5.

Omenn GS, et al. Effects of a combination of beta-carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med 1996;334:1150-5.

Ontario Breast Cancer Information Exchange Project. Guide to unconventional cancer therapies. 1st ed. Toronto: Ontario Breast Cancer Information Exchange Project, 1994:123-124.

Rapola JM, et al. Randomized trial of alpha-tocopherol and beta-carotene supplements on incidence of major coronary events in men with previous myocardial infarction. Lancet 1997;349;1715-20.

Romney SL, et al. Effects of beta-carotene and other factors on outcome of cervical dysplasia and human papillomavirus infection. Gynecologic Oncology 1997;65:483-92.

Sankaranarayanan R, et al. Chemoprevention of oral leukoplakia with vitamin A and beta carotene: an assessment. Oral Oncology 1997;33:231-6.

Smigel K. Beta-carotene didn't prevent cancer: what's up, doc? Journal of the National Cancer Institute 1990 June 6;82(11):899-900.

Spencer JW, Jacobs JJ. Complementary/alternative medicine: an evidence based approach. Toronto: Mosley, 1999:134-5.

van Poppel G. Carotenoids and cancer: an update with emphasis on human intervention studies. European Journal of Cancer 1993;29A:1335-1344.

Varis K, et al. Gastric cancer and premalignant lesions in atrophic gastritis: a controlled trial on the effect of supplementation with alpha-tocopherol and beta-carotene. The Helsinki Gastritis Study Group. Scandanavian Journal of Gastroenterology 1998;33:294-300.

World Cancer Research Fund in Association with American Institute for Cancer Research. Food, nutrition and the prevention of cancer: a global perspective. World Cancer Research Fund/American Institute for Cancer Research, 1997;411.

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