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. 2024 Sep 28:1-15.
doi: 10.1080/01635581.2024.2407007. Online ahead of print.

Effects of a Phytoestrogen Intervention and Estrogen Receptor β Genotype on Prostate Cancer Proliferation and PSA Concentrations-A Randomized Controlled Trial

Rebecca Ahlin  1   2 , Andreas Josefsson  3   4   5 , Sanna Nybacka  6 , Rikard Landberg  7 , Johan Stranne  8   9 , Gunnar Steineck  1 , Maria Hedelin  1   10
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Effects of a Phytoestrogen Intervention and Estrogen Receptor β Genotype on Prostate Cancer Proliferation and PSA Concentrations-A Randomized Controlled Trial

Rebecca Ahlin et al. Nutr Cancer. .

Abstract

A phytoestrogen-rich diet has been suggested to reduce tumor proliferation among men with prostate cancer, and the effect may differ between men with different polymorphisms of the estrogen receptor-beta gene (ERβ). Patients with low- or intermediate-risk prostate cancer scheduled for radical prostatectomy were randomized to an intervention group (n = 71) provided with soybeans and flaxseeds (∼200 mg phytoestrogens/day) to eat until surgery (approximately 6 wk) or to a control group (n = 69). Tumor proliferation was assessed using Ki-67 indexes, prostate-specific antigen (PSA) concentrations were analyzed in blood, and ERβ polymorphism was genotyped in all subjects. The intervention group had a 13% unit lower risk [95% confidence interval (CI): -28%, 1.8%] of a higher Ki-67 index compared to controls, but the effect was most pronounced among TT carriers of ERβ [risk difference (RD) -19%, 95% CI: -45%, 6.8%]. Subjects with genotype TC/CC had a lower risk (RD -29%, 95% CI: -46%, -1.2%) and TT genotype a higher risk (RD 25%, 95% CI: 8.7%, 42%) of increased PSA concentration, comparing the intervention group to controls. In conclusion, a phytoestrogen-rich diet may cause lower tumor proliferation and concentration of PSA in men with prostate cancer with a specific genetic upset of ERβ.

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