What is the role of calcium in the etiology of prostate cancer?

Updated: Oct 11, 2019
  • Author: Mark A Moyad, MD, MPH; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Higher milk intake has been shown to be associated with an increased risk of developing advanced prostate cancer. Whether this is related to the high fat or even caloric content in milk or to the amount of calcium, or possibly to increased serum levels of insulin-like growth factor-I (IGF-I), has not been clarified. [84, 85]

Giovannucci et al hypothesized that the high calcium intake could lower 1,25(OH)2 vitamin-D levels, which would promote increased dedifferentiation of the cancer cells. [86] Their examination of the records of 47,750 men who were participating in the Health Professionals Follow-up Study found that dietary or supplemental calcium was independently associated with increased risk. More importantly, calcium intake of greater than 1500 mg daily was associated with lower vitamin D2 levels and a higher risk of developing an aggressive cancer.

Gao et al also provided evidence suggesting that cancer risk is associated with calcium intake, [87] but Severi and colleagues obtained data from the Melbourne Collaborative Cohort Study that did not support this contention. [88] The interpretation of these findings is that calcium is good, but that too much may be harmful.

Consumers and clinicians need to be aware of the increasing fortified and natural sources of calcium in the food supply and ideally should work with a dietician to calculate their average daily intake of dietary calcium from foods and beverages (eg, fish, vegetables, milk alternatives). For example, numerous milk alternatives—such as almond, cashew, hemp, and soy milk—contain 400-500 mg of calcium per 8 ounces.

Randomized trials in the general population (eg, the Women's Health Initiative trials) have shown that many individuals consume the recommended amounts of dietary calcium (1000-1200 mg/day) and thus have no need for dietary supplementation. [43] In addition, normalizing calcium intake using dietary sources carries no significant or consistent increased risk of stone disease compared with excessive intake of calcium supplements, which has been associated with an increased risk of stone disease, as well as constipation.


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