***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Pomegranate has been shown to prolong PSA doubling time in early prostate cancer , but no data from a placebo controlled trial has been published yet . The objective of this study was to prospect ively evaluate the impact of pomegranate juice in patients with prostate cancer . We conducted a phase IIb , double blinded , r and omized placebo controlled trial in patients with histologically confirmed prostate cancer . Only patients with a PSA value ≥ 5ng/ml were included . The subjects consumed 500 ml of pomegranate juice or 500 ml of placebo beverage every day for a 4 week period . Thereafter , all patients received 250 ml of the pomegranate juice daily for another 4 weeks . PSA values were taken at baseline , day 14 , 28 and on day 56 . The primary endpoint was the detection of a significant difference in PSA serum levels between the groups after one month of treatment . Pain scores and adherence to intervention were recorded using patient diaries . 102 patients were enrolled . The majority of patients had castration resistant prostate cancer ( 68 % ) . 98 received either pomegranate juice or placebo between October 2008 and May 2011 . Adherence to protocol was good , with 94 patients ( 96 % ) completing the first period and 87 patients ( 89 % ) completing both periods . No grade 3 or higher toxicities occurred within the study . No differences were detected between the two groups with regard to PSA kinetics and pain scores . Consumption of pomegranate juice as an adjunct intervention in men with advanced prostate cancer does not result in significant PSA declines compared to placebo BACKGROUND Findings from early observational studies have suggested that the intake of dietary fat might be a contributing factor in the etiology of prostate cancer . However , the results from more recent prospect i ve studies do not support this hypothesis , and the possible association between different food sources of fat and prostate cancer risk also remains unclear . OBJECTIVE The objectives were to assess whether intakes of dietary fat , subtypes of fat , and fat from animal products were associated with prostate cancer risk . DESIGN This was a multicenter prospect i ve study of 142,520 men in the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) . Dietary fat intake was estimated with the use of country-specific vali date d food question naires . The association between dietary fat and risk of prostate cancer was assessed by using Cox regression , stratified by recruitment center and adjusted for height , weight , smoking , education , marital status , and energy intake . RESULTS After a median follow-up time of 8.7 y , prostate cancer was diagnosed in 2727 men . There was no significant association between dietary fat ( total , saturated , monounsaturated , and polyunsaturated fat and the ratio of polyunsaturated to saturated fat ) and risk of prostate cancer . The hazard ratio for prostate cancer for the highest versus the lowest quintile of total fat intake was 0.96 ( 95 % CI : 0.84 , 1.09 ; P for trend = 0.155 ) . There were no significant associations between prostate cancer risk and fat from red meat , dairy products , and fish . CONCLUSION The results from this large multicenter study suggest that there is no association between dietary fat and prostate cancer risk Plasma fatty acid composition reflects dietary fatty acids . Whether the total fat content of the diet alters the fatty acid composition of plasma phospholipid , cholesteryl ester , triacylglycerol and free fatty acids is unknown . To evaluate the effects of low versus high fat diets on plasma fatty acids , a 12-wk , r and omized , crossover , controlled feeding trial was conducted in healthy men and women with isoenergic low fat ( 20 % energy ) and high fat ( 45 % energy ) diets containing constant proportions of fatty acids . Ten subjects consumed one  experimental diet  for 28 d , their usual diet for 4 wk and the alternate experimental diet for 28 d.  Endpoint measures of plasma fatty acids were determined at the end of each experimental period . The effects of the two diets were compared within subjects by analysis of variance . Plasma fatty acids ( % ) varied in response to total dietary fat with significantly greater total polyunsaturated fat , ( n-6 ) and 18:2(n-6 ) levels in phospholipids and cholesteryl esters after high fat dietary consumption . The low fat diet was associated with significantly greater total ( n-3 ) fatty acids , 20:5(n-3 ) and 22:6(n-3 ) levels in plasma phospholipid fatty acids and cholesteryl esters . Consumption of a low fat diet alters fatty acid patterns in a manner similar to that observed with feeding of ( n-3 ) long-chain fatty acids . This change is likely related to decreased competition for the enzymes of elongation and desaturation , with reduced total intake of 18:2(n-6 ) favoring elongation and desaturation of available ( n-3 ) fatty acids The threat of prostate cancer and the significant and often negative impact of its treatment underscore the importance of prevention . High- grade prostatic intraepithelial neoplasia ( HGPIN ) has been identified as a potential premalignant lesion marking an increased risk of prostate cancer and substantial evidence suggests that men with HGPIN are in need of prostate cancer prevention . In vitro , in vivo , epidemiologic , and clinical trial evidence that selenium supplementation protects against prostate cancer motivated the study we report here : a double-blind , r and omized ,  placebo-controlled  trial of selenium 200 ( μg/d ) as selenomethionine  in men with HGPIN . The primary endpoint was progression of HGPIN to prostate cancer over a 3-year period . This National Cancer Institute Intergroup trial was coordinated by the Southwest Oncology Group ( SWOG ) . Of 619 enrolled patients , 423 r and omized men with HGPIN ( 212 selenium and 211 placebo ) were eligible ( by central pathology review ) and included in the primary analysis . Three-year cancer rates were 36.6 % ( placebo ) versus 35.6 % ( selenium ; P = 0.73 , adjusted ) . The majority of patients who developed cancer  on trial ( 70.8 % , selenium and 75.5 % , placebo ) had a Gleason score of 6 or less than 6 ; there were no differences in Gleason scores between the two arms . Subset analyses included the finding of a nonsignificantly reduced prostate cancer risk ( relative risk = 0.82 ; 95 % CI : 0.40–1.69 ) in selenium versus placebo patients in the lowest quartile of baseline plasma selenium level ( < 106 ng/mL ) . Overall , and in all other subsets defined by baseline blood selenium levels , selenium supplementation had no effect on prostate cancer risk . The 36 % prostate cancer rate in men with HGPIN indicates the association of this lesion with an elevated prostate cancer risk . Future study in this setting should focus on selenium-deficient population s and selenium pharmacogenetics . Cancer Prev Res ; 4(11 ) ; 1761–9 . © 2011 AACR Previous studies have associated higher milk intake with greater prostate cancer ( PCa ) incidence , but little data are available concerning milk types and the relation between milk intake and risk of fatal PCa . We investigated the association between intake of dairy products and the incidence and survival of PCa during a 28-y follow-up . We conducted a cohort study in the Physicians ' Health Study ( n = 21,660 ) and a survival analysis among the incident PCa cases ( n = 2806 ) . Information on dairy product consumption was collected at baseline .  PCa cases and deaths ( n = 305 ) were confirmed during follow-up . The intake of total dairy products was associated with increased PCa incidence [ HR = 1.12 ( 95 % CI : 0.93 , 1.35 ) ; > 2.5 servings/d vs. ≤0.5 servings/d ] . Skim/low-fat milk intake was positively associated with risk of low- grade , early stage , and screen-detected cancers , whereas whole milk intake was associated only with fatal PCa [ HR = 1.49 ( 95 % CI : 0.97 , 2.28 ) ; ≥237 mL/d ( 1 serving/d ) vs. rarely consumed ] . In the survival analysis , whole milk intake remained associated with risk of progression to fatal disease after diagnosis [ HR = 2.17 ( 95 % CI : 1.34 , 3.51 ) ] . In this prospect i ve cohort , higher intake of skim/low-fat milk was associated with a greater risk of nonaggressive PCa . Most importantly , only whole milk was consistently associated with higher incidence of fatal PCa in the entire cohort and higher PCa-specific mortality among cases . These findings add further evidence to suggest the potential role of dairy products in the development and prognosis of PCa Purpose : Phytochemicals in plants may have cancer preventive benefits through antioxidation and via gene-nutrient interactions . We sought to determine the effects of pomegranate juice ( a major source of antioxidants ) consumption on prostate-specific antigen ( PSA ) progression in men with a rising PSA following primary therapy . Experimental Design : A phase II , Simon two-stage clinical trial for men with rising PSA after surgery or radiotherapy was conducted . Eligible patients had a detectable PSA > 0.2 and < 5 ng/mL and Gleason score ≤7 . Patients were treated with 8 ounces of pomegranate juice daily ( Wonderful variety , 570 mg total polyphenol gallic acid equivalents ) until disease progression . Clinical end points included safety and effect on serum PSA , serum-induced proliferation and apoptosis of LNCaP cells , serum lipid peroxidation , and serum nitric oxide levels . Results : The study was fully accrued after efficacy criteria were met . There were no serious adverse events reported and the treatment was well tolerated . Mean PSA doubling time significantly increased with treatment from a mean of 15 months at baseline to 54 months posttreatment ( P < 0.001 ) . In vitro assays comparing pretreatment and posttreatment patient serum on the growth of LNCaP showed a 12 % decrease in cell proliferation and a 17 % increase in apoptosis ( P = 0.0048 and 0.0004 , respectively ) , a 23 % increase in serum nitric oxide ( P = 0.0085 ) , and significant ( P < 0.02 ) reductions in oxidative state and sensitivity to oxidation of serum lipids after versus before pomegranate juice consumption . Conclusions : We report the first clinical trial of pomegranate juice in patients with prostate cancer . The statistically significant prolongation of PSA doubling time , coupled with corresponding laboratory effects on prostate cancer in vitro cell proliferation and apoptosis as well as oxidative stress , warrant further testing in a placebo-controlled study BACKGROUND Epidemiologic studies have suggested that vitamin E and beta-carotene may each influence the development of prostate cancer . In the Alpha-Tocopherol , Beta-Carotene Cancer Prevention Study , a controlled trial , we studied the effect of alpha-tocopherol ( a form of vitamin E ) and beta-carotene supplementation , separately or together , on prostate cancer in male smokers . METHODS A total of 29133 male smokers aged 50 - 69 years from southwestern Finl and were r and omly assigned to receive alpha-tocopherol ( 50 mg ) , beta-carotene ( 20 mg ) , both agents , or placebo daily for 5 - 8 years ( median , 6.1 years ) . The supplementation effects were estimated by a proportional hazards model , and two-sided P values were calculated . RESULTS We found 246 new cases of and 62 deaths from prostate cancer during the follow-up period . A 32 % decrease ( 95 % confidence interval [ CI ] = -47 % to -12 % ) in the incidence of prostate cancer was observed among the subjects receiving alpha-tocopherol ( n = 14564 ) compared with those not receiving it ( n = 14569 ) . The reduction was evident in clinical prostate cancer but not in latent cancer . Mortality from prostate cancer was 41 % lower ( 95 % CI = -65 % to -1 % ) among men receiving  alpha-tocopherol .  Among subjects receiving beta-carotene ( n = 14560 ) , prostate cancer incidence was 23 % higher ( 95 % CI = -4%-59 % ) and mortality was 15 % higher ( 95 % CI = -30%-89 % ) compared with those not receiving it ( n = 14573 ) . Neither agent had any effect on the time interval between diagnosis and death . CONCLUSIONS Long-term supplementation with alpha-tocopherol substantially reduced prostate cancer incidence and mortality in male smokers . Other controlled trials are required to confirm the findings CONTEXT Secondary analyses of 2 r and omized controlled trials and supportive epidemiologic and pre clinical data indicated the potential of selenium and vitamin E for preventing prostate cancer . OBJECTIVE To determine whether selenium , vitamin E , or both could prevent prostate cancer and other diseases with little or no toxicity in relatively healthy men . DESIGN , SETTING , AND PARTICIPANTS A r and omized , placebo-controlled trial ( Selenium and Vitamin E Cancer Prevention Trial [ SELECT ] ) of 35 
    Output:
    
Results Red meat , dietary fat and milk intake should be minimised as they appear to increase the risk of prostate cancer .
Selenium and vitamin supplements can not be advocated for the prevention of prostate cancer and indeed higher doses may be associated with a worse prognosis .
There is no specific evidence regarding benefits of probiotics or prebiotics  in prostate cancer .