Zinc and prostate cancer: a critical scientific, medical, and public interest issue (United States).

The role of zinc in the development and progression of prostate malignancy and its potential application in the prevention and treatment of prostate cancer (PCa) are contemporary critical issues for the medical/scientific community and the public-at-large. The overwhelming clinical and experimental evidence provides a compelling rational basis for the expectation and concept that prostate zinc accumulation is an important factor in the development and progression of prostate malignancy; and that zinc could be efficacious in the prevention and treatment of PCa. In contrast, various epidemiologic studies have produced divergent and conflicting results regarding the efficacy of dietary and supplemental zinc against PCa. Before reaching any definitive conclusions regarding this complex issue, one should have a complete understanding of the clinical and experimental evidence associated with the involvement of zinc in the normal and malignant prostate. Also, an understanding of interacting effects of confounding factors on the absorption, assimilation, and bioavailability of supplemental dietary zinc is important. The purpose of this review is to present the current state of the clinical and experimental information regarding zinc relationships in the normal prostate and in the pathogenesis PCa. The evidence in support of a potential beneficial effect of zinc supplement versus potential harmful effects on PCa is assessed. A discussion of the divergent results of the epidemiologic studies is presented along with a description of important factors and conditions that impact or mask the effects of dietary zinc on PCa development and progression. We also hope to bring more attention to the medical and research community of the critical need for concerted clinical and basic research regarding zinc and PCa, for the development of appropriate human prostate models to investigate these relationships, for further appropriately designed epidemiologic studies, and for future well-controlled clinical trials.