Fish Oil, Prostate Cancer, and Way Too Much Information

man-reading-newspaper

I think it was 2005 when I went to Canyon Ranch for one of their intensive “ultraprevention” check-ups. This approach to wellness was tied to a book of the same title by Canyon Ranch Chief Medical Officer Mark Liponis and general practitioner Mark Hyman. The book and program focus on understanding the unique health needs of each person and tailoring wellness regimens based on data from genetic testing, nutritional sensitivities, and an intensive physical examination. After my stay at Canyon Ranch, I had a thick folder of brochures and test results, including an intimidating analysis of my genetic makeup. One of the more accessible documents was a list of nutritional supplements I should consider taking.

I’m a pretty good patient in most respects, so I decided to buy all the supplements they recommended, including a massive multivitamin, something called Mitothera to protect against free radicals, and marine fish oil for heart health. For the last decade-and-a-half, no breakfast has been complete without popping a handful of pills into my mouth and chasing them down with orange juice. That ritual has made me feel invested in my health; and though I’ve seen reports along the way questioning whether, say, multivitamins provide any real benefit, I’ve stuck with my supplements in the belief they’re safe and potentially helpful.

The other day, nearly 14 years after my Canyon Ranch visit, I came across a news story about a link between the omega-3 fatty acids in fish oil and aggressive prostate cancer. The story referenced a 2013 study published in the Journal of the National Cancer Institute, which found that men who had the highest concentrations of omega-3s in their blood were 43-percent more likely to develop prostate cancer than men with the lowest concentrations. On top of that, the men with the highest blood levels of omega-3s were 71-percent more likely to develop aggressive, potentially fatal prostate cancer. Having taken omega-3 for over a decade and then undergone treatment for stage-3 prostate cancer in the Spring of 2018, I took a particular interest in this article. More specifically, as I read, I found myself silently mouthing “What the fuck?”

Fired up, I went downstairs and told my wife about this revelation. She listened with the epic patience of a cancer survivor’s spouse. Then I went to my pill dispenser (yes, I use a pill dispenser and, yes, I resisted it for a long time) and methodically plucked out every translucent gold capsule of marine fish oil. I should have probably kept researching before I flew off the handle. After I settled down a bit, I went back online and checked out other articles on this fish oil connection. As is so often the case, the more I read, the more I realized there is a significant debate swirling around the study, with the likes of Andrew Weil and the Mayo Clinic weighing in on its shortcomings. Most of the articles concluded that the furor caused by the study was, as Weil put it, “an unfortunate combination of questionable science, unwarranted conclusions, and dreadful media coverage.”

Take a Deep Breath—But Keep Reading

After my anxious morning of research, I took a deep breath and reflected on what I learned from my mental maelstrom. The most obvious conclusion, of course, is that the sheer abundance of studies—and their resultant press coverage—on nearly every health topic creates the potential for contradiction and controversy that leaves a consumer’s head spinning. Caveat emptor doesn’t quite capture the caution required when perusing new findings. But as tempting as it is to dismiss studies because they aren’t universally accepted as conclusive, it’s still important to stay on top of the science related to your health—particularly concerns for which you have a known risk. If you’re a man over 50, you should know the consensus opinion on, say, the risk of high LDL cholesterol or PSA screening. The same thing goes for women and breast or ovarian cancer. My wife cautions that it’s easy to become preoccupied, even obsessed with the barrage of health news that comes at you. “We don’t all want to turn into the ‘worried well’,” she observes. I agree. But the alternative to being a neurotic consumer doesn’t have to be ignorance. We have no choice but to be alert, well informed, and discerning in our consumption of health news. How one accomplishes this is a matter of personal choice.

Because I know I have certain risks, I try to stay apprised of developments related to prostate cancer, cholesterol, heart disease, and stroke. My approach has been to set up Google Alerts for my most immediate concerns and scan the results as they come in, reading further only when the information comes from obviously credible sources. The best news outlets provide objective assessments of new studies, presenting the findings in a broader scientific context. In addition to monitoring the media, I take a list of reasonable questions to my physical exam each year for my doctor’s input. Naturally, I try to respect my doctor’s time, so I do my homework and ask only the most pertinent questions. What’s more, if, like me, you take supplements, remember that they are largely unregulated and can have unintended health effects. Treat them like prescription drugs and familiarize yourself with their risks as diligently as you would with Lipitor or Coumadin.

To be frank, if I’d followed this monitoring practice more religiously when I was younger, I might have questioned my doctor’s choice to use only digital rectal exams for detecting prostate cancer. Had I been a better informed and more assertive patient, I might have caught a gnarly stage-3 cancer when it was a tamer stage-1. It’s no picnic being a 21st-century health-care consumer. If you want to stay well informed and manage your risks, you have to invest some intellectual energy. Just remember not to get too fired up when you read somewhere that sexual intercourse causes male pattern baldness.

Wait, what? I’ve got to research that one some more.

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