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Comment: I am a board certified urologist who incorporates complementary medicine into my daily practice. I found the article by Teresa Klepser and Nicole Nisly, "Chondroitin for the Treatment of Osteoarthritic Pain" (Alternative Medicine Alert, August 2000 pp. 85-88) to be very informative. However, the authors apparently are unaware of research which suggests that chondroitin sulfate may cause prostate cancer to spread or recur following treatment.1 Although the exact mechanism is unknown, when chondroitin sulfate binds with versican—a growth-stimulating protein that is found within the prostate—the resulting chondroitin sulfate-versican complex can stimulate the spread of prostate cancer.2 Although the data are preliminary, I encourage men with prostate cancer, and those who are at risk of developing prostate cancer, to avoid chrondroitin sulfate until there is a definitive answer.
Mark W. McClure, MD, FACS
1. Ricciardelli C, et al. Elevated levels of peritumor chondroitin sulfate are predictive of poor prognosis in patients treated by radical prostatectomy for early-stage prostate cancer. Cancer Res 1999;59:2324-2328. In: Myers C. Chondroitin sulfate. Prostate Forum 1999;4:6-7.
2. Ricciardelli C, et al. Elevated levels of versican but not decorin predict disease progression in early-stage prostate cancer. Clin Cancer Res 1998;4:963-971. In: Myers C. Chondroitin sulfate. Prostate Forum 1999;4:6-7.
Response: We appreciate your comments regarding our article and the references you site regarding the possibility that chondroitin sulfate may cause prostate cancer to spread or recur post-treatment. The information presented is intriguing, and certainly requires further investigation. We agree that until more conclusive information is available, males who are at risk of developing or who already have prostate cancer should avoid chondroitin. In those patients, glucosamine may be an alternative option.
Teresa Klepser, PharmD Assistant Professor, Division of Clinical and Administrative Pharmacy, College of Medicine
Nicole Nisly, MD
Assistant Professor, Department of Medicine
University of Iowa, Iowa City