Written by Gabriele Dennert and the CAM-Cancer Consortium.
Updated October 20, 2013

Selenium – during cancer treatment

Abstract and key points

  • The trace element selenium is nutritionally essential for human health.
  • Supplemental selenium has been promoted for the treatment of cancer as well as the prevention or treatment of cancer-related symptoms and adverse effects of cancer therapy.
  • There is no evidence that selenium yeast supplements can prolong progression-free survival in people with non-small-cell lung cancer.
  • The role of selenium supplements during radio- or chemotherapy for cancer treatment, or the prevention of therapy-associated adverse effects, is unclear.
  • There is no evidence that selenium alleviates lymphoedema after surgery.
  • Selenium is toxic in high doses and might have adverse effects when taken at supranutritional doses for longer periods of time.

This summary is currently (April 2016) being updated, the version published here was last updated in October 2013. 

The trace element selenium is a nutrient essential to human health and occurs naturally in various food types. Inorganic forms (e.g. sodium selenite or selenite) and organic forms (e.g., selenomethionine) are both used in large numbers of selenium-containing medications, nutritional supplements or dietary aids that are promoted for medical or health purposes. These may contain either selenium alone (mono-supplements) or selenium in combination with other trace minerals as well as vitamins.

Supplemental selenium has been promoted for the treatment of cancer as well as the prevention or treatment of cancer-related symptoms and adverse effects of cancer therapy.

The role of selenium in the treatment of cancer, as well as the treatment or prevention of therapy-associated adverse effects, is unclear. One trial found an increased rate of remission in patients with non-Hodgkin lymphoma receiving CHOP-28 therapy plus selenium but the generalisability of these findings is uncertain. Another randomised clinical trial found no benefit of selenium yeast on five-year progression-free survival in people with resected stage I non-small-cell lung cancer.

Although a number of health problems have been linked to selenium deficiency, selenium is toxic in large doses and might have adverse effects when taken at supranutritional doses for longer periods of time. Long-term supplementation has caused symptoms of chronic overexposure and has also been linked to increased risks of developing type 2 diabetes mellitus.

Citation

Gabriele Dennert, CAM-Cancer Consortium. Selenium – during cancer treatment [online document]. http://www.cam-cancer.org/The-Summaries/Dietary-approaches/Selenium-during-cancer-treatment. October 20, 2013.

Document history

Summary first published in November 2010, authored by Gabriele Dennert.

Original summary divided into “Selenium – prevention” and “Selenium – during cancer treatment”, fully revised and updated in October 2013 by Gabriele Dennert.

References

  1. Rayman MP, Infante HG, Sargent M. Food-chain selenium and human health: spotlight on speciation. Br J Nutr 2008; 100: 238-53.
  2. Rayman MP. The use of high-selenium yeast to raise selenium status: how does it measure up? Br J Nutr 2004; 92(4): 557-73.
  3. http://iom.edu/Activities/Nutrition/SummaryDRIs/~/media/Files/Activity%20Files/Nutrition/DRIs/ULs%20for%20Vitamins%20and%20Elements.pdf, accessed 13 August 2013
  4. Biologische Krebsabwehr: Selen. http://www.biokrebs-heidelberg.de/images/stories/download/Therapie_Infos/Selen.pdf (last access 29/06/2013).
  5. Fakih MG, Pendyala L, Brady W, Smith PF, Ross ME, Creaven PJ, Badmaev V, Prey JD, Rustum YM. A Phase I and pharmacokinetic study of selenomethionine in combination with a fixed dose of irinotecan in solid tumors. Cancer Chemother Pharmacol 2008; 62(3): 499-508.
  6. Reilly C. Selenium in food and health. 2nd Edition. New York: Springer 2006.
  7. Rayman, MP: Selenium and human health. Lancet 2012; 379: 1256–68.
  8. National Cancer Institute: Antioxidants and Cancer Prevention: Fact Sheet http://www.cancer.gov/cancertopics/factsheet/prevention/antioxidants (last access 29/06/2013).
  9. Nagel G, Hoyer H, Katenkamp D. Use of complementary and alternative medicine by patients with breast cancer: observations from a health-care survey. Support Care Cancer 2004; 12(11): 789-96.
  10. Bruns F, Glatzel M, Schönekaes K, Riesenbeck D, Mücke R, Büntzel J, Micke P, Schäfer U, Kisters K, Micke O. Complementary and alternative medicine experience in radiation oncology patients: first results of a multi-center approach. Trace Elements & Electrolytes 2006; 23(4): 318-26.
  11. Sehouli J, David M, Kaufmann B, Lichtenegger W. Unkonventionelle Methoden in der Krebsmedizin - Postoperative Nutzung durch Patientinnen mit gynäkologischen Malignomen [Use of alternative treatments by patients after surgery for gynecologic malignancies]. Geburtsh Frauenheilk 2000; 60: 147-54.
  12. Bishop FL, Rea A, Lewith H, Chan YK, Saville J, Prescott P, von Elm E, Lewith GT: Complementary medicine use by men with prostate cancer: a systematic review of prevalence studies. Prostate Cancer and Prostatic Diseases 2011:14, 1–13.
  13. OTC ingredient tables. http://www.aesgp.be/facts-figures/otc-ingredients/ (accessed 29/06/2013).
  14. Asfour IA, Fayek M, Raouf S, Soliman M, Hegab HM, El-Desoky H, Saleh R, Moussa MA. The impact of high-dose sodium selenite therapy on Bcl-2 expression in adult non-Hodgkin's lymphoma patients: correlation with response and survival. Biol Trace Elem Res 2007; 120(1-3): 1-10.
  15. Karp DD, Lee SJ, Keller SM et al. Randomized, double-blind, placebo-controlled, phase III chemoprevention trial of selenium supplementation in patients with resected stage I non-small-cell lung cancer: ECOG 5597. J Clin Oncol 2013;31(33):4179-87.
  16. Dennert G, Horneber M. Selenium for alleviating the side effects of chemotherapy, radiotherapy and surgery in cancer patients. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD005037.
  17. Kasseroller R. Sodium selenite as prophylaxis against erysipelas in secondary lymphedema. Anticancer Res 1998; 18(3C): 2227-30.
  18. Zimmermann T, Leonhardt H, Kersting S, Albrecht S, Range U, Eckelt U. Reduction of postoperative lymphedema after oral tumor surgery with sodium selenite. Biol Trace Elem Res 2005; 106(3):193-203.
  19. Mücke R, Schomburg L, Glatzel M, Berndtskorka R, Baaske D, Reichl B, Büntzel J, Kundt G, Prott FJ, DeVries A, Stoll G, Kisters K, Bruns F, Schaeffer U, Willich N, Micke O, German Working Group Trace Elements and Electrolytes in Oncology - AKTE: Multicenter phase 3 trial comparing selenium supplementation with observaton in gynecologic radiation oncology. Int J Radiat Oncol Biol Phys 2010; 78: 828-835; doi:10.1016/j.ijrobp.2009.08.013.
  20. Buentzel J, Micke O, Glatzel M, Bruns F, Kisters K, Muecke R: Evaluation of the effect of selenium on radiation-induced toxicities in head neck cancer patients (abstract). J Clin Oncol 27, 2009 (suppl; abstr e20698); http://meetinglibrary.asco.org/content/33802-65 (last accessed 29/06/2013)
  21. Büntzel, J, Riesenbeck, D, Glatzel, M, Berndt-Skorka, R, Riedel, T, Mücke, R, Kisters, K, Schönekaes, KG, Schäfer, U, Bruns, F, Micke, O: Limited effect of selenium substitution in the prevention of radiation-associated toxicities. Results of a randomized study in head and neck cancer patients. Anticancer Res 2010; 30: 1829-1832.
  22. Büntzel, J, Micke, O, Kisters, K, Bruns, F, Glatzel, M, Schönekaes, K, Kundt, G, Schäfer, U, Mücke, R: Selenium substitution during radiotherapy of solid tumours – laboratory data from two observation studies in gynaecological and head and neck cancer patients. Anticancer Res 2010; 30: 1783-1786.
  23. Hu YJ, Chen Y, Zhang YQ, Zhou MZ, Song XM, Zhang BZ, Luo L, Xu PM, Zhao YN, Zhao YB, et al. The Protective Role of Selenium on the Toxicity of Cisplatin-Contained Chemotherapy Regimen in Cancer Patients. Biol Trace Elem Res 1997; 56: 331-41.
  24. Reid ME, Stratton MS, Lillico AJ, Fakih M, Natarajan R, Clark LC, Marshall JR: A report of high-dose selenium supplementation: response and toxicities. J Trace Elem Med Biol 2004; 18(1):69-74.
  25. Lippman SM, Klein EA, Goodman PJ, et al: Effect of Selenium and Vitamin E on Risk of Prostate Cancer and Other Cancers: The Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA 2009; 301(1):39-51
  26. Sutter ME, Thomas JD, Brown J, Morgan B. Selenium toxicity: a case of selenosis caused by a nutritional supplement. Ann Intern Med 2008;148(12): 970-1.
  27. Stranges S, Marshall JR, Natarajan R, Donahue RP, Trevisan M, Combs GF, Cappuccio FP, Ceriello A, Reid ME: Effects of Long-Term Selenium Supplementation on the Incidence of Type 2 Diabetes: A Randomized Trial. Ann Intern Med 2007; 147:217-223.
  28. Pfeffer H. Schwerwiegender Zwischenfall bei Selen-Medikation. Hamburger Zahnärzteblatt 2002;42(3): 3.
  29. See KA, Lavercombe PS, Dillon J, Ginsberg R. Accidental death from acute selenium poisoning. Med J Aust 2006; 185(7): 388-9.
  30. SCF (Scientific Committee on Food): Opinion of the Scientific Committee on Food on the Tolerable Upper Intake Level of Selenium. 2000. http://ec.europa.eu/food/fs/sc/scf/out80g_en.pdf (accessed 01/10/2012).
  31. Duffield-Lillico AJ, Reid ME, Turnbull BW, Combs GF, Jr., Slate EH, Fischbach LA, Marshall JR, Clark LC. Baseline characteristics and the effect of selenium supplementation on cancer incidence in a randomized clinical trial: A summary report of the Nutritional Prevention of Cancer Trial. Cancer Epidemiol Biomarkers Prev 2002; 11(7): 630-9.
  32. Sandström B: Micronutrient interactions: effects on absorption and bioavailability. Br J Nutr 2001; 85: S181-S185.