Study finds association between melatonin intake and improved survival among prostate cancer patients with poor prognosis

Research published on October 13, 2020 in the journal Oncotarget found an increase in overall survival among prostate cancer patients with poor prognosis who were treated with the hormone melatonin.

Melatonin is a sleep-promoting hormone released by the brain’s pineal gland in response to darkness. The hormone also plays a role in immune function.

The retrospective study included 955 men who received standard treatment for prostate cancer between 2000 and 2019 at the Granov Russian Research Center for Radiology and Surgical Technologies. Three hundred ninety-six men received oral melatonin and 559 control group patients did not receive the hormone. Patients were classified as having favorable, intermediate or poor prognosis according to cancer stage, Gleason stage and prostate specific antigen (PSA) levels.

Men who had a favorable or intermediate prognosis did not significantly differ in median overall survival during follow-up. “In the group of patients with poor prognosis, we see the opposite picture,” Gennady M. Zharinov and colleagues reported. For men with a poor prognosis, median overall survival was 64 months among those who did not use melatonin and 153.5 months among those who were treated with the hormone. At a five-year median follow-up, patients who received melatonin had survived an average of 13 months longer than those who did not receive it.

As possible mechanisms, the authors noted melatonin’s ability to activate T helper type 1 cells, increase the production of specific cytokines, inhibit the formation of new blood vessels, reduce the expression of vascular endothelial growth factor (VEGF) receptors, activate apoptosis (programmed cell death) in tumor cells and other factors. They remarked that the effectiveness of modern medical treatments against local and highly differentiated prostate cancer among patients who have a favorable or intermediate prognosis may explain the apparent insignificance of further effects in association with melatonin intake among these groups in the current study.

“Taking into consideration the optimistic conclusions obtained in our work, based on large clinical material, it is advisable to conduct prospective randomized studies with an assessment of survival rates in patients with prostate cancer of various prognosis groups,” the authors concluded.

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Apply What You’ve Learned: Prostate Cancer

As of 2018, prostate cancer is the second most common cancer and the fifth leading cause of cancer mortality in men worldwide.¹
Based on 2016 data, prostate cancer that has no sign of having spread or has spread only to nearby structures or lymph nodes is associated with a nearly 100% five-year survival rate.²
One method of classification of prostate tumors is according to clinical stage. Stage T1 describes a tumor that is not felt during physical examination nor is visible with imaging. T2 is used to classify tumors that are confined to the prostate and can be felt and seen. In T3, the tumor has grown beyond the gland and may have spread to the seminal vesicles. T4 tumors are those that have spread to tissues other than the seminal vesicles, such as the bladder or pelvic wall. (These stages include further subclassifications.)³
Surgery, radiation and hormone (androgen deprivation) therapy are among the most common methods of treating prostate cancer. Rather than receiving treatment, older men diagnosed with low-risk, slow-growing tumors are often given the choice of receiving active surveillance, which involves “watchful waiting” to monitor tumor growth.

References

Bray F et al.CA Cancer J Clin. 2018 Nov;68(6):394-424.
“Survival Rates for Prostate Cancer.” American Cancer Society. Revised 2021 Feb 2.
“Prostate Cancer Stages” Johns Hopkins Medicine.

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