Boron Supplements for Prostate Cancer: Not Recommended

Guideline-Based Standard of Care

• The European Society for Medical Oncology recommends immediate continuous androgen deprivation therapy (ADT) with LHRH agonists or surgical castration as the standard first-line treatment for metastatic hormone-naïve disease 3
• The European Society for Medical Oncology suggests novel hormone agents (abiraterone, enzalutamide, apalutamide, darolutamide) combined with ADT, or docetaxel chemotherapy for symptomatic patients with good performance status and castration-resistant disease 2
• The European Society for Medical Oncology recommends denosumab or zoledronic acid to prevent skeletal-related events in patients with bone metastases, not boron compounds 1

Evidence Against Boron Supplementation

• No association was found between dietary boron intake or total boron supplementation and prostate cancer risk in a large cohort study, with a hazard ratio of 1.17 (95% CI 0.85-1.61) 1

Appropriate Micronutrient Supplementation

• The American College of Nutrition recommends vitamin D and calcium supplementation (1200 mg calcium/day, 800-1000 IU vitamin D3/day) for men on ADT at high risk for osteoporosis 7
• The American Society for Nutrition recommends against high-dose single micronutrients, as some studies show increased mortality with beta-carotene, vitamin A, or vitamin E 8

Clinical Pitfalls to Avoid

• The European Society for Medical Oncology advises against recommending boron supplements based on small preliminary studies or animal data when larger human studies show no benefit 2
• The European Society for Medical Oncology recommends not delaying evidence-based treatments (ADT, novel hormone agents, chemotherapy) in favor of unproven supplements 2
• The American Society for Nutrition warns that high-dose micronutrients can increase mortality in cancer patients 8