Xinchun Zhou, MD, PhD, Akram Shalaby, MD, Timothy C. Allen, MD, JD
Context: Omega-3 poly unsaturated fatty acids (omega-3 PUFAs) have been widely studied regarding their associations with pathogenesis, prevention, and treatment of prostate cancer (PCa); however, no agreement has been reached as to whether omega-3 PUFAs are protective by reducing the risk of PCa.Objective: To provide information to public readers regarding thecontroversies in the effects of individual omega-3 PUFA species, including α-Linolenic acid (ALA) eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) on PCa, and regarding the causes underlying these controversies.Data Sources: Research articles archived online related to the effects of omega-3 PUFAs on PCa published in the past four decades. The protective effect of each omega-3 PUFA species on PCa was evaluated in study categories of epidemiological survey/food query, plasma/RBC membrane, prostatic tissue, PCa cell line in vitro, and clinical trial/animal modelin vivo.Conclusions: Controversies surrounding omega-3 PUFAs and PCa broadly exist in each individual omega-3 PUFAspecies, between omega-3 PUFAs from plant and sea food sources, and among omega-3 PUFAs from sea food sources in every study categories. These controversies are mainly due to: 1) presuming that the levels omega-3 PUFAs in circulation, in RBC membranes and in estimates in diet intake are proportional to those in prostate; 2) using percentage changes to represent alterations in real concentrations of omega-3 PUFAs between two pathological conditions in data analysis, and 3) administrating omega-3 PUFA(s) to PCa cells in vitro with doses far above physiological levels in human prostate in some studies.