Does Betacarotene use in smokers increase cancer risk?

1. Deurali-Janta
Pharmaceuticals Pvt. Ltd.
Presented by:
Phr. Asad Kamran
Technical Consultant, MPD
Deurali-Janta Pharmaceuticals Pvt. Ltd.
BETA-CAROTENE
Increases Cancer Risk?

2. INTRODUCTION

3. Beta-Carotene
• A member of the carotenes.
• Most common form of carotene in plants.
• In nature, β-carotene is a precursor to vitamin A.
• it is very lipophilic.
• Most common side effect of excessive β-carotene
consumption is carotenodermia.
• Chronic, high doses of synthetic β-carotene supplements have
been associated with a higher rate of lung cancer in smokers.
• β-carotene may increase the risk of prostate cancer,
intracerebral hemorrhage, and cardiovascular and total
mortality in people who smoke cigarettes or have a history of
high-level exposure to asbestos.
Beta-carotene

4. Beta-Carotene
• If the body has enough vitamin A, the conversion of β-
carotene decreases. Therefore, β-carotene is a very safe
source of vitamin A and high intakes will not lead
to hypervitaminosis A.
• Excess β-carotene is predominantly stored in the fat tissues of
the body.
• β-Carotene can interact with medication used for
lowering cholesterol. Taking them together can lower the
effectiveness of these medications and is considered only a
moderate interaction.
• β-Carotene should not be taken with Orlistat, a weight loss
medication, as Orlistat can reduce the consumption of β-
carotene by as much as 30%.
Beta-carotene

5. Beta-Carotene
• Consuming alcohol with β-carotene can decrease its ability to
convert to retinol and could possibly result in hepatotoxicity.
Beta-carotene

6. Beta-Carotene & Lung
Cancer in Smokers
Beta-carotene

7. … Lung Cancer
• Chronic high doses of β-carotene supplementation increases
the probability of lung cancer in cigarette smokers.
Cancer 113 (1): 150–7. July 2008
• The effect is specific to supplementation dose as no lung
damage has been detected in those who are exposed to
cigarette smoke and who ingest a physiologic dose of β-
carotene (6 mg), in contrast to high pharmacologic dose
(30 mg).
• Therefore, the oncology from β-carotene is based on both
cigarette smoke and high daily doses of β-carotene.
Pure Appl. Chem. 74(8): 1461–1467. 2002
Beta-carotene

8. … Lung Cancer
• β-carotene does not appear to decrease the risk of cancer
overall.
• High levels of β-carotene may increase the risk of lung cancer
in current and former smokers.
Ecancermedicalscience 7: 365. (2013)
• Because beta-carotene is unstable in cigarette smoke exposed
lungs where it forms oxidized metabolites that can induce
carcinogen-bioactivating enzymes.
Beta-carotene

9. Beta-Carotene & Lung
Cancer in Smokers
-Literature Survey-
Beta-carotene

10. University of Maryland
• According to University of Maryland Medical Centre;
• Eating foods rich in beta-carotene, along with other
antioxidants, including vitamin C & E, seems to protect against
some kinds of cancer.
• However, beta-carotene supplements may increase the risk of
heart disease & cancer in people who smoke or drink heavily.
• Those people should not take beta-carotene, except under a
doctor’s supervision.
Beta-carotene

11. Fred Hutchinson Cancer Research Centre
• Gary E. Goodman, MD, of the Fred Hutchinson Cancer
Research Centre in Seattle’s finding is;
• In smokers, the higher risk of lung cancer & death continues
even after a person stops taking beta-carotene.
Beta-carotene

12. How Beta-carotene hurts Smokers?
• The most likely reason is that damaging free radicals in
cigarette smoke may get a boost from megadoses of beta-
carotene.
• Because beta-carotene is unstable in cigarette smoke exposed
lungs where it forms oxidized metabolites that can induce
carcinogen bioactivating enzymes.
• A lifetime of healthy eating, they say, is far better than a few
years of high-dose vitamins during middle age.
Beta-carotene

13. Nutr Cancer. 2009
• Intervention studies in smokers have unexpectedly reported
increased lung tumor rates after high, long term, beta-
carotene supplementation.
• No effects or even protective effects against smoke or
carcinogen exposure were observed when beta-carotene was
applied at physiological dosages or in combination with
vitamin C & E, either as a mixture or in a stable formulation.
• Human & animal studies have shown that specific
circumstances, among them heavy smoking, seem to
influence the effect of high beta-carotene intakes. In normal,
healthy, nonsmoking populations, there is evidence of
beneficial effects.
Beta-carotene

14. Int J Cancer. 2010
• The incidence of lung & stomach cancers were significantly
increased in individuals supplemented with beta-carotene at
20-30mg a day, in smokers & asbestos workers compared to
the placebo group.
• Conversely, it was associated with increased risk not only of
lung cancer but also of gastric cancer at doses of 20-30mg a
day, in smokers & asbestos workers.
Beta-carotene

15. Journal Of American Medical Association
• A Finnish study , reported in the Journal of American Medical
Association, followed male smokers over 5-8 years. Those
taking beta-carotene supplements had an 18 percent higher
lung cancer rate.
• Another study, CARET, taking 18000 women and men who
smoked heavily or were exposed to asbestos showed an
increased lung cancer rate of 28% in the group that
supplemented with beta-carotene/Vitamin A.
• Beta-carotene is easily lost from the body and it should be
taken as 3-5 mgs up to 4 times a day.
Beta-carotene

16. CONCLUSION
Beta-carotene

17. Conclusion
“The conclusion is simple and has nothing
to do with supplements: smoking increases
the risk of lung cancer.”
Andrew Shao, PhD, CRN
Beta-carotene

18. Conclusion
• High dosing (20-30mg a day) in heavy smokers & asbestos
works is a risk i.e. increases the risk of lung & gastric cancer.
• In normal, healthy, nonsmoking populations, Beta-carotene is
safe & well tolerated.
• When beta-carotene is applied at physiological dosages or in
combination with vitamin C & E, either as a mixture or in a
stable formulation there are no effects or even protective
effects against smoke or carcinogen exposure.
• In smokers, the higher risk of lung cancer & death continues
even after a person stops taking beta-carotene.
Beta-carotene

19. Phr. Asad Kamran
Technical Consultant, MPD
Deurali-Janta Pharmaceuticals Pvt. Ltd.